sports medicine presentation topics

Oct 16, 2019 / Sports Medicine

Hot Topics in Sports Medicine: Modalities and Trends

• There is no evidence, to date, that PRP in acute muscle injuries is superior than placebo or rehabilitation alone.
• PRP is associated with a reduction in patient reported pain (up to one year) for certain conditions.
• Despite widespread usage, little is known on benefits of PRP on the musculoskeletal system.
• Past decade, research showing BFR in combo w/ LL (light load) training → significant muscle strength and size in healthy individuals
• Concerns about adverse effects have not been published in studies, only case reports.
• Promising but not conclusive results for post ACL reconstruction early strengthening and pain for some patellofemoral pain populations.
• Positive results as an adjunct to traditional physical therapy post-knee arthroscopy.
• Clinical applications for BFR training in patients with musculoskeletal conditions are vast.
• Further studies are needed to study the efficacy and safety of BFR in both operative and non-operative orthopedic conditions.
• More effective than low-load training alone but less effective than heavy-load training.
• Limited data is available in the pediatric population.
• Might be appropriate adjunct therapy for knee OA, patellofemoral pain, post op knee arthroscopy, post-ACLR and muscle injuries (hamstrings).
• Lack of standardized protocols for temperature, timing and frequency. 
• Unknown effects on muscle recovery after mechanical overload in athletic populations. 
• Wide variation in study designs. 
• Inability to blind (and unable to eliminate placebo effect).
• Possible benefits include enhanced recovery after injuries, post-exercise and counteract inflammatory symptoms from overuse, post-traumatic recovery, pain and performance.
• NOT FDA regulated, NOT cleared/approved by FDA as a safe and effective device to treat medical conditions.
• Skilled and trained personnel must control procedures to prevent adverse effects (necrosis, skin burning).
• Current contraindications: cryoglobulinaemia, cold intolerance, Raynaud’s disease, hypothyroidism, acute respiratory system disorders, cardiovascular disease, purulent-gangrenous cutaneous lesions, sympathetic nervous system neuropathies, cachexia, hypothermia, claustrophobia, mental disorders hindering cooperation during test, pregnant women, children  under 18 (need parental consent).
• Positive results in studies that include children and adolescents.
• Living sedentary lifestyle or periods of inactivity, obesity, hypertension, diabetes: obtaining medical clearance from physician may be appropriate prior to starting HITT program.
• Can easily be modified for people of all fitness levels and special conditions (i.e. overweight, diabetes).
• Can be performed on all exercise modes: cycle, walk, swim, aqua training or elliptical.
• Time efficiency: similar benefits as to continuous endurance workouts, but in a less time.
• Burns more calories especially post workout due to increased excess post-exercise oxygen consumption (EPOC) after HIIT workouts.

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• Volume 47, Issue 1
• What's hot today? Current topics in sports and exercise medicine
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• David J Berkoff , MD
• UNC Department of Orthopaedics and Emergency Medicine , UNC School of Medicine, UNC Chapel Hill, North Carolina , USA
• Correspondence to Dr David J Berkoff, 3142 bioinformatics bldg. CB 7055, UNC Dept of Orthopaedics, Chapel Hill, NC 27599, USA; david_berkoff{at}med.unc.edu

https://doi.org/10.1136/bjsports-2012-091965

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• Exercise rehabilitation
• Sports rehabilitation programs

This American Medical Society for Sports Medicine (AMSSM)-shaped issue of BJSM highlights ‘hot topics’ in sports medicine. The Merriam-Webster's dictionary defines ‘hot’ as: of intense and immediate interest. I used this simple definition to guide AMSSM's selection of articles for this issue. This issue's selections are clearly ‘hot topics’ but to whom are they considered ‘hot?’

Hot for whom?

What defines a sport and exercise medicine practitioner? Is it the team physician who cares for the professional or elite athlete? Is it the paediatrician who encourages the obese adolescent to put down the Wii controller and get outside? Or is it the cardiologist who dedicates herself to getting a heart failure patient back to tolerating light exercise? How does someone best describe what we do for our patients? We as ‘sports and exercise medicine’ providers have a unique role that encompasses multiple specialties, age groups and patient populations. We are tasked with prescreening athletes prior to activity, preventing and treating all manners of sporting injury. We care for the elderly, the young and those with chronic illness. We follow patients after injuries and are often the experts consulted with difficult and challenging medical cases that are both medical and sports related. We are a diverse group and we meet a wide range of needs. Thus, choosing what is ‘hot’ and relevant to everyone reading this AMSSM-shaped issue was challenging.

The power of placebo

The emerging treatments such as PRP, orthokine and stem cell therapy are not directly represented in this issue. Whereas novel treatments are receiving increased attention in many sports medicine journals, I instead chose to review the power of placebo ( http://dx.doi:10.1136/bjsports-2012-091472 http://dx.doi:10.1136/bjsports-2012-091472). The placebo effect and the need for the double-blind placebo-controlled trial was first described in 1955 by Henry Beecher. 1 This was elaborated on by Shapiro et al 2 and has since become the standard to which we compare all new interventions. A PubMed search today results in 4311 citations highlighted using the search term ‘placebo effect.’ To understand the value of a novel treatment we need to know how these therapies stack up to this powerful standard. Before we adopt a new treatment, we need to understand the influence of what we do and how we measure the persuasive power of placebo in affecting positive change.

The team physician: it only gets more complicated

At the 2012 AMSSM national conference in Atlanta, the presentation by Dr Tracey Viola was a highlight. Team physicians travel around the US providing care to athletes and staff. 3–5 Surely, intranational travel does not involve licensing and malpractice risks. To the surprise, and consternation, of many of us, Dr Viola outlined major licensure and malpractice coverage gaps ( see page 60 ). Having to worry about how to legally perform our duties in other states makes our jobs more difficult. In addition, increasingly difficult is the complicated duty of the team physician to communicate confidential medical information. We are now fully immersed in the social media blogosphere. Facebook, Twitter, LinkedIn and a plethora of other often anonymous sources often leak medical information about our athletes. How do we control this flow of information? What happened to confidentiality and the doctor–patient relationship? Who is leaking these details and who is ultimately responsible for it? The article by Ribbans et al ( see page 40 ) looks at what kind of information is making it to the media, and how this is potentially putting the treating practitioner at risk.

As I continued to narrow down the list of ‘hot topics’, I was left with three topics that were the most pervasive in the past issues: concussion, cardiology and physical activity and health. Each has a uniqueness to it and an international impact that cannot be ignored.

Concussion—an evolution in understanding

The AMSSM has spent the last year collaborating to assemble a society position paper ( http://dx.doi:10.1136/bjsports-2012-091941 ). This document is an outstanding compilation of prior concussion data and research. The clinical experts involved have synthesised reams of information and created this exceptional position statement for our members and clinicians involved in concussion care. This paper will be an influential reference for practitioners worldwide. Equally important is the timing of this concussion statement with the recent 4th Zurich consensus meeting and its consensus paper being published in BJSM 's Concussion Themed Injury Prevention and athlete's Health Protection issue in March 2013. We are confident that the AMSSM position paper will stand along side the 2013 consensus statement as a reference for sports medicine practitioners everywhere.

Long QT syndrome: which athletes are really at risk?

The high-impact research into sudden cardiac death and preparticipation screening by Dr Jonathan Drezner and his colleagues has brought a new level of attention to the quality and breath of research performed by the members of AMSSM. ECG screening is a hot topic worldwide, 6 – 8 and there exists significant debate regarding the precise protocol for preparticipation cardiovascular risk assessment. Dr Michael Ackerman, one of the world's leading experts in long QT syndrome (LQTS), has been studying this high-risk group of athletes for many years. 9 His manuscript published in this issue is truly eye opening ( http://dx.doi:10.1136/bjsports-2012-091751 ). We gather information, do our best to interpret the results, but are we really saving lives or are we merely needlessly excluding young athletes from participation? Dr Ackerman's manuscript sheds new light on this regarding LQTS and restriction from participation. On the subject of sports cardiology, do not forget the special BJSM supplement on this topic in November 2012, 10 and next month's BJSM will have even more on this topic. It is hot and BJSM is the leading sports and exercise medicine journal for sports cardiology.

Physical inactivity is the #4 risk factor for mortality worldwide. What are we doing to change this?

Physical activity saves lives! Physical activity and health is a BJSM focus as evidenced by the volume of articles that are published related to physical activity (PA) and obesity, youth, the elderly and much more. 11 – 14 Salt Lake City sports physician Dr Joy details how we take the next step from identifying physical inactivity as a problem to implementing solutions ( http://dx.doi:10.1136/bjsports-2012-091620 ). Complementing that paper, we have selected an article highlighting a simple single-question method for evaluating PA. If the process of determining PA is onerous, practitioners will not do it. Dr Milton et al ( see page 44 ) show that a single question can be sufficient to determine if a patient's activity level is sufficient to benefit their health.

AMSSM is committed to clinical research and the education of sports medicine providers and has assembled one of the most exciting line ups ever for their upcoming National conference. We invite you to attend the 22nd AMSSM Annual Meeting from 17 to 21 April in sunny San Diego, California. We will highlight hot topics, clinically relevant content and original research submissions. Find out more at www.amssm.org . Also check the BJSM podcast where we discuss this special AMSSM issue and preview the conference in more detail.

See you in San Diego—register today!

• ↵ Shapiro AK. Etiological factors in the placebo effect. JAMA 1964;187:712–4 .
• Whiteside J ,
• Sahebzamani F ,
• Pfister GC ,
• Puffer JC ,
• Johnson JN ,
• Ackerman MJ
• Bennett K ,
• Kujala UM ,
• Andersen LB ,
• McLaughlin D ,

Funding None.

Competing interests None.

Provenance and peer review Commissioned; internally peer reviewed.

Linked Articles

• Original articles Can a single question provide an accurate measure of physical activity? Karen Milton Stacy Clemes Fiona Bull British Journal of Sports Medicine 2012; 47 44-48 Published Online First: 20 Apr 2012. doi: 10.1136/bjsports-2011-090899
• Short report A survey of state medical licensing boards: can the travelling team physician practice in your state? Tracey Viola Chad Carlson Thomas H Trojian Jeffrey Anderson British Journal of Sports Medicine 2012; 47 60-62 Published Online First: 04 Oct 2012. doi: 10.1136/bjsports-2012-091460
• Original articles Sports medicine, confidentiality and the press Bill Ribbans Hannah Ribbans Craig Nightingale Michael McNamee British Journal of Sports Medicine 2012; 47 40-43 Published Online First: 18 Sep 2012. doi: 10.1136/bjsports-2011-090439

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Osteochondrosis, Apophysitis, Other Bone-related pediatric injuries

Scat 6 – 2023 concussion update, rheumatology serology overview, apophysitis, groin pain in athletes (non-hip joint), cardiac rehabilitation, stress testing and exercise prescription.

Dermatological Conditions in Athletes

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Iron Deficiency in Athletes

Preparticipation History and Physical

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Understanding Sports Medicine: A Comprehensive Guide

Sports medicine is a specialized branch of medicine that focuses on the prevention, diagnosis, treatment, and rehabilitation of injuries related to sports and physical activity. It combines medical knowledge with exercise science and aims to optimize athletes' performance while minimizing the risk of injuries. 

Pepperdine University offers two sports medicine degrees ;a bachelor of science in sports medicine and a bachelor of art in sports medicine. A sports medicine degree helps prepare students for careers in applied or clinical health professions and/or graduate work. Students who earn a sports medicine degree learn across multiple disciplines, including orthopedics, physical therapy, sports nutrition, sports psychology, and biomechanics, to provide comprehensive care to athletes of all levels.

In this in-depth article, we’ll explore multiple aspects of the sports medicine field, including common injuries, preventive measures, and performance optimization techniques. Use the article to get a better understanding of what sports medicine entails and determine if earning a degree in it might be a good fit for you.

Table of Contents

• Common Sports Injuries
• Preventive Measures for Sports Injuries
• Diagnosis and Treatment of Sports Injuries
• Supporting Athletes through Sports Medicine
• Sports Medicine and Performance Enhancement
• Sports Medicine and Biomechanics
• Frequently Asked Questions

1. Common Sports Injuries

Sports injuries are an unfortunate reality for athletes and active individuals. Understanding common sports injuries can help us take proactive measures to prevent them and seek timely treatment when necessary. Let's explore some of the most prevalent sports injuries:

1.1. Sprains and Strains

Sprains and strains are among the most common types of sports injuries. They involve the stretching or tearing of ligaments (sprains) or muscles/tendons (strains). These injuries can occur due to sudden movements, overexertion, or inadequate warm-up. Proper conditioning, warm-up exercises, and maintaining flexibility can reduce the risk of sprains and strains.

1.2. Fractures and Dislocations

Fractures and dislocations can result from high-impact sports or traumatic incidents. Fractures refer to broken bones, while dislocations involve the displacement of bones from their normal positions. Prompt medical attention and immobilization are essential for proper healing and recovery.

1.3. Concussions

Concussions are mild traumatic brain injuries commonly associated with contact sports. They occur due to a sudden blow or jolt to the head, causing the brain to move within the skull. Recognizing the signs and symptoms of a concussion and allowing adequate rest and recovery are crucial to avoid long-term complications.

1.4. Tendonitis

Tendonitis refers to the inflammation of tendons, which are the thick cords that connect muscles to bones. Overuse, repetitive motions, and inadequate rest can contribute to the development of tendonitis. Proper training techniques, adequate rest periods, and appropriate equipment can help prevent tendonitis.

1.5. Shin Splints

Shin splints are characterized by pain along the tibia (shinbone) and are common in activities involving running and jumping. They often result from overuse or sudden changes in training intensity. Proper footwear, gradual training progression, and surface modification can aid in the prevention and management of shin splints.

1.6. ACL Tears

ACL (anterior cruciate ligament) tears are prevalent in sports that involve sudden stops, changes in direction, or pivoting movements. These injuries can significantly impact an athlete's performance and require surgical intervention for repair. Proper training techniques, strengthening exercises, and neuromuscular training can reduce the risk of ACL tears.

1.7. Rotator Cuff Injuries

The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint. Rotator cuff injuries can occur due to repetitive overhead motions or traumatic events. Understanding proper shoulder mechanics, performing strengthening exercises, and using correct techniques during sports activities can help prevent rotator cuff injuries.

1.8. Stress Fractures

Stress fractures are tiny cracks in the bone caused by repetitive stress and overuse. They are commonly observed in weight-bearing bones and often result from activities involving high impact or repetitive motions. Adequate rest, gradual training progression, and proper nutrition are crucial in preventing stress fractures.

2. Preventive Measures for Sports Injuries

Preventing sports injuries is a key aspect of sports medicine. By adopting appropriate preventive measures, athletes can minimize the risk of injuries and optimize their performance. Let's explore some effective preventive measures for sports injuries:

2.1. Proper Warm-Up and Cool-Down

A thorough warm-up before engaging in physical activity prepares the body for the demands of exercise, increasing flexibility and blood flow to the muscles. Similarly, a cool-down routine allows for gradual recovery and prevents muscle stiffness. Incorporating dynamic stretches, light aerobic exercises, and foam rolling into warm-up and cool-down routines can significantly reduce the risk of injuries.

2.2. Adequate Conditioning and Strength Training

Proper conditioning and strength training are essential for athletes of all levels. Building strength, flexibility, and endurance through targeted exercises can enhance performance and reduce the risk of injuries. Working with a qualified strength and conditioning specialist can help athletes design individualized training programs that address their specific needs.

2.3. Balanced Nutrition and Hydration

Proper nutrition and hydration are fundamental for optimal sports performance and injury prevention. A well-balanced diet rich in nutrients, vitamins, and minerals supports muscle recovery and overall health. Adequate hydration before, during, and after physical activity helps maintain optimal bodily functions and prevents dehydration-related complications.

2.4. Gradual Training Progression

Gradual training progression allows the body to adapt to increasing demands, minimizing the risk of overuse injuries. Athletes should gradually increase training volume, intensity, and frequency to avoid overwhelming the body's ability to recover. Periodization, which involves planned variations in training volume and intensity, can optimize performance while minimizing the risk of injuries.

2.5. Proper Technique and Biomechanics

Using proper technique and biomechanics during sports activities can significantly reduce the risk of injuries. Coaches and trainers play a vital role in teaching athletes correct movement patterns, body mechanics, and sport-specific skills. Understanding and implementing proper technique not only enhances performance but also minimizes the risk of acute and overuse injuries.

3. Diagnosis and Treatment of Sports Injuries

When sports injuries occur, prompt and accurate diagnosis followed by appropriate treatment is crucial for effective recovery. Sports medicine professionals employ various diagnostic techniques and treatment modalities to ensure optimal outcomes. Let's explore the diagnosis and treatment options for sports injuries:

3.1. Medical History and Physical Examination

A comprehensive medical history and physical examination are essential for evaluating sports injuries. Understanding the mechanism of injury, identifying predisposing factors, and assessing the affected area's range of motion and stability aids in the initial diagnosis. Sports medicine professionals use this information to guide further diagnostic tests and treatment plans.

3.2. Imaging Techniques

Imaging techniques such as X-rays, magnetic resonance imaging (MRI), and ultrasound are commonly used to visualize and assess sports injuries. X-rays provide valuable insights into fractures and bony abnormalities, while MRI and ultrasound offer detailed information about soft tissue structures, including muscles, tendons, ligaments, and cartilage. These imaging techniques help confirm diagnoses, assess the extent of injuries, and guide treatment decisions.

3.3. Rehabilitation and Physical Therapy

Rehabilitation and physical therapy are integral components of sports injury treatment. Sports medicine professionals work closely with physical therapists to design individualized rehabilitation programs that focus on restoring strength, range of motion, and function. Rehabilitation may include exercises, manual therapy, modalities (e.g., heat or cold therapy), and functional training to aid in recovery and prevent future injuries.

3.4. Medications and Injections

Medications and injections may be prescribed to manage pain, reduce inflammation, and facilitate healing. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to alleviate pain and inflammation associated with sports injuries. In some cases, corticosteroid injections may be administered to target specific areas of inflammation and provide localized relief.

3.5. Surgical Intervention

In cases of severe sports injuries, surgical intervention may be necessary. Orthopedic surgeons, a type of sports medicine professional, specialize in surgical procedures for sports-related injuries. Surgical treatments can involve fracture fixation, ligament reconstructions, cartilage repair, and other procedures aimed at restoring function and promoting recovery.

4. Supporting Athletes through Sports Medicine

Sports medicine plays a vital role in ensuring the health and well-being of athletes of all ages. As athletes age, sports medicine plays a crucial role in helping them maintain their physical fitness, prevent injuries, and manage age-related conditions. Understanding the unique considerations and challenges athletes face can help provide appropriate care and support and contribute to their overall well-being. 

4.1. Injury Prevention and Safety Education

Preventing injuries and promoting safety education are paramount for young athletes. Sports medicine professionals provide guidance on appropriate warm-up and cool-down routines, protective gear usage, and injury prevention strategies. Educating young athletes about the importance of rest, recovery, and reporting potential injuries fosters a proactive approach to their well-being.

4.2. Long-Term Athlete Development

Long-term athlete development encompasses a holistic approach to athletes' physical, mental, and social well-being. It focuses on creating positive sporting experiences, emphasizing skill acquisition, and promoting lifelong physical activity. Sports medicine professionals collaborate with coaches, parents, and educators to support young athletes in their athletic journeys.

4.3. Mental Health Support

Young athletes face various pressures and expectations, which can impact their mental health. Sports medicine professionals play a vital role in recognizing and addressing mental health concerns in young athletes. They work in conjunction with mental health professionals to provide support, counseling, and resources to promote positive mental well-being.

4.4. Age-Related Changes and Performance

As individuals age, they experience physiological changes that can impact sports performance. Decreased muscle mass, reduced bone density, and altered cardiovascular capacity are some of the age-related changes that can affect athletic abilities. Sports medicine professionals work with aging athletes to optimize their performance and mitigate the effects of aging.

4.5. Cardiorespiratory Health and Endurance

Maintaining cardiorespiratory health and endurance is vital for aging athletes. Regular aerobic exercise, such as walking, swimming, or cycling, can improve cardiovascular fitness and overall health. Sports medicine professionals provide guidance on safe exercise intensity, duration, and appropriate monitoring for aging athletes to ensure cardiovascular well-being.

4.6. Psychological Support and Motivation

Psychological support and motivation are crucial for athletes to maintain their passion for sports and physical activity. Sports medicine professionals understand the emotional challenges associated with aging and provide counseling, goal-setting strategies, and motivational techniques to support aging athletes in their athletic pursuits.

5. Sports Medicine and Performance Enhancement

Sports medicine plays a role in optimizing athletic performance through various performance enhancement strategies. These strategies aim to enhance strength, power, speed, endurance, and overall athletic abilities. Let's explore key aspects of sports medicine and performance enhancement:

5.1. Sport-Specific Training

Sport-specific training focuses on developing skills, techniques, and physical attributes specific to a particular sport. Sports medicine professionals collaborate with coaches and trainers to design training programs that address the demands of the sport and the individual athlete's needs. Sport-specific training enhances performance and reduces the risk of sport-specific injuries.

5.2. Strength and Power Training

Strength and power training aim to improve an athlete's ability to generate force and power. Sports medicine professionals design strength and power training programs that target specific muscle groups and energy systems relevant to the sport. These programs often involve resistance training, plyometrics, and explosive exercises to enhance overall athletic performance.

5.3. Speed and Agility Training

Speed and agility training focus on enhancing an athlete's ability to move quickly, change direction, and react rapidly. Sports medicine professionals incorporate speed and agility drills into training programs to improve reaction time, acceleration, and deceleration. These exercises simulate sport-specific movements and help athletes gain a competitive edge.

5.4. Endurance Training and Conditioning

Endurance training and conditioning aim to improve an athlete's aerobic capacity and stamina. Sports medicine professionals prescribe appropriate endurance training methods, such as long-distance running, interval training, or circuit training, to enhance cardiovascular fitness and overall endurance. This training allows athletes to perform at a high level for extended periods.

5.5. Recovery and Regeneration Techniques

Optimizing recovery and regeneration is essential for sustaining high-level performance. Sports medicine professionals employ various recovery strategies, including adequate rest, nutrition, hydration, and specific techniques like compression therapy, cryotherapy, and massage. These techniques promote muscle repair, reduce fatigue, and facilitate optimal recovery between training sessions and competition

6. Sports Medicine and Biomechanics

Biomechanics is an important field within sports medicine that analyzes the mechanical principles of human movement. Understanding the relationship between biomechanics and sports performance can help athletes optimize their technique, prevent injuries, and enhance overall efficiency. Let's explore the intersection of sports medicine and biomechanics:

6.1. Motion Analysis

Motion analysis involves assessing an athlete's movement patterns, joint angles, and forces exerted during sports activities. High-speed cameras, motion capture systems, and force platforms are used to collect data and analyze biomechanical variables. This analysis provides insights into movement efficiency, technique optimization, and injury prevention.

6.2. Gait Analysis

Gait analysis focuses on evaluating an athlete's walking or running pattern. By examining foot strike, stride length, cadence, and other gait parameters, sports medicine professionals can identify abnormalities and biomechanical issues that may contribute to overuse injuries. Gait analysis helps guide interventions such as orthotics, footwear modifications, and corrective exercises.

6.3. Equipment Evaluation and Design

Biomechanical analysis plays a role in evaluating and designing sports equipment to enhance performance and reduce injury risk. Sports medicine professionals collaborate with equipment manufacturers to optimize equipment design, such as footwear, protective gear, and sports-specific equipment, based on biomechanical principles.

6.4. Injury Prevention and Biomechanical Interventions

Biomechanical interventions aim to correct movement imbalances and optimize biomechanics to prevent injuries. Sports medicine professionals use a combination of exercise prescription, technique modifications, and equipment adjustments to address biomechanical issues identified through analysis. These interventions can reduce the risk of overuse injuries and improve performance.

6.5. Sports Performance Enhancement

Biomechanics plays a significant role in optimizing sports performance. By analyzing an athlete's movement patterns, sports medicine professionals identify areas for improvement and design interventions to enhance technique, power output, efficiency, and overall performance. Biomechanical analysis can provide valuable insights for athletes looking to gain a competitive edge.

6.6. Biomechanics and Rehabilitation

Biomechanical analysis also informs rehabilitation strategies for athletes recovering from injuries. By assessing movement patterns and identifying compensatory mechanisms, sports medicine professionals develop targeted rehabilitation programs. These programs address underlying biomechanical issues, restore proper movement patterns, and facilitate safe return to sports activities.

7. Frequently Asked Questions (FAQs)

Faq 1: when should i see a sports medicine specialist.

You should consider seeing a sports medicine specialist if you experience any sports-related injuries or conditions that affect your ability to participate in physical activity. Sports medicine specialists can provide accurate diagnosis, develop customized treatment plans, and guide your rehabilitation process to help you recover and return to your sport safely.

FAQ 2: Can sports medicine be beneficial for non-athletes?

Yes, sports medicine principles can benefit individuals who engage in physical activity, regardless of their athletic level. Sports medicine professionals can provide guidance on injury prevention, exercise prescription, and overall health and well-being. They can help non-athletes maintain an active lifestyle and address any musculoskeletal concerns that may arise.

FAQ 3: How can I prevent sports injuries?

Preventing sports injuries involves adopting appropriate preventive measures. These include warming up and cooling down properly, engaging in regular strength and conditioning exercises, using appropriate sports gear, maintaining balanced nutrition and hydration, gradually progressing training, and using proper technique and biomechanics. Following these guidelines can significantly reduce the risk of sports injuries.

FAQ 4: What role does nutrition play in sports medicine?

Nutrition plays a critical role in sports medicine, as proper fueling and hydration can optimize performance, enhance recovery, and prevent injuries. A well-balanced diet that includes adequate macronutrients (carbohydrates, proteins, and fats) and micronutrients (vitamins and minerals) supports energy production, muscle repair, immune function, and overall health.

Understanding sports medicine is crucial for athletes and individuals seeking to optimize their performance, prevent injuries, and promote overall well-being. Sports medicine professionals play a vital role in providing comprehensive care, supporting athletes at all stages of their athletic journeys, and helping them achieve their goals.

By implementing preventive measures recommended by sports medicine professionals, athletes can enhance their abilities and maintain a healthy and sustainable approach to sports and physical activity.  If being part of a team that helps athletes perform at their best sounds interesting, you might want to consider earning a sports medicine degree .

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The following represent additions to UpToDate from the past six months that were considered by the editors and authors to be of particular interest. The most recent What's New entries are at the top of each subsection.

ADOLESCENT AND PEDIATRIC SPORTS MEDICINE

Concussion and mental health disorders in children and adolescents (March 2024)

Ongoing research continues to examine the complex relationship between concussion and mental health disorders. In a recent case-control study of over 18,000 children (≤17 years old) with concussion and over 37,000 matched controls, concussion was associated with an increased risk for a new diagnosis of a behavior disorder at two and four years after injury [ 1 ]. For most diagnoses, the absolute numbers were low. Confidence in a causal relationship is limited by risk of confounding and reliance on an electronic medical record for establishing lack of baseline behavioral problems prior to injury. Whether pediatric concussion is an independent risk factor for new behavioral problems after recovery remains unclear. (See "Concussion in children and adolescents: Management", section on 'Mental health disorders' .)

Overuse injuries, overtraining, and burnout in children and adolescents (February 2024)

Greater numbers of children and adolescents now specialize in a single sport, thereby increasing the risk for overuse injuries, overtraining, and burnout. The American Academy of Pediatrics has issued a new clinical report that reviews the medical literature about these conditions and summarizes key findings pertaining to risk factors, clinical presentation, and prevention [ 2 ]. The report emphasizes the importance of achieving a healthy balance between stress and recovery. Specific recommendations include taking one to two days off from competition and sport-specific training each week and two to three months away from any specific sport each year. Discussions of endurance sports and weekend tournaments are included. (See "Overtraining syndrome in athletes", section on 'Special considerations in the young athlete' .)

Benign acute childhood myositis (January 2024)

Benign acute childhood myositis (BACM) is a self-limited syndrome associated with calf pain and creatinine kinase elevation, often following infection with influenza. In a retrospective study of 65 patients with BACM, the median age was 6.6 years and 66 percent of patients were male [ 3 ]. The most common symptoms were bilateral calf pain, refusal to walk, and diffuse weakness. The median creatinine kinase was 1827 U/L, which normalized after an average of seven days. Early recognition of this syndrome allows the clinician to avoid an unnecessary evaluation for other muscle diseases. (See "Overview of viral myositis", section on 'Benign acute childhood myositis' .)

MANAGEMENT AND REHABILITATION OF MUSCULOSKELETAL INJURIES

Risk of reinjury following ACL repair (February 2024)

Despite advances in surgical techniques, the risk of reinjury following repair of a ruptured anterior cruciate ligament remains substantial, ranging from 5 to 15 percent depending on the patient's age and activities. According to a systematic review of 71 studies involving over 600,000 patients, factors associated with an increased risk for retear following surgery include male sex, younger age, preoperative high-grade knee laxity, return to a high activity level or sport, and concomitant medial collateral ligament injury [ 4 ]. The modifiable factors identified highlight the importance of following a rigorous rehabilitation program and allowing time for complete healing before returning to sport. (See "Anterior cruciate ligament injury", section on 'Risk of reinjury' .)

Barbotage procedure for calcific tendinopathy of shoulder (January 2024)

To date, few high-quality studies have assessed the effectiveness of barbotage, an ultrasound-guided procedure to remove deposits in patients with calcific tendinopathy of the shoulder. In a recent, multicenter trial, 220 adults with calcific tendinopathy of at least three months duration were randomly assigned to one of three treatment arms: barbotage plus injection with glucocorticoid and analgesic; sham barbotage plus injection with glucocorticoid and analgesic; or, sham barbotage plus injection of analgesic alone [ 5 ]. At four months, patients in all three groups experienced moderate improvement in shoulder symptoms and function, but no significant differences were noted among treatment groups. At 24 months, neither barbotage with glucocorticoid injection nor glucocorticoid injection alone was superior to sham treatment (ie, analgesic injection alone). While barbotage is likely less effective than previously thought, we believe it remains a useful therapy for some patients. (See "Calcific tendinopathy of the shoulder", section on 'Barbotage' .)

Return to sport following stress fracture (November 2023)

Evidence is limited regarding return to sport (RTS) following stress fracture. A new systematic review of 76 studies involving nearly 3000 cases,provides some guidance; most of the studies were retrospective and involved predominately male athletes [ 6 ]. The lowest overall rates for RTS were reported for injuries of the femoral neck (55 percent), talus (69 percent), anterior tibial shaft (76 percent), and tarsal navicular (83 percent). The longest average times for RTS were reported for stress fractures of the tarsal navicular (127 days), femoral neck (107 days), and medial malleolus (106 days). These figures are averages, and healing for individuals may vary substantially given the many factors involved, including location within the bone, radiologic grade, duration of symptoms, compliance with treatment, and underlying bone health. Nevertheless, these findings inform treatment decisions and anticipatory guidance for athletes. (See "Overview of stress fractures", section on 'Return to activity' .)

Heavy load resistance exercise for tendinopathy (November 2023)

Evidence supporting the effectiveness of resistance exercise for the treatment of chronic (overuse) tendinopathy is growing. A recent systematic review and meta-analysis of 110 studies with just under 4000 subjects assessed research primarily involving the rotator cuff, Achilles, lateral elbow, and patellar tendons [ 7 ]. While noting that resistance dose was not well documented in many studies, researchers found consistent evidence that rehabilitation programs using resistance loads in excess of body weight and performed less frequently (ie, less than daily) demonstrated greater efficacy. These findings are consistent with our approach to treatment. (See "Overuse (persistent) tendinopathy: Overview of management", section on 'Heavy-load resistance training' .)

PREVENTION AND BIOMECHANICS OF MUSCULOSKELETAL INJURIES

Running injuries in high school and collegiate athletes (March 2024)

Although running is the most common form of exercise, few high-quality reviews of running-related injuries have been published. A recent systematic review that included 24 prospective cohort studies (nearly 2000 adolescent and young adult competitive runners) found that female runners sustained more injuries than their male counterparts [ 8 ]. All runners, but particularly females, with risk factors for relative energy deficiency in sport (REDS) experienced higher injury rates; athletes with weak hip and thigh muscles were at increased risk of developing anterior knee pain (eg, patellofemoral pain). This study also confirmed known risk factors, such as a history of prior running-related injury. Overall, study quality and certainty of evidence were low to moderate. These findings reinforce the importance of sound nutrition and adjunct strength training to prevent running injuries. (See "Running injuries of the lower extremities: Risk factors and prevention", section on 'Sex and age' .)

OTHER PRIMARY CARE SPORTS MEDICINE

New guidelines for management of mass participation sporting events (April 2024)

Mass participation sporting events such as marathons and sports tournaments continue to gain popularity, and sports medicine physicians are frequently called upon to organize and provide medical care at such events. The American College of Sports Medicine has published updated guidelines to assist clinicians providing these services [ 9 ]. The new guidelines address the increased focus on event security and health concerns stemming from environmental changes. Key concepts for medical planning include adequate preparation for catastrophic health problems, coordination with community medical services (including emergency departments and emergency medical services), and development or adoption of standardized protocols for the management of common and important medical conditions likely to occur. The new guidelines are largely consistent with our approach. (See "Preparation and management of mass-participation endurance sporting events", section on 'Key concepts and tasks' .)

• Delmonico RL, Tucker LY, Theodore BR, et al. Mild Traumatic Brain Injuries and Risk for Affective and Behavioral Disorders. Pediatrics 2024; 153.
• Brenner JS, Watson A, COUNCIL ON SPORTS MEDICINE AND FITNESS. Overuse Injuries, Overtraining, and Burnout in Young Athletes. Pediatrics 2024; 153.
• Attaianese F, Costantino A, Benucci C, et al. Benign acute children myositis: 5 years experience in a tertiary care pediatric hospital. Eur J Pediatr 2023; 182:4341.
• Zhao D, Pan JK, Lin FZ, et al. Risk Factors for Revision or Rerupture After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. Am J Sports Med 2023; 51:3053.
• Moosmayer S, Ekeberg OM, Hallgren HB, et al. Ultrasound guided lavage with corticosteroid injection versus sham lavage with and without corticosteroid injection for calcific tendinopathy of shoulder: randomised double blinded multi-arm study. BMJ 2023; 383:e076447.
• Hoenig T, Eissele J, Strahl A, et al. Return to sport following low-risk and high-risk bone stress injuries: a systematic review and meta-analysis. Br J Sports Med 2023; 57:427.
• Pavlova AV, Shim JSC, Moss R, et al. Effect of resistance exercise dose components for tendinopathy management: a systematic review with meta-analysis. Br J Sports Med 2023; 57:1327.
• Joachim MR, Kuik ML, Krabak BJ, et al. Risk Factors for Running-Related Injury in High School and Collegiate Cross-country Runners: A Systematic Review. J Orthop Sports Phys Ther 2024; 54:1.
• Herring SA, Kibler WB, Putukian M, et al. Mass Participation and Tournament Event Management for the Team Physician: A Consensus Statement (2022 Update). Med Sci Sports Exerc 2024; 56:575.

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Home | Blog | Activities and Resources for Teaching Sports Medicine Classes

Activities and Resources for Teaching Sports Medicine Classes

Sports medicine is a growing pathway for students who are sports fans. These high-demand sports medicine professionals are involved in diagnosing, treating, and preventing sport-related injuries or illnesses. But keeping amateur, collegiate, and professional athletes in peak physical form requires both technical and soft skills.

In a recent webinar , Realityworks Product Manager Denise DuBois shared numerous engaging resources for sports medicine classes. Keep reading to see her recommendations for teaching sports medicine classes. You’ll get ideas for equipping sports medicine students with both hard and soft skills.

Soft skills for sports medicine classes

Many experts agree job success comes from having well-developed soft skills. Key soft skills for the sport medicine pathway include team spirit, self-confidence, communication, empathy, assertiveness, and personality. Using scenarios and simulations naturally lead to practicing patient communication.

Activity: Scenario-based learning gives students something to remember; it provides a safe zone to make mistakes and provide corrective feedback, and it leads to problem solving and critical thinking. Use this Teamwork scenario and Time Management scenario from Realityworks’ Sports Medicine Career Scenario Cards to jump-start the soft skills conversations.

Resources: Ask industry experts, local businesses leaders, colleagues, family members, and even students to write scenarios from their own experiences exposing students to varying workplace experiences.

Technical skills for sports medicine classes

Knowledge of the techniques needed to compete in the sports medicine profession is critical. Hands-on practice can save time and check off essential skills before patient interaction. Classroom simulation tools provide the experience and activities to give students confidence for real-world practice.

Activities: Students can participate in simulation training such as Sports Medicine First Aid, Airway Skills, and Taping and Wrapping. No simulators? With low-cost bandaging supplies students can practice with peers or family members. Check out Denise’s complete list of activities for teaching skills training.

Resources : Online videos, quizzes and games can benefit many sports medicine courses. Many times, these online resources are easily adaptable to fit a variety of learning environments. Watch Denise’s webinar to see how she proposes modifying lessons for students in an array of learning situations. See the full list of the resources Denise discusses in her webinar.

Training tools for sports medicine classes

From BVM Ventilation education to treating concussions to assessing common knee and ankle injuries , check out Realityworks’ sports medicine learning tools . They not only provide hands-on practice and critical skill development, but come with comprehensive curriculum, including pre- and post- assessments, presentation slides, and student activities.

• Help your students hone the soft skills they’ll need to succeed in sports medicine careers by downloading our free guide , “5 Ideas for Incorporating Soft Skills Into Any Classroom.”
• Use our downloadable posters and infographics to generate discussions about a variety of topics related to our skills training tools, including Sports Medicine.
• Read how our Sports Medicine training tools can be used in HOSA competitions in this blog
• See what’s new for Health Science education in our Health Science Program Catalog
• Follow Realityworks on your favorite social media platforms ( Twitter ,  Facebook ,  LinkedIn ,  Instagram ,  Pinterest  and  YouTube ) for other tips and tricks

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• v.8(3); 2022 Mar

Sports Medicine and Movement Sciences

Giuseppe musumeci.

a Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Via S. Sofia 87, 95123, Catania, Italy

b Research Center on Motor Activities (CRAM), University of Catania, 95123, Catania, Italy

c Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA, 19122, USA

Sports Medicine is a relatively new topic in medicine and includes a variety of medical and paramedical fields. Although sports medicine is mistakenly thought to be mainly for sports professionals/athletes, it actually encompasses the entire population, including the active and non-active healthy populations, as well as the sick [ 1 ]. Sports medicine also engages amateur sportsmen and strives to promote physical activity and quality of life in the general population. Hence, the field involves all ages from childhood to old age, aiming to preserve and support every person at every age. Sports medicine, which started developing in the 19 th century, is today a medical speciality.

Currently, there exist different technologies applied in the world of sports medicine dedicated to the detection of health problems. Evidence has demonstrated that virtual environments can be useful therapeutic tools with demonstrated positive outcomes. Modern technological advances have led to the implementation of digital devices, such as wearables and smartphones, which have been shown to provide opportunities for healthcare professionals and researchers to monitor physical activity and therefore engage patients in daily exercising. Additionally, the use of digital devices has emerged as a promising tool for improving frequent health data collection, disease monitoring, and supporting public health surveillance. The leveraging of digital data has laid the foundation for the development of a new concept of epidemiological study, known as “Digital Epidemiology”, which could contribute in the future to personalized and precision sports medicine.

The understanding of the importance of physical activity and fitness as part of a healthy lifestyle is increasing all over the world, as well as the number of amateur athletes and the profession of sports medicine takes a big part in this process.

Physical inactivity is the fourth leading cause of morbidity and mortality worldwide [ 2 ]. Regular physical activity is highly beneficial for the primary, secondary and tertiary management of many common chronic conditions. There is considerable evidence for the benefits of physical activity for cardiovascular disease, diabetes, obesity, musculoskeletal conditions, some cancers, mental health and dementia [ 3 ]. Yet there remains a large evidence-practice gap between physicians’ knowledge of the contribution of physical inactivity to chronic disease and routine effective assessment and prescription of physical activity.

The benefits of physical activity for the prevention and treatment of many chronic diseases are well established, including the infection of Sars-CoV-2. Considering the countless positive effects of exercise, planning an adapted physical activity in all phases of recovery (bed rest, rehabilitation, and post-hospitalization) of the patient represents an important strategy to mitigate the decline of cognitive functions and improve the physical and psychological wellbeing of subjects affected by COVID-19. Physical activity, if adapted to the needs of the individual, practiced consistently and regularly, shows a positive influence on the immune system due to its natural protective and anti-inflammatory action. Correct and constant physical exercise, even at home, at all ages and especially in the elderly, is an extra shield against Sars-CoV-2 [ 4 ]. Thanks to the Adapted Physical Activity patients improve the skills: psychological, mental, cardiorespiratory and muscular.

For some chronic conditions, structured exercise interventions are at least as effective as drug therapy. The adapted physical activity should be prescribed in the same way as pharmacological treatment, deciding on the “dosage” and “formulation” for each patient. The “dosage” is calculated to reach a specific level of efficacy that prevents or improves symptoms but does not result in toxic effects [ 3 ]. The exercise regime should always be "adapted" personalized and "tailored" since the level of exercise will depend on the tolerability of the individual, since the body of each of us always responds differently. No do-it-yourself or generalized training/protocols should be allowed, because physical activity if done poorly, can cause more damage than a sedentary lifestyle. As stated by the American College of Sports Medicine, physical activity should be prescribed/administered, alternatively or in association with drug treatment by the Sports and/or Family Physician and/or the Kinesiologist [ 5 ].

With sincere satisfaction and pride, I present to you the Special Issue titled “Sports Medicine and Movement Sciences” . This Special Issue bridging the gap between science and practice in the promotion of exercise and health and in the scientific assessment, study, and understanding of sports performance, sports injury prevention and treatment, exercise for health as non-surgical and non-pharmacological treatments, rehabilitation techniques, adapted physical activity, drugs in sport, and recommendations for training and nutrition.

This Special issue comprises 3 review articles and 16 original research publications from a number of Sports Medicine and Movement Sciences researchers [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Taken together, these articles are geared toward the advancement of our understanding Sports Medicine and Movement Sciences arena, including: Cognitive function; Brain health; Gait analysis; Biomechanics; Health sciences; Physiology; Physical activity; Occupational health; Musculoskeletal system; Evidence-based medicine; Aerobic threshold; Anaerobic threshold; Maximal oxygen uptake; Neuroscience; Exercise; Physical Activity; Balance; Metastability; Neuromuscular control; Prevention; Rehabilitation; Health Promotion; Anatomy; Health Technology; Three-dimensional motion analysis; Reliability; knee injury; Athletic pubalgia; Cardiology; Women's Health; Female athletes; Applied psychology; Clinical psychology; Paralympic sport; Goalball; Soccer; Cognitive psychology; Quality of life; Disability; Regenerative medicine; Osteoarthritis; Virtual reality; Sensorimotor control; Sports injury prevention; Epidemiology; Public health; Psychology; COVID-19; Pandemic; Quarantine; Home based exercise; IPAQ-SF; Psychological well-being; PGWBI; Nerve injury; Nerve regeneration; Therapeutic exercise; Wearable technologies; Sprint initiation; Step technique; Multi-directional movement; Novel training environments and digital devices; Adherence; Breast cancer; Lifestyle; Public Health and Digital Epidemiology.

I hope that readers of Heliyon enjoy reading these significant contributions that remind us of the crucial importance of interdisciplinary collaboration between those working in Sports Medicine and their counterparts in Movement Sciences.

Conflict of interest declaration

The author of this editorial does not have any conflict of interests.

Acknowledgements

The author of this editorial wishes to thank all authors who have contributed to this Special Issue and express his gratitude to Heliyon Clinical Research editorial Team for their assistance and co-operation, in particular Dr. Christian Schulz the Lead Editor of Heliyon and Dr. Lo, On Ching the Editorial Team Leader of Heliyon Clinical Research. Special thanks to the publishing group (Cell Press) who encouraged and made possible the realization of this special issue.

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In This Section:

Clinical highlights from sports medicine reports | 2024 q1.

I would like to highlight three not-to-be-missed cases from the past quarter:

Proximal Muscle Weakness in a Collegiate Volleyball Player  submitted by Granley and Vidlock. This case to me highlights the need to always have a broad differential as you cannot diagnose what you don’t know. Getting a thorough history and cataloging all the symptoms led to a very thorough workup and a diagnosis of dermatomyositis, a very uncommon idiopathic myopathy. A great part of this case is the authors highlight the updated clinical decision tool, so if you have a similar case you can reference this tool to help with the diagnosis.

Penetrating Flank Injury in an Adolescent Due to Exercise Resistance Band Malfunction submitted by Ruzga and Gorra. This crazy case is an example of something that you couldn’t recreate if you tried. What are the chances of a metal carabiner snapping off, flying through the air, and penetrating the skin and ending up in the peritoneum? I wanted to highlight this case report to emphasize the risks associated with home exercise and kids – 12,000 ER visits a year!! I never gave a second thought to the dangers of resistance bands.  Be careful.

Psoas Abscess in a Snowboarder: A Musculoskeletal Manifestation of Crohn’s Disease submitted by Dennis, et al. This case to me highlights the importance of the Primary Care aspect of Primary Care Sports Medicine. A thorough review of prior treatments and the history along with a detailed current physical examination helped identify the etiology of the pain. If you haven’t already, look at the images of the pathology -- clearly not at all like the other side.

We also have awesome section articles that cover a variety of areas, and I would like to highlight three from the past quarter:

Nasal Injuries and Issues in Athletes submitted by Escalona and Okamura. This is an awesome review of the anatomy and the role the nose plays in respiratory function. The authors provide a very thorough and concise review of the medical and traumatic causes of nose pathology. If you cover combat sports and need a refresher on nose bleeds and fractures, this is a great place to look. I recently had a case of a middle school softball player who fielded a well-hit ground ball with her nose and not the glove. It was an impressive comminuted nasal fracture that ENT fixed quickly and you wouldn’t even know it happened. If only I could fix her concussion as quickly.

A Critical Review of Existing Evidence-Based Sport Psychological Interventions for College Athletes with Comorbid Attention Deficit-Hyperactivity Disorder and Sport-Related Concussions submitted by Davis, et al. Multifactorial conditions require multidisciplinary solutions. This article highlights and summarizes the role and the unique skill set of sports psychologists and how they can be instrumental in optimizing the treatment of athletes. While it focuses mainly on the intersection of sports-related concussion and ADHD, clearly there is a significant added benefit. I am a big believer in sports medicine is a team sport and bringing to bear the maximum skill set of every team member will provide the best outcomes.

Legg-Calve-Perthes Disease: Diagnosis, Decision Making and Outcome submitted by Ng, et al. Maybe because I have started my preparation to take the CAQ exam (again this will be the 3 rd time) this article struck me as perfect. It is an OUTSTANDING review article on the pathology, risk factors, presentation, physical exam, and management. The tables are great as are the images. This article will help you handle the 4 to 8-year-old who presents with a progressing limp with or without pain. Anyone up for authoring an updated review of the limping child?

The ACSM Annual Meeting is fast approaching, and I now realize I haven’t bought plane tickets yet. There are a lot of great topics and talks that can be converted into articles. If you are giving one of these awesome talks or hear one, please reach out to us at [email protected] or maybe we will run into each other in Boston.

CSMR is ACSM’s official monthly clinical review e-journal. Written specifically for physician and clinician members, CSMR articles provide thorough overviews of the most current sports medicine literature. ACSM physician members receive an online subscription to this journal as a member benefit.

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Sport and exercise genomics: the FIMS 2019 consensus statement update

Affiliations.

• 1 Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan.
• 2 Collaborating Centre of Sports Medicine, University of Brighton, Eastbourne, UK.
• 3 Murdoch Children's Research Institute, Parkville, Victoria, Australia.
• 4 Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
• 5 School of Engineering and Materials Science, Queen Mary University of London, London, UK.
• 6 Department for Health and Longevity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
• 7 Department of Neuroscience and Physiology, Center for Health and Performance, Goteborg University, Göteborg, Sweden.
• 8 Sahlgrenska University Hospital/Ostra, Göteborg, Sweden.
• 9 Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.
• 10 Sport Medical Center, Japan Institute of Sports Sciences, Tokyo, Japan.
• 11 Department of Sport Medicine, Humboldt University and Charité University School of Medicine, Berlin, Germany.
• 12 UCT Research Unit for Exercise Science and Sports Medicine, Cape Town, South Africa.
• 13 Department for Health, University of Bath, Bath, UK.
• 14 I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow, Russian Federation.
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• 17 British Association of Sport and Exercise Medicine, Doncaster, UK.
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• 20 Institute of Sports Science, University of Vienna, Vienna, Austria.
• 21 Austrian Institute of Sports Medicine, Vienna, Austria.
• 22 Sport Medicine Unit, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.
• 23 Collaborating Centre of Sports Medicine, University of Brighton, Eastbourne, UK [email protected].
• PMID: 32201388
• PMCID: PMC7418627
• DOI: 10.1136/bjsports-2019-101532

Rapid advances in technologies in the field of genomics such as high throughput DNA sequencing, big data processing by machine learning algorithms and gene-editing techniques are expected to make precision medicine and gene-therapy a greater reality. However, this development will raise many important new issues, including ethical, moral, social and privacy issues. The field of exercise genomics has also advanced by incorporating these innovative technologies. There is therefore an urgent need for guiding references for sport and exercise genomics to allow the necessary advancements in this field of sport and exercise medicine, while protecting athletes from any invasion of privacy and misuse of their genomic information. Here, we update a previous consensus and develop a guiding reference for sport and exercise genomics based on a SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis. This SWOT analysis and the developed guiding reference highlight the need for scientists/clinicians to be well-versed in ethics and data protection policy to advance sport and exercise genomics without compromising the privacy of athletes and the efforts of international sports federations. Conducting research based on the present guiding reference will mitigate to a great extent the risks brought about by inappropriate use of genomic information and allow further development of sport and exercise genomics in accordance with best ethical standards and international data protection principles and policies. This guiding reference should regularly be updated on the basis of new information emerging from the area of sport and exercise medicine as well as from the developments and challenges in genomics of health and disease in general in order to best protect the athletes, patients and all other relevant stakeholders.

Keywords: genes; genetic testing; genetics.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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• Exercise / physiology*
• Genetic Privacy*
• Health Policy
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• Sports / physiology*

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Dispelling severe 'morning sickness' myths: It's not normal or harmless, but prevention and treatment might be on the way

Late last year, geneticist Marlena Fejzo and colleagues made the discovery that morning sickness's most serious presentation, hyperemesis gravidarum (HG), is caused by the hormone GDF15, not human chorionic gonadotropin as previously thought. In a peer-reviewed opinion article publishing May 22 in the journal Trends in Molecular Medicine , Fejzo dispels common morning sickness myths and discusses potential treatments, including sensitizing people to GDF15 prior to pregnancy, similar to the way we treat allergies.

"HG can be life threatening and is associated with adverse outcomes that need to be taken seriously," says Fejzo of the Keck School of Medicine of the University of Southern California. "Now that we know that GDF15 is the most likely cause of HG, we are on the cusp of having treatments that target this hormonal pathway and end the suffering."

Myth 1: Severe morning sickness is harmless and normal

Pregnant people with HG are essentially starving, Fejzo says, and an increasing number of studies have demonstrated that this has serious short- and long-term clinical implications for both the parent and child. HG is a top predictor of postnatal depression, and 26% of pregnant people with HG report suicidal ideation while 18% meet the full criteria for post-traumatic stress disorder.

For the child, HG is associated with preterm birth, low birth weight, and later in life, autism spectrum disorder, ADHD, depression, social problems, in addition to an increased risk of childhood cancer and respiratory and cardiovascular disease. Still, pregnant people with the condition are often dismissed by their clinicians and families.

"It really is like a teratogen in pregnancy, a factor which interferes with normal fetal development, but it's still not taken seriously by a lot of medical professionals," Fejzo says. "A lot of people are brushed off and told, 'oh that's normal, it's okay, just don't take your pre-natal vitamins; you don't need them.'"

At its most extreme, individuals with HG can develop Wernicke encephalopathy, a life-threatening swelling of the brain due to thymine (vitamin B1) deficiency. Since individuals with HG can have trouble even swallowing vitamins, the American College of Obstetricians and Gynecologists currently recommends that they replace broad spectrum prenatal vitamins with folic acid, but Fejzo warns that this is likely insufficient, and that thiamine supplementation is also warranted for individuals with HG.

"I believe all women who have hyperemesis should be given vitamin B1 to avoid this serious brain swelling that can lead to permanent brain damage and often leads to fetal death," Fejzo says.

Myth 2: Morning sickness is caused by human chorionic gonadotropic hormone (hCG) or is psychosomatic

Though it was long thought that morning sickness is caused by hCG, the recent breakthrough has shown that HG's main cause is actually the hormone GDF15, which is part of a normal stress response. Usually, GDF15 is expressed only in very small amounts, but during early pregnancy it spikes by a huge amount, then wanes, and finally rises again during the third trimester.

A recent Nature study co-authored by Fejzo showed that individuals who suffer from HG can have genetic variants that causes them to have lower levels of circulating GDF15 prior to pregnancy, which makes them extra sensitive when they become pregnant and are suddenly exposed to high levels. This finding has clinical implications for preventing and treating HG, since preliminary research suggests that it might be safe to manipulate GDF15 during or even prior to pregnancy.

"GDF15 may be safe to manipulate in pregnancy or even prior to pregnancy," says Fejzo. "If we can increase levels of GDF15 before someone becomes pregnant, that might desensitize them, similar to how we try to desensitize people to allergens who have severe allergies," says Fejzo. "And during pregnancy, we may be able to minimize or get rid of symptoms by blocking GDF15 or its receptors in the brain stem."

Myth 3: Only humans experience morning sickness

Nausea and appetite loss during gestation is not a uniquely human trait -- these symptoms have been observed throughout the animal kingdom, from monkeys, dogs, and cats, to chickens, vipers, and octopuses.

"I always think it's interesting that the recommendation for cats is that if they're unable to eat for a day, you should contact your veterinarian, but we don't have that recommendation out there for women with hyperemesis," says Fejzo. "If you call your doctor's office and say you haven't eaten for a day, they'll say, 'that's normal' and won't do anything. There's more proactive care for cats than humans."

In addition to preventing ingestion of harmful foods, Fejzo speculates that pregnancy-induced nausea likely evolved to prevent dangerous foraging trips.

"This condition likely evolved because it was probably beneficial to avoid going out searching for food during pregnancy," says Fejzo. "That may still be true for animals, but people don't need this anymore, so let's end the suffering once and for all if we can."

Now, Fejzo is working toward developing and testing the proposed GDF15-based treatments. She also plans to investigate other genes and variants of GDF15 that might contribute to HG.

• Pregnancy and Childbirth
• Birth Defects
• Mental Health Research
• Teen Health
• Diseases and Conditions
• Delayed sleep phase syndrome
• Stem cell treatments
• Breech birth
• Miscarriage
• Spanish flu
• Adult stem cell

Story Source:

Materials provided by Cell Press . Note: Content may be edited for style and length.

Journal Reference :

• Marlena Schoenberg Fejzo. Hyperemesis gravidarum theories dispelled by recent research: a paradigm change for better care and outcomes . Trends in Molecular Medicine , 2024; DOI: 10.1016/j.molmed.2024.04.006

Cite This Page :

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