Note from Editor-in-Chief William O. Roberts
I was saddened to hear of two deaths in high school football players from exercise associated hyponatremia. These recent deaths underscore the critical importance of sensible fluid replacement. The headlines read “Georgia high school athlete dies from apparent over-hydration: Experts warn of dangers as school football practices begin” and “A Jackson Prep student hospitalized during Friday's football game has died, school officials said.” Both deaths the result of over-zealous fluid replacement resulting in too much free water in the body and death from brain swelling.
Exercise related hyponatremia was first described around 1980 in runners and had been a cause of death in marathon runners, ultradistance runners, triathletes, Grand Canyon hikers, and military personnel. This is the first time I am aware of that deaths have been reported in football players. The player from Jacksonville, FL is reported to have consumed two gallons of Gatorade and two gallons of water during and around practice on the day of his collapse. The fluid intake for the player from Jackson, MS has not been reported, but his collapse occurred during a game on a very hot evening. While replacement is important, taking in more than is lost in sweat can be fatal, even in football players, as the recent deaths have demonstrated. Our job is to keep the education at the forefront to prevent additional deaths.
This issue of Current Sports Medicine Reports (CSMR) covers Extremity and Joint Conditions and Sport-Specific Illness and Injury sections with a wide array of topics that should pique the interest of every reader.
Extremity and Joint Conditions Section Editor John P. DiFiori, MD, FACSM, has assembled a set of articles that will prove useful on a variety of topics. Check out this section to learn more about lower extremity nerve entrapments in athletes and the evidence based shoulder exam. In this section, you’ll also want to read the interesting case report about sacral stress fractures in a sprint and throw athlete.
When exploring the Sport-Specific Illness and Injury segment recruited by Section Editor Craig C. Young, MD, FACSM, you will learn more about soccer injury and prevention, clinical challenges of the global game rugby, and the sport-specific issues in men’s and women’s lacrosse. You won’t want to miss the case report about a stress fracture of the second rib and scapular spine in a female softball player in this section.
Additionally, for those of you interested in collecting injury and illness surveillance data, you’ll want to take a look at the special communication, “Sport Medicine Surveillance 101: What Clinicians Need to Know When Choosing Software Programs to Record Injuries and Illnesses.” This overview will help clinicians and researchers understand the most important underlying principles necessary to choose or develop software designed to improve the management of patients’ injuries and illnesses, and also allow for more complex analyses in the future.
Pearls & Pitfalls looks at blood clots and consequences in athletes. Scanning Sports Medicine covers the latest clinical research published by ACSM, and Web Alerts reviews several interesting Web sites. Our Clinician Profile features Eugene S. Hong, MD, a member of the journal’s editorial board and an active member of ACSM since 2001.
I hope the topics covered in this edition will help you help your athletes and active patients perform at their peak, return to competition safely, and reduce their risk of injury.
Lastly, please note that beginning with the January 2015 issue, CSMR is transitioning to an e-only publication. The journal will continue to publish its valuable, not-to-be-missed content on a bimonthly basis and will still be easily accessible on the journal’s Web site www.acsm-csmr.org, through its iPad® app http://goo.gl/bf3IhP, and in mobile view. Be the first to know when a new issue of CSMR publishes; sign up to receive an eTOC message by clicking on “Subscribe to eTOC” and entering your email address from the journal’s homepage.
William O. Roberts, MD, MS, FACSM