Welcome to our July 2020 Issue of the Clinical Journal of Sport Medicine. This month, we bring you a great line-up of articles including three Position Statements, a Consensus Statement, three Review articles and a wealth of Original Research and Brief Reports on a diverse range of topics.
I hope that you, your families, and your patients have been well since I last wrote. The worldwide COVID-19 pandemic continues to be of major concern to us all. Thankfully, however, things seem have taken a turn for the better in some Countries and we have started to see the resumption of some major sporting events around the World including the Premier and Championship League Soccer calendars in the United Kingdom, albeit things aren't quite the same as they were before in many ways. A wide number of safety measures have been put into place in order to ensure the safety of all sports participants and others working in sport. An example of these measures introduced by the English Premier league can be seen here.
We are far from out of the woods, but fingers crossed we will see the safe resumption of the wider sporting calendar in the near future and an end to this most difficult of times for all of us.
Since the start of the COVID-19 pandemic, there have been many changes for sports physicians in the way that we live and work. CJSM Deputy Editor James MacDonald has interviewed a number of sports medicine physicians from different Countries around the World as part of a special series of CJSM podcasts. Those interviewed have offered some interesting insights into how their lives and practice have been affected in recent times. I hope that you have had the opportunity to listen to some of these podcasts, but if not then you can check them out here (they are all free to download from the Apple Podcasts site).
We start this Issue with two important Position Statements from one of our major Affiliate Societies, the American Medical Society for Sports Medicine (AMSSM).
First up, we bring you an AMSSM Position Statement Update on Blood-Borne Pathogens in the Context of Sports Participation. This Statement encompasses general considerations in relation to blood-borne pathogens including HIV and Hepatitis B, C and D, and offers guidelines for the prevention and management of these infections in the sports setting. In addition, considerations with relation to exercise for those who have on-going infections are discussed, together with educational strategies focused on prevention of infections.
The Second AMSSM Position Statement this month focuses on the topic of Sexual Violence in Sport, and seeks to both raise awareness of this important issue amongst sports medicine physicians and allied healthcare professional, and to stimulate the development of a long-term plan for collaborative action in order to reduce sexual violence in Sport.
The Third Position Statement this Issue comes from the Faculty of Sport and Exercise Medicine (FSEM (UK)), which has produced a Statement on Sport Preparticipation Screening for Asymptomatic Atlantoaxial Instabilty in Patients with Down Syndrome. The FSEM (UK) Statement discusses the role of plain radiography as a screening test for asymptomatic atlantoaxial instability amongst this population, together with other important elements of screening including a focused history and clinical examination. Sports which are considered to be high risk for this population are also presented, together with suggestions for the promotion of safe sporting activities.
In addition to the Position Statements in this Issue, we bring you a Consensus Statement regarding Recommendations on the Prehospital Care of the Injured Athlete with a Suspected Catastrophic Cervical Spine Injury, produced by the Spine Injury in Sport Group. This Statement has been simultaneously co-published in both the Journal of Athletic Training and the Journal of Emergency Medical Services.
This comprehensive Consensus Statement, produced using a Delphi Consensus approach following a panel review of the current literature, addresses a number of key research questions in relation to the Prehospital Care of athletes with a suspected serious cervical spine injury, and forms both a useful and practical evidence-based update for all of those involved in pitchside emergency care.
We bring you three Review articles this Issue. Lovett-Carter and Colleagues present a Meta-analysis of the Surgical and Rehabilitative Outcomes of Hip Arthroscopy in Athletes with Femoroacetabular Impingement.The Authors find high levels of return to pre-injury level of sporting activity (over 85%) amongst those undergoing this procedure. Rabello and Colleagues present a Systematic Review on the Association between Clinical and Imaging Outcomes after Therapeutic Loading Exercise in Patients with Achilles or Patellar Tendinopathy at short or long-term follow up. Finally, Sultan and Colleagues present an interesting literature review on the Nonoperative Applications of Placental Matrix Tissue in Orthopaedic Sports Injuries.
Our Original Research article offerings this month commence with two papers on issues related to the cardiovascular health of athletes. Peterson and Colleagues present a 2-year prospective surveillance study on the etiology of sudden cardiac arrest and death (SCA/D) amongst competitive athletes, including middle school, high school, and professional athletes, between 2014-2016. In this study, a total of 179 cases of SCA/D were identified, of which just over 65% had an adjudicated diagnosis. Conway and Colleagues present an Infrastructure Assessment of Preparticipation Cardiovascular Screening in Collegiate Athletics (NCAA programs). In their study, the Authors find that secondary testing for cardiovascular abnormalities appears to be readily available for NCAA athletes, which is a reassuring finding.
We have a wide variety of other Original Research articles this Issue with topics including the effects of different length isometric contractions for patients with patellar tendinopathy, the association between a physical activity vital sign and cardiometabolic disease in high-risk patients, and an interesting survey by Ekhtiari and Colleagues on the preferences of physicians regarding ultrasound-guided intra-articular injections.
As ever, you can keep up to date with events in the world of sport and exercise medicine on our CJSM Blog, our twitter account on @CJSMonline and on our Facebook account.
Don't forget to check out our ever-growing range of CME articles on the CME Lippincott CME Connection website.
Until I write again, stay safe, and look after yourselves as well as your patients.
Christopher Hughes MBBS MSc