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November 2021 - Volume 31 - Issue 6

  • Christopher Hughes, MBBS, MSc
  • 1050-642X
  • 1536-3724
  • 6 issues / year
  • Orthopedics 27/81
    Sport Sciences 18/82
    Physiology 27/81
  • 3.638
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​It's hard to believe that we have reached the last Issue of the Clinical Journal of Sport Medicine in 2021. 

Last is definitely not least on thi​​​​s occasion, and I'm pleased to say that we bring you the biggest line up we have had for as long as I can remember. There is so much on offer in this jam-packed issue that it's hard for me to focus on just a few of the many interesting articles coming your way. Nevertheless, I'll mention some of the highlights below. 

The topic of Regenerative Medicine continues to cause controversies amongst clinicians working throughout the whole spectrum of healthcare specialties, including those of us working in sport and exercise medicine. There is an expanding body of research on the subject, with both basic science work and clinical trials being conducted using therapies such as platelet-rich plasma (PRP) and autologous stem cells. Regular readers will recall a Position Statement produced by one of Affiliate Societies, the Australasian College of Sport and Exercise Physicians (ACSEP), which was published in CJSM back in 2016 on the place of mesenchymal stem cell (MSC) therapies in sport and exercise medicine. This ACSEP Position Statement focused on the evidence for the therapeutic use of MSCs, and on priorities for patient health and welfare. 

This month, we bring you an important Position Statement from our Affiliate Society, the American Medical Society for Sports Medicine (AMSSM), on the Principles for the Responsible Use of Regenerative Medicine in Sports Medicine. The AMSSM Statement presents a comprehensive review of the topic and includes terminology, aspects of basic and clinical science regarding the use of different substances and modalities including PRP and cellular therapies, and discusses regulatory considerations regarding the use of these therapies. Advice is given to clinicians who may be considering using Regenerative Medicine modalities in their clinical practice and covers important issues such as informed consent, knowledge and training, quality control and the use of outcome measures. ​The Statement will assist those clinicians who wish to use Regenerative Medicine as part of their clinical practice, in ensuring that both they, and their patients, are able to make informed decisions and adopt safe practises. 

Complementary to the Position Statement, we are delighted to bring you a podcast interview with two of the authors of this AMSSM Position Statement, Drs Kenneth Mautner and Shane Shapiro, conducted by our Deputy Editor James MacDonald. ​

Professor Grant Iverson from the Department of Physical Medicine and Rehabilitation in Harvard and his Colleagues have produced some outstanding work on the topic of concussion and mild traumatic brain injury over the years. This issue, we include an important piece of Original Research from Professor Iverson produced with co-authors Zachary Merz and Douglas Terry, on the subject of participation in high school football and the subsequent risk of suicidal ideation. 

In a prospective cohort study of 3147 boys who participated in high school football during adolescence, subjects were re-interviewed at four time points from 1994 to 2008, with 2535 subjects eventually re-interviewed at the end of the study. It was found that young men who played high school football did not have an increased risk of suicidal ideation during their early 20s and late 20s, but those subjects who experienced mental health problems during high school were much more likely to experience suicidal ideation during their twenties. The Authors conclude that the published literature does not suggest a link between suicidality and playing high school football. No doubt this topic will continue to cause debate and generate more research interest in the future. 

In association with this Original Research piece, we bring you a complementary podcast interview conducted by Deputy Editor, James MacDonald, with Douglas Terry. I'm sure you'll enjoy the conversation with the discussion about the study and the topic in general.  

As we come to the end of the year, we are still firmly in the grip of the SARS-CoV-2 global pandemic. Dr Bruce Hamilton, Director of Performance Health High Performance Sport based in New Zealand and Colleagues, present a thoughtful narrative discussion on the topic of Decision-Making in Sport during a Pandemic, and discuss the application of ethical principles and value-based decision making in this regard. I'm sure that many of the points discussed in this paper will be familiar to those of us who have been practising during the pandemic, and will provoke further thought and discussion from readers and Colleagues. We'd love to hear your views on this topic.

The rest of our line-up this issue​ will keep you busy over the winter period, with no less than 31 pieces of Original Research in total plus two Critical Reviews, four General Reviews, three Brief Reports, two Case Reports and two Letters to the Editor with one reply. 

You may already know that CJSM is now on Instagram as well as our other social media outlets including Twitter and Facebook, so don't forget to keep an eye out for us on these sites as well as on the CJSM Blog to keep up to date with what's going on in the world of Sports Medicine. 

Our bank of CME articles on the Lippincott CME Connection website continues to grow, with recent additions on topics including the Male Athlete Triad and injectable corticosteroids in sport. 

Also, don't forget to test your clinical reasoning skills with our clinical case studies, produced in association with AMSSM and AOASM and available for free on our website​

I'm sure you'll enjoy our last issue of 2021. All of us at CJSM pride ourselves on bringing you such an abundance of original research, and we look forward to bringing you even more next year. In the meantime, look after yourselves and on behalf of myself and my colleagues at the Journal, wishing you a great Christmas and a very Happy New Year with better times ahead to come in 2022 and beyond. 

With warmest wishes, 



Christopher Hughes MBBS MSc


American Medical Society for Sports Medicine Position Statement: Principles for the Responsible Use of Regenerative Medicine in Sports Medicine

Finnoff, Jonathan T.; Awan, Tariq M.; Borg-Stein, Joanne; More

Clinical Journal of Sport Medicine. 31(6):530-541, November 2021.

AMSSM Position Statement: Principles for the Responsible Use of Regenerative Medicine in Sports Medicine

Playing High School Football Is Not Associated With an Increased Risk for Suicidality in Early Adulthood

Iverson, Grant L.; Merz, Zachary C.; Terry, Douglas P.

Clinical Journal of Sport Medicine. 31(6):469-474, November 2021.

Playing High School Football Is Not Associated With an Increased Risk for Suicidality in Early Adulthood