Clinical Journal of Sport Medicine

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May 2023 - Volume 33 - Issue 3

  • Christopher Hughes, MBBS, MSc
  • 1050-642X
  • 1536-3724
  • 6 issues / year
  • Orthopedics 26/86
    Sport Sciences 34/87
    Physiology 31/81
  • 3.454
Other Supplements

​​​Welcome to our May 2023 issue of the Clinical Journal of Sport Medicine. 

​Following the Canadian Academy of Sport and Exercise Medicine (CASEM) 2023 Annual Symposium in March, this time the spotlight is on the 2023 American Medical Society for Sports Medicine Annual Meeting.​ 

This year marks the 32nd occasion the meeting has taken place. Over the years, the AMSSM annual meeting has grown into one of the largest and most impressive global educational meetings for physicians and allied healthcare professionals ​caring for those involved in sport and exercise. 

This year's conference takes place in the Phoenix convention center from ​April 28th to May 3rd, ​and delegates will enjoy the opportunity to learn from a world-class faculty on a wide variety of sports medicine topics. 

CJSM is proud to bring you all of the 2023 AMSSM conference abstracts, including the Research Podium presentations, Rising with Research Presentations, Oral Research Poster Presentations and Case Podium Presentations. We give you free access to all of the AMSSM conference abstracts online. There is a wealth of interesting topics within the abstracts to explore, and lots to learn - well worth a read. 

This issue kicks off with an important AMSSM Position Statement on Athletes with Attention-Deficit/Hyperactivity Disorder. ADHD is more common than most of us think. There are a number of challenges for the sports physician when caring for patients with this condition. The new AMSSM Position Statement highlights important issues including diagnostic criteria, differential diagnosis and co-morbid conditions, diversity equality and inclusivity, and management aspects including pharmacotherapy (treatment and regulatory issues concerning stimulants) and exercise as a therapy. There is also an interesting discussion on the relationship between ADHD and concussion. 

Clinicians will find the key clinical recommendations useful in their everyday practice. We'd be interested to hear your feedback on the statement, and particularly on how you find the key clinical recommendations of use in your everyday practice. 

Pallikadavath and Colleagues from the University of Leicester in the UK present their findings from the AFLETES Study (Atrial Fibrillation in Veteran Athletes and the Risk of Stroke). Using an International online survey, the authors sought to estimate the risk of stroke in veteran endurance athletes who develop atrial fibrillation (AF) versus those remaining in sinus rhythm. A total of 1002 responses to a self-administered questionnaire survey were received from participants recruited through social media advertising, and from questionnaires circulated to relevant sporting clubs, encompassing responses from individuals in 41 different countries. 

The authors found that AF was independently associated with stroke in athletes. This association was noted even in those with a low CHA2DS2-VASC score, suggesting that current risk stratification for anticoagulation may not be accurate in this group using the score stated. 

An association between swimming and atrial fibrillation was found when compared with other sports, and it was also found that 20% of participants reported AF which is far higher than the general population prevalence. There was evidence of a dose-response effect of exercise to the risk of AF. 

The authors call for more studies to address whether the risk of stroke in athletes with AF is higher than that for the general population, and a potential reconsideration of risk stratification in this group. 

Jokela and colleagues investigated mechanisms of hamstring injury in professional soccer players using video analysis and magnetic resonance imaging (MRI) findings. Fourteen videos of acute hamstring injuries in 13 professional male soccer players were analyzed revealing sprint-related, stretch-related and mixed-type injury mechanisms. Most injuries occurred at high horizontal speed, and MRI findings revealed that 79% of injuries were isolated single-tendon injuries. The authors concluded that proximal and isolated single-tendon (mostly biceps femoris injuries) should be suspected if the injury mechanisms described were seen during game-play. 

Other original research articles this issue include studies investigating the association between magnetic resonance imaging and time to return to sport and muscle injuries in high-level youth athletes, the relationship between high sport specialization and musculoskeletal injuries in canadian high school students, and the relationship between sensory organization testing scores with lower extremity injuries and prior concussion in professional soccer players

Silber and colleagues present a systematic review on return to activity (work and / or sport) following arthroscopically-assisted repair of the triangular fibrocartilage complex (TFCC). This review included 15 studies representing 478 patients, and found that an average of 84% of patients were able to fully return to their previous occupational or sporting activities following surgery, even those participating in more strenuous activities. The authors concluded that the long-term success of TFCC repair is established in the literature, but that there is a lack of evaluation of timescales for improvement. 

Our Practical Management article this issue discusses a standardised aerobic exercise program for adolescents with concussion in the absence of graded exercise. Chizuk and colleagues present an evidence-based program of subsymptom threshold aerobic exercise not requiring an exercise test, which also accounts for the effects of sex and days post-injury. The program includes consideration of exercise type, intensity and volume and should be useful for practising clinicians and their patients. CJSM would be interested to receive your feedback on this program. 

CJSM looks forwrad to keeping you updated with events at the AMSSM conference on our social media channels, including Instagram , Twitter and Facebook. ​Don't forget to check out our CME offerings on the Lippincott CME Connection website with some free modules​ available for all to explore, offering ACCME credits. 

Have a great conference at AMSSM, and look forward to seeing you there. 

Best wishes, 



Christopher Hughes MBBS MSc




Athletes With Attention-Deficit/Hyperactivity Disorder: Position Statement of the American Medical Society for Sports Medicine

Pujalte, George G.A.; Narducci, Dusty Marie; Smith, Michael Seth; More

Clinical Journal of Sport Medicine. 33(3):195-208, May 2023.

Athletes with attention deficit-hyperactivity disorder - Position Statement of the American Medical Society for Sports Medicine

The AFLETES Study: Atrial Fibrillation in Veteran Athletes and the Risk of Stroke

Pallikadavath, Susil; Richards, Caryl; Bountziouka, Vasiliki; More

Clinical Journal of Sport Medicine. 33(3):209-216, May 2023.

The AFLETES Study: Atrial Fibrillation in Veteran Athletes and the Risk of Stroke

Practical Management: A Standardized Aerobic Exercise Program for Adolescents With Concussion in the Absence of Graded Exercise Testing

Chizuk, Haley M.; Haider, Mohammad N.; Edmonds, Jasmine Q.; More

Clinical Journal of Sport Medicine. 33(3):276-279, May 2023.

Practical Management: A Standardized Aerobic Exercise Program for Adolescents With Concussion in the Absence of Graded Exercise Testing