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November 2018 - Volume 28 - Issue 6

  • Christopher Hughes, MBBS, MSc
  • 1050-642X
  • 1536-3724
  • 6 issues / year
  • Orthopedics 30/77
    Sport Sciences 33/81
    Physiology 48/83
  • 2.224
​​As 2018 draws near to a close, we welcome you to this, our Sixth and final Issue of the Clinical Journal of Sport Medicine this year. 

In our Editorial this month, Thompson and colleagues discuss issues related to the risk of exertional rhabdomyolysis secondary to blood-flow restriction training (BFR). BFR has been gaining popularity within both the strength training communities and amongst rehabilitation clinicians as a method of using lower-intensity strength training protocols in order to achieve similar gains in muscle mass to those which might be observed when using higher-intensity protocols. 

However, BFR is not without its inherent risks. Two Case Reports previously published in CJSM have suggested an association between BFR and rhabdomyolysis. In 2010, Iverson and Røstad described a case of rhabdomyolysis in an Ice Hockey player undergoing late-stage rehabilitation post-knee surgery. More recently, Clark and Manini described a second case of BFR-associated rhabdomyolysis in a subject enrolled in a training study.

On the related issue of adverse events occurring during BFR exercise, Martín-Hernández and colleagues present a small case cohort of individuals experiencing syncopal and pre-syncopal episodes during BFR training.

As a clinician using this modality for some of my own patients, this month's Editorial and the Case Reports mentioned serve as a useful reminder of the need to carefully monitor the systemic response to this form of exercise, especially amongst those who become symptomatic during a rehabilitation or training regime involving BFR. 

We bring you two General Reviews this Issue. O'Connell and colleagues present a Systematic Review on the use of blood biomarkers in the assessment of sport-related traumatic brain injuries (TBIs). The idea of a sensitive and specific early marker of sport-related TBI as part of diagnosis and to monitor resolution seems appealing. As things stand, SB100 seems to be the most promising marker candidate for use in clinical practice, but blood biomarkers currently have only a limited role in the assessment and management of sport-related TBI. Research is on-going, so watch this space. 

In their General Review, Cantinotti and colleagues discuss eligibility criteria for sports participation amongst young individuals with congenital heart disease, highlighting differences between recommendations for participation in Europe and the United States.  They call for comprehensive consensus recommendations in this area. 

As usual, we also present a wide range of Original Research articles ranging from topics such as Preparticipation sport physical examinations, shoulder injuries in canoeing and kayaking, and the effects of intravenous cold saline in hyperthermic athletes. 

Don't forget to check out our Continuing Medical Education modules on the LWW CME Connection website. We bring you a growing number of CME modules related to our main Journal content and allied topics, with our two latest modules on the topics of the care of athletes with ADHD and relationships between the Functional Movement Screen, Star Excursion Balance Test and Balance Error Scoring Systems. It's worthwhile checking the website regularly as we will be continuing to produce more CME content on a regular basis, and remember that you can secure ACCME CME credits for completing modules successfully. 

We will shortly be bringing you some Clinical Case modules, in association with two of our Affiliate Societies, the American Medical Society for Sports Medicine (AMSSM) and the American Osteopathic Academy of Sports Medicine (AOASM), and hope to have these up and running on our website in the New Year. We'll keep you updated with our progress on these. 

In the meantime, you can keep up-to-date with us on the CJSM blog  and on our social media channels on Twitter @CJSMonline , FaceBook  

 Wishing you all the best for holiday period, and a Happy New Year in advance. 

See you in 2019!

Best wishes, 



Christopher Hughes MBBS MSc




Use of Blood Biomarkers in the Assessment of Sports-Related Concussion—A Systematic Review in the Context of Their Biological Significance

O'Connell, Brendan; Kelly, Áine M.; Mockler, David; More

Clinical Journal of Sport Medicine. 28(6):561-571, November 2018.

The use of blood biomarkers in the assessment of sport-related concussion - a systematic review in the context of their biological significance