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

ABSTRACT: Athletes of all ages may be affected by medical and mental health issues. Sports medicine physicians should be familiar with common conditions that may affect the well-being of athletes, such as attention-deficit/hyperactivity disorder (ADHD). ADHD behaviors have the potential to affect a person's ability to concentrate. It is likely that social and cognitive therapies combined with pharmacotherapy will be the most effective way to treat ADHD in athletes. Medications used for ADHD, especially stimulant types, are known to improve alertness, reaction time, anaerobic performance, and endurance, which would potentially improve athletic performance. Furthermore, stimulant medications may enable student athletes with ADHD to focus on academic studies for longer periods of time, beyond usual levels of fatigue, important for those who may be exhausted after practices and games. The purported performance enhancement effects and potential adverse effects of stimulant medications have prompted many sports governing bodies to ban prescription stimulants or establish strict rules for their use. Athletes taking physician-prescribed stimulants to treat ADHD need to provide the appropriate documentation for approval before competition or risk punitive measures. Physicians should strive to provide a high quality of care to athletes with ADHD through early diagnosis, appropriate and careful multidisciplinary treatment, and complete and timely documentation to facilitate continued sports participation.

Physical Inactivity and the Role of Bullying Among Gender Minority Youth Participating in the 2017 and 2019 Youth Risk Behavior Survey.

PURPOSE: Evidence from small-scale studies suggests that transgender youth are less physically active than nontransgender youth, putting them at risk for worse health outcomes. This study examined the relationship between gender modality and participation in physical activity, physical education (PE), and sports teams in a multistate sample of high school youth and assessed whether bullying impacted this relationship. METHODS: Multiple regression was used to analyze data from the state and local Youth Risk Behavior Survey from 2017 to 2019 to examine the relationship between the gender modality and participation in physical activity, PE, and sports teams. The sample was stratified by sex and adjusted for demographics and in-school and online bullying victimization. RESULTS: Transgender participants who reported a male or female sex, respectively, reported lower odds of physical activity (adjusted odds ratio [aOR] 0.46, p < .001; aOR 0.46, p < .001, respectively) but similar odds of PE participation. Female transgender students were less likely to participate in sports (aOR 0.55, p = .007); however, this relationship was not seen in adjusted models. Adjusting for demographics, male transgender students were significantly more likely to participate in sports (aOR 2.1, p = .002). Adjusting for bullying experiences did not significantly change these results. DISCUSSION: Transgender youth are less likely to participate in physical activity but participate similarly or more than cisgender peers in PE and sports. Factors other than bullying may limit physical activity among transgender youth, and the Youth Risk Behavior Survey may not capture experiences of trans-specific victimization. Increased inclusion and safety may help increase physical activity and amplify its benefits for transgender students.

Tufted Angioma of the Index Finger Middle Phalanx.

A tufted angioma is a benign vascular tumor of the skin and subcutaneous tissue that classically presents as a violaceous nodule on the trunk or extremities in early childhood. Tufted angiomas of the finger are uncommon, and intraosseous involvement of these tumors is exceedingly rare. When present in the bone, these lesions may be difficult to distinguish from the more common pediatric condition of osteomyelitis or osteoid osteoma. We present the clinical, radiographic, and histopathologic findings for a unique case of a tufted angioma with intraosseous involvement in the middle phalanx treated by surgical excision and curettage with preservation of function.

Boys gymnastics injuries: A 9-year retrospective review.

OBJECTIVES: Young male gymnasts are a frequently injured, yet infrequently studied population. Literature on gymnastics injuries has focused primarily on female gymnasts at elite and collegiate levels. Gymnastics equipment, rules, and training methods have continued to evolve over the past few decades so the previous data likely does not reflect current injury patterns. Our study aimed to provide a description of injury patterns for contemporary club-level, pre-collegiate male gymnasts. METHODS: This was a retrospective chart review of 163 gymnastics injuries from 84 male subjects ages 4-19 years. Subjects were seen between 2010 and 2019 in pediatric sports medicine clinics. Gymnast demographics, injury locations, injury types, and gymnastics apparatus were collected as available. RESULTS: Our cohort had a mean age of 12.5 ± 3.0 years, gymnastics participation for 8.1 ± 2.9 years, and gymnastics level of 7.4 ± 1.7. Overuse injuries (59.5%) were more common than acute injuries (40.5%). The most common injury locations were lower extremity (42.3%), followed by upper extremity (32.5%), spine/trunk (19.6%), and head/neck (5.5%). The leading injury types were strains (16.6%) and apophysitis (12.9%). The most common apparatus for injury was floor (25%) followed by vault (20%). Binomial logistic regressions revealed that higher gymnastics level (OR = 5.19, p = .031) and younger age (OR = 4.05, p = .012) were predictors of lower extremity injuries. CONCLUSION: Our data show that injuries among club-level, young male gymnasts were most frequently located in the lower extremities. This contrasts older studies of primarily elite male gymnasts where injuries were more common in upper extremities. Overuse injuries were most prevalent in our cohort, and the most frequent injury types were strains and apophysitis.

Musculoskeletal and Sports Medicine Curriculum Guidelines for Pediatric Residents.

ABSTRACT: Musculoskeletal (MSK) and sports-related conditions are relatively common in the pediatric population. Pediatric residencies should provide residents with the knowledge and skills to assess and manage both acute and chronic MSK and sports injuries and complaints. Residents should develop the competencies and attitudes to safeguard and promote a healthy and active lifestyle for youth. Programs can use a variety of educational tools, both in the clinic and on the field, to provide a well-rounded MSK curriculum throughout the residency years. This article provides a review of general pediatric sports medicine curriculum guidelines and suggested implementation strategies.