Remembering our roots: eponyms in sports medicine.

For as long as athletes have been competing, injuries from competition have resulted. Sports medicine has a rich and storied history with significant contributors from many different countries and civilizations. Over time, we have honored the contributions of important figures in sports medicine with the use of eponyms. However, the continued use of eponyms in medicine has been called into question by a number of authors. They cite inaccuracies in definition and context, lack of descriptive value, and the possible celebration of unsavory characters. However, eponyms are pervasive in the medical literature. They bring color and character and allow us to honor those who came before us. Furthermore, eponyms can hide some distressing aspects of a disease. This review of eponyms in sports medicine provides an opportunity to celebrate our predecessors, recognize the international flavor of sports medicine, and promote accurate use of eponyms for the future.

[The Luxembourg Society for Sports Medicine (SLM) after 60 years]. / La société Luxembourgeoise de Medecine du Sport (SLMS) a 60 ans.

This review will mainly focus the last 10 years of the society's history because several important changes occurred during this relatively short period. The most important was the creation of the first clinical sports medicine department in Luxembourg in 2004. This modern new infrastructure was made possible by the recruitment of 2 highly competent sports physicians, the excellent collaboration of the governing board of the Centre Hospitalier de Luxembourg (CHL) and the support of the sports minister. In 2008 the new department received the label "Medical Olympic Centre of Luxembourg". One year later a Research Lab of Sports Medicine (CRP-Santé) completed the new concept. Thus within 4 years the structure of Luxembourgish sports medicine was completely rearranged and includes today orthopaedic surgery and traumatology, functional rehabilitation, sports cardiology, exercise physiology, physiotherapy and specific sports medicine research. An important new challenge of the SLMS will be to integrate the external sports physicians into this new infrastructure. Another ongoing mission of the SLMS will be the education and training of new young sports medicine specialists. Here the new department could play an outstanding role and the SLMS is in close negotiations with the University of Luxembourg, in charge of academic education in Luxembourg. A recruitment of new young sports physicians is necessary to perpetuate the routine sports medicine exams in the 15 regional centres in Luxembourg, where such an exam is mandatory in order to get an official sports licence. Since 2010 an ECG exam has been added for all new licence candidates, according to the recent recommendations of the scientific societies. New young sports physicians will also be needed to assure the medical attendance of the different national teams of Luxembourg. Until 1985 these activities were confined only to the Olympic teams every 4 years, but since the implementation of the Games of the Small European Countries in 1985, where rather big teams represent Luxembourg every two years, this mission has become more important. The history of the SLMS reflects the development both of sports and sports medicine during the last 60 years. At the beginning of the 21.century sports medicine is well settled in the Grand-duchy of Luxembourg.

O controle médico-esportivo no Departamento de Educação Física do Estado de São Paulo: aproximações entre esporte e medicina nas décadas de 1930 e 1940 / Medical supervision of sports by the São Paulo State Department of Physical Education: relations between sports and medicine in the 1930s and 1940s

Analisa as avaliações médicas em esportistas nos primeiros anos de funcionamento do gabinete médico do Departamento de Educação Física do Estado de São Paulo (DEF-SP), fundado em 1935 para promover o controle médico das práticas da 'ginástica e dos esportes' no estado. O controle médico-esportivo do DEF-SP tentou ordenar práticas esportivas mais higiênicas, com o fim de definir tipos físicos adequados para determinadas modalidades esportivas. Observa também que nesses primórdios da medicina esportiva em São Paulo, influenciada pelo pensamento científico eugenista, houve a tentativa de caracterização de um tipo físico nacional.

Adoption of new technology in sports medicine: case studies of the Gore-Tex prosthetic ligament and of thermal capsulorrhaphy.

Evaluation of new technology in sports medicine is supposed to promote improvements in the care of patients. It is also supposed to prohibit technology that can harm patients. This evaluation process is not perfect and at times can promote technology that not only does not help patients but may harm them. Two examples of new sports medicine technology that were widely adopted but eventually abandoned are thermal capsulorrhaphy for treatment of shoulder instability and the Gore-Tex prosthetic ligament (W. L. Gore & Associates, Flagstaff, AZ) for patients with anterior cruciate ligament deficiency. On analysis of the quick adoption of these 2 failed procedures, certain recommendations are apparent for improvement of the evaluation process. There must be a sound rationale behind any new technology, basic science research into the theory of the medical technology, and demonstrated improvements in animal models and clinical studies that are prospective cohort studies or randomized controlled trials, and finally, there must be careful follow-up and postmarket surveillance.

History of computer-assisted orthopedic surgery (CAOS) in sports medicine.

Computer-assisted orthopedic surgery and navigation applications have a history rooted in the desire to link imaging technology with real-time anatomic landmarks. Although applications are still evolving in the clinical and research setting, computer-assisted orthopedic surgery has already demonstrated in certain procedures its potential for improving the surgeon's accuracy, reproducibility (once past the learning curve), and in reducing outlier outcomes. It is also being used as an educational tool to assist less experienced surgeons in interpreting measurements and precision placements related to well defined anatomic landmarks. It also can assist experienced surgeons, in real-time, plan their bony cuts, tunnel placement, and with ligament balancing. Presently, the additional time, the expense to acquire the needed software and hardware, and restricted reimbursement have slowed the widespread use of navigation. Its current applications have been primarily in joint replacement surgery, spine surgery, and trauma. It has not been widely used in the clinical setting for sports medicine procedures. Sports medicine applications such as individualizing tunnel placement in ligament surgery, opening wedge osteotomy with and without accompanying ligament reconstruction, and balancing and tensioning of the ligaments during the procedure (allowing real-time corrections if necessary) are currently being evaluated and being used on a limited clinical basis.

Herodicus, the father of sports medicine.

Herodicus (fifth century BC: ) is the first person in the history of medicine who actually combined sports with medicine. He used to be a sports teacher, who later studied medicine and managed to succeed Euryphon in the medical school of Cnidos, one of the most prominent in ancient Greece together with its neighbor medical school of Cos (Hippocrates' home). In Cnidos Herodicus formed his own theoretical perspective of medicine. He considered, namely, bad health to be the result of imbalance between diet and physical activity and for this reason he recommended strict diet, constant physical activity and regular training. He believed that this combination was the ideal way to maintain good standards of health and he applied this type of treatment method to his patients. Unfortunately, Herodicus' works are lost today. However, excerpts of his medical system, which can be traced in ancient texts, support the fact that Herodicus can be considered as the father of sports medicine.

Scientific considerations for physiological evaluations of elite athletes.

This case describes the physiological maturation from ages 21 to 28 yr of the bicyclist who has now become the six-time consecutive Grand Champion of the Tour de France, at ages 27-32 yr. Maximal oxygen uptake (Vo(2max)) in the trained state remained at approximately 6 l/min, lean body weight remained at approximately 70 kg, and maximal heart rate declined from 207 to 200 beats/min. Blood lactate threshold was typical of competitive cyclists in that it occurred at 76-85% Vo(2max), yet maximal blood lactate concentration was remarkably low in the trained state. It appears that an 8% improvement in muscular efficiency and thus power production when cycling at a given oxygen uptake (Vo(2)) is the characteristic that improved most as this athlete matured from ages 21 to 28 yr. It is noteworthy that at age 25 yr, this champion developed advanced cancer, requiring surgeries and chemotherapy. During the months leading up to each of his Tour de France victories, he reduced body weight and body fat by 4-7 kg (i.e., approximately 7%). Therefore, over the 7-yr period, an improvement in muscular efficiency and reduced body fat contributed equally to a remarkable 18% improvement in his steady-state power per kilogram body weight when cycling at a given Vo(2) (e.g., 5 l/min). It is hypothesized that the improved muscular efficiency probably reflects changes in muscle myosin type stimulated from years of training intensely for 3-6 h on most days.

Historical remarks on the development of the aerobic-anaerobic threshold up to 1966.

During the years 1957 to 1963, we introduced the concept of the onset of anaerobic metabolism to measure cardiopulmonary and peripheral aerobic performance capacity. On the basis of bicycle and crank ergometer work with load increments of 3 min duration, we described a point at which the pulmonary ventilation (VE) increases at a greater rate than O2 uptake (VO2). Because the changes of the arterial blood lactate (Laa) and VE coincide we defined this point as the "point of the optimal ventilatory efficiency," identical with the "O2 endurance performance limit," later called "anaerobic threshold" by Wasserman et al.