Failure to Participate in Sports: An Evaluation of Preparticipation Physicals in a Local School District.

PURPOSE: To determine the incidence of the documentation of athlete failure of preparticipation sports physicals. METHODS: This was a retrospective observational study that involved review of preparticipation examination physical form documentation from multiple clinicians for all student athletes who participated in athletics during the 2018 to 2019 academic year at Galveston Independent School District (GISD). We collected the reasons for failure to pass the preparticipation physical examination. RESULTS: Of the approximately 800 student athlete forms reviewed, 183 forms indicated individual athletes failed the visual acuity or cardiovascular portions of the preparticipation physical examination. DISCUSSION: Athlete failures of the preparticipation physical examination may cause delays in sports participation, and time and monetary costs to students and their parents. Inconsistences in guidelines used to clear athletes as well as variation in form completion impacts whether athletes reportedly failed or passed the examination. Mass participation screening becomes a safety net for communities for athletes who may not have primary care providers to encourage follow-up with a regular clinician for previously undiagnosed medical issues and standardizing guideline use and form completion across clinicians who do these exams may improve numbers of athletes who are cleared to play sports. CONCLUSION: Focusing on preventable and addressable preparticipation examination failures may help clinicians who perform these exams, while also establishing a safety net for previously undiagnosed medical conditions. Instituting yearly vision checks, addressing cardiovascular issues, and encouraging yearly follow-up with primary care clinicians can more readily address physical and mental health issues and will provide more comprehensive care to student athletes.

Mindfulness for Young Athletes.

Mindfulness has been around for centuries and a significant amount of research has been published in the past 6 years. Mindfulness has been shown to be helpful to improve overall well-being and sports performance. There has been a large increase in anxiety, depression, and overall stress in the pediatric, adolescent, and young adult population. This clinical commentary highlights the importance of using mindfulness as one tool to help young athletes improve their overall well-being and athletic performance. It also describes how it can be utilized in the sports medicine world along with noting a novel program at a Children's Hospital that is utilizing these tools to help young athletes.

Conclusiones de las XII Jornadas del Grupo Avilés sobre Medicina del Deporte / Conclusions of the XII Conference of the Avilés Group on Sports Medicine

El Grupo de Trabajo Avilés surgió en 2009 con el impulso del Consejo Superior de Deportes (CSD) y está formado, entre otros, por representantes de los Centros de Medicina dela Educación Física y el Deporte de todas las comunidades autónomas que cuentan con estas infraestructuras. Como objetivos de este grupo de trabajo figuran la coordinación entre estas estructuras autonómicas de la medicina del deporte, el planteamiento de soluciones comunes a las diferentes problemáticas que sufren cada uno de los centros y el ser un grupo de asesoramiento, en los diferentes ámbitos de la medicina de la educación física y el deporte, para el CSD. Este grupo de trabajo se reúne periódicamente y en su última reunión, celebrada en Miranda de Ebro (Burgos) el 2 y 3 de octubre de 2023, se acordaron una serie de conclusiones, en relación a los beneficios de la actividad física en patologías como la diabetes, el cáncer o las enfermedades neurodegenerativas, la defensa de la Prescripción de Ejercicio Físico como una actuación sanitaria de máxima prioridad, la digitalización de los centros de medicina del deporte y el uso de la inteligencia artificial y la necesidad de crear plazas de formación para especialistas. (AU)

Acupuncture in Sports Medicine.

Acupuncture is gaining popularity and wider acceptance as a treatment modality within the field of sports medicine. Our objective was to provide a comprehensive review of the existing literature pertaining to acupuncture in sports medicine to shed light on approaches utilized in acupuncture while revealing its personalized nature and its impact on athletes' preparation, performance, and recovery. We evaluated acupuncture research in the context of medicine and sports-related injury treatment, assessing its impact on athletic performance across demographics of athletes. Athletes participating in most sports have shown positive outcomes from acupuncture interventions. Acupuncture improves peak oxygen levels, maximum heart rate, delayed-onset muscle soreness, pain, swelling, explosive force production, and joint mobility. Furthermore, the efficacy of acupuncture appears to be similar regardless of age and sex. Lastly, the acceptance of acupuncture is influenced by cultural factors, with Western and traditional East Asian cultures exhibiting distinct perspectives on its rationale and mechanisms of action. Traditional East Asian acupuncturists typically employ qi and meridian theories in their acupuncture practices, with the recent incorporation of Western concepts. Acupuncture shows promise as an effective treatment for musculoskeletal pain and neuropathies in athletes across different age groups and for addressing injuries in various sports. Our comprehensive review will enhance our understanding of acupuncture's potential as a complementary or distinct therapeutic approach compared to conventional therapies. Additionally, our review explores its specific applications within different sports and delves into the cultural dimensions involved in integrating this practice into modern sports medicine.

Physician attitudes toward sports medicine coverage of mixed martial arts.

BACKGROUND: The popularity of modern Mixed Martial Arts (MMA) has been increasing since 2000s. It has drawn the attention of the media due to higher injury rates compared to other sports, and it is possible that this may have led to a generally negative image of MMA among viewers, including but not limited to, physicians. Therefore, our study aimed to understand the attitudes of physicians toward MMA and being asked to cover MMA events. METHODS: A cross-sectional study with an online survey was answered by 410 physicians from four physician organizations throughout the USA. Demographic data, sports event-related, sports coverage experience, athleticism, and familiarity with MMA answers were analyzed. Wilcoxon, Fisher Exact, and χ2 tests were used to compare the data. The main outcomes was the association between characteristics of physicians and attitude toward MMA coverage. RESULTS: Physician characteristics influenced positive attitudes toward MMA coverage. Those who regularly followed MMA felt more strongly that combat sport events required physician coverage, mainly for boxing (92.4% vs. 73.4%; P<0.001), kickboxing (89.9% vs. 54.7%; P<0.001), and taekwondo (50.6% vs. 38.4%; P=0.046). Doctors who considered themselves athletic or who had covered MMA events in the past were more likely to think that all sporting events should be covered by physicians (97.4% vs. 65.9%; P<0.01; 98.4% vs. 72.8%, P<0.001, respectively). Family medicine (72/139 [51.8%]) and physical medicine and rehabilitation (7/11 [63.6%]) were the specialties more inclined to agree with physician coverage for these events. CONCLUSIONS: Physicians familiar with MMA, either as a previous ringside physician or as a spectator, are more inclined to believe these events should have physician coverage as are those more experienced with sports medicine, such as family medicine and physical medicine and rehabilitation specialists. Therefore, specialized sports medicine training should be provided to allow for appropriate MMA physician coverage. With additional training, MMA event organizers should feel comfortable asking physicians in any specialty to provide sports medicine coverage to improve care for MMA athletes.

Call It an "Evolution": Promoting Student-Athlete Well-Being During the Transition From Collegiate Sport.

After highly publicized stories of student-athletes' struggles with mental health, the spotlight on mental health and well-being in this special issue coincides with a broader growing concern for the long-term impact of competitive sport participation on student-athlete health and wellness. The end of a competitive sport career represents a potentially vulnerable life transition. As demonstrated in the literature, the unique aspects of elite sport culture shape student-athletes' perceptions of their identity, health, and health behaviors, which have implications for how student-athletes navigate their health and well-being as they transition away from the embedded health care structure inherent to elite sport. Given evidence indicating that student-athletes may face mental and physical health concerns after retirement from sports, targeted transitional strategies are needed to provide patient-centered care in this population. In this article, we briefly summarize current understanding of sport transition and highlight some key findings from studies conducted by the contributing authors' research groups exploring the impact of sport career transitions on student-athlete well-being. We also reflect on limitations of the existing research and transition models and, in turn, propose potential directions for adopting a nuanced and multidimensional framework to explore interconnected transition domains. We conclude by offering recommendations for sports medicine professionals to consider in future research, programming, and policies to promote student-athletes' holistic well-being through this critical transition.

Clinical Rationale and Rehabilitation Guidelines for Post Biologic Therapy.

The use of orthobiologic modalities such as platelet-rich plasma in orthopedics and sports medicine to deliver high concentrations of naturally occurring biologically active growth factors and proteins to the site of injury is very promising and continues to evolve. Early protection and tissue-specific progressive loading are critical components to successful outcomes following orthobiologic intervention. Each tissue heals and responds differently. Ligament, tendon, muscle, and articular cartilage each have unique healing properties that require tissue-specific loading. The authors have found using a criteria-based loading and exercise progression guided by dynamic imaging when appropriate to further advance the goal-oriented rehabilitation program. Each patient and injured tissue are unique and require specific intervention and rehabilitation.

Processos de reflexividade dos psicólogos do esporte e coaches: um estudo fenomenológico / Reflexivity processes of sport psychologists and coaches: a phenomenological study / Procesos de reflexividad de psicólogos del deporte y coaches: un estudio fenomenológico

O objetivo desta pesquisa é identificar e compreender fenomenologicamente, por meio de relato de Psicólogos de Esporte (PE) e de Coaches, em sua vivência prática, como ocorrem os processos reflexivos em sua atuação, conforme apreendidos a partir de relatos de experiências. O método de investigação escolhido foi a fenomenologia, pois oferece os recursos necessários para tal mergulho junto à experiência reflexiva. A amostra intencional foi delineada por PE e Coaches (profissionais de Educação Física que recorrem ao Coaching) em atividade em esportes de alto rendimento, que tenham atuado ou estejam atuando em modalidades esportivas coletivas e/ou individuais. Realizaram-se nove entrevistas (cinco com PE, quatro com Coaches). O acesso ao objeto desse estudo se deu por meio de entrevistas em profundidade e semiestruturadas, orientadas pela escuta suspensiva. As questões disparadoras foram formuladas com base no Procedimento Estruturado de Reflexão adaptado. Para análise das entrevistas, realizou-se uma síntese de cada relato, seguindo-se de cruzamento intencional. Como resultados, percebeu-se que PE e Coaches trazem algumas similaridades no que se refere aos modos de refletir sobre sua prática. No entanto, as experiências que eles fazem desses processos reflexivos é que podem tomar rumos distintos. Os(as) PE amparam-se na regulamentação da profissão e resguardam-se em seus apontamentos, trazendo suas experiências e reflexões sobre os processos vividos. Os(as) Coaches trazem em suas explanações um trabalho coerente, organizado e compatível com o método do Coaching. Problematizar os processos reflexivos desses profissionais permite diferenciar qualitativa e eticamente suas atuações, possibilitando o fomento multiprofissional no esporte.(AU)

The aim of this study consists in phenomenologically identifying and understanding, by the report of Sport Psychologists (SP) and coaches, in their practical experience, how would be the reflexive processes that take place in their performance, as learned from reports of their experiences. The research method chosen was phenomenology, since it offers the necessary resources for such a dive along with the reflective experience. The intentional sample was outlined by SP and coaches (Physical Education professionals who use coaching) active in high performance sports, who have or are working in collective and/or individual sports. Nine interviews were conducted (five with SP, four with coaches). Access to the object of this study took place by in-depth and semi-structured interviews, guided by suspensive listening. The triggering questions were formulated based on the adapted Structured Reflection Procedure. For the analysis of the interviews, a synthesis of each report was carried out, followed by the intentional crossing. As results, it was noticed that SP and coaches bring some similarities regarding the ways of reflecting on their practice. However, their experiences of these reflective processes are that they can take different directions. The SP are based on the regulation of the profession and guard themselves in their notes, bringing their experiences and reflections on the processes experienced. Coaches bring in their explanations a coherent, organized, and compatible work with the coaching method. Problematizing the reflective processes of these professionals allows to differentiate their actuation qualitatively and ethically, making the multiprofessional phenomenon in sport possible.(AU)

El objetivo de este estudio consiste en identificar y comprender fenomenológicamente, a partir de la experiencia práctica de psicólogos del deporte (PD) y coaches, cómo serían los procesos reflexivos que se llevan a cabo en su rendimiento, tal y como se desprende de los informes de experiencias. El método de investigación elegido fue la fenomenología, ya que ofrece los recursos necesarios junto con la experiencia. La muestra intencional fue delineada por PD y coaches (profesionales de la educación física que utilizan el coaching) activos en deportes de alto rendimiento, que tienen o están trabajando en deportes colectivos e/o individuales. Se realizaron nueve entrevistas (cinco con PD, cuatro con coaches). El acceso al objeto de este estudio fue entrevistas en profundidad y semiestructuradas, guiadas por escuchas suspensivas. Las preguntas se formularon desde el procedimiento de reflexión estructurado adaptado. Para el análisis de las entrevistas, se hizo una síntesis de cada informe, seguida del cruce intencional. Como resultados, se notó que los PD y coaches tienen algunas similitudes con respecto a las formas de reflexionar sobre su práctica. Sin embargo, las experiencias que hacen de estos procesos pueden tomar diferentes direcciones. Los(las) PD se basan en la regulación de la profesión y se protegen en sus notas, aportando sus experiencias y reflexiones sobre los procesos vividos. Los(las) coaches plantean en sus explicaciones un trabajo coherente, organizado y compatible con el método de Coaching. Problematizar los procesos reflexivos de estos profesionales permite diferenciar sus acciones de manera cualitativa y ética, además de posibilitar la promoción multiprofesional en el deporte.(AU)

A disciplina psicologia do esporte nos cursos de psicologia e educação física / Sports psychology in psychology and physical education courses / La materia psicología del deporte en los cursos de psicología y educación física

Este discute a representatividade da disciplina Psicologia do Esporte nos cursos de Psicologia e Educação Física em instituições de ensino superior reconhecidas pelo MEC e situadas na região Sul do país. Foi realizado um estudo documental, com base nos currículos das Instituições. Os resultados revelaram que no Sul do Brasil 21,02% dos cursos de Psicologia, 41,96% dos cursos de bacharelado em Educação Física e apenas 14,83% dos cursos de licenciatura em Educação Física apresentam a disciplina Psicologia do Esporte em sua grade curricular. Observou-se que a disciplina é ofertada mais frequentemente em regime obrigatório nos cursos de bacharelado em Educação Física. Nos cursos de Psicologia, quando ofertada, costuma ser optativa. Os resultados evidenciam uma maior oferta da disciplina para os estudantes de Educação Física, em relação aos de Psicologia, o que pode estar relacionado ao próprio contexto de surgimento da disciplina e sua popularização no meio acadêmico. Para que esse panorama possa mudar e se possa oferecer uma formação adequada no curso de Psicologia para fomentar essa opção de carreira, há necessidade de se repensar o currículo e o próprio perfil do egresso, de forma a dar mais oportunidade aos estudantes para que conheçam as bases teóricas e os campos de aplicação da Psicologia do Esporte. Tal lacuna pode acarretar a fragilização da disseminação desse conhecimento aos estudantes de graduação e a consequente ocupação do mercado de trabalho.(AU)

This study discusses the representativeness of Sports Psychology in Psychology and Physical Education courses at higher education institutions from Southern Brazil. A documentary study was conducted based on the institutions' curricula. Results show that 21.02% of the Psychology major, 41.96% of the bachelor's in Physical Education, and only 14.83% of the license in Physical Education offer Sports Psychology in their curricula. Sports Psychology is most often offered as a compulsory subject in the bachelor's program in Physical Education, whereas Psychology courses offer it mainly as an elective. Physical Education students have greater contact with the discipline when compared with Psychology students, which may be explained by its context of development and popularization in the academic environment. To change this scenario and offer adequate education in the Psychology programs to foster this career option, institutions must rethink their curriculum and the graduate profile itself. This would give students better opportunity to get to know its theoretical bases and fields of application. Such a gap can hinder the dissemination of this knowledge to undergraduate students and the consequent labor market occupation.(AU)

El objetivo de este estudio es discutir la representatividad de la materia Psicología del Deporte en los cursos de Psicología y Educación Física en instituciones de educación superior de la región Sur de Brasil, reconocidas por el Ministerio de Educación (MEC). Se realizó un estudio documental, basado en los planes de estudio de las instituciones. Los resultados revelaron que, en el Sur de Brasil, el 21,02% de los cursos de Psicología, el 41,96% de los cursos de licenciatura en Educación Física y sólo el 14,83% de los cursos de profesorado en Educación tienen la materia Psicología del Deporte en sus planes de estudio. Se observó que la materia Psicología del Deporte se ofrece con mayor frecuencia como asignatura obligatoria en los cursos de licenciatura en Educación Física. Cuando se ofrece en los cursos de Psicología, es una materia optativa. Los resultados muestran una mayor oferta para los estudiantes de Educación Física en comparación con Psicología, lo que puede estar relacionado con el contexto del surgimiento de la Psicología del Deporte como materia y su popularización en el ámbito académico. Para que este escenario cambie y sea posible ofrecer una formación adecuada en el curso de Psicología con el fin de fomentar esta opción de carrera, es necesario repensar el plan de estudios y el perfil del egresado, así los estudiantes tendrán más oportunidades de conocer sus bases teóricas y sus campos de actuación. Tal brecha puede debilitar la difusión de este conocimiento a los estudiantes de grado y la consecuente ocupación en el mercado laboral.(AU)

Sports Medicine: Ergogenic Aids.

Ergogenic aids include performance-enhancing substances, nutritional supplements, and a variety of techniques aimed to improve an athlete's exercise performance capacity. Dietary supplement consumption in athletes is common and is higher in those with desire to become Olympic or world champions. Supplements with performance benefits include caffeine, creatine, nitrate, and sodium bicarbonate. Anabolic-androgenic steroids; stimulants, such as ephedrine; and body mass builders, such as human growth hormone, are the most used performance-enhancing substances in competition. The World Anti-Doping Agency (WADA) is responsible for generating the list of banned performance-enhancing substances as well as establishing the testing standards for national and international events. Makers of dietary supplements are not required to prove the products are safe or test them for quality. Products with third-party testing certifications can help minimize the risk of ingesting contaminated or banned substances. Therapeutic use exemptions may be granted in Olympic, professional, or NCAA sports for athletes with a medical necessity for banned substances. The role of the physician or other medical professional is to guide informed decision-making.

Auditing the Representation of Female Versus Male Athletes in Sports Science and Sports Medicine Research: Evidence-Based Performance Supplements.

Although sports nutrition guidelines promote evidence-based practice, it is unclear whether women have been adequately included in the underpinning research. In view of the high usage rates of performance supplements by female athletes, we conducted a standardised audit of the literature supporting evidence-based products: ß-alanine, caffeine, creatine, glycerol, nitrate/beetroot juice and sodium bicarbonate. Within 1826 studies totalling 34,889 participants, just 23% of participants were women, although 34% of studies included at least one woman. Across different supplements, 0-8% of studies investigated women exclusively, while fewer (0-2%) were specifically designed to compare sex-based responses. The annual publication of female-specific studies was ~8 times fewer than those investigating exclusively male cohorts. Interestingly, 15% of the female participants were classified as international/world-class athletes, compared with 7% of men. Most studies investigated performance outcomes but displayed poorer representation of women (16% of participants), whereas health-focussed studies had the greatest proportion of female participants (35%). Only 14% of studies including women attempted to define menstrual status, with only three studies (~0.5%) implementing best practice methodologies to assess menstrual status. New research should target the efficacy of performance supplements in female athletes, and future sports nutrition recommendations should specifically consider how well female athletes have contributed to the evidence-base.

Translating 2019 ACSM Cancer Exercise Recommendations for a Physiatric Practice: Derived Recommendations from an International Expert Panel.

In 2018, the American College of Sports Medicine (ACSM) reconvened an international, multi-disciplinary group of professionals to review pertinent published literature on exercise for people with cancer. The 2018 roundtable resulted in the publication of three articles in 2019. The three articles serve as an important update to the original ACSM Roundtable on Cancer, which convened in 2010. Although the focus of the three 2019 articles is on exercise, which is only one part of comprehensive cancer rehabilitation, the evidence presented in the 2019 ACSM articles has direct implications for physiatrists and other rehabilitation professionals who care for people with cancer. As such, the narrative review presented here has two primary objectives. First, we summarize the evidence within the three ACSM articles and interpret it within a familiar rehabilitation framework, namely the Dietz model of Cancer Rehabilitation, in order to facilitate implementation broadly within rehabilitation practice. Second, via expert consensus, we have tabulated relevant exercise recommendations for specific cancer populations at different points in the cancer care continuum and translated them into text, tables, and figures for ease of reference. Notably, the authors of this article are members of the Cancer Rehabilitation Physician Consortium (CRPC), a group of physicians who subspecialize in cancer rehabilitation medicine (CRM).

Bringing human-animal interaction to sport: Potential impacts on athletic performance.

To gain an edge in performance, athletes, coaches, trainers, and sport psychologists worldwide leverage findings from psychological research to develop training and performance strategies. The field of sport psychology draws upon research on stress, anxiety, mindfulness, and team building to develop these strategies. Here, we introduce human-animal interaction as a potential area of research that may apply to athletic performance. Structured interactions with animals-particularly therapy dogs-can provide physiological benefits associated with stress and the oxytocin system, psychological benefits for anxiety and motivation, and social benefits through social support. Yet these effects have not yet been systematically investigated in athletes. Integration of human-animal interactions into athletics can occur through animal visitation programmes and resident therapy animal programmes. Integrating human-animal interactions into athletics presents some unique challenges and limitations that must be considered before implementing these programmes, and these interactions are not a panacea that will work in every situation. But, given the amount of human-animal interaction research suggesting benefits in medicine, mental health, and education contexts, it is worthwhile exploring potential benefits not just for athletic performance, but also for injury prevention and recovery. HighlightsHuman-animal interaction is a potential area of research that may apply to athletic performance.Structured interactions with animals can provide physiological, psychological, and social benefits to athletes, through it is not a panacea that will work in every situation.Integrating human-animal interactions into athletics presents some unique challenges and limitations that must be considered before implementing these programs.

Analysis of the fight-ending chokes in the history of the Ultimate Fighting Championship™ mixed martial arts promotion.

OBJECTIVE: Knowledge of sportive chokes is vital to the practice of Sports Medicine when providing care at mixed martial arts and submission grappling events. This is a descriptive analysis of fight-ending chokes to help provide data on the topic not previously presented. METHODS: An analysis was done on every fight-ending choke in the history of the UFC™ mixed martial arts promotion. Investigators focused on the frequency of chokes, types of chokes, handedness of the chokes, and whether chokes resulted in loss of consciousness. This analysis was done using existing fight outcome reports and video analysis of every choke that ended a fight in UFC™ history. RESULTS: During the study period there were 904 such chokes, comprising 15.5% of fight outcomes and 76.2% of grappling submissions. The makeup of right (50.1%) and left (49.9%) handedness of the chokes has been essentially identical (χ2 [1] = 0.0011, p =.947, phi =.00). Most of the fight-ending chokes culminated in voluntary submission; however, 11% resulted in loss of consciousness. The rear naked choke (RNC) was significantly more frequent than other chokes, comprising 49.1% of the total choke finishes; 19 other choke types accounted for the remaining 50.9%. CONCLUSION: Fight-ending chokes have been common in MMA. Many types of chokes have successfully ended UFC™ fights, with the RNC accounting for almost half of fight-ending chokes. Loss of consciousness occurred in 11% of fight-ending chokes. Right and left handed chokes were utilized equally.

A comparative study of the effectiveness of an osteopathic primary care sports medicine led intervention on performance in men's collegiate lacrosse players.

CONTEXT: Comprehensive sports medicine care goes beyond the treatment of injuries resulting from athletic activities. Ultimately, it is a competence that includes knowledge in physical therapy, training, nutrition, coaching, motivation, competition, mentoring, psychology, and spirituality that allows the physician and patient to collaborate on promoting the patient's health goals. The current literature demonstrates a lack of knowledge in the Osteopathic Primary Care Sports Medicine Model's effectiveness in performance. OBJECTIVES: To determine whether a comprehensive osteopathic primary care sports medicine approach can improve performance and health outcomes in collegiate athletes. METHODS: A randomized controlled trial commenced just prior to the start of the lacrosse season and concluded at the end of the season. All the New York Institute of Technology (NYIT) collegiate lacrosse players were educated first in a 1-day seminar of the core competencies, and all participants had access to ask questions on their own volition. Then they were randomized into two groups, either the experimental group receiving the direct osteopathic primary care sports medicine intervention (n=18) or the control group not having active intervention (n=19). Also, the overall team winning percentage for that season was computed and compared to that for the previous years and the following year. Participants were assessed before and after the intervention with the Patient Health Questionnaire (PHQ-9), the 36-Item Short Form Survey (SF-36), custom Osteopathic Primary Care Sports Medicine questionnaire, and body fat composition, and their changes were compared between the experimental group and the control group. Collected data were analyzed using the repeated-measures analysis of variance. RESULTS: Thirty-seven participants were enrolled in the study. After 14 participants were excluded due to being lost to follow-up, 23 athlete records were analyzed. The winning percentage of the team was highest during the year of the study period time than in the 3 previous years and the following year. The test group did not have any statistically significant change in the PHQ-9, SF-36, custom Osteopathic Primary Care Sports Medicine questionnaire, as well as in body fat composition. CONCLUSIONS: When used during a collegiate lacrosse season, this Osteopathic Primary Care Sports Medicine intervention did not significantly improve health outcomes. This preliminary study, despite its limitations in compliance and study population size, did demonstrate improvement in overall team performance when comparing the intervention sport season to other seasons but was not statistically significantly. Therefore, further studies are warranted to improve the understanding in this approach to athlete health outcomes and performance.

Editorial Commentary: Risks of Biologic Therapies in Sports Medicine: Landmines on the Road to the Holy Grail.

Biologic therapies hold great promise in the treatment of a variety of sports medicine conditions, including cartilage injuries, osteoarthritis, and tendon or ligament tears. Cell-based therapies currently under investigation include autologous products such as platelet-rich plasma, bone marrow aspirate concentrate, other adipose and mesenchymal stem cell products, and allogeneic products such as umbilical cord and placenta-derived products. However, their use does not come without risk, and the complications of these treatments can be underreported. Risks include infection, sterile inflammatory response, or a combination. Many times, when offering injection therapy, we consider the greatest risk a lack of efficacy. A "no harm, no foul" attitude is taken. Many of us think that the biggest risk of such injections, due to out-of-pocket expense, would be damage to someone's checkbook more than damage to their health. However, there are real medical risks to our treatments. Regulatory efforts around the use of biologics are needed to track both efficacy and side effects, as we advance this technology and expand its use in the future.

Therapeutic Potential for Cannabinoids in Sports Medicine: Current Literature Review.

ABSTRACT: Cannabidiol and other cannabinoids are being used more frequently for sports medicine-related conditions. This review will help sports medicine clinicians answer questions that their athletes and active patients have about the potential effectiveness of cannabinoids on common sports medicine conditions. In the article, the authors compare cannabidiol and delta-9-tetrahydrocannabinol effects, noting the difference on the endocannabinoid and nonendocannabinoid receptors. The theoretical benefits of these two compounds and the current legality in the United States surrounding cannabidiol and delta-9-tetrahydrocannabinol use also are addressed.

The Danish sports chiropractic landscape: an exploration of practice characteristics and salient developmental issues.

BACKGROUND: As is the case around the globe, the Danish chiropractic community appears to be an active service provider for the athletic sub-population. However, a paucity of evidence elucidating the experiences, perceptions, and practices of individuals who identify as 'sports chiropractors' complicates strategic development efforts. METHODS: A sequential mixed-methods study was conceptualized in which interview responses from seven purposefully selected stakeholders provided context and informed a national descriptive survey exploring practice characteristics and opinions regarding sports chiropractic among Danish chiropractors. RESULTS: Thematic highlights included divided opinions on the criteria that define a sports chiropractor, the role of a chiropractor functioning beyond the clinic setting, and the need for a structured approach to developing sports chiropractic as a legitimate sub-specialty. The survey response rate was 34.9% (227 of 651), with 27% of responders identifying as a 'sports chiropractor'. Compared to non-sports chiropractors, sports chiropractors engaged in a significantly higher level of interprofessional practice (3.8 versus 2.7 partners), in particular medical doctors (p = 0.016) and personal trainers (p <  0.001). Whether participants identified as a sports chiropractor or not, there was consensus that a high-quality post-graduate qualification and continued education was important. Generally speaking, the framing of sports chiropractic into a protected title was not a priority. CONCLUSION: The Danish sports chiropractor tends to be male, has a specialist education and engages other chiropractors, medical practitioners and professional trainers more often as practice partners than generalist chiropractors. The position of the sports chiropractor as a 'knowledgeable expert' was seen as more important than establishing a protected title. Experiential training appears to be an untapped resource for developing real-world competency and gaining greater professional exposure. Given the potential for development across Europe, more focus is required on a strategic plan for embedding chiropractic professionals in inter-professional athletic health and performance practice settings.

Prehabilitation program composed of blood flow restriction training and sports nutrition improves physical functions in abdominal cancer patients awaiting surgery.

INTRODUCTION: The impact of prehabilitation remains controversial due to a short presurgical waiting period and the diminished capacity of the patient population. A strategy to augment and optimize the effectiveness of prehabilitations for abdominal cancer patients may be found in the unlikely field of sport science. We investigated the use of blood flow restriction training and sport nutrition supplementation to augment functional capacity and increase muscle strength in twenty-four abdominal cancer patients awaiting surgery. MATERIALS AND METHODS: The sport science-based program was comprised of blood flow restriction exercise 5 to 6 times per week and a daily sports nutrition supplement containing l-citrulline, creatine monohydrate, and whey protein. RESULTS: After 4 weeks of prehabilitation, 6-min walk test, timed up and go, short physical performance battery, 5-chair stand test and physical component score of quality of life were significantly improved (all p < 0.05). Total body and appendicular lean mass as assessed by dual energy X-ray absorptiometry increased by 0.73 ± 1.04 kg (p = 0.004) and 0.42 ± 0.64 kg (p = 0.006), respectively. Total body fat mass and trunk fat mass decreased (p = 0.004 and p = 0.021). There were no significant changes in hand grip strength, fear of falling, the mental component summary of quality of life, or fasting serum concentrations of myostatin, follistatin, and growth hormone. CONCLUSION: A multimodal prehabilitation program, which encompasses blood flow restriction training and sports nutrition supplements, is both feasible and effective in improving lean mass and physical function in abdominal cancer patients prior to surgery.