Review of Injury Patterns of the 2018 Bank of America Chicago Marathon to Optimize Medical Planning.

ABSTRACT: Medical planning for a marathon requires an understanding of the volumes and types of injuries experienced by runners during a race. This chart review of medical records from the 2018 Bank of America Chicago Marathon (N = 1016) measured volume and types of injuries at the race aid stations to determine the impact that race distance has on medical resource utilization. The type and volume of each injured runner diagnosis was compared between quartiles of the race using a chisquare analysis. The most common presenting complaints were musculoskeletal (MSK), followed by medical/other, and then wound care. The proportion of MSK complaints increased over the course of the race, whereas the percentage of medical and wound care complaints was highest at the finish line tents. Understanding the expected volume and type of injuries along the course of a race optimizes medical planning and leads to better utilization of resources and staff.

At-home exercises for 4 common musculoskeletal complaints.

This pictorial review can help you advise patients on how to reduce pain and increase ROM, strength, and balance following acute injury or in chronic impairment.

Exercise Is Medicine.

There is overwhelming evidence in the scientific and medical literature that physical inactivity is a major public health problem with a wide array of harmful effects. Over 50% of health status can be attributed to unhealthy behaviors with smoking, diet, and physical inactivity as the main contributors. Exercise has been used in both the treatment and prevention of a variety of chronic conditions such as heart disease, pulmonary disease, diabetes, and obesity. While the negative effects of physical inactivity are widely known, there is a gap between what physicians tell their patients and exercise compliance. Exercise is Medicine was established in 2007 by the American College of Sports Medicine to inform and educate physicians and other health care providers about exercise as well as bridge the widening gap between health care and health fitness. Physicians have many competing demands at the point of care, which often translates into limited time spent counseling patients. The consistent message from all health care providers to their patients should be to start or to continue a regular exercise program. Exercise is Medicine is a solution that enables physicians to support their patients in implementing exercise as part of their disease prevention and treatment strategies.

Move It or Lose It: Summarizing Peer-reviewed Evidence for Practicing What You Preach.

Physically active health care providers are more likely to provide physical activity (PA) counseling to their patients, but barriers in PA counseling exist. Common barriers include knowledge, time constraints, lack of reimbursement, as well as lack of personal habits. This article will summarize evidence-based knowledge regarding provider PA habits as a means of improving rapport, compliance, and empathy for patients when prescribing PA. Clinical pearls for successful PA counseling scenarios also will be discussed.

Acute Illness in the Athlete.

Athletes are susceptible to many acute illnesses that can interfere with their ability to train and compete as well as potentially affecting teammates and coaching staff. A solid understanding of the preventive measures, diagnosis, and management of such diseases is paramount in the care of an athletic population.

Infectious disease.

Athletes are susceptible to the same infections as the general population. However, special considerations often need to be taken into account when dealing with an athlete who has contracted an infectious disease. Health care providers need to consider how even common illnesses can affect an athlete's performance, the communicability of the illness to team members, and precautions/contraindications related to athletic participation. Recent advances in the prevention, diagnosis, and/or management of frequently encountered illnesses, as well as certain conditions that warrant special attention in the athletic setting, are discussed in detail.

Rehabilitation of the wrist and hand following sports injury.

In sports, wrist and hand injuries are commonplace. Too often, injuries to these areas can be under-treated and left for further complications to arise. While some injuries to the wrist and hand can be treated conservatively with immediate return to play, others require a more in-depth assessment prior to return to play. This article describes the most common wrist and hand injuries in sport, and provides information related to current treatment approaches.

Preparing for the surge: perspectives on marathon medical preparedness.

In preparing for medical coverage of a mass participation event such as a marathon, race directors and their medical staff members need to account for the unexpected. Extremes in weather as well as the potential for outside threats need to be given consideration before race day in order to adequately prepare. Through the recruitment of local expertise from various agencies in one's community during both the planning stages, and on race day, the added stressors of such extremes will be minimized, if not eliminated. This article will provide concrete examples of how the Chicago Marathon has used its own experiences with such extremes. Readers will be given useful tools to implement in their own marathons or other mass participation events-planning to equip them better for the unexpected surge.

On thin ice: preparing and caring for the ice skater during competition.

The competitive sport of figure skating has changed in many ways over the last few decades with the advent of increasingly difficult programs, the additions of new disciplines within the sport, and changes to the types of injuries seen. With increased numbers of participants, there is more need for medical coverage at many skating events throughout the country. The sports medicine physician responsible for the care of skaters at a competition will need a working knowledge of the basics of skating and the injuries these athletes sustain in order to provide exceptional care to the skaters. This article reviews the basics of figure skating along with the common injuries and medical conditions often experienced by figure skaters to allow a physician to feel comfortable dealing with potential rinkside emergencies and issues. It also provides guidance on the preparation required to provide medical coverage at an ice skating competition.

Medical concerns of marathons.

One must remember that the first marathon runner, Phidippides, collapsed and died at the finish of his race. Fortunately, death has been an infrequent occurrence in modern day marathons. However, the physical exertion required to complete a marathon coupled with exposure to often harsh environmental conditions and an increase in the number of novice participants makes injuries inevitable. The medical team's main goal is to implement strategies to prevent serious injury and illness through pre-event planning, race day preparedness, and postevent evaluations. The three general categories of injuries encountered with marathon participation include medical conditions, musculoskeletal injuries, and dermatologic complaints. The focus of this article is on the evaluation and management of the varied medical concerns encountered on race day along with the essentials in prerace planning and preparedness.

Exercise prescription for underprivileged minorities.

Physical inactivity is a growing epidemic in industrialized nations, contributing to the increasing prevalence and worsening of many chronic disease processes such as diabetes mellitus, cerebral vascular disease, and depression. It is well recognized that certain subpopulations are less likely to partake in physical activity than the population at large. Many minority populations, especially those of lower socioeconomic status, and women and children within these groups, are the most likely to be inactive. Promotion of increased physical activity within these subpopulations has been fraught with many obstacles. Interventions need to be developed with these groups in mind, addressing the beliefs and barriers specific to each group. This article reviews the available research on physical activity within minority populations, the barriers that exist, and offers recommendations on methods to increase adoption and maintenance of physical activity within minority groups.

Advances in emergent airway management.

The threatened airway is, fortunately, an infrequent occurrence in sports medicine, but one that requires up-to-date knowledge and skill in order to be managed in an effective and timely manner. Sports medicine physicians are responsible for having the education and tools required to secure a compromised airway in any setting. Often, careful positioning of the athlete with simple maneuvers learned through basic life support training is all that is necessary to secure the airway. At other times, however, more advanced techniques (including the use of advanced airways such as endotracheal tubes, laryngeal mask airways, esophageal tracheal combitubes, and surgical airways) will need to be utilized. This article offers physicians some perspective on the newest innovations that exist in airway management in comparison with the standard equipment and techniques. It is up to sports medicine physicians to develop treatment algorithms they are comfortable with, should they encounter an airway emergency.