The Highly Reliable, Patient-Centered Sports Medicine Practice.

Patient-centered care is safe and eliminates preventable patient harm. Sports medicine teams that understand and apply the principles of high reliability, as demonstrated by high-performing communities in the US Navy, will provide safer, higher-quality care. Sustaining high-reliability performance is challenging. Leadership is essential to creating an accountable but psychologically safe environment fostering active engagement by all team members and resisting complacency. Leaders who invest the time and energy to create the appropriate culture and who model the required behaviors enjoy an exponential return on their investment in terms of professional satisfaction and the delivery of truly patient-centered, safe, high-quality care.

Coaching in Sports Medicine.

Similar to elite athletes, surgeons use their skills on a daily basis but coaching for skillset refinement is not common among surgeons. Surgeon coaching has been proposed a method by which surgeons can gain insight into their performance and optimize their practice. However, many barriers exist to surgeon coaching such as logistics, time, cost, and pride. Ultimately, the tangible improvement in surgeon performance, the elevation of surgeon well-being, the optimization of the practice, and better patient outcomes support a wider implementation of surgeon coaching for surgeons at all stages of their career.

Exercise in bushfire smoke for high performance athletes: A Position Statement from the Australian Institute of SportEndorsed by Australasian College of Sport and Exercise Physicians (ACSEP) and Sport Medicine Australia (SMA).

OBJECTIVES: The frequency of bushfires in Australia is increasing and it is expected bushfire smoke will become a more prevalent phenomenon impacting air quality. The objective of this position statement is to provide guidance to the sport sector regarding exercise in air affected by bushfire smoke. DESIGN: This is position statement from the Australian Institute of Sport, based on a narrative review of the literature regarding bushfire smoke and its effects on health and exercise performance. METHODS: A narrative review of scientific publications regarding the effects of bushfire smoke on health and exercise performance. RESULTS: Bushfire smoke has negative impacts on health and performance. Athletes exercising at high intensity over a prolonged duration will increase their exposure to air pollutants. Athletes with a history of elevated airway responsiveness are likely to be at increased risk of an adverse response to bushfire smoke exposure. CONCLUSIONS: Athletes, coaches, support staff and sport organisations should monitor air quality (PM2.5 concentration) and make appropriate adjustments to training duration and intensity.

Sports Medicine and the Pelvic Floor.

ABSTRACT: The female athlete is seen as a specialist population meaning female considerations, such as pelvic floor dysfunction, are not widely taught within sports medicine. Females have unique anatomical characteristics compared with males including a wider pelvic diameter and an additional orifice in the form of the vagina. Furthermore, symptoms of pelvic floor dysfunction are prevalent among female athletes and transitional periods in their lifespan. They also are a barrier to training and performance. Therefore, it is essential that sports medicine practitioners understand how to identify and manage pelvic floor dysfunction. This report aims to describe the anatomy and function of the pelvic floor, outline the types and rates of pelvic floor dysfunction, discuss evidence-based management, and raise awareness of perinatal bodily changes. Practical recommendations are made to aid sports organizations and sports medicine practitioners in supporting the female athlete and in using a proactive approach to manage the perinatal athlete.

Disparities in Sports Medicine Health Care Access in Illinois High Schools: Access to Team Physicians, Athletic Trainers, and Automated External Defibrillators.

ABSTRACT: High school athletes have higher rates of injuries and sudden death than their college counterparts. Medical care for these athletes should include access to team physicians, athletic trainers, and automated external defibrillators. Disparities in medical care access provided by high schools for their athletes may be due to school characteristics or socioeconomic or racial factors. This study investigated relationships between these factors and access to team physicians, athletic trainers, and automated external defibrillators. Medical care access is negatively related to the percentage of low-income students and positively related to the number of sports offered. Relationships between race and access to a team physician became nonsignificant when the percentage of low-income students was considered. Physicians who treat high school athletes should consider the medical care access provided by their schools when they educate these patients about preventing and treating sports injuries.

Sports Diagnostics-Maximizing the Results or Preventing Injuries.

Sports diagnostics is a comprehensive scientific concept and comprises an aspect of training monitoring and/or sports medicine [...].

Online Sports Medicine Fellowship Education: The Genesis of a National Program and Year-1 Analysis.

ABSTRACT: The COVID-19 pandemic has created numerous challenges in all walks of life. One such challenge was the strain and subsequent effects on medical education, including the elimination of in-person learning opportunities. Consequently, in March of 2020, a nationwide Sports Medicine fellowship online education series was developed. Presentations were available for live and recorded viewing. Over the course of the 2020-2021 academic year, 38 presentations were offered, covering 45 topics. Live viewership totaled nearly 1600 through the year, while views of recorded lecture reached nearly 34,000. There was no statistical difference in the number of viewers for musculoskeletal versus nonmusculoskeletal topics in either the live (46.50 ± 35.37 vs. 43.38 ± 27.28 viewers, respectively; P = 0.77) or recorded formats (843.60 ± 337.66 vs 876.67 ± 624.70 viewers, respectively; P = 0.85). This article presents the novel approach to sports medicine education by the American Medical Society for Sports Medicine in the 2020-2021 academic year through the genesis the National Online Fellowship Education Program along with analyses of viewership data.

Trends in the Sports Medicine Match: An Analysis of the National Resident Matching Program Data from 2010 to 2021.

ABSTRACT: Sports medicine (SM) fellowship training has become popular among residents. Thus, an analysis was undertaken to assess data on matching rates from 2010 to 2021. The purpose of this study is to analyze trends in SM fellowship applications using National Resident Matching Program data. Retrospective study with analysis of applicants applying into accredited SM fellowships between 2010 and 2021. The number of accredited programs and fellowship positions have more than doubled from 2010 to 2021. There was a significant increase in match rates over time (P < 0.001); match rates were at 70% or below prior to 2015 and above 70% after 2015. The average number of applicants per position stayed consistent. The number of Doctor of Osteopathic Medicine applicants increased 110% whereas the number of U.S. born foreign and non-U.S. citizen applicants decreased 20.8%. SM fellowship training has increased since 2010. Acceptance rates and number of applicants have increased over time because of the growth in fellowship programs and accredited positions.

Prepare for the Unexpected: A New Look at Trauma Triage and Care in Mass Participation Sporting Events.

ABSTRACT: Few sports medicine physicians have extensive experience in managing mass casualty trauma. Yet many, or most, of us find ourselves covering competitions, races, and events in venues where thousands of athletes and spectators gather, and these could quickly become mass casualty events in the setting of an explosion/bombing, active shooter, or similar incident. When this happens, the sports medicine team, already on site, is in a unique position to provide immediate assistance until additional resources arrive. In this article, we will discuss a framework for this initial trauma response to the mass casualty event at a mass participation sporting event.

Online Sports Medicine Fellowship Education: The Genesis of a National Program and Year-1 Analysis.

ABSTRACT: The COVID-19 pandemic has created numerous challenges in all walks of life. One such challenge was the strain and subsequent effects on medical education, including the elimination of in-person learning opportunities. Consequently, in March of 2020, a nationwide Sports Medicine fellowship online education series was developed. Presentations were available for live and recorded viewing. Over the course of the 2020-2021 academic year, 38 presentations were offered, covering 45 topics. Live viewership totaled nearly 1600 through the year, while views of recorded lecture reached nearly 34,000. There was no statistical difference in the number of viewers for musculoskeletal versus nonmusculoskeletal topics in either the live (46.50 ± 35.37 vs. 43.38 ± 27.28 viewers, respectively; P = 0.77) or recorded formats (843.60 ± 337.66 vs 876.67 ± 624.70 viewers, respectively; P = 0.85). This article presents the novel approach to sports medicine education by the American Medical Society for Sports Medicine in the 2020-2021 academic year through the genesis the National Online Fellowship Education Program along with analyses of viewership data.

Training and Practice Settings of Physicians Dual-Certified in Emergency and Sports Medicine.

ABSTRACT: Survey study of training and practice paradigms and job satisfaction of dual-boarded emergency medicine (EM) and sports medicine (SM) physicians. The REDCap survey was sent to 193 American Board of EM members who hold a Certificate of Added Qualification in SM. A total of 124 EM/SM physicians responded (67.5% male). More than 70% completed three-year residencies while only 28.5% had an EM/SM residency faculty. One-quarter delayed fellowship after residency 6.45 years on average. Regarding their first job after fellowship, 27.6% practiced only EM, 54.5% practiced both EM and SM, and 12.2% practiced only SM. Regarding their current job, 29.1% practice only EM. 47.3% practice both EM and SM, and 20.9% practice only SM. Only 13.9% and 9.9% indicated they are unhappy with their first job and current job, respectively. There is significant variability in practice settings for EM/SM physicians with the overwhelming majority being happy with their career choices.

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.

Medical Concerns in Orthobiologics Procedures.

Orthobiologics have shown immense treatment potential in many medical fields including sports medicine, musculoskeletal disorders, and pain management. As with the case of any medical procedures and treatments, there are potential side effects or caveats that physicians and patients should be cognizant of. Nevertheless, the use of orthobiologics does not seem to have consistent severe side effects and do not have increased risks with transmissible disease, immune-modulated reactions, or oncologic processes.

Incorporating Biologics Into Your Sports Medicine Practice: Who, What, When, Why, and How?

Orthobiologic techniques can be used in the treatment of a variety of sports medicine pathologies, using an evidence-based approach focused on the value of all available approaches. The orthopaedic surgeon should be aware of the indications for and any technical pearls and pitfalls related to the use of orthobiologic agents as treatment for, or as an adjunct to management of, common sports medicine injuries and pathologies. Expected outcomes, including return to sport/activity, as well as potential complications and how to avoid them, should be considered. Although promising results have been reported, significant lack of high-level studies, inconsistent findings, and variability among current research make it challenging to reach a definitive conclusion about application, target populations, and overall effectiveness.