AAP Council on Sports Medicine and Fitness Blog

ROSEMONT, Ill., March 3 –The Board of the American Orthopaedic Society for Sports Medicine’s (AOSSM) Medical Publishing Group is proud to announce the selections of Edward M. Wojtys, MD (Editor-in-Chief), George J. Davies, DPT, ATC, CSCS (Associate Editor - Physical Therapy Section), Matthew Gammons, MD (Associate Editor - Primary Care Section), and Riann Palmeri-Smith, PhD, ATC (Associate Editor - Athletic Training Section) as the founding editors of Sports Health: A Multidisciplinary Approach.

“The comprehensive care of athletes requires a diverse team of professionals, including athletic trainers, physical therapists, primary care physicians and orthopaedic surgeons,” Dr. Wojtys says. “I am excited to have the opportunity to work with Drs. Davies, Gammons and Palmieri-Smith to address the interrelated topics of clinical care sports medicine. Our goal with this publication is to improve the care and rehabilitation of athletes.”

Sports Health, a bi-monthly publication, to be launched in January 2009, is aimed at physicians and allied health professionals who work with athletes. The Journal is a collaborative publication by AOSSM, American Medical Society of Sports Medicine (AMSSM), National Athletic Trainers’ Association (NATA) and the Sports Physical Therapy Section (SPTS) and will be published by Sage Publications.

Link: http://www.ohio.com/lifestyle/health/16410186.html?page=all&c=y

By Tracy Wheeler
Beacon Journal medical writer

Published on Saturday, Mar 08, 2008

There’s a reason Nike pays millions of dollars to have its swoosh logo on the shoes — and hats, shirts, pants, socks and sweatbands — of professional athletes.

There’s a reason Gatorade pays millions to put pro athletes in its TV advertisements.

‘’What athletes wear, do, say and take have a huge impact on your young athletes,'’ said Dr. Bernard Griesemer.

And that includes what professional athletes do with steroids and other performance-enhancing drugs, he told a roomful of pediatricians and trainers Friday morning as part of Akron Children’s Hospital’s Building Young Athletes — Safe and Healthy seminar.

Griesemer, of Springfield. Mo., is known as an expert on steroid use in young athletes. He helped write the American Academy of Pediatrics’ position statement against anabolic steroid use and was an anti-doping investigator in the 1998 Winter Olympics.

Click here for the full article

Link: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/03/07/MN47VF2V8.DTL

Here is an article from 3/7/08 San Francisco Chronicle. Comes from a press release from the 2008 AAOS meeting. There are some interesting comments made by readers at the newspapers’ site, including one that the all the talk about overuse is just a way for us as medical professionals to “increase demand.” I’m sure that’s it, since it isn’t the 5 game a weekend tourneys or the performance enhancement and travel teams/multiple teams that are the culprit…..

Here is a Word file of the article

By GRETCHEN REYNOLDS
Published: March 2, 2008

To understand the toll that overtraining can take on an athlete’s life, consider the competitive arc of Whitney Myers, a fifth-year senior and a world-class swimmer at the University of Arizona. In 2006, Myers won the women’s N.C.A.A. title in the 200- and 400-yard individual medleys and, to the surprise of almost everyone, won gold in the 200-meter individual medley at the Pan Pacific Championships. The accolades kept coming: Myers was named an all-American in several events and an N.C.A.A. Breakout Performer of the Year and swam for the United States national team. But barely a year later, she floundered badly at the 2007 long-course championships, making the finals in only one event. For weeks before that, her performance in practices had been miserable: slow times, inert form. “I remember standing behind the starting blocks at the pool and thinking, ‘I don’t want to be here,’ ” she says. “I felt terrible, mentally and physically.” While trying to build on her breakthrough season, she had pushed too hard. She had overtrained. She was, for a while at least, finished as a swimmer.

To review article, see http://www.nytimes.com/2008/03/02/sports/playmagazine/02play-physed.html?pagewanted=1&_r=1&ei=5087&em&en=2d0368311cacfd34&ex=1204606800

HEALTH
Myth Meets Science

By Jeneen Interlandi | NEWSWEEK
Feb 25, 2008 Issue

Everybody’s talking about human growth hormone, and lots of people are using it. But what does it do?

Link: http://www.newsweek.com/id/112768

Link: http://www.2theadvocate.com/features/16014967.html?showAll=y&c=y

This was from a newspaper in Louisiana and since it was talking about a link from diabetes and HCM, which I’m not aware of any specific link between, there may be some young athletes who hear about this and get concerns. So here is the source.

Cardiologists say heart condition that took the life of female athlete is usually genetic
By JOHN BOYD
Advocate staff writer
Published: Feb 27, 2008 - Page: 1E
The heart condition which caused the death of a Glen Oaks girls basketball player Feb. 18 is usually genetic and is not related to juvenile diabetes, local cardiologists say.

An initial East Baton Rouge Parish Coroner’s Office statement stopped short of definitively linking hypertrophic cardiomyopathy and diabetes, but said diabetes likely exacerbated the effects of the heart problem which killed Shannon Veal during a playoff basketball game.

Pediatric cardiologist Dr. Michael Crapanzano received about 50 phone calls in the two days following Veal’s death during a playoff basketball game.

Many were parents concerned their children’s diabetes could lead to sudden heart failure.

“There has been a lot of panic,” Crapanzano, of Pediatric Cardiology Associates of Our Lady of the Lake, said.

Crapanzano said diabetes poses its own cardiac risks, but patients with diabetes have no greater risk of developing hypertrophic cardiomyopathy than the general population.

Hypertrophic cardiomyopathy (HC) causes the wall separating the lower chambers of the heart to unnaturally expand from about .8 centimeters to as much as 6 centimeters until eventually it chokes off the supply of blood to the body.

“Over time, the thickening gets worse and worse until you have an event,” Crapanzano said. “In about a third of those cases the event is death.”

The condition is treatable by medication, pacemaker, defibrillator implant or, in severe cases, a controlled heart attack known as an alcohol septal ablation, Baton Rouge General Chief of Cardiovascular Services Steven Kelly said.

Hypertrophic cardiomyopathy is sometimes confused with “athlete’s heart,” a natural enlargement of the heart muscle caused by repeated participation in vigorous exercises, such as swimming, rowing or running.

The enlargement allows the heart to pump more oxygen-rich blood to the body with each beat.

A primary difference between athlete’s heart and HC is the extent to which the heart wall thickens.

In a teenager with athlete’s heart, the wall may only expand to about 1.4 centimeters, Crapanzano said. The growth is uniform across the wall and fades soon after the athlete stops his or her regular regimen.

In HC, the thickening centers on the septum dividing the two chambers, slowly choking off the blood supply.

The condition often renders the heart unable to re-sync when arrhythmias throw the natural heartbeat out of whack.

The result is severe chest pains, loss of consciousness or even death.

Because the potential for arrhythmias is so high for athletes competing in strenuous sports such as basketball and football, doctors will not clear an athlete to participate in these kinds of activities following a diagnosis of HC, Kelley and Crapanzano concurred.

Kenny Henderson, commissioner of the Louisiana High School Athletic Association, said his organization does not require an HC screen as part of an athlete’s annual physical.

The condition’s presence is likely to sound an alarm during the exam though, Kelley said.

“If they have a murmur they can detect that,” Kelley said, “but not only in the physical part but during the medical history. Do they have any chest pains? Shortness of breath? Is there a history of anyone dying early in their family? Do they ever black out?”

Such red flags get an athlete automatically sent to Crapanzano for further exams.

Crapanzano said he receives about 250 red flag cases from the general student population each year; about 50 are athletes.

His specialized screening process turns up only one or two cases of HC each year, he said.

The screening may miss minor cases of HC, he said, but regular check-ups are likely to eventually root out the problem.

“There are subtle things you look for,” Crapanzano said. “It just takes time sometimes to manifest itself, but the subtle ones aren’t the ones that die

From David in Madison :

From the New York Times, 2/17/08 Click here for the Microsoft Word file.

From the Morning Edition, 2/21/08 Click here for the Microsoft Word file.

Thursday, Feb. 14, 2008
Little Athletes, Big Injuries

It ought to be hard to take the fun out of play, but if you’re an overambitious parent or coach with a young athlete in your charge, you may have managed to do it. Weekly sessions of intensive muscle-strengthening, grueling push-up regimens and long intervals on fast-paced treadmills are becoming common for grade-school kids. Elite training centers that promise to give young athletes an edge during the off-season have been popping up since 2000, especially in affluent sections of New England and the Midwest.

To sports-medicine professionals, that’s a worrying trend. Hard-core training can do kids more harm than good–particularly if they’re under 12. As more children are pushed beyond their physical limits, sports injuries once reserved largely for the pros are turning up in the playground set.

A young body that’s worked too hard can suffer in a lot of ways, but it’s the bones that take the worst pounding. Activities like skating uphill on a Plexiglas surface, which allows skaters to strengthen their strides, or doing the explosive muscle-building movements known as plyometrics can wreak havoc on the skeletal system, particularly the epiphyseal plate, or growth plate, which is essential in bone development–a process that is not complete until the late teens.

Harming a plate before a child hits puberty can affect the way the bones grow. “I saw one kid who was asked to do multiple plyometric jumps through the pain, and he pulled a growth plate off his knee,” says Dr. Jordan Metzl, a member of the American College of Sports Medicine’s youth sports committee. “Another kid tore a piece of plate off his hip from using too high weights while lunging and squatting.”

There are other problems as well. Tommy John ligament surgery, an elbow procedure named after the Los Angeles Dodgers pitcher who was the first to undergo it, used to be limited to players in their 20s and older, but it is now performed on kids as young as 12–not surprising if they started pitching excessively at age 8 or 9. Similarly, stress fractures in the backs of middle-school football and soccer players have nearly doubled over the past decade as a result of overtraining.

No one is saying that kids shouldn’t play sports or even that they shouldn’t train. But “you shouldn’t be training a 9-to-12-year-old to be a superstar,” says Dr. Michael Bergeron of the Medical College of Georgia. “You should be thinking down the road so they can be that superstar at 18.” That’s what some training centers are now aiming to do. The coaches at BlueStreak Sports Training in Stamford, Conn., for example, assess each athlete’s risk for knee injury, paying particular attention to girls, who are six times as likely as boys to injure their knees for a number of reasons, including basic anatomy, muscle strength and hormonal differences. The most vulnerable athletes are then required to wear a bracelet while training as a warning to coaches to take it slow.

But the biggest adjustment will have to be a psychological one: persuading coaches with unrealistic performance standards and parents with the means to pay an average of $900 for a six-week training session that they must back off and put the health of the child first. “Sports used to be this wonderful even playing field,” says Regan McMahon, a writer for the San Francisco Chronicle who has covered the professionalization of youth sports. “Now it’s the rich kids who make the team. It’s the upper-middle-class parents who can afford all of these supplemental programs.”

In fairness to the grownups, the kids themselves need to relax too. “I’m a kid who stays focused and works hard,” says Connor Humphrey, an earnest 14-year-old football and lacrosse player in New Canaan, Conn. “I have goals for the future. I want to play lacrosse at Duke.” That dream is commendable, but while pushing young bodies to the limit may mean more time in the game, it can just as easily mean a lifetime on the bench