Sports Medicine Notes

Sports Medicine Overview

  • Presenter: Joseph Garry, MD, FACSM, FAAFP, Professor and Head, Department of Family & Community Medicine, University of Illinois College of Medicine, Rockford.

  • Conflict of Interest: All individuals involved in content control for this session have disclosed no relevant financial relationships.

Learning Objectives

  • Cite clinical recommendations related to the pre-participation exam (PPE).

  • Review medical conditions in athletes:

    • Cardiac issues: Understanding conditions like Hypertrophic Cardiomyopathy and Marfan’s syndrome.

    • Other conditions: Exercise-Induced Bronchoconstriction (EIB), Mononucleosis, Heat illness, Skin infections, Concussion, and the Female Athlete Triad.

  • Cite sports-related injury rates in high school athletes.

  • Study sports-related musculoskeletal injuries:

    • Anterior shoulder dislocation

    • ACL injury

    • Ankle sprain

Objectives of the PPE

  • Primary Objectives:

    • Screen for life-threatening or disabling conditions.

    • Identify conditions that may predispose athletes to injury or illness.

  • Secondary Objectives:

    • Assess general health.

    • Entry point to healthcare for adolescents.

    • Start discussions on health-related topics.

Clinical Recommendations for PPE

  • Vital Screening:

    • Assess exertional symptoms, heart murmurs, family history of cardiac issues, and symptoms of Marfan’s.

  • Recommended Blood Pressure Guidelines:

    • Athletes with systolic BP < 160 and diastolic BP < 100 may participate.

  • Asthma Management:

    • Well-controlled asthma does not restrict participation.

  • Screening Tests:

    • Routine blood and urine tests are not recommended for asymptomatic athletes.

Cardiac Screening in Young Athletes

  • 14-Element Cardiovascular Screening Checklist includes:

    • Personal and family history of cardiac issues.

    • Physical examination for heart murmur and stigmata of Marfan syndrome.

  • Screening ECG: Not routinely recommended unless questionnaire is positive.

Common Causes of Sudden Cardiac Death (CSD) in Athletes

  • Predominantly affects athletes aged <35.

  • High-Risk Groups: Male sex, black race, and basketball players.

  • Common Causes: Hypertrophic cardiomyopathy, coronary artery anomalies, and myocarditis.

Concussion Management

  • Symptoms: Headache, dizziness, confusion.

  • Management Protocol:

    • Initial physical and cognitive rest post-injury (24-48 hours).

    • Gradual return to activities; no same-day return to play.

  • Risk Factors for SRC: Contact sports, previous concussions, gender, and age.

Sports-Related Injury Overview

  • Most Common Injuries:

    • Anterior shoulder dislocations (70% are traumatic).

    • Ankle sprains (80% lateral sprains).

    • ACL tears (70% non-contact injuries).

  • Injury Prevention: Neuromuscular training can significantly reduce injuries.

Female Athlete Triad

  • Components: Low energy availability, menstrual dysfunction, osteoporosis.

  • Multidisciplinary Approach: Involves medical providers, dietitians, and mental health professionals.

  • Screening: Should occur during PPE or annual exams.

Treatment of Ankle Injuries

  • Main Types of Sprains: Lateral, syndesmotic (high), and medial sprains.

  • Immediate Management: Rest, ice, elevation, and protection.

  • Rehabilitation: Early range of motion improves recovery.

Infections in Sports

  • Types: Bacterial, viral, or fungal infections.

  • Precautions: Athletes with infections should not participate until treated adequately.

Conclusion

  • Continued education and awareness around sports medicine is crucial to protect athletes’ health and facilitate effective participation in sports activities.

Sources:

  • American Academy of Family Physicians (AAFP)

  • Circulation Journals

  • British Journal of Sports Medicine (Br J Sports Med)

  • Clinical Journal of Sports Medicine