Sports Medicine for All
Introducing Our New 'Practice Essentials' Series
THE PHYSICIAN AND SPORTSMEDICINE - VOL 29 - NO. 8 - AUGUST 2001
The field of sports medicine offers a model of multidisciplinary healthcare that needs to be shared with the world. And, as we know, there are areas within clinical medicine that lack rigorous evidence or even consensus to guide our treatment approaches. That's where applying a sports medicine model can help in diagnosing and treating common conditions—and is the focus of our latest series, "Practice Essentials," which we launch this month with "Managing Low-Back Pain: Steps to Optimize Function and Hasten Return to Activity."
Series editors Kim Harmon, MD, and Aaron Rubin, MD, have compiled a collection of articles covering a wide array of common musculoskeletal and medical topics for which exercise and sports participation guidelines are typically lacking. Upcoming topics include ankle sprain, menstrual irregularities, clavicle injury, abdominal pain, skin conditions, and upper-respiratory infections. The articles are especially geared toward our many readers who have limited sports medicine experience but whose patients have countless sports medicine concerns. Those well-versed in sports medicine will also benefit from the practical clinical advice and return-to-play guidance.
Articles will cover evidence-based approaches to the diagnosis, treatment, and return-to-play decisions that are so subjective yet important, but they will also offer practical guidelines based on accepted practice and expert opinion. Patient handouts are also planned to run with the articles, supplying even more helpful information (see this month's version).
Recognizing the considerable subjectivity in making decisions regarding return to play, the series will highlight this aspect of treatment. What are known factors that govern these decisions? What represents common sense? How does the physician make the decision? Do circumstances related to the timing of practice and competitions influence these decisions? What are risky decisions in terms of returning to sport too quickly? Which are benign decisions where the worst-case scenario is slow recovery but the risk for short- and long-term health is minimal to nil? How consistent are we in our approaches?
In my practice I'm often reminded of the lack of rigor surrounding return-to-play decisions. I remember covering an Olympic hockey game in which one of our players sustained a severe concussion. After receiving a CT scan of the brain, he was admitted to the hospital by a neurosurgeon. The next morning he was discharged with the recommendation that he not participate in contact sports for 2 weeks. The player told the neurosurgeon the next game was against the Soviets. The neurosurgeon said, "When is the next game?" The player replied, "In 2 days." And with that the neurosurgeon replied, "You should be fine by then!"
Drs Harmon and Rubin have done a fantastic job in selecting expert authors and in shaping the series. The articles will be succinct, clinically relevant, and very informative. We know you'll enjoy this series and look forward to your comments and suggestions.