Welcome to the highlights and the review of the AWESOME articles and case reports published over the last quarter in Current Sports Medicine Reports (CSMR). This past quarter for CSMR was amazing. I was going through the articles and cases that were published and on my first review I selected almost all of them. While this is a great problem to have, it would make this quarterly highlight too long, so I went back and selected what I thought were the best of the best.

Four highlighted section articles from the past quarter:

Oxygen Straight to the Brain: An Overview of Hyperbaric Oxygen Therapy for a Variety of Brain Morbidities written by Leighton, VanHorne and Parsons. This is a very interesting topic to me as we are frequently asked about hyperbaric oxygen therapy (HBOT) by veterans and first responders who are participating in the The THRIVE Program here at the University of North Carolina, Chapel Hill. The authors do a great job explaining what HBOT is, how it works and what the current FDA indications are for HBOT. They then examine the use of HBOT for mTBI, PTSD and headaches. They present and critique the evidence that is out there and rightly state “hyperbaric therapeutic impacts for these in the acute and chronic or prolonged symptoms are elusive.” Cost and lack of sustained relief are two areas emphasized by the authors and they conclude that better studies are needed to provide high fidelity treatment metrics.

Adaptive Athlete Considerations for Races and Other Mass Participation Sporting Events written by Sedgley, et al. There is always a lot of discussion on emergency action plans (EAPs) and one thing I liked about this topic when the authors approached me was the singular focus on adaptive athletes. Both the number of adaptive athletes participating in sports and the number of sports available to adaptive athletes continues to rise. This is a population that has unique medical complications and risks from athletic participation that must be considered. The authors did a great job of using current EAPs and highlighting the specific needs of adaptive athletes.

Vigorous Exercise in Patients with Hypertrophic Cardiomyopathy written by Fox, et al. It always felt to me that we talked about hypertrophic cardiomyopathy (HCM) from the standpoint of you can’t miss this on the PPE -- sudden cardiac death = no sports. However, we never talked about what can we do for these patients, other than not let them play sports.  The authors do a great job reviewing the evolving data on the topic and emphasizing shared decision making with HCM patients to allow participation in health promoting activities. 

A Scoping Review of the Epidemiology, Management, and Outcomes of Golf-Related Fractures written by Chen, et al. We just had the US Open down the road a bit in Pinehurst and I wanted to highlight golfers and note that Donald Ross can make some challenging greens. I love the game of golf but can’t really play due to some injuries. When I did golf, I just hoped my shots landed on earth. Watching the pros try to land their ball in a 3 x 5-inch area from 300 yards away is impressive. I wanted to highlight this article that thoroughly reviews golf-related fractures, not just the pisiform bone.

Case Reports

Case reports are a great way to learn, whether it is some rare, uncommon condition or just a different presentation of a common problem. I would like to highlight three not-to-be-missed cases from the past quarter:

Ice Sheet Cooling in the Field Reduces Morbidity in Exertional Heat Stroke written by Willcox, Rhodehouse and DeGroot. I had the privilege to work with Dr. Dave DeGroot while in the military and the work that continues to come out of The Army Heat Center under his direction is saving lives. They are working to find and show evidence-based ways to decrease the morbidity and mortality related to heat stroke during military training. Ice sheets work!

Gluteus Maximus Distal Myotendinous Junction Tear in a Pickleball Player: A Case Report written by King, Johnson and Jelsing. I have a couple older patients who are very active and competitive playing pickleball -- I never thought you could get hurt playing it. This is an interesting case report about a 72-year-old male who injured his gluteus maximus playing pickleball. This is an interesting case with an excellent review of anatomy.

Ankle Pain Due to Pigmented Villonodular Synovitis written by Chambers, Carey and Silvis. This is a super interesting case that reminds us to create broad differential diagnosis. I will admit I have only seen pigmented villonodular synovitis a couple times in the knee and it wouldn’t have been on my initial differential, but it will be now.

CSMR is ACSM’s official monthly clinical review e-journal. Written specifically for physician and clinician members, CSMR articles provide thorough overviews of the most current sports medicine literature. ACSM physician members receive an online subscription to this journal as a member benefit.

Shawn F. Kane, MD, FACSM, is a family physician, professor in the Department of Family Medicine, and adjunct assistant professor in the Department of Exercise and Sports Science at the University of North Carolina (UNC) Chapel Hill. He received his medical degree from the Uniformed Services University of the Health Sciences and served in the U.S. Army for 27 years. While in the Army he spent more than 18 years serving as a physician-leader in numerous units within the US Army Special Operations Command. He is interested in sports medicine, concussion care, veterans’ health, and primary care of patients with post-traumatic stress disorder. Dr. Kane joined ACSM in 2003 and became a fellow in 2011. He currently serves as the editor-in-chief for Current Sports Medicine Reports, on ACSM’s Clinical Sports Medicine Leadership Committee, ACSM’s Health & Fitness Summit Program Committee, and ACSM’s Program Committee. Outside of the office, Dr. Kane enjoys hanging out with his Leonbergers (big furry, cute German Mountain dogs), as well as working out and traveling.