Current sports medicine reports
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Concussion is a physiological injury to the extremely complex and dynamic human brain. Individual variability adds to the challenge of concussion management, and sports medicine practitioners recently have begun to realize the need for an individualized approach. ⋯ This article reviews what is known or assumed about how some of these risk factors affect concussion. We conclude by providing several key concepts that we feel are important to keep in mind when managing an athlete with concussion.
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Postconcussion syndrome (PCS) is a constellation of physical, cognitive, and emotional symptoms that persist in a small percentage of patients who suffer from a concussion. There is significant debate regarding the definition and pathophysiology of PCS. This article reviews these controversies, the factors that may predict PCS, potential diagnostic and treatment options, and return-to-activity considerations for the sports medicine physician.
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Low back pain is a common presenting complaint to sports medicine providers. The lumbar spine is a complex anatomic structure with multiple potential pain generators. Epidemiologic studies have shown that the intervertebral disc is the most common pain generator in all patients with low back pain. ⋯ Facet pain can have different presentations, and pain emanating from other lumbopelvic structures can present similarly as facet joint pain. This article reviews the anatomy and biomechanics of the lumbar facet joints, presenting symptoms and physical examination findings seen with facet pain. We also will discuss diagnostic and treatment paradigms that are helpful to the clinician treating low back pain in athletes.
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Curr Sports Med Rep · Jan 2010
Concussion symptom scales and sideline assessment tools: a critical literature update.
Sports-related concussion remains a diagnostic and management challenge for the sports medicine practitioner. Numerous symptom scales and sideline assessment tools are available for team physicians and athletic trainers to objectively assess this difficult injury. The purpose of this article is to update the reader on literature published within the past year relevant to concussion symptom scales and sideline assessment tools. ⋯ Many tools remain based more on expert opinion than rigorous scientific evaluation. A multifaceted approach to sports concussion is advised. The sports medicine practitioner must not rely on any one tool in managing concussion and must be aware of the strengths and limitations of whichever method is chosen to incorporate into a concussion evaluation and management plan.
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Curr Sports Med Rep · Nov 2009
ReviewA review of viscosupplementation for osteoarthritis of the hip and a description of an ultrasound-guided hip injection technique.
Viscosupplementation of the hip for symptomatic osteoarthritis appears to be safe and effective in more than 25 yr of use in Europe. More than 11 studies suggest that viscosupplementation in the hip is as effective as viscosupplementation in the knee. It appears to be a safe and reasonable alternative to nonsteroidal antiinflammatory drugs or intra-articular steroids for the treatment of osteoarthritis pain. ⋯ Viscosupplementation in the hip appears to work better in patients with fewer radiographic changes of osteoarthritis. Placement of viscosupplement in the hip under real-time ultrasound or fluoroscopic guidance is safe and well tolerated. Hip joint communication with the iliopsoas bursa may be a factor in studies of the effectiveness of viscosupplementation in the hip.