Current sports medicine reports
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Piriformis syndrome is a nondiscogenic cause of sciatica from compression of the sciatic nerve through or around the piriformis muscle. Patients typically have sciatica, buttocks pain, and worse pain with sitting. They usually have normal neurological examination results and negative straight leg raising test results. ⋯ For recalcitrant cases, corticosteroid and botulinum toxin injections may be attempted. Ultrasound and other imaging modalities likely improve accuracy of injections. Piriformis tenotomy and decompression of the sciatic nerve can be done for those who do not respond.
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Exertional heat stroke (EHS) is a clinical syndrome of hyperthermia, encephalopathy, and multiorgan dysfunction that can be irreversible and fatal. While prompt recognition and immediate, aggressive total body cooling can prevent progression of the clinical syndrome, even a short delay can exacerbate the effects of hyperthermia-induced changes. ⋯ Furthermore normalizing the body temperature of patients with EHS, especially when hyperthermia recognition and total body cooling are delayed, may not prevent SIRS and its clinical consequences. This narrative review focuses on the inflammatory response behind the pathway leading to EHS-associated organ pathology and recommends a new insight to possible clinical interventions beyond whole body cooling.
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The physician who cares for athletes and physically active patients will encounter various headache syndromes. These symptoms can be debilitating and result in a spectrum of time away from the patient's exercise routines to death. Knowing key symptoms and signs of headache syndromes may lead to faster recovery and be rewarding for both the patient and physician. This article reviews major headache syndromes and their treatment, with attention to those found in patients who participate in competitive sports and lead active lifestyles.
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Chronic traumatic encephalopathy (CTE) has received widespread media attention and is treated in the lay press as an established disease, characterized by suicidality and progressive dementia. The extant literature on CTE is reviewed here. There currently are no controlled epidemiological data to suggest that retired athletes are at increased risk for dementia or that they exhibit any type of unique neuropathology. ⋯ Despite claims that CTE occurs frequently in retired National Football League (NFL) players, recent studies of NFL retirees report that they have an all-cause mortality rate that is approximately half of the expected rate, and even lower suicide rates. In addition, recent clinical studies of samples of cognitively impaired NFL retirees have failed to identify any unique clinical syndrome. Until further controlled studies are completed, it appears to be premature to consider CTE a verifiable disease.