Why I Like The King-Devick Concussion Tool

I really like the King Devick rapid number naming testas part of a comprehensive concussion assessment program. We find it to be easy, fast, reliable, and with a large amount of independent scientific studies vouching for its validity. At the high schools I work with we use the King Devick in our preseason concussion baseline assessment and then use it as a part of our comprehensive evaluation for in-game concussions. I’d recommend you consider using it too. (Neither I, nor Sideline Sports Doc have any financial relationship with the company).

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Questionable Science

Sensational headlines frequently drive viewership through social media and mainstream news outlets. In the world of sports health, research about diet, nutrition, exercise regimens, and even the long-term effects of childhood injury are frequently hijacked by the media to fuel their agenda. I’m going to deviate a bit from my typical blog post to highlight a few things to beware of when you are reading about scientific studies. The problem frequently stems from something called an “observational study” that claims to show cause and effect.

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Are Wealthier Kids at Higher Risk for Sports Overuse Injuries?

There are a number of factors that appear to be correlated with an increased risk of youth sports overuse injuries:

Single sport specialization prior to the age of 14
Playing that single sport more than eight months out of the year
Practicing and playing a combined number of hours per week more than your age in years
Conversely it appears that free unstructured play rather than organized sport lowers a child’s risk of overuse injury. Appropriate periods of rest from sport as well as limitation in participation hours per week also appear to reduce injury risk. Is it possible that children from wealthier households are at higher risk of developing overuse injuries than children from poor households? One recently published study suggests that household wealth may be correlated with overuse injury risk.

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New Treatment For Elbow Ligament Injury: Possible To Cut Rehab Time In Half

The ulnar collateral ligament in the elbow is a critical stabilizer, and one that gets stressed during the baseball pitch. We’ve seen a substantial increase in tears of the ulnar collateral ligament in all age groups but especially in teenage pitchers. The standard of care for those athletes choosing surgery is a ligament reconstruction commonly known as “The Tommy John” procedure. The traditional surgery has undergone refinements over the years and has a high success rate, but the downside is that return to competitive pitching takes more than a year, often around 16 months (that’s two seasons of sport…). But a new procedure offers the chance to potentially cut the rehab time and return to play time to less than half.

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Getting Strong Without Getting Hurt

Many injured athletes and other patients I see need to get stronger in order to improve their function or performance. But for many of these folks getting strong through traditional resistance based strength training might lead to pain, or be dangerous after surgery. I wrote a few weeks back about a technique called blood flow restriction training, in which strength gains are made through very low load resistance. I believe there is great benefit for athletes with painful conditions, or rehab after surgery.

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The Female Athlete Triad: An Under-recognized Sports Health Disorder

The female athlete triad is a potentially serious health condition typically affecting teenage girls and young women. It’s made up

of three key components (“the triad”):

Low energy availability, sometimes associated with an eating disorder
Abnormalities in the menstrual cycle
Low bone mineral density, sometimes leading to stress fractures or osteoporosis
As sports medicine doctors, we will often find that a young athlete first comes in to see us when she’s developed a stress fracture. The typical teenage athlete may hide conditions such as an eating disorder or abnormalities in her menstrual cycle from her friends, family, and coaches, so the stress fracture is often the thing that requires her to seek medical care.

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Lightning Safety For Outdoor Sports

The end of summer and early fall are some of the busiest times of the year for outdoor sports participation, and unfortunately this is also the time of year with the highest number of cloud-to-ground lightning strikes.  According to data from the National Oceanic and Atmospheric Administrationthere are about 25 million cloud-to-ground lightning flashes each year.  The highest number occurs in southeast Florida and decreases towards the western United States.

Absolutely no practice or games outdoors during active lightning storms.
“When the thunder roars, go indoors”.  Play should not resume until at least 30 minutes after the last sound of thunder or flash of lightning.

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Be On The Lookout For Anxiety In Young Athletes

According to the National Institute for Mental Health, it’s estimated that about 32% of all adolescents in the U.S. have some form of anxiety and about 8% have what would be classified as severe anxiety. It shouldn’t be surprising then that the estimates for anxiety disorders in young athletes is also high. While there are only a limited number of high quality studies about anxiety specific to the athletic population, it’s still estimated that more than 30% of collegiate student-athletes have experienced overwhelming anxiety.

The good news is that when anxiety and depression are recognized, they can be successfully treated and lead to substantial improvements in quality of life.

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Making The Game Day “Go” Or “No Go” Decision

The decision whether an athlete should be allowed to play or should sit out after injury is always an interesting one to observe from afar. These decisions are particularly difficult for team physicians at the professional level when there is a critical need for an athlete to compete, as I wrote about last week with Egyptian soccer player Mo Salah. (I got that one wrong…).

I’d like to outline below the basic framework that a team physician would take when making this decision. These principles were nicely outlinedin an article co-authored by my former Stanford partner, Dr. Gord Matheson.

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Coming Back From: Shoulder Separation (Egypt’s Eyes Are On Mo Salah)

This week I’ll offer up some pre-World Cup injury recovery info, inspired by Egypt/Liverpool brilliant playmaker Mo Salah. There’s been much speculation about the nature of Salah’s recent shoulder injury, and I haven’t been able to find a clear diagnosis in publicly available sources. But if I had to guess (and this is a pure guess), given the way the injury occurred and the evaluation from the physician in the accompanying photo, I’d say he likely sustained a shoulder separation.

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