AMSSM Sports Medcasts

Journal Club Podcast - Returning to Play from COVID

Drew Watson, MD, MS, joins host Nate Milburn, MD, MBA, on a special episode of the AMSSM Journal Club Podcast to apply knowledge of several articles toward a common issue we’re all experiencing — COVID-19.

It has been an unusual year for all healthcare providers, and there have been some additional, unique issues that have presented themselves in the sports medicine world. The majority of this episode focuses on what the pandemic has inflicted on the physical and mental wellbeing of patients and how sports medicine physicians can guide them back safely to activity.

Resources:

CDC Exercise Guidelines: https://www.cdc.gov/physicalactivity/basics/adults/index.htm

The Relation of Physical Activity and Exercise to Mental Health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1424736/pdf/pubhealthrep00100-0085.pdf

Relative Energy Deficiency in Sport (RED-S) and Female Athlete Triad Articles from the AMSSM 120: http://amssm.blogspot.com/p/top-100-female-athletic-triad.html

CRN Spotlight - ORCCA Registry with Drs. Jon Drezner and Kim Harmon

On this episode of the AMSSM CRN Spotlight Podcast, host Dr. Jeremy Schroeder, DO, is joined by BJSM Editor-in-Chief Dr. Jonathan Drezner, MD, FAMSSM, and Kimberly Harmon, MD, FAMSSM, who are both Past Presidents of AMSSM.

In this 23-minute conversation, Drs. Drezner and Harmon discuss the Outcomes Registry for Cardiac Conditions in Athletes (ORCCA) national registry and address the following topics:

• Details about the ORCCA registry, what makes it unique and why it was created
• The early findings of the registry and what they mean for team physicians and athletic trainers
• How this study and others are impacting return-to-play decisions after COVID
• The current recommendations regarding cardiac imaging in athletes
• Finding the right balance in our professional and personal lives

Resources:

SARS-CoV-2 Cardiac Involvement in Young Competitive Athletes

Telehealth and Sports Medicine with Dr. Crystal Wong

On this episode of the AMSSM Sports Medcast, host Ashwin Rao, MD, FAMSSM, is joined by Dr. Crystal Wong, MD, a family medicine physician at the University of Washington and an Associate Medical Director at UW Neighborhood Clinics. She was instrumental in developing and implementing telemedicine services at the University of Washington during the COVID-19 pandemic, when UW saw a 29,000 percent increase in telemedicine visits.

In this 22-minute conversation, Dr. Wong discusses her experience with telehealth services and addresses the following topics:

• What do you see as the benefits of telemedicine in primary care and how might translate to other disciplines?
• What are some of the challenges and barriers of telemedicine?
• What types of visits are most amendable to the telehealth format?
• What about efforts to replicate a physical exam virtually?
• What are the challenges of administering telemedicine across state lines?
• Will telemedicine continue to have a prominent role in practice after the pandemic?
• What advice does she have for sports medicine providers interested in pursuing telemedicine services?

Resources:

Telemedicine Management of Musculoskeletal Issues - American Family Physician (aafp.org)

CRN Spotlight – Dr. John Leddy

In 2017, John Leddy, MD, FAMSSM, led a team of researchers that received the first AMSSM CRN $300,000 Multi-Site Research Grant, which supports quality, multi-site research to address key priority areas within the field of sports medicine.

Christina Master, MD, and William Meehan III, MD, served as co-principal investigators for the research project titled “Sub-symptom aerobic exercise therapy to improve recovery from acute sport-related concussion: A randomized controlled trial.”

On the inaugural CRN Spotlight podcast, Dr. Leddy discusses his research with Dr. Jake Wessels, and answers the following questions:

• What did your research entail, and why did you choose to apply for CRN funding?
• How did you initially come to the idea for these research efforts?
• What are some of the findings regarding this study?
• How did you go about collecting the data for this research?
• Can this research provide guidance for clinicians when it comes to return-to-play considerations?
• Are there aspects to this grant funding that are unique to the CRN, compared to other funding opportunities?

Learn more about Dr. Leddy’s research, which is unpublished as of this episode’s release: https://www.amssm.org/amssm-awards-$300000-rese-p-219.html?StartPos=&Type

Resources:

Bezherano I, Haider MN, Willer BS, Leddy JJ. Practical Management: Prescribing Subsymptom Threshold Aerobic Exercise for Sport-Related Concussion in the Outpatient Setting. Clin J Sport Med. 2020 Feb 13. doi: 10.1097/JSM.0000000000000809. Epub ahead of print. PMID: 32058454.

Leddy JJ, Haider MN, Ellis MJ, Mannix R, Darling SR, Freitas MS, Suffoletto HN, Leiter J, Cordingley DM, Willer B. Early Subthreshold Aerobic Exercise for Sport-Related Concussion: A Randomized Clinical Trial. JAMA Pediatr. 2019 Apr 1;173(4):319-325. doi: 10.1001/jamapediatrics.2018.4397. PMID: 30715132

Leddy JJ, Haider MN, Ellis M, Willer BS. Exercise is Medicine for Concussion. Curr Sports Med Rep. 2018 Aug;17(8):262-270. doi: 10.1249/JSR.0000000000000505. PMID: 30095546; PMCID: PMC6089233.

CMO Corner - Dr. John DiFiori

This episode of the CMO Corner podcast features Dr. John DiFiori, a Past President of AMSSM and the Director of Sports Medicine of the National Basketball Association. Dr. Ashley Austin spoke with Dr. DiFiori in early December of 2020, leading up to the start of the 2020-21 NBA season. They talk about his role as Sports Medicine Director of the NBA, some of the lessons and takeaways from last year’s “bubble season” and much more.

For a full transcript of this episode, check out the December 2020 edition of The Sideline Report newsletter: https://www.amssm.org/NewsletterPDFS/December2020-84.pdf

CMO Corner - Dr. Margot Putukian

This episode of the CMO Corner podcast features Dr. Margot Putukian, a Past President of AMSSM and the Chief Medical officer of Major League Soccer. Host Dr. James MacDonald spoke with Dr. Putukian in July of 2020, just days before the start of the MLS is Back Tournament in Orlando, Florida. They discuss her role as CMO in this unique season, the most rewarding parts of her position and much more.

For a full transcript of this episode, check out the September 2020 edition of The Sideline Report newsletter: https://www.amssm.org/NewsletterPDFS/September2020-82.pdf

 

An In-Depth Discussion on Exertional Heat Illness with Dr. Doug Casa and Dr. Fran O’Connor

On this week’s podcast, Dr. Douglas Casa PhD, ATC and Dr. Francis O’Connor MD, MPH, FAMSSM join Dr. Seth Smith MD, PharmD on AMSSM’s Sports Medcast to discuss exertional heat illness with an emphasis on exertional heat stroke.

 

In this conversation, Dr. Casa and Dr. O’Connor will address the following topics:

• What is the basic paradigm for the prehospital care of exertional heat stroke (EHS)?
• How to develop a thorough emergency action plan (EAP) for recognition and management of EHS?
• What steps can be taken to help reduce the occurrence of EHS?
• What future items may be used to help guide return to activity for patients who have suffered an EHS?

 

Dr. Casa is a Professor in the Department of Kinesiology, College of Agriculture, Health and Natural Resources, University of Connecticut where he serves as the Chief Executive Officer of the Korey Stringer Institute.  He leads a team of experts who study sport safety, sudden death in sports, and exertional heat illness/exertional heat stroke.  He has published over 200 peer-reviewed publications/book chapters, presented over 400 times, and has been a lead or co-author on over 15 position/consensus statements on exertional heat illness/sudden death. He is widely recognized as one of the leading authorities worldwide on exertional heat illness.

 

Dr. O’Connor is Professor and Chair, Military and Emergency Medicine and Associate Director for Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences where he leads sports performance and sports medicine research for over 20 years.  He has authored over 75 peer-reviewed publications/book chapters, been on the board of American College of Sports Medicine and former president of the American Medical Society for Sports Medicine. He is a Colonel in the United States Army and graduate of the United States Military Academy at West Point.

 

 

National Athletic Trainers’ Association Position Statement on Exertional Heat Illness

Casa DJ, DeMartini JK, Bergeron MF, et al. National Athletic Trainers’ Association position statement: Exertional heat illnesses. J Athl Train. 2015; 50 (9): 986-1000.

 

Consensus Statement: Prehospital Care of Exertional Heat Stroke

Belval LN, Casa DJ, Adams WM, et al. Consensus statement – Prehospital care of exertional heat stroke. Pre Emer Care. 2018; 22 (3): 392-397.

 

American College of Sports Medicine: Roundtable on Exertional Heat Stroke

O’Connor FG, Casa DJ, Bergeron MF. American College of Sports Medicine roundtable on exertional heat stroke – Return to duty/return to play: Conference proceedings. Curr Sports Med Rep. 2010; 9 (5): 314-321.

Cardiac Concerns in College Sport with Drs. Jon Drezner and Michael Ackerman

What is COVID myocarditis and how strong is the data to create a link between COVID and potential arrhythmias? Was COVID myocarditis the leading factor in the recent decisions of some American athletic conferences to shut-down the fall sports season? What are the criteria to start participation again?

On this episode of the AMSSM Sports Medcast, host Devin McFadden, MD is joined by sports medicine physicians and internationally renowned experts on Sports Cardiology Jonathan Drezner, MD, FAMSSM and Michael Ackerman, MD, who have both been influential in the debate on whether a Collegiate Athletic season can safely occur in the midst of the ongoing COVID-19 Pandemic.

Dr. Jonathan Drezner is a Professor from the Department of Family Medicine and Director of the University of Washington Center for Sports Cardiology, past president of the AMSSM, team physician for the Seattle Seahawks, UW Huskies, and OL Reign and deputy editor of the BJSM. Dr. Michael Ackerman is a Professor of Medicine, Pediatrics, and Pharmacology at the Mayo Clinic College of Medicine and Science. He is the Director of the Windland Smith Rice Genetic Heart Rhythm Clinic and Windland Smith Rice Sudden Death Genomics Laboratory, as well as the president of the Sudden Arrhythmia Death Syndromes (SADS) Foundation.

In this 40 minute conversation Drs. Drezner and Ackerman addressed the following topics:

• What is COVID myocarditis and why is it so concerning?
• How strong is the link between COVID-19 and was this a driving factor in the cancelling of the FALL sports season by some collegiate conferences?
• What metrics need to be satisfied in order to safely return to play, and will that occur this year?

Health and Well Being Considerations for PAC-12 Institutions: Guidance for Local Planning for Return to Sporting Activity https://xs.pac-12.com/2020-08/Pac-12%20Covid-19%20Return%20to%20Play%20Considerations%2008.10.2020.pdf Puntmann VO, Carerj ML, Weiters I. Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19) https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916 Baggish A, Drezner JA, Kim J, et al. Resurgence of sport in the wake of COVID-19: cardiac considerations in competitive athletes https://bjsm.bmj.com/content/early/2020/06/18/bjsports-2020-102516 Maron BJ, Zipes DP, Kovacs RJ, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: a scientific statement from the American Heart Association and the American College of Cardiology. Copublished in Circulation and the Journal of the American College of Cardiology 2015. https://www.acc.org/~/media/fb92803045d249ae91b715650dd0ebe4.pdf Pelliccia A, Solberg EE, Papadakis M, et al. Recommendations for participation in competitive and leisure time sport in athletes with cardiomyopathies, myocarditis, and pericarditis: position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology (EAPC). European Heart Journal 2019;40:19.

https://academic.oup.com/eurheartj/article/40/1/19/5248228

AMSSM Journal Club Podcast - Returning to Learning Following a Concussion

In this Journal Club Podcast episode, host Dr. Julia Kammel speaks with Dr. John Leddy about "Returning to Learning Following a Concussion", which was published in Pediatrics.

Original Article:

https://pediatrics.aappublications.org/content/132/5/948

Ketogenic Diet – Fad or Future?

Host Dr. Chris Hicks is joined by AMSSM Past Presidents Dr. John DiFiori and Dr. Jon Divine to discuss the ketogenic diet and how it affects athletes and their performance.

In this entertaining podcast, we will be discussing the following topics:

• What is a Ketogenic Diet?
• What are the ratios of fats, carbohydrates and proteins that define the Ketogenic Diet?
• What does the high-fat content in Ketogenic Diet mean for athletes’ overall health?
• Are there any negatives that accompany this diet?
• Does the Ketogenic diet offer any enhancements in athletic performance?
• What are the overall recommendations for athletes and Ketogenic Diet?

REFERENCES:

Hyun-seung Rhyu, et al. The effects of a ketogenic diet on oxidative stress and antioxidative capacity markers of Taekwondo athletes. Journal of Exercise Rehab. 2014;10(6):362-366.

Seidelmann, Sara B. et al. Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis. Lancet Public Health. 2018(18)2468-2667.

Paoli, Antonio et al. Ketogenic diet does not affect strength performance in elite artistic gymnasts. Journal of the International Society of Sports Nutrition. 2012, 9:34.

Urbain, Paul et al. Impact of a 6-week non-energy-restricted ketogenic diet on physical fitness, body composition and biochemical parameters in healthy adults. Nutrition and Metabolism. 2017, 14:17.

Wilson, Jacob M. et al. The effects of ketogenic dieting on body composition, strength, power and hormonal profiles in resistance training males. Journal of Strength and Conditioning.

Holdsworth, David A. et al. A ketone ester drink increases postexercise muscle glycogen synthesis in humans. Medicine and Science in Sports and Exercise. 2017.

Burke, Louise M. et al. Low carbohydrate, high fat diet impairs exercise economy and negates the performance benefit from intensified training in elite race walkers. J. Physiol 000.00(2017) 1-23.