With proper training and safety precautions, windsurfing is relatively safe, but its unique equipment and unpredictable environmental conditions can produce serious injuries. Clinicians may see fall-related ankle injuries, tarsometatarsal injuries, or anterior shoulder dislocations; chronic low-back pain from torso stress; skin lacerations; and…

People who participate in regular vigorous or strenuous physical activities undergo significant changes in cardiac structure and function. Occasionally, these changes may be confused with those of hypertrophic cardiomyopathy (HCM). Differentiating between athletic heart syndrome and HCM requires careful examination. ECG and echocardiograms may be…

Describes a quick, simple tie-through suture technique (in which a collodion packing is secured to the auricle with two buttons) for preventing cauliflower ear following external ear trauma in wrestlers and boxers. The technique ensures constant compression; multiple treatments for fluid reaccumulation are rarely necessary. (SM)

Presents a case conference by 2 experts on the relationship between a 26-year-old marathoner's amenorrhea and her sustained unusual stress fractures in 4 ribs (plus previous similar fractures of the calcaneal, navicular, metatarsal, and tibial bones). The experts conclude that she suffers many manifestations of overtraining. (SM)

The prevalence of artificial playing surfaces and the use of shoes on football fields is associated with increased incidence of turf toe. Artificial turf decreases shock absorption, and lightweight shoes do not provide adequate support. Treatment is recommended because of the potential for long-term sequelae including hallux rigidus. (SM)

Athletes with type 1 diabetes require frequent blood glucose checks throughout the day and intensive diabetes management to balance insulin, carbohydrate intake, and the effects of exercise. Effective care begins with a targeted preparticipation examination. Decreasing insulin dosage may be necessary for heavier exercise programs. Analysis of…

The amount of protein needed by athletes is an area of controversy. Some researchers are studying the claims that protein supplements stimulate muscle growth. Others are examining the protein needs of endurance and strength athletes. However, few studies have controlled for the right mix of nutrition and exercise variables. (Author/SM)

Presents statistics on injury patterns in youth sports, recommending that physicians who care for young athletes understand the kinds of injuries likely to be sustained. Awareness of injury patterns helps medical professionals identify variables associated with injury, anticipate or prevent injuries, plan medical coverage, and compare individual…

Reviews causes and treatment of heat syncope, heat exhaustion, and exertional heatstroke and discusses the effectiveness of cooling heatstroke victims in ice versus cooled water. Cooled water appears to be as effective, though ice water decreases the incidence of cardiovascular complications. An energy depletion model is presented. (Author/SM)

Describes the scope and importance of gastrointestinal bleeding in runners and other athletes, discussing causes, sites, and implications of exercise-related bleeding. Practical tips to mitigate the problem, potentially more troublesome in women because of lower iron stores, are presented (e.g., gradual conditioning and avoidance of prerace…

Regular exercise training results in a variety of cardiovascular adaptations including increases in left ventricular chamber size and wall thickness, and in resting vagal tone. Research has demonstrated that the changes are physiologic and are associated with preserved or enhanced cardiovascular function. (Author/JD)

Discusses the use of performance-enhancing substances in athletics, focusing on the use-detection race, burgeoning new products and off-label uses, and ways to combat the problem. The article suggests drug education programs, particularly those for adolescent athletes, have the potential to change behavior and be more cost-effective than further…

Preventing infectious disease in sports is fundamental to maintaining team effectiveness and helping athletes avoid the adverse effects of illness. Good hygiene, immunization, minimal exposure to specific diseases, and certain prophylactic measures are essential. Teammates, coaches, trainers, officials, healthcare providers, and community public…

Describes infectious mononucleosis (IM), examining viral transmission and infection, clinical features, diagnosis, and management. Focuses on answers to several commonly asked questions about IM in sport (e.g., when it is safe to resume sports after IM, how often fatigue or depression are related to earlier bouts of IM, and how often IM is…

Presents exercise guidelines for elderly individuals, noting that people of all ages receive physical and emotional benefits from appropriate exercise programs. These programs must be carefully evaluated for each individual's physical limitations; type of exercise, as well as its frequency, duration, and intensity, must be considered. (SM)