April 2019 Primary Care Sports Medicine Journal Roundup
The American Journal of Sports Medicine (April 2019)
The risk of prolonged opioid use after arthroscopic shoulder procedures is 8.3%, and it is higher among women and among those with greater opioid use in the early postoperative period, mental health conditions, substance dependence and abuse, and preexisting pain disorders
Nonoperatively treated (85%) and operatively treated (72%) athletes successfully returned to the same sport without injury for at least 1 full season (P = .11).
Players sustaining a dislocation were significantly more likely to fail to return when compared with those sustaining a subluxation (26% vs 89%, P = .013).
Among patients with chronic gluteal tendinopathy and a length of symptoms >15 months, a single intratendinous LR-PRP injection performed under ultrasound guidance results in greater improvement in pain and function than a single CSI.
The improvement after LR-PRP injection is sustained at 2 years, whereas the improvement from a CSI is maximal at 6 weeks and not maintained beyond 24 weeks.
The CES-D score indicated mild to moderate symptoms of depression in 48 (16.6%) and severe symptoms in 41 (14.1%) players
The GAD-7 score indicated an at least moderate generalised anxiety disorder in 24 (8.3%) players
Only a third of the 45 (15.7%) players who stated that they currently wanted or needed psychotherapeutic support received it!!
Physical activity declines modestly between adolescence and young adulthood
Athletes were often unable to achieve sleep recommendations during training or competition periods.
Sleep was impaired the night of competition compared with previous nights.
Early morning training, increases in training load, travel departure times, jet lag and altitude can impair athletes’ sleep
Sports Medicine (April 2019)
Only 5 of 23 substance classes show evidence of having the ability to enhance actual sports performance, i.e. anabolic agents, β2-agonists, stimulants, glucocorticoids and β-blockers.
One additional class, growth hormone, has similar evidence but only in untrained subjects.
The observed effects all relate to strength or sprint performance (and accuracy for β-blockers); there are no studies showing positive effects on reliable markers of endurance performance.
For 11 classes, no well-designed studies are available, and, for the remaining six classes, there is evidence of an absence of a positive effect.
VAD attributed to sports participation is uncommonly reported and the mechanisms are varied.
Impact to the mastoid region is consistently implicated in fatal cases and should be the focus of injury prevention strategies in sport.
There are currently no published evidence-based criteria to inform RTS decisions for patients with an LAS injury.