Current sports medicine reports最新文献

Abstract: Black individuals in the United States experience a disproportionate burden of cardiovascular disease, driven by higher prevalence of traditional risk factors such as hypertension, diabetes, obesity, and hyperlipidemia, as well as the enduring impact of structural racism, socioeconomic inequality, and environmental injustice. These disparities contribute to elevated cardiovascular mortality and sudden cardiac death, including among competitive athletes. Additionally, Black athletes face a higher risk of cardiac arrest and are more likely to have preparticipation electrocardiograms misclassified as abnormal, which can lead to inappropriate disqualification from sport. Current diagnostic standards reinforce systemic bias and perpetuate the myth of biological racial determinism. Instead, a race-conscious approach - one that integrates the social determinants of health, develops inclusive diagnostic reference ranges, and ensures equitable access to preventive care - can reduce false positives, improve risk stratification, and foster more equitable clinical decision-making. Addressing these disparities requires comprehensive strategies, including upstream investment in equitable health systems and downstream implementation of culturally competent, evidence-based care tailored to athletes' needs. By shifting the focus from race as a biological construct to race as a proxy for structural inequities, sports cardiology can advance toward a more just and prevention-focused model that improves cardiovascular outcomes for all athletes.

Abstract: Cervical spine injuries in mixed martial arts athletes present unique challenges, especially regarding return to play after anterior cervical discectomy and fusion. While single-level anterior cervical discectomy and fusion has shown favorable return to play outcomes in collision sports, mixed martial arts involves higher cervical impact forces, increasing the risk of adjacent segment disease, muscle imbalances, and proprioceptive deficits. Return to play following multilevel anterior cervical discectomy and fusion remains controversial, with limited data and no standardized guidelines. Rehabilitation post-anterior cervical discectomy and fusion for mixed martial arts athletes should focus on early mobilization, trunk stabilization, advanced neck-specific exercises, and addressing psychological barriers like fear-avoidance behavior through multidisciplinary care. These concepts are highlighted through a case study of a 37-year-old professional Ultimate Fighting Championship athlete who successfully returned to competition within 6 months after two-level anterior cervical discectomy and fusion. This case emphasizes phased rehabilitation strategies, from postoperative management to precompetition training, underscoring gaps in advanced cervical training and psychological support. Future research should develop evidence-based guidelines to enhance safety performance in mixed martial arts.

Abstract: Osteoarthritis is a leading cause of disability in both the United States and worldwide. In comparison to nonexposed controls, athletes, including tactical athletes such as military members and first responders, have higher rates of osteoarthritis. Management of osteoarthritis in the athletic population is largely similar to management of osteoarthritis in the general population, with a strong emphasis on conservative management. The focus of this article is to provide an evidence-based overview of the conservative management of osteoarthritis in athletic individuals to include exercise, biomechanical interventions, pharmaceutical modalities, as well as emerging nonpharmaceutical modalities such as extracorporeal shockwave therapy, radiofrequency ablation, Tai Chi, and acupuncture.

Abstract: Bone stress injury is a common musculoskeletal condition presenting with insidious bony pain that is progressive and occurs with a number of intrinsic or extrinsic risk factors, particularly with a recent change in training. When elicited, the presence of bony tenderness remains the most important component of the physical exam, although reproduction at deeper sites is a challenge and requires a high index of suspicion and imaging for diagnosis. MRI should be utilized as the gold standard for diagnosis, grading, and return-to-sport timing prognosis when available, with plain radiographs used as first-line imaging. Careful management of training loads, appropriate periodization and rest, gradual progression, resistance training, and nutrition optimization are important for bone stress injury prevention. In bone stress injury treatment, identification of low-risk versus high-risk sites in conjunction with addressing modifiable risk factors and a two-phased approach of mechanical load control and pain-free progression will optimize recovery.

Abstract: Patellofemoral pain syndrome is a common cause of anterior knee pain. It has a prevalence of 22.7% in the general population and tends to affect females more than males. Understanding the anatomy of the hip, knee, ankle, and foot helps to assess biomechanical risk factors that contribute to the development of patellofemoral pain syndrome. At the knee, decreased knee flexion angle, knee flexion and extension strength, and increased frontal plane projection angle have been shown to increase the risk of developing patellofemoral pain syndrome. Increased femoral internal rotation, weak hip external rotators, and an increased dynamic Q angle have been identified as hip biomechanical risk factors. Foot and ankle risk factors include excessive foot pronation, pes planus, pes cavus, and limited ankle dorsiflexion. Biopsychosocial factors, like kinesiophobia, also may contribute to patellofemoral pain syndrome. It is important to consider all these factors together when assessing and treating patients with anterior knee pain.