Return to Activity Considerations in a Football Player Predisposed to Exertional Heat Illness: A Case Study

2007 ◽  
Vol 16 (3) ◽  
pp. 260-270 ◽  
Author(s):  
Eric Emmanuel Coris ◽  
Stephen Walz ◽  
Jeff Konin ◽  
Michele Pescasio
Keyword(s):  
Sports Medicine ◽  
Football Player ◽  
Return To Play ◽  
Heat Illness ◽  
Competitive Sport ◽  
Exertional Heat Illness ◽  
The Third ◽  
Return To Activity ◽  
Medicine Team

Context:Heat illness is the third leading cause of death in athletics and a leading cause of morbidity and mortality in exercising athletes. Once faced with a case of heat related illness, severe or mild, the health care professional is often faced with the question of when to reactivate the athlete for competitive sport. Resuming activity without modifying risk factors could lead to recurrence of heat related illness of similar or greater severity. Also, having had heat illness in and of itself may be a risk factor for future heat related illness. The decision to return the athlete and the process of risk reduction is complex and requires input from all of the components of the team. Involving the entire sports medicine team often allows for the safest, most successful return to play strategy. Care must be taken once the athlete does begin to return to activity to allow for re-acclimatization to exercise in the heat prior to resumption particularly following a long convalescent period after more severe heat related illness.

Assessment of Mild Head Injury Using Measures of Balance and Cognition: A Case Study

1997 ◽  
Vol 6 (3) ◽  
pp. 283-289 ◽  
Author(s):  
Bryan L. Riemann ◽  
Kevin M. Guskiewicz
Keyword(s):  
Head Injury ◽  
Sports Medicine ◽  
Athletic Trainers ◽  
Head Injuries ◽  
Football Player ◽  
Athletic Participation ◽  
Return To Play ◽  
Mild Head Injury ◽  
Collegiate Football

Mild head injury (MHI) represents one of the most challenging neurological pathologies occurring during athletic participation. Athletic trainers and sports medicine personnel are often faced with decisions about the severity of head injury and the timing of an athlete's return to play following MHI. Returning an athlete to competition following MHI too early can be a catastrophic mistake. This case study involves a 20-year-old collegiate football player who sustained three mild head injuries during one season. The case study demonstrates how objective measures of balance and cognition can be used when making decisions about returning an athlete to play following MHI. These measures can be used to supplement the subjective guidelines proposed by many physicians.

Dehydration, Cramping, and Exertional Rhabdomyolysis: A Case Report with Suggestions for Recovery

2007 ◽  
Vol 16 (3) ◽  
pp. 244-259 ◽  
Author(s):  
Michelle Cleary ◽  
Daniel Ruiz ◽  
Lindsey Eberman ◽  
Israel Mitchell ◽  
Helen Binkley
Keyword(s):  
High School ◽  
Differential Diagnosis ◽  
Previous History ◽  
Football Player ◽  
Return To Play ◽  
Initial Assessment ◽  
Severe Dehydration ◽  
Exertional Rhabdomyolysis ◽  
Hospitalization Period ◽  
Return To Activity

Objective:We present a case of severe dehydration, muscle cramping, and rhabdomyolysis in a high school football player followed by a suggested program for gradual return to play.Background:A 16-year-old male football player (body mass = 69.1 kg, height = 175.3 cm) reported to the ATC after the morning session on the second day of two-a-days complaining of severe muscle cramping.Differential Diagnosis:The initial assessment included severe dehydration and exercise-induced muscle cramps. The differential diagnosis was severe dehydration, exertional rhabdomyolysis, or myositis. CK testing revealed elevated levels indicating mild rhabdomyolysis.Treatment:The emergency department administered 8 L of intravenous (IV) fluid within the 48-hr hospitalization period, followed by gradual return to activity.Uniqueness:To our knowledge, no reports of exertional rhabdomyolysis in an adolescent football player exist. In this case, a high school quarterback with a previous history of heat-related cramping succumbed to severe dehydration and exertional rhabdomyolysis during noncontact preseason practice. We provide suggestions for return to activity following exertional rhabdomyolysis.

Infectious Mononucleosis in an Athlete: Another Potentially Life-Threatening Complication

2017 ◽  
Vol 22 (6) ◽  
pp. 28-31
Author(s):  
Byron Moran ◽  
Eric E. Corris
Keyword(s):  
Athletic Training ◽  
Infectious Mononucleosis ◽  
Sports Medicine ◽  
Nasal Congestion ◽  
Football Player ◽  
Laboratory Evaluation ◽  
Severe Thrombocytopenia ◽  
Intercollegiate Football ◽  
Life Threatening ◽  
Medicine Team

A 19-year-old male intercollegiate football player presented to the athletic training room with symptoms of sore throat, nasal congestion, fatigue, and bleeding, experienced for 3 weeks. His clinical and laboratory evaluation was consistent with infectious mononucleosis and severe thrombocytopenia. The athlete was immediately removed from participation and evaluated by a hematologist who confirmed the diagnosis and started oral glucocorticoid therapy. The athlete’s symptoms improved and thrombocytopenia resolved with therapy. Timely identification of severe thrombocytopenia allows for safe removal from participation. Collaboration among the sports medicine team as well as specialists, when needed, allows for optimal management of these rare complications.

scholarly journals Exertional Heat Illness in American Football Players: When Is the Risk Greatest?

2016 ◽  
Vol 51 (8) ◽  
pp. 593-600 ◽  
Author(s):  
Earl R. Cooper ◽  
Michael S. Ferrara ◽  
Douglas J. Casa ◽  
John W. Powell ◽  
Steven P. Broglio ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Sports Medicine ◽  
National Collegiate Athletic Association ◽  
The United States ◽  
American Football ◽  
Football Players ◽  
Heat Illness ◽  
Wet Bulb Globe Temperature ◽  
Exertional Heat Illness ◽  
Globe Temperature

Context: Knowledge about the specific environmental and practice risks to participants in American intercollegiate football during preseason practices is limited. Identifying risks may mitigate occurrences of exertional heat illness (EHI). Objective: To evaluate the associations among preseason practice day, session number, and wet bulb globe temperature (WBGT) and the incidence of EHI. Design: Descriptive epidemiology study. Setting: Sixty colleges and universities representing 5 geographic regions of the United States. Patients or Other Participants: National Collegiate Athletic Association football players. Main Outcome Measure(s): Data related to preseason practice day, session number, and WBGT. We measured WBGT every 15 minutes during the practice sessions and used the mean WBGT from each session in the analysis. We recorded the incidence of EHIs and calculated the athlete-exposures (AEs). Results: A total of 553 EHI cases and 365 810 AEs were reported for an overall EHI rate of 1.52/1000 AEs (95% confidence interval [CI] = 1.42, 1.68). Approximately 74% (n = 407) of the reported EHI cases were exertional heat cramps (incidence rate = 1.14/1000 AEs; 95% CI = 1.03, 1.25), and about 26% (n = 146) were a combination of exertional heat syncope and heat exhaustion (incidence rate = 0.40/1000 AEs; 95% CI = 0.35, 0.48). The highest rate of EHI occurred during the first 14 days of the preseason period, and the greatest risk was during the first 7 days. The risk of EHI increased substantially when the WBGT was 82.0°F (27.8°C) or greater. Conclusions: We found an increased rate of EHI during the first 14 days of practice, especially during the first 7 days. When the WBGT was greater than 82.0°F (27.8°C), the rate of EHI increased. Sports medicine personnel should take all necessary preventive measures to reduce the EHI risk during the first 14 days of practice and when the environmental conditions are greater than 82.0°F (27.8°C) WBGT.

scholarly journals ACSM Expert Consensus Statement on Exertional Heat Illness: Recognition, Management, and Return to Activity

2021 ◽  
Vol 20 (9) ◽  
pp. 470-484
Author(s):  
William O. Roberts ◽  
Lawrence E. Armstrong ◽  
Michael N. Sawka ◽  
Susan W. Yeargin ◽  
Yuval Heled ◽  
...  
Keyword(s):  
Consensus Statement ◽  
Expert Consensus ◽  
Heat Illness ◽  
Exertional Heat Illness ◽  
Return To Activity ◽  
Illness Recognition

scholarly journals Clavicular Fracture in a Collegiate Football Player: A Case Report of Rapid Return to Play

2011 ◽  
Vol 46 (1) ◽  
pp. 107-111 ◽  
Author(s):  
Sarah B. Rabe ◽  
Gretchen D. Oliver
Keyword(s):  
Surgical Treatment ◽  
Sports Medicine ◽  
National Collegiate Athletic Association ◽  
Health And Safety ◽  
Field Evaluation ◽  
Football Player ◽  
Return To Play ◽  
Clavicular Fracture ◽  
Rehabilitation Protocols ◽  
Division I Football

Abstract Objective: To present the case of surgical treatment and rehabilitation of a midshaft clavicular fracture in a National Collegiate Athletic Association Division I football athlete. Background: While attempting to catch a pass during practice, the athlete jumped up and then landed on the tip of his shoulder. On-the-field evaluation was inconclusive, with a sideline evaluation diagnosis of clavicular fracture. Postinjury radiographs revealed a midshaft clavicular fracture. Differential Diagnosis: Spiral oblique midshaft clavicular fracture. Treatment: The sports medicine staff discussed surgical and nonsurgical options. A surgical procedure of internal fixation with an 8-hole plate was performed. Uniqueness: Surgical treatment for clavicular fractures is becoming increasingly common. This is the first report of an advanced rehabilitation protocol for surgical repair. We suggest that new rehabilitation protocols for clavicular repairs be investigated now that surgical treatment is being pursued more frequently. Conclusions: More aggressive treatment procedures and rehabilitation protocols for clavicular fractures have evolved in recent years. With these medical advancements, athletes are able to return to play much more quickly without compromising their health and safety.

Identification of Risk Factors for Exertional Heat Illness: A Brief Commentary on Genetic Testing

2007 ◽  
Vol 16 (3) ◽  
pp. 222-226 ◽  
Author(s):  
Sheila Muldoon ◽  
Rolf Bunger ◽  
Patricia Deuster ◽  
Nyamkhishig Sambuughin
Keyword(s):  
Risk Factors ◽  
Genetic Testing ◽  
Sports Medicine ◽  
Data Extraction ◽  
Data Sources ◽  
Hereditary Diseases ◽  
Heat Illness ◽  
Data Synthesis ◽  
Exertional Heat Illness ◽  
Type Data

Objective:This commentary discusses known links between Exertional Heat Illness (EHI), Malignant Hyperthermia (MH), and other hereditary diseases of muscle. Genetic and functional testing is also evaluated as measures of fitness to return to duty/play.Data Sources:Reviews and research articles from Sports Medicine, Applied Physiology, and Anesthesiology.Data Extraction:Detailed comparisons of existing literature regarding clinical cases of EHI and MH and the potential utility of genetic testing, specifically the ryanodine receptor (RYR1) gene and other genes related to disorders of skeletal muscle.Data Synthesis:EHI is a complex disorder wherein physiological, environmental, and hereditary factors interact to endanger an individual’s ability to maintain thermal homeostasis.Conclusions:Individuals’ genetic background is likely to play an important role, particularly when EHI recurs. Recurrent EHI has been associated with MH and other genetic disorders, highlighting the importance of identification and exclusion of individuals with known high risk factors.

scholarly journals Case Study: The Conservative Management and Rehabilitation of Insertional Patella Tendinopathy in an Elite Footballer

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
David Rhodes ◽  
◽  
Mark Leather ◽  
Andrew Proctor
Keyword(s):  
Sports Medicine ◽  
Objective Assessment ◽  
Return To Sport ◽  
Assessment Process ◽  
Return To Play ◽  
Level Of Evidence ◽  
Clearance Level ◽  
Design Case Study ◽  
Patella Tendinopathy

Background and Purpose: Chronic insertional patella tendinopathy is a complex condition to manage within elite athletes. Pain and symptoms increase when spikes or changes in relation to training or game load are experienced. These spikes are often seen in football on return to training or in periods of fixture congestion, presenting a contemporary challenge for the sports medicine team. Study Design: Case Study. Case Description: The presented case summarises the conservative rehabilitation and pain free return to play of a 24 years (yrs) old elite professional footballer with a long-standing history of patella tendinopathy. Symptoms returned post a spike in training load during pre-season, with a diagnosis of a 7.4 mm insertional thickening detected through magnetic resonance imaging. Presented is a summary of the assessment process, 24-week treatment and rehabilitation protocol and subsequent 12-week pre-habilitation plan, routinely completed on return to training and game play. Outcomes: The implemented management strategy led to the successful symptom free return to play of the athlete. Conclusion: The management of this injury was facilitated through subjective and objective assessment markers and imaging obtained to manage the athlete’s symptoms. The authors suggest that medical and conditioning based specialists could apply a rounded loading approach with prescribed isometric and isotonic drills before progression to energy release and pitch-based training to advance the athlete through a safe and controlled return to sport clearance. Level of Evidence: 5.

A Rare injury in Collegiate Athletics—The Lisfranc Fracture-Dislocation

1993 ◽  
Vol 2 (4) ◽  
pp. 281-286
Author(s):  
Keith M. Gorse ◽  
Graham Johnstone ◽  
Jennifer Cruse
Keyword(s):  
Sports Medicine ◽  
Athletic Trainers ◽  
Football Player ◽  
Time Frame ◽  
Collegiate Athletics ◽  
Fracture Dislocation ◽  
Team Physician ◽  
Rare Injury ◽  
Type Of Injury

A rare injury in collegiate athletics is the Lisfranc fracture-dislocation of the foot. This case study will give team physicians and athletic trainers an idea of what to look for in this type of injury. It will be shown how an 18-year-old college football player received the injury, how it was evaluated by the sports medicine staff, and how it was surgically treated by the team physician. Finally, the athlete's rehabilitation will be summarized and the time frame during which full activities were started again will be outlined. This case study will give sports medicine specialists a better understanding of the Lisfranc topic and how to deal with it.

Sports Medicine Staff Size Influences Exertional Heat Illness Policies in High School Football

2018 ◽  
Vol 23 (4) ◽  
pp. 172-177 ◽  
Author(s):  
Riana R. Pryor ◽  
Douglas J. Casa ◽  
Susan W. Yeargin ◽  
Zachary Y. Kerr
Keyword(s):  
High Schools ◽  
Sports Medicine ◽  
Action Plan ◽  
Management Strategies ◽  
Medical Personnel ◽  
Heat Illness ◽  
Team Physician ◽  
High School Football ◽  
Exertional Heat Illness ◽  
Safety Strategies

All high schools should implement exertional heat illness (EHI) safety strategies. We determined if there were differences in the implementation of EHI safety strategies between schools with and without additional paid athletic trainers (ATs) or a team physician present at preseason football practices. High schools with multiple ATs or a team physician implemented more EHI prevention and management strategies than schools with only a single AT, including training staff in EHI recognition and treatment and having an emergency action plan. However, schools with a paid team physician were more likely to have double practices in the first week of football practice. Schools with additional medical personnel at football preseason practices were more likely to implement EHI safety strategies.

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