Focus on Sports Medicine

Host: Alan S. Brown, MD, FACC, FAHA, FNLA Guest: Joseph Marek, MD Sudden cardiac death is rare in younger patients, but it remains one of the leading causes of death in young athletes. To learn more about this, Dr. Alan Brown is joined by Dr. Joseph Marek, Clinical Cardiologist and Senior Medical Director of Cardiopulmonary Service at Advocate Medical Group, to share how his foundation, Young Hearts 4 Life, is working to increase awareness for sudden cardiac arrest and provide young athletes resources.

Host: Prathima Setty, MD Dr. Prathima Setty traveled to the Physician Advisor and Medical Director Summit in Orlando, Florida, where she caught up with Dr. Simon Ahtaridis. As the National Clinical Advisor and the Chief Medical Officer of Advisory Services of Sound Physicians, Dr. Ahtaridis describes the implications of the change regarding total knee replacements and how providers and patients alike will be impacted.

Host: Brian P. McDonough, MD, FAAFP Guest: Benjamin Levine, MD, FACC Poor fitness in middle age is a strong predictor of a person’s future risk of heart failure. Prolonged exercise training, including a regular routine of high-intensity and moderate-intensity workouts, can forestall the effects of sedentary aging by preventing increased left ventricular stiffness. Dr. Benjamin Levine joins host Dr. Brian McDonough to talk about how regular exercise training may provide protection against the sedentary aging of the heart by preventing an increase in cardiac stiffness. Dr. Levine is a Professor of Internal Medicine at the UT Southwestern Medical Center and the Director of Autonomic Function and Cardiopulmonary Clinics at the Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital.

Host: Shira Johnson, MD Guest: Bennett Omalu, MD Many studies have demonstrated long-lasting and even permanent brain damage that can originate from just one concussion. With athletes suffering multiple repeated head traumas due to high-contact sports, the controversies over player safety and long-term health risks remain hot-button issues. Pathologist Dr. Bennett Omalu coined the term "CTE" and published the first evidence for chronic traumatic encephalopathy after autopsying American football players. In this second of a two-part interview, he shares his perspectives on CTE in athletes and the lifelong dangers of contact sports.

Host: Shira Johnson, MD Guest: Bennett Omalu, MD Chronic Traumatic Encephalopathy (CTE) is a degenerative brain disease found in athletes, military veterans, and others who experience repetitive brain trauma. Pathologist Dr. Bennett Omalu coined the term "CTE" and published the first evidence for this condition after autopsying American football players. Host Dr. Shira Johnson welcomes Dr. Omalu to share the story of his discovery and the medical, athletic, and public responses that followed.

Host: Brian P. McDonough, MD, FAAFP Exercise can improve your health and reduce the risk of developing several diseases such as type 2 diabetes, cancer, and cardiovascular disease. Host Dr. Brian McDonough chats with veteran personal trainer and exercise therapy specialist Bobby Whisnand about ways to to keep your workout "working out" and how to avoid exercise pitfalls.

Host: Rebecca Kaplan Dealing with inflammatory bowel disease (IBD) on its own is difficult, but managing it with a professional athletic schedule is another task altogether. Dajuan Wagner, a former NBA player, was diagnosed with IBD early in his career. In this episode, he will discuss how he learned to manage his disease, and his advice for physicians treating IBD patients who are also athletes. He is joined by Rebecca Kaplan of the Crohn’s and Colitis Foundation.

Host: John J. Russell, MD Guest: James Glazer, MD, FACSM Guest: Louis Guzzi, MD, FCCM Exertional heat stroke, or EHS, is a sudden and unpredictable condition, commonly affecting young, active, and healthy individuals. But this common patient population doesn’t tell the whole story of EHS and who is at high risk, making the need to understand both typical and atypical case presentations a crucial matter. Joining Dr. John Russell in this panel discussion are doctors Lou Guzzi and James Glazer. Dr. Glazer is the medical director of the Outpatient Physical Therapy & Sports Medicine Program at Memorial Hospital in North Conway, New Hampshire. Dr. Guzzi is a quadruple-board certified physician, who practices at Florida Hospital Medical Group in Orlando, Florida.

Host: Andrew Wilner, MD, Author of "The Locum Life: A Physician's Guide to Locum Tenens" Guest: Julian E. Bailes, MD Exertional heat stroke is caused by physical activity, such as exercising or working outside, in hot and humid environments. Left untreated, EHS leads to significant neurological dysfunction and high mortality rates. Dr. Andrew Wilner welcomes Dr. Julian Bailes, Director of the Department of Neurosurgery and Co-Director of the NorthShore University Health System Neurological Institute in Chicago, to discuss EHS characterization, pathophysiology, symptoms, and the various neurological assessment methods that enable physicians to make a diagnosis quickly and accurately.

Host: Brian P. McDonough, MD, FAAFP Guest: Howard Spiva Wearing a helmet is an overlooked but critical safety precaution, particularly among children. Attorney Howard Spiva knows the lifelong struggle of individuals recovering from traumatic brain injuries, having devoting much of his career to providing helmet safety education for children. Joined by host Brian McDonough, Mr. Spiva discusses important details about helmet safety, the current status of helmet laws, and continuing efforts to reduce traumatic brain injuries nationwide.

Host: David Weisman, MD Dr. David Weisman explores a study from Wake Forest School of Medicine that examined the effects of concussions for youth football participants.

Host: Kathy King, RDN Traditionally, marathon runners eat a high carbohydrate meal before a race to maximize the storage of glycogen in their muscles. But is this the best method to ensure race endurance? Host Kathy King chats with sport nutritionist Nancy Clark about the best nutrition and diet strategies for training and running a marathon.

Host: Kathy King, RDN What role does nutrition play in the success of high performance athletes? Host Kathy King speaks with Lilah Al-Masri, registered dietitian and specialist in sports dietetics. Ms. Al-Masri is the former sports dietitian for the United States Naval Academy, and she has co-authored the book 100 Questions and Answers about Sports Nutrition and Exercise. The two discuss nutritional considerations in various athletic contexts, from sport types to environmental changes to training-versus-competitive cycles.

Host: Brian P. McDonough, MD, FAAFP Muhammed Ali died on June 3rd, 2016. The cause of death was respiratory complications from septic shock, but his 30-year battle with Parkinson's disease played a major role in his declining health. Did a storied career in boxing contribute to and/or cause the development of this disease? Dr. Brian McDonough previews the current clinical understandings and medical literature connecting chronic traumatic encephalopathy (CTE) with the development of Parkinson's disease.

[Read the Article] Despite targeted efforts to reduce obesity through diet and exercise, these rates continue to rise. A new study from Ontario, Canada found that obesity and diabetes rates were lower in more walkable neighborhoods compared to less walkable neighborhoods, where they saw an increase in these rates.Researchers from St. Michael's Hospital in Toronto studied almost 9,000 neighborhoods in Southern Ontario looking at walkability scores, along with government health data and survey results during a twelve-year period. They examined whether neighborhoods that were more walkable experienced a slower increase in obesity and diabetes compared to less walkable neighborhoods. [Watch more videos of The JAMA Report]

[Read the Article] Approximately one-third of children who experience a concussion will experience persistent post-concussion symptoms. Researchers have developed a new clinical scoring system that may help predict which patients are at a higher risk for prolonged symptoms.Canadian researchers evaluated more than 3,000 patients, ages 5 to 18, who presented within 48 hours of an acute head injury. About thirty percent ended up with persistent post-concussion symptoms at 28 days. Researchers identified nine clinical factors that were predictive of post-concussive symptoms. These factors were then used in a twelve point risk score that included items like age, sex, history of migraines or depression, prior history of concussion, and problems with balance.Although the clinical score was better than a physician's judgement alone, further research is needed before it is fully adopted into clinical practice. [Watch more videos of The JAMA Report]

Host: Brian P. McDonough, MD, FAAFP Dr. Brian McDonough welcomes John Roman, CEO of Defend Your Head, a sports safety company based in Chester County, PA. Mr. Roman is a former offensive lineman in the NFL with the New York Jets (1976-1983) before launching a 30-year successful career on Wall Street. He joins Primary Care Today to discuss technological advances in helmet design and construction for football players of all ages. His company has recently developed ProTech, a football helmet product using a soft outer-shell technology designed to improve energy and force dissipation and reduction.

Host: Jennifer Caudle, DO Guest: G. Russell Huffman, MD, MPH Host Dr. Jennifer Caudle welcomes Dr. G. Russell Huffman, Associate Professor and Director of the Shoulder and Elbow Fellowship at the University of Pennsylvania. Dr. Huffman provides an overview of the various types of elbow injuries, treatment options for athletes at all levels, and special considerations for those who require surgery. Dr. Huffman focuses in particular on updated techniques in ulnar collateral ligament reconstruction, otherwise known as the Tommy John surgery.

Host: Brian P. McDonough, MD, FAAFP Sedentary behaviors are rapidly on the rise as technological advances streamline public capabilities to work and conduct regular tasks at the click of a button. Yet while some health impacts of increased sedentary lifestyles are now generally understood and accepted, the question of whether sporadic or even regular exercise habits can compensate for sedentary time is not well known. But an advancing arm of research is addressing this knowledge gap, and the initial findings are startling. Joining Primary Care Today to share new insights is Dr. Wendy King, Associate Professor of Epidemiology at the University of Pittsburg Graduate School of Public Health. Dr. King and colleagues authored a report published in Preventive Medicine focusing on sedentary behaviors and how they affect health outcomes in the presence and absence of exercise.

Host: Jennifer Caudle, DO Guest: James L. Carey, MD, MPH What happens when articular cartilage is damaged? And what are the differences between focal cartilage defects and arthritis? Joining Dr. Jennifer Caudle to discuss current mechanistic understandings of articular cartilage is Dr. James Carey, Director of the Penn Center for Cartilage Repair and Osteochodritis Dissecans Treatment; and, Assistant Professor of Orthopaedic Surgery at Penn Medicine

[Read the Article] Among obese older patients with an increasingly common type of heart failure, calorie restriction and/or exercise training improved their ability to participate in physical activity without experiencing shortness of breath, according to a new study.Heart failure with preserved ejection fraction (HFPEF) is the most rapidly increasing form of heart failure in the United States. Although the heart pumps normally, it does not fill with enough blood because the lower chamber of the heart is too stiff. More than eighty percent of patients with HFPEF are overweight or obese. Despite multiple studies, so far, no currently available medications have improved symptoms in patients with HFPEF.Researchers from the Wake Forest School of Medicine randomly assigned 100 older obese participants with HFPEF to 20 weeks of diet, exercise, or both. They found that the exercise participants lost three percent of body weight, the diet group lost seven percent and the combined group lost ten percent of body weight. Patients in both the diet and exercise groups showed improvement in their ability to participate in exercise without significant symptoms. [Watch more videos of The JAMA Report]

Host: Brian P. McDonough, MD, FAAFP Guest: Samir Mehta, MD Patients of all ages can be affected by a traumatic injury. These injuries can be complex to treat and may involve multiple parts of the body. And, in traumatic situations, decisions need to be made quickly. Host Dr. Brian McDonough welcomes Dr. Samir Mehta, Assistant Professor in the Department of Orthopaedic Surgery at the Perelman School of Medicine; and, Chief of the Orthopaedic Trauma and Fracture Service at the University of Pennsylvania.

Host: Jennifer Caudle, DO Dr. Jennifer Caudle welcomes Dr. Rebecca Fishman, Director of Medical Education at Mercy Medical Center, New York, NY. Dr. Fishman was a professional dancer before becoming a DO and has a number of dance professionals in her family. Dr. Fishman joins Dr. Caudle on site at the American Osteopathic Association's annual medical education conference, OMED2015. Dr. Fishman is focused on OMT for dancers and equates professionals to elite athletes because of the amount of training and physical demands placed on their bodies. This segment is intended to introduce the niche specialty of performing arts medicine and include the social/emotional tolls that dance can have on its performers.

Host: Brian P. McDonough, MD, FAAFP Shoulder pain is one of the most common presentations in primary care, but the most proper workups to determine causes and develop effective treatment plans are not universally known. Joining Dr. Brian McDonough to update clinicians on common shoulder injuries, the patient histories that often correspond with them, and best treatment practices for each problem, is Dr. Kelton Burbank, orthopedic surgeon and the Worcester Medical Center in Worcester, MA. Dr. Burbank is the orthopedic consultant for the UMass-Amherst men’s hockey team and the Massachusetts representative to the American Orthopaedic Society for Sports Medicine. He is also president of the New England Orthopedic Society.

Host: Brian P. McDonough, MD, FAAFP Dr. Brian McDonough welcomes Dr. Liz Joy, President-Elect of the American College of Sports Medicine, President of the Female Athlete Triad Coalition, and Adjunct Professor of Family & Community Health at the University of Utah School of Medicine. Their discussion centers on health maintenance for female athletes and the special factors that must be considered to care for this unique patient population.

[Read the Article] Some evidence suggests that physical activity can help slow cognitive decline. A new study evaluated whether a program of moderate physical activity would result in better cognitive function, lower risk of dementia, or both, for older adults compared with a health education program.Researchers from Wake Forest School of Medicine, Winston-Salem, North Carolina evaluated more than 1,600 sedentary adults, between the ages of 70 and 89, and randomly assigned them to either physical activity or a health education program. The participants were monitored for 24 months, during which their cognitive function was measured using a variety of clinical tests.Results found that both groups preserved their cognitive function over the two year study period. Although there was no difference between the groups, the outcomes still prove notable, since steady decline in cognitive function would generally be expected within this age group. [Watch more videos of The JAMA Report] JAMA Report videos provided pursuant to license. ©2015 American Medical Association, publisher of JAMA® and The JAMA Network® journals.

Host: John J. Russell, MD In the late 19th century, America’s most popular spectator sport drew thousands of fans, created celebirty athletes, endured scandals for performance-enhancing drugs, and opened doors for immigrants, African Americans, and women. But this sport wasn’t baseball, boxing, or horseracing—it was competitive walking. Dr. John Russell speaks with Matthew Algeo, author of Pedestrianism, about competitive walking’s peculiar appeal and popularity, its rapid demise, and its enduring influence in American spectator sports.

Host: Matt Birnholz, MD Many people believe that exercise during pregnancy is detrimental to the health of the fetus. This belief seems to have come from an outdated study that the fetus’s heart rate drops if the mother exercises. More recent studies, however, have supported a counterposition that exercise during pregnancy is safe and can actually be beneficial for both the mother and fetus. Join Dr. Matt Birnholz and Dr. Linda Szymanski, Medical Director of Labor and Delivery at Johns Hopkins Hospital at the Johns Hopkins School of Medicine. They discuss the latest research on exercise during pregnancy, from benefits to harms, and how clinicians can counsel patients on the "right" amount of exercise during this life period.

Host: Brian P. McDonough, MD, FAAFP Dr. Brian McDonough welcomes Donovan Green, personal trainer and author of No Excuses Fitness, to Primary Care Today. Mr. Green talks about practical, brass tacks strategies for getting in shape, starting with the basic primer to just get people moving regardless of fitness level.

Host: John J. Russell, MD When was it decided that exercise could only be good for you? In his recent book, Exercise Will Hurt You: Concussion, Traumatic Brain Injury, and How the Dangers of Sports and Exercise Can Affect Your Health, leading neurosurgeon Dr. Steven Barrer calls for a change in the way we think about exercise in the United States. His work arises from an extensive career treating exercise-related injuries, anecdotal experiences from his own personal exercise injuries over the years, and scientific data culled from the latest research. Dr. Barrer is Director of the Neurosciences Institute and Chief of the Division of Neurosurgery at Abington Memorial Hospital in Philadelphia.

Guest: Gary Wadler, MD Host: Bruce Japsen Even after steroids scandals in Major League Baseball and more than 30 athletes were withheld from the winter Olympics in Vancouver for breaking anti-doping rules, why do athletes still engage in pharmacological cheating? The latest concern among sport officials is a new erythropoietin called Hematide, still in investigate trials. Dr. Gary Wadler, chairman of the World Anti-Doping Agency's Prohibited List and Methods Sub-Committee, talks to host Bruce Japsen about the never-ending battle against the abuse of pharmacology in order to enhance athletic ability.

Guest: George Collins, PA-C Host: Lisa Dandrea Lenell, PA-C, MPAS, MBA Over ten percent of all physician assistants work in orthopedics, and the number continues to grow. So why is this such a popular career choice? George Collins, chief physician assistant and PA director for Orthocarolina in Charlotte, North Carolina, discusses with host Lisa Dandrea Lenell why PAs are drawn to athletics, what it takes to build a career in sports medicine and how to get involved with a sports team in your area.

Guest: Joseph Maroon, MD Host: Bruce Japsen It takes more than orthopedic specialists and personal trainers to keep professional athletes ready to play their best. Today's team physicians are noted researchers and leading specialists who perform alongside Super Bowl champions. Dr. Joseph Maroon, neurosurgeon at the University of Pittsburgh School of Medicine and the neurosurgeon for the Pittsburgh Steelers, tells host Bruce Japsen about what he's learned from 20 years of caring for professional athletes and in the course of his own research along the way.

Guest: Allan Mishra, MD Host: Shira Johnson, MD The common standard of treatment for tendonitis usually involves cortisone shots, medication, physical therapy and sometimes surgery. Platelet rich plasma, utilized for years to heal bone injuries, is now being examined across the United States as a possible treatment for soft tissue injuries such as tendonitis. Dr. Alan Mishra, an adjunct clinical professor of orthopedic surgery at Stanford University in Palo Alto, California, and the director of Total Tendon, joins host Dr. Shira Johnson to discuss his research on platelet rich plasma in this rapidly evolving field.

Guest: Jeff Bazarian, MD Host: Shira Johnson, MD Brain injuries have come to the forefront since actress Natasha Richardson died following a skiing accident. Concussions are one of the most common injuries seen in emergency rooms across the country, but hundreds of thousands of people hit their heads every year and are never seen by a doctor. Dr. Jeff Bazarian, an associate professor of emergency medicine, neurology and neurosurgery at the University of Rochester in Rochester, New York, joins host Dr. Shira Johnson to discuss a blood test that could diagnose a brain injury without a CT scan.

Host: Mark Nolan Hill, MD Guest: Anthony Miniaci, MD Early arthritis of the knee is a frustrating and painful condition, especially for our more active patients. Some will begrudgingly accept the end of their adult sports league careers, others will be less inclined to hang up their sneakers. In this case, depending on the severity of the condition, there could be several procedural options, including a new arthroscopic resurfacing technique for those with less severe arthritis: could this be the quickest route back to the playing field? Dr. Anthony Miniaci, executive director of Cleveland Clinic Sports Health and one of the developers of this new procedure, explains why this procedure could be the answer for patients who have failed all biologic procedures, but are not yet ready for a total knee replacement. Which of your patients might be a candidate? Dr. Mark Nolan Hill hosts.

Guest: Ann McKee, MD Host: Mark Nolan Hill, MD Many elite athletes dedicate their lives to sport. In a high-impact game like football, the physical toll of this dedication can be devastating. One example of this is chronic traumatic encephalopathy, a form of brain damage most commonly linked to boxing. Now, a group of pro football players and other athletes are promising to post-humously donate their brains for research on this condition. Dr. Ann McKee, associate professor of neurology and pathology, and co-director of the Center for the Study of Traumatic Encephalopathy at Boston University School of Medicine, where this research will be conducted, joins host Dr. Mark Nolan Hill to explain the research goals which her team aims to achieve with this inspiring gift.

Guest: Laurie Goodyear, PhD Host: Larry Kaskel, MD Dr. Laurie Goodyear, a senior investigator and head of the section on metabolism at the Joslin Diabetes Center in Boston, discusses with host Dr. Larry Kaskel how exercise impedes the development of type 2 diabetes. Tune in to hear the implications of Dr. Goodyear's research on exercise and how it works to promote the uptake of glucose into muscles. Could an exercise pill mimic the exercise-activated glucose uptake?

Host: Mary Leuchars, MD Guest: Brian Kelly, MD In sports medicine, the hip has traditionally received less attention from physicians than other joints. What are the types of non-arthritic hip pain that clinicians need to recognize in order to make accurate diagnoses for both recreational and professional athletes? Dr. Brian Kelly, assistant professor of orthopedic surgery at the Weill Medical College of Cornell University and attending physician at the Hospital for Special Surgery in New York, examines this issue from two vantage points: as clinician researcher, and as team physician for the NFL's New York Giants. Dr. Mary Leuchars hosts.

Guest: Scott Rodeo, MD Host: Mary Leuchars, MD Swimmers rely heavily on the stability and flexibility of their shoulders to maintain optimum performance. At times the line between joint laxity and instability can be difficult to assess. What sorts of injuries do swimmers incur around the shoulder joint, and what are the latest treatment techniques available? Guest Dr. Scott Rodeo, Professor of Orthopedic Surgery at Weill Cornell Medical College and Co-Chief of the Sports Medicine and Shoulder Service at The Hospital for Special Surgery, speaks on both professional and personal athletic experiences to address this clinical challenge. Hosted by Dr. Mary Leuchars.

Guest: Riley J. Williams III, MD Host: Sherwin Ho, MD The latest cartilage repair strategies can restore cartilage in the knees of athletes who one time would have had their career ended by their injuries. Dr. Riley Williams, associate professor of orthopedic surgery at Weill Medical College and director of the Institute for Cartilage Repair at the Hospital for Special Surgery, both in New York, talks with host Dr. Sherwin Ho about different techniques for repairing cartilage. What are the trade-offs between procedures that use the patient's own tissue, donor tissue, or biologics? Find out how today's autologous chondrocyle implantation procedure provides better results than its predecessors, and discover what the future holds for tissue repair.

Guest: Riley J. Williams III, MD Host: Sherwin Ho, MD Muscle strength and flexibility are the best defense against lower extremity soccer injuries. Dr. Riley Williams, associate professor of orthopedic surgery at Weill Medical College in New York and medical director for the New York Red Bulls professional soccer club, tells host Dr. Sherwin Ho why Pilates is the preferred off season strength training method. In the second half of the interview they discuss the prevention, diagnosis and correction of hip injuries. When is surgery necessary to get the player back in the game?