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    Alex Diamond

    As our schools and children struggle to meet ever-changing and mandated academic standards, challenges in the time spent on physical activity continue to arise. On the other hand, however, we continue to face a global climate mired in the... more
    As our schools and children struggle to meet ever-changing and mandated academic standards, challenges in the time spent on physical activity continue to arise. On the other hand, however, we continue to face a global climate mired in the midst of an obesity epidemic. It is widely accepted that the health benefits of exercise are wide-ranging and powerful. It appears that cognitive function and academic achievement are additional realms beyond the physical where exercise is beneficial. The school setting presents a unique public health opportunity to enact change on a variety of levels. As sports medicine and exercise specialists, we need to support efforts that increase access to quality physical fitness across the board for all children.
    Rhabdomyolysis is a syndrome characterized by muscle pain, weakness and myoglobinuria and ranges in severity from asymptomatic to life threatening with acute kidney failure. While a common condition in adult populations, it is... more
    Rhabdomyolysis is a syndrome characterized by muscle pain, weakness and myoglobinuria and ranges in severity from asymptomatic to life threatening with acute kidney failure. While a common condition in adult populations, it is understudied in pediatrics and the majority of adolescent cases are likely exercise-induced, caused by strenuous exercise in athletes. Recently, in our pediatric sports medicine practice, we have seen numerous cases of late adolescent high school athletes who present with severe muscle pain and were found to have elevated creatine kinase levels. The cases review potential contributing factors including characteristics of the workout, use of supplements, caffeine, medication, and metabolic or genetic predisposition. Treatment for exercised-induced rhabdomyolysis rarely requires more than rehydration. Return to play should be progressive, individualized, and include acclimatization and monitoring of hydration status, though guidelines require further review.
    Traumatic glenohumeral instability represents a commonly encountered clinical scenario. Two case vignettes are presented along with an evidence-based review of epidemiology, pathophysiology, diagnosis, and treatment options.
    As with most mental health disorders, the topic of hazing is not exclusive to the student athlete. However, it is also clear that the unique set of situations faced by athletes create a set of additional and difficult challenges to their... more
    As with most mental health disorders, the topic of hazing is not exclusive to the student athlete. However, it is also clear that the unique set of situations faced by athletes create a set of additional and difficult challenges to their mental and physical well-being. A deep-rooted culture, a lack of knowledge about hazing and its causal relationships, and a failure to act by teammates and adults all play a role in the propagation of this danger. Also, in an era where the popular press similarly celebrates and chastises episodes of hazing, it is increasingly crucial to turn to the scientific literature for guidance. To provide a comprehensive review of the scientific research on hazing in sports and to make recommendations for enhancing the approach and assistance to those in need on an individual and societal level. Qualitative literature review of hazing in collegiate and school sports. Databases including PubMed, Google Scholar, SPORTDiscus, EMBASE and MEDLINE were searched using standardised terms, alone and in combination, including 'hazing', 'bullying', 'sport', 'athlete', 'college', 'school' and 'youth'. Despite increased attention to its dangers, hazing remains pervasive throughout the sports world. However, many do not recognise those actions as consistent with hazing. A change in culture, increased education and awareness, along with methodologically sound strategies for action must occur in order to reduce the ill effects and cycle of hazing. To date, current information and efforts are lacking.
    As participation in athletics continues to increase, so too will the occurrence of on-field injuries and medical emergencies. The field of sports medicine continues to advance and many events will have on-site medical staff present. This... more
    As participation in athletics continues to increase, so too will the occurrence of on-field injuries and medical emergencies. The field of sports medicine continues to advance and many events will have on-site medical staff present. This article reviews the most catastrophic injuries and medical emergencies that are encountered in sports and presents the highest level evidence in regards to on-field approach and management of the athlete.
    Traumatic glenohumeral instability represents a commonly encountered clinical scenario. Two case vignettes are presented along with an evidence-based review of epidemiology, pathophysiology, diagnosis, and treatment options.
    In its third iteration, the Concussion in Sport Group identified 10 modifying factors that were presumed clinically to influence the investigation and management of concussions in sports. "Dangerous style of play" was delineated... more
    In its third iteration, the Concussion in Sport Group identified 10 modifying factors that were presumed clinically to influence the investigation and management of concussions in sports. "Dangerous style of play" was delineated as one of these factors, most likely based on clinical lore. These modifying factors were retained in a more recent Concussion in Sport Group statement. To date, there has been no concerted effort to support or refute the inclusion of this constellation of behaviors as a modifying factor in sports-related concussion. This article reviews and summarizes the limited evidence related to a dangerous style of play in sports-related concussion, offers a preliminary assessment of its relevance as a modifying factor, and provides additional information on other aspects of player, coach, and governing body behavior and their potential effect(s) on reducing concussive injuries.
    Achilles tendon ruptures commonly affect middle-aged athletes and can result in considerable functional impairment. While the cause is multifactorial, the greatest risk is present for athletes involved in sports that involve sudden... more
    Achilles tendon ruptures commonly affect middle-aged athletes and can result in considerable functional impairment. While the cause is multifactorial, the greatest risk is present for athletes involved in sports that involve sudden acceleration and deceleration. A thorough history and physical examination can accurately yield a diagnosis, but when question remains, magnetic resonance imaging is superior to ultrasound-guided evaluation. The best evidence available suggests that operative treatment has a lower rate of rerupture, a higher rate of return to the same level of sport participation, and a higher complication rate, if an open technique is used. Percutaneous methods of fixation have lower complication rates without an increase in the rate of rerupture when compared with open methods. Augmentation of an Achilles tendon repair has demonstrated no clinical benefit. Rehabilitation with early mobilization leads to improved patient-reported outcomes.
    Objective: To present athletic trainers with recommendations on developing a plan for recognizing and referring student-athletes at the intercollegiate setting with psychological concerns for an evaluation and/or treatment by mental... more
    Objective: To present athletic trainers with recommendations on developing a plan for recognizing and referring student-athletes at the intercollegiate setting with psychological concerns for an evaluation and/or treatment by mental health care professionals, considerations in developing this plan in collaboration with athletic department and institutional administration, as well as campus and local mental health care professionals. Background: There are growing concerns of the prevalence and understanding of mental illness
    1. Pediatr Ann. 2007 Nov;36(11):730-1, 735-7. The male adolescent athlete: specific concerns. Diamond A, Gregory A. Vanderbilt University School of Medicine, USA. PMID: 18074989 [PubMed - indexed for MEDLINE]. Publication Types: Case... more
    1. Pediatr Ann. 2007 Nov;36(11):730-1, 735-7. The male adolescent athlete: specific concerns. Diamond A, Gregory A. Vanderbilt University School of Medicine, USA. PMID: 18074989 [PubMed - indexed for MEDLINE]. Publication Types: Case Reports. MeSH Terms: ...
    As participation in athletics continues to increase, so too will the occurrence of on-field injuries and medical emergencies. The field of sports medicine continues to advance and many events will have on-site medical staff present. This... more
    As participation in athletics continues to increase, so too will the occurrence of on-field injuries and medical emergencies. The field of sports medicine continues to advance and many events will have on-site medical staff present. This article reviews the most catastrophic injuries and medical emergencies that are encountered in sports and presents the highest level evidence in regards to on-field approach and management of the athlete.
    Youth football is a popular sport in the United States and has been for some time. There are currently more than 3 million participants in youth football leagues according to USA Football. While the number of participants and overall... more
    Youth football is a popular sport in the United States and has been for some time. There are currently more than 3 million participants in youth football leagues according to USA Football. While the number of participants and overall injuries may be higher in other sports, football has a higher rate of injuries. Most youth sporting events do not have medical personnel on the sidelines in event of an injury or emergency. Therefore it is necessary for youth sports coaches to undergo basic medical training in order to effectively act in these situations. In addition, an argument could be made that appropriate medical personnel should be on the sideline for collision sports at all levels, from youth to professional. This article will discuss issues pertinent to sideline coverage of youth football, including coaching education, sideline personnel, emergency action plans, age and size divisions, tackle versus flag football, and injury prevention.