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Background: Foot friction blisters in military personnel lessen a soldier's mobility, concentration, and critical decision-making skills.Objective: To determine the prevalence of and factors associated with friction blisters during deployment in all military personnel who nonurgently presented to the 28th Combat Support Hospital.Methods: A cross-sectional survey was performed at the 28th Combat Support Hospital. Statistical tests used included descriptive statistics, chi-square tests, and logistic regression for nominal data.Results: The response rate was 97% with 872 surveys completed. Blister prevalence was 33% (95% confidence interval [CI] = 30.0-36.4). Eleven percent of these sought treatment (p < 0.001). Factors increasing the risk of developing blisters include female sex (prevalence ratio [PR] = 1.55, 95% CI = 1.27-1.91), wearing boots not broken in (PR = 1.52, CI = 1.26-1.85), longer than 6 months in theater (PR = 1.33, CI = 1.09-1.63), and history of prior blisters (PR = 2.08, CI = 1.69-2.56).Conclusions: The prevalence of foot friction blisters was 33% during a 12-month block of Operation Iraqi Freedom I. Of these, 11% required medical care. The group most likely to develop blisters is women, ages 26 to 34, who are unable to break in their boots and have a past history of blisters. [ABSTRACT FROM AUTHOR]

Shoulder, or more specifically glenohumeral joint, dislocations are common in the outpatient setting, with anterior dislocations seen most often. Diagnosis is based on a history of a typical mechanism for shoulder injury and a physical examination showing anterior-inferior fullness of the shoulder joint. Traditional postreduction treatment includes short-term immobilization, analgesics, and physical therapy. Orthopedic follow-up is recommended. [ABSTRACT FROM AUTHOR]

Physicians providing medical coverage at endurance events know that athletes often collapse during the race or shortly after crossing the finish line. An athlete who collapses during a race may have an ominous condition, such as a cardiac or neurologic event. The most common reason that athletes collapse at or shortly after the finish line is exercise-associated collapse, a benign postural hypotensive episode that resolves with rest, oral fluids, and elevation of the lower extremities. Volunteer clinicians at races must be able to quickly determine the cause of collapse and take appropriate steps to ensure that athletes receive proper initial care. [ABSTRACT FROM AUTHOR]

Exercise is perhaps the best 'medication' healthcare providers can prescribe for their geriatric patients. Increasing fitness by participating in a regular exercise program can reduce the effects of aging that lead to functional declines and poor health. By exercising modestly and regularly, elderly patients can substantially lower their risk of death from coronary artery disease, colon cancer, and complications of diabetes. Even for those who start between the ages of 60 and 75, regular exercise can reduce overall mortality rates. Elderly patients can benefit tremendously from a comprehensive exercise prescription. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is the leading cause of death worldwide, but prevalence estimates in former professional athletes are limited., Objectives: HUDDLE (Heart Health: Understanding and Diagnosing Disease by Leveraging Echocardiograms) aimed to raise awareness and estimate the prevalence of CVD and associated risk factors among members of the National Football League (NFL) Alumni Association and their families through education and screening events., Methods: HUDDLE was a multicity, cross-sectional study of NFL alumni and family members aged 50 years and older. Subjects reported their health history and participated in CVD education and screening (blood pressure, electrocardiogram, and transthoracic echocardiogram [TTE] assessments). Phone follow-up by investigators occurred 30 days postscreening to review results and recommendations. This analysis focuses on former NFL athletes., Results: Of 498 participants screened, 57.2% (N = 285) were former NFL players, the majority of whom were African American (67.6%). The prevalence of hypertension among NFL alumni was estimated to be 89.8%, though only 37.5% reported a history of hypertension. Of 285 evaluable participants, 61.8% had structural cardiac abnormalities by TTE. Multivariable analysis showed that hypertension was a significant predictor of clinically relevant structural abnormalities on TTE., Conclusions: HUDDLE identified a large discrepancy between participant self-awareness and actual prevalence of CVD and risk factors, highlighting a significant opportunity for population health interventions. Structural cardiac abnormalities were observed in most participants and were independently predicted by hypertension, affirming the role of TTE for CVD screening in this population aged older than 50 years. (Heart Health: Understanding and Diagnosing Disease by Leveraging Echocardiograms [HUDDLE]; NCT05009589)., Competing Interests: Funding Support and Author Disclosures The HUDDLE trial was sponsored by Edwards Lifesciences, Irvine, California, USA. Drs Okoh and Amponsah have received consulting fees from Edwards Lifesciences. Dr Patel is a proctor for Edwards Lifesciences. Dr Brennan is the team physician for the NFL Tampa Bay Buccaneers. Dr Park is an employee of Edwards Lifesciences. Dr Gunnarsson is an employee of Edwards Lifesciences. Dr Snowden is an employee of Edwards Lifesciences. Dr Mootz is an employee of Edwards Lifesciences. Dr Koepnick is an employee of Edwards Lifesciences. Dr Wheeler is an employee of Edwards Lifesciences. Dr Clarke is an employee of Edwards Lifesciences. Dr Prince is an employee of Edwards Lifesciences. Dr Sannino has received research grants from CardioMech, Cardiovalve, Edwards Lifesciences (including the core lab contract for this study), and Restore Medical. Dr Grayburn has received research grants from Abbott Vascular, CardioMech, Cardiovalve, Edwards Lifesciences (including the core lab contract for this study), Medtronic, Neochord, Restore Medical, and 4C Medical; and has served on the Advisory Board as a consultant for Abbott Vascular, Edwards Lifesciences, Medtronic, and 4C Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Abstract: Venous thromboembolism (VTE) is not rare and is becoming more recognized in our athletic population. This diagnosis can be elusive. A provider must have a high clinical suspicion and use pretest probabilities to order the appropriate studies and accurately diagnose a VTE. Treatment using direct oral anticoagulants for 3 months is recommended in most cases. Gradual return to play can be achieved after treatment is complete. Some athletes, however, may require lifelong anticoagulation. Return to collision sports may be possible using a timed dose strategy if long-term anticoagulation is needed. The management of an athlete with a VTE should include an individualized treatment plan and involve shared decision making with the athlete, team physicians, and hematologic specialists., (Copyright © 2022 by the American College of Sports Medicine.)

Patients often seek care from a family physician when they have a musculoskeletal injury or sport-related ailment. Family physicians must be adequately trained to provide this care. While general guidance is provided by the Accreditation Counsel for Graduate Medical Education (ACGME) it is left up to the individual programs to develop, implement, and execute their orthopedic and sports medicine curriculums. The American Academy of Family Physicians' (AAFP) Recommended Curriculum Guideline for Family Medicine Residents - Musculoskeletal and Sports Medicine provides a basic outline format for curriculum content and reference resources. The aim of this article is to elaborate on those training requirements and help programs to develop a curriculum implementation plan that will deliver a baseline level of competence for family medicine trainees.

Exercise-induced asthma (EIA) and exercise-induced bronchospasm (EIB)/bronchoconstriction (EIC) describes two clinical entities by which exercise triggers bronchial hyperresponsiveness. Exercise is a common trigger of bronchospasm in the asthmatic (EIA), as well as athletes without the underlying inflammation associated with asthma (EIC/EIB). Approximately 10% to 20% of the general population have EIA or EIB (). The approach to the diagnosis and subsequent management relies on the clinician's ability to recognize clinical signs and symptoms, then selecting the correct diagnostic test. A baseline spirometry/pulmonary function test is recommended for all athletes to evaluate for underlying asthma. Subsequent direct or indirect bronchial provocation testing is recommended to correctly diagnose EIA or EIB (). Athletes should not be treated empirically with bronchodilators based on symptoms alone without confirmatory spirometry and provocative testing.

Chronic exertional compartment syndrome of the lower leg is a well-described and documented cause of exercise-related pain in recreational, elite, and military athletes. Although this condition is common, the exact underlying mechanisms, those most at risk, long-term effects on muscular strength if unrecognized, and prevention strategies are relatively uncertain. Runners are most commonly affected and can be markedly impaired by the recurrent, often predictable pain that develops with exercise. An accurate history, high index of suspicion, and compartment pressure testing before and after symptomatic exercise confirms the diagnosis. Conservative therapy is minimally effective. Fasciotomy is the treatment of choice for athletes who are unwilling to modify their exercise or sport.

Myocarditis is a pathologic entity that has serious potential consequences for competitive athletes. Myocarditis is an inflammation of the myocardium accompanied by myocellular necrosis. Cardiotropic viruses, in particular the Coxsackie B virus, have been implicated as the most common cause of acute myocarditis in the United States. A thorough history, physical examination, electrocardiogram, echocardiogram, elevated cardiac enzymes, and an elevated sedimentation rate help make the diagnosis. Athletes recovering from acute myocarditis should abstain from moderate to vigorous activity for 6 months, have normal cardiac function, and have no demonstrable arrhythmia before returning to sports.

Friction blisters can have a negative effect on an individual's ability to perform his or her sport or duties. In a recent study, 69% of soldiers participating in a 20-km road march were found to have blisters, 10% of whom required medical intervention. Blistering of the feet is one of the most common injuries sustained by runners while training and racing. Although most blisters are minor and can be treated conservatively, others can lead to intense pain, cellulitis, and even sepsis. The best way to treat friction blisters is to prevent them; however, if they do occur, timely and effective treatment will help prevent the complications that can impede athletic performance.