ABSTRACT
Endurance events are increasing in popularity in wilderness and remote settings, and participants face a unique set of potential risks for participation. The purpose of this article is to outline these risks and allow the practitioner to better guide the wilderness adventurer who is anticipating traveling to a remote or desert environment.
Subject(s)
Hyponatremia , Physical Examination/methods , Sports Medicine/methods , Sports/physiology , Wilderness , Environment , Exercise/physiology , Humans , Hyponatremia/epidemiology , Hyponatremia/etiology , Hyponatremia/physiopathology , Hyponatremia/prevention & control , Physical Endurance/physiology , Risk Assessment , Risk FactorsABSTRACT
Children, older adults, disabled and special needs athletes, and female athletes who participate in outdoor and wilderness sports and activities each face unique risks. For children and adolescents traveling to high altitude, the preparticipation physical evaluation should focus on risk assessment, prevention strategies, early recognition of altitude-related symptoms, management plans, and appropriate follow-up. As the risk and prevalence of chronic disease increases with age, both older patients and providers need to be aware of disease and medication-specific risks relative to wilderness sport and activity participation. Disabled and special needs athletes benefit from careful pre-event planning for the potential medical issues and equipment modifications that may affect their health in wilderness environments. Issues that demand special consideration for female adventurers include pregnancy, contraceptive use, menses, and ferritin levels at altitude. A careful preparticipation evaluation that factors in unique, population- specific risks will help special populations stay healthy and safe on wilderness adventures. The PubMed and SportDiscus databases were searched in 2014 using both MeSH terms and text words and include peer-reviewed English language articles from 1977 to 2014. Additional information was accessed from Web-based sources to produce this narrative review on preparticipation evaluation for special populations undertaking wilderness adventures. Key words include children, adolescent, pediatric, seniors, elderly, disabled, special needs, female, athlete, preparticipiation examination, wilderness medicine, and sports.
Subject(s)
Environment , Medical History Taking/methods , Physical Examination/methods , Wilderness , Wounds and Injuries/prevention & control , Adolescent , Adult , Aged , Aging/physiology , Altitude Sickness/complications , Altitude Sickness/epidemiology , Altitude Sickness/prevention & control , Athletes , Child , Chronic Disease/epidemiology , Disabled Persons , Female , Humans , Male , Middle Aged , Pregnancy , Risk Assessment , Risk Factors , Sports , Wounds and Injuries/epidemiologyABSTRACT
Endurance events are increasing in popularity in wilderness and remote settings, and participants face a unique set of potential risks for participation. The purpose of this article is to outline these risks and allow the practitioner to better guide the wilderness adventurer who is anticipating traveling to a remote or desert environment.
Subject(s)
Physical Examination , Physical Exertion , Sports , Wilderness Medicine , Risk Assessment , Safety , WildernessABSTRACT
Children, older adults, disabled and special needs athletes, and female athletes who participate in outdoor and wilderness sports and activities each face unique risks. For children and adolescents traveling to high altitude, the preparticipation physical evaluation should focus on risk assessment, prevention strategies, early recognition of altitude-related symptoms, management plans, and appropriate follow-up. As the risk and prevalence of chronic disease increases with age, both older patients and providers need to be aware of disease and medication-specific risks relative to wilderness sport and activity participation. Disabled and special needs athletes benefit from careful pre-event planning for the potential medical issues and equipment modifications that may affect their health in wilderness environments. Issues that demand special consideration for female adventurers include pregnancy, contraceptive use, menses, and ferritin levels at altitude. A careful preparticipation evaluation that factors in unique, population-specific risks will help special populations stay healthy and safe on wilderness adventures. The PubMed and SportDiscus databases were searched in 2014 using both MeSH terms and text words and include peer-reviewed English language articles from 1977 to 2014. Additional information was accessed from Web-based sources to produce this narrative review on preparticipation evaluation for special populations undertaking wilderness adventures. Key words include children, adolescent, pediatric, seniors, elderly, disabled, special needs, female, athlete, preparticipiation examination, wilderness medicine, and sports.
Subject(s)
Disabled Persons , Physical Examination/methods , Wilderness , Wounds and Injuries/prevention & control , Adolescent , Adult , Age Factors , Aged , Athletes , Child , Female , Humans , Male , Middle Aged , Risk Assessment , Wilderness Medicine , Young AdultABSTRACT
Acute lumbar disk herniations are the most common cause of sciatica. After excluding emergent causes, such as cauda equina syndrome, epidural abscess, fracture, or malignancy, a six-week trial of conservative management is indicated. Patients should be advised to stay active. If symptoms persist after six weeks, or if there is worsening neurologic function, imaging and invasive procedures may be considered. Most patients with lumbar disk herniations improve over six weeks. Because there is no difference in outcomes between surgical and conservative treatment after two years, patient preference and the severity of the disability from the pain should be considered when choosing treatment modalities. If a disk herniation is identified that correlates with physical findings, surgical diskectomy may improve symptoms more quickly than continued conservative management. Epidural steroid injections can also provide short-term relief.
