Osteitis pubis: solving a perplexing problem.

Osteitis pubis is a painful condition that affects the pubic symphysis and surrounding tendinous attachments. One common cause stems from unusual biomechanical stress to the pelvis. Patients typically have a variety of vague and nonspecific symptoms, which makes accurate diagnosis of this condition difficult, particularly for clinicians not familiar with the disorder. A systematic approach to evaluating these patients is essential because the differential can be quite large and includes isolated muscle tears, lumbar radiculopathy, and stress fractures. Fortunately, once the diagnosis is confirmed, conservative treatment such as rest and nonsteroidal anti-inflammatory drugs usually leads to a favorable outcome.

Postcompetition elevation of muscle enzyme levels in professional football players.

Strenuous exercise causes a rise in circulating levels of creatine kinase (CK), and well-trained athletes liberate smaller amounts than do untrained individuals. Plasma CK, aspartate aminotransferase, and lactate dehydrogenase were measured in a group of 23 professional football players 48 hours after competition. All players were asymptomatic for myalgias or chest discomfort despite elevations of CK levels. Physicians should be aware of these elevations in muscle enzymes postexertion and interpret each in conjunction with the athlete's symptoms.

Osteitis pubis in collegiate football players.

Osteitis pubis in athletes is an inflammatory condition of the pubic symphysis and surrounding muscular insertions. It is of uncertain etiology, however, and is seen particularly in those sports requiring sprinting and sudden changes of direction. There is a paucity of literature of this condition occurring in players of American football. This report presents two such cases and details proposed etiology and a specific management protocol.

Depression and chronic fatigue in athletes.

For the most part, the competitive athlete is a well-adjusted individual who demonstrates considerable vigor and well-being, as well as less depression, anxiety, and fatigue than nonathletic counterparts. The well-trained athlete, however, may also have a personality that is somewhat rigid, strongly goal oriented, and perfectionist. It is not unrealistic to expect that when confronted with diminished performance or success, such an athlete may be compelled to drive himself or herself harder to succeed. Such behavior typically leads to the phenomenon of overtraining, which can express itself in the form of chronic fatigue and depression. There are a number of other organic causes of chronic fatigue and depression, however, which must be excluded by careful evaluation and appropriate diagnostic testing. Although the evaluation of the athlete who presents with chronic fatigue and depression can be somewhat complex, a diagnostic framework has been outlined here to assist the clinician in the assessment of an athlete who presents with such complaints.

Depression and chronic fatigue in the college student-athlete.

For the most part, the intercollegiate athlete is a well-adjusted individual who demonstrates considerable vigor and well-being and less depression, anxiety, and fatigue when compared with nonathletic counterparts. The well trained athlete also demonstrates a personality that may be somewhat rigid, is strongly goal oriented, and strives for excellence. It is not unrealistic to expect that when confronted with diminished performance or success, athletes may be compelled to drive themselves harder to succeed. Such behavior typically leads to the phenomenon of overtraining, which can express itself in the form of chronic fatigue and depression. A number of other organic causes of chronic fatigue and depression must be excluded by careful evaluation and appropriate diagnostic testing. Although the evaluation of the athlete who presents with chronic fatigue and depression can be somewhat complex, a diagnostic framework has been outlined that may assist the clinician in the assessment of the athlete who presents with such complaints.