Medicine in the Sport of Horse Racing.

Horseracing is among the most popular and increasingly lucrative industry sports in the nation. The average jockey must control a thoroughbred horse 10 times their weight that may act unpredictably whether at rest or full gallop resulting in falls, kicks, or even biting injuries. Despite the risks, jockeys do not have access to the same quality of medical care that is standard in similarly profitable sports organizations. Beyond the mental and physical demands of training and performance endured by any professional athlete, jockeys are confronted with health challenges unique to their sport. In this review of the literature, we aim to educate sports medicine physicians regarding the underlying causes of injuries, describe injury management, and make recommendations for appropriate preventive strategies. Overall, there is a void of literature, and so our authors offer expert opinion and encourage others to get involved in making this a safer sport.

Epidemiology of Sport-Related Concussion in an NCAA Division I Football Bowl Subdivision Sample.

BACKGROUND: Concussions are common in football, and knowledge of their incidence rates across settings is needed to develop strategies to decrease occurrence. PURPOSE: To examine sports-related concussion rates in a National Collegiate Athletic Association (NCAA) Division I Football Bowl Subdivision sample based on the activity setting where injuries occurred, during which type of play, and when relative to the 2010 NCAA concussion management policy. STUDY DESIGN: Descriptive epidemiology study. METHODS: Medical records from January 2006 to January 2015 for an NCAA Division I Football Bowl Subdivision program were analyzed. Concussion rates (per 1000 athlete-exposures [AEs]) were compared among the following settings: spring practice, preseason training camp, regular season high-contact practice, regular season low-contact practice, bowl game practice, and game competition. Play-type analyses examined incidence rates during offensive, defensive, and special teams plays. Changes in concussion rate coinciding with the 2010 NCAA concussion management policy were also studied. RESULTS: Of the 452 unique players on the roster during the 9-year study period, 118 (26.1%) were diagnosed with a concussion. The concussion rate during games was significantly higher than all practices combined (P < .001). However, when game rate (4.46 per 1000 AEs) was compared with preseason training camp alone (3.81 per 1000 AEs), there was no significant difference (P = .433). The concussion rate during special teams plays was significantly higher than that during offensive (P < .001) or defensive plays (P < .001). The concussion rate in the 4 seasons (2010-2014) after the 2010 NCAA concussion management policy was initiated was significantly higher than the 4 seasons (2006-2009) preceding the policy (P = .036). CONCLUSION: Study results show that (1) based on activity type, games and preseason training camp present the greatest risk of sustaining a concussion; (2) based on play type, special teams plays pose the greatest risk of sustaining a concussion; and (3) the 2010 NCAA concussion management policy coincided with a significant increase in recognition of concussion.

Electrodiagnostic evaluation of compressive nerve injuries of the upper extremities.

Electrodiagnostic testing includes electromyography and nerve conduction studies that are physiologic tests used in the diagnosis of peripheral nerve injuries. It is a supplement rather than a replacement for a physical examination. This article reviews the terminology as well as the findings seen and used in electrodiagnostic studies. Common compression nerve injuries including the median, ulnar, radial, axillary, and suprascapular nerves and their electrical findings are reviewed.