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Context: Participating in sports while experiencing symptoms of a concussion can be dangerous. An athlete's lack of knowledge may be one factor influencing his or her decision to report symptoms. In an effort to enhance concussion education among high school athletes, legislation in Florida has attempted to address the issue through parental consent forms. Objective: To survey high school varsity football players to determine their level of knowledge about concussions after the initiation of new concussion-education legislation. Design: Cross-sectional study. Setting: Descriptive survey administered in person during a team meeting. Patients or Other Participants: A total of 334 varsity football players from 11 high schools in Florida. Main Outcome Measure(s): Participants completed a survey and identified the symptoms and consequences of a concussion among distractors. They also indicated whether they had received education about concussions from a parent, formal education, neither, or both. Results: The most correctly identified symptoms were headache (97%), dizziness (93%), and confusion (90%), and the most correctly identified consequence was persistent headache (93%). Participants reported receiving education from their parents (54%) or from a formal source (60%). Twenty-five percent reported never receiving any education regarding concussions. No correlations were found between the method of education and the knowledge of symptoms or consequences of concussion. Conclusions: The high school football players we surveyed did not have appropriate knowledge of the symptoms and consequences of concussions. Nausea or vomiting, neck pain, grogginess, difficulty concentrating, and personality or behavioral changes were often missed by participants, and only a small proportion correctly identified brain hemorrhage, coma, and death as possible consequences of inappropriate care after a concussion. Even with parents or guardians signing a consent form indicating they discussed concussion awareness with their child, 46% of athletes suggested they had not.

Context: Repetitive throwing at high velocities leads to altered range of motion (ROM) in the dominant shoulder compared with the nondominant shoulder in overhead-throwing athletes. Loss of glenohumeral internal rotation (IR), or glenohumeral internal-rotation deficit (GIRD), is associated with shoulder injuries. Therefore, GIRD should be evaluated during the clinical examination of the thrower's shoulder.Objective: To assess glenohumeral ROM in competitive baseball and softball athletes at 3 intervals over the course of an athletic season in order to (1) examine changes in ROM over time and (2) monitor the prevalence of GIRD.Design: Observational, repeated-measures study. Setting: Collegiate athletic training room.Patients or Other Participants: Forty-eight healthy National Collegiate Athletic Association (NCAA) Division I or Division II athletes (age 5 19 6 1 years, height 5 174 6 14 cm, mass 5 77.8 6 18.1 kg; 19 softball, 29 baseball players).Main Outcome Measure(s): We measured glenohumeral IR, external rotation (ER), total arc (ER + IR), and GIRD at 3 times: prefall, prespring, and postspring. We calculated GIRD in 2 ways: as the difference in IR between dominant and nondominant shoulders and as the percentage of the total arc.Results: In the dominant shoulder, ER increased during the season (F 2,96 5 17.433, P , .001), but IR remained the same (F 2,96 5 1.839, P 5 .17). The total arc in the dominant shoulder increased between time intervals (F 2,96 5 14.030, P , .001); the mean difference between prefall and postspring measurements was 9.6946 (P , .001), and the mean difference between prefall and postspring measurements was 10.9906 (P , .001). In the nondominant shoulder, ER increased over the season (F 2,96 5 23.395, P , .001), but IR did not change over the season (F 2,96 5 0.087, P 5 .90). The total arc in the nondominant shoulder increased between prefall and prespring measurements and between prefall and postspring measurements (F 2,96 5 18.552, P , .001). No changes were noted in GIRD over time. However, more athletes with GIRD were identified with the GIRD (IR difference) calculation in prefall (n 5 6) than in prespring (n 5 1) and postspring (n 5 4) (Cochran Q 5 5.2, P 5 .07). In addition, more athletes with GIRD were identified with the GIRD (% total arc) calculation in postspring (n 5 6) than in prefall (n 5 5) or prespring (n 5 4) (Cochran Q 5 2.6, P 5 .27).Conclusions: Healthy NCAA Division I and Division II athletes did not display changes in glenohumeral IR over an athletic season. However, they gained in ER and total arc during the season in both shoulders. Future researchers should investigate changes over multiple seasons. The 2 methods of calculating GIRD identified different athletes as having GIRD, indicating that additional investigation is warranted to determine the clinical benefits of each method.Key Words: shoulder, upper extremity, glenohumeral internal-rotation deficit Key Points N No changes occurred in internal rotation over the course of the season. N External rotation increa...

A significant number of adolescent athletes throughout the world participate in various throwing-dominant sports, including but not limited to baseball, cricket, handball, softball, track and field throwing events, and water polo. Due to the unique stresses placed on the throwing arm and entire body in these sports, a robust volume of literature has highlighted concerns about sport specialization in these athletes and an associated increased risk of injury, particularly to the dominant shoulder and elbow, with sport specialization. This review will highlight the evidence-based literature for this athletic niche, focusing on risk factors for injury, national and international organizations' recommendations for limiting overuse injuries, principles of conditioning and rehabilitative programs, and potential future areas of research to curb the growing incidence of throwing-related injuries among adolescent throwing athletes.

Team physicians and athletic trainers should employ evidence-based, region- and population-specific EHI prevention guidelines. Sports medicine teams, coaches, and athletes should be aware of the increased risk of EHIs during August practices and the risk of prolonged practices during August.