Competitive athletes are pushed routinely to the limits of their physical abilities. When tempered with periods of rest and recovery, a highly demanding training schedule can have tremendous benefits. However when an athlete is pushed too far, overtraining syndrome (OTS) can develop and result in career-ending damage. Overreaching and overtraining are part of the same spectrum that can lead to OTS. The pressure to perform placed on elite athletes is a real danger. Athletes and coaches understand the importance of rest days, but the insidious onset of OTS slowly saps the efficacy of recovery times so the athlete is no longer able to reach previously attainable goals. Identifying markers that correlate with overreaching and overtraining can arrest progression of a potentially negative cycle. We will examine the current literature and discuss possible screening tests and red flags that will assist in preventing OTS from occurring.
Glenohumeral osteoarthritis is a relatively uncommon type of osteoarthritis characterized by loss of anterior or forward flexion. Assessing range of motion, impingement, and strength, combined with radiologic imaging, can help determine the extent of damage. Published studies focus primarily on surgical treatment, but commonly used nonsurgical approaches include anti-inflammatory medications, oral and injectable viscosupplementation, and physical therapy. These conservative measures can be very effective for active patients and also appeal to their physicians who consider shoulder surgery as a last resort.
The three most commonly used metabolic tests are the Resting Metabolic Rate, Anaerobic Threshold Testing, and V.O2max. For several decades, these metabolic tests have been confined to the setting of university-based physiology laboratories and cardiopulmonary environments, i.e., metabolic carts in the intensive care units. The information gathered is used as a research and clinical tool in evaluating metabolic activity in a variety of physiological states from a body at rest, to exercise (aerobic and anaerobic), in certain medical states like illness, fed/starvation, and medicinal or supplementation affective states. Over the last decade, as technology has improved, so have the metabolic testing carts. They have become widely available for mainstream use by a variety of health care professionals. The purpose of this article is to review these three tests and how they may be useful in a medical practice.
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