Sportsman's hernia (SH) is a controversial cause of chronic groin pain in athletes. Most commonly seen in soccer and ice hockey players, SH can be encountered in a variety of sports and in a variety of age groups. Although there are several reports of SH in women, it is almost exclusively found in men. SH is largely a clinical diagnosis of exclusion. History of chronic groin pain that is nonresponsive to treatment should raise suspicion of SH, but physical examination findings are subtle and most diagnostic tests do not definitively confirm the diagnosis. Conservative treatment of SH does not often result in resolution of symptoms. Surgical intervention results in pain-free return of full activities in a majority of cases.

Hip apophyseal injuries in young athletes are a fairly rare problem, and often go unrecognized by health professionals. These injuries can be extremely painful, and may take months to heal. Timely, accurate diagnosis is imperative so proper treatment can be initiated. In some cases, surgery is required.

Gastroesophageal reflux (GER) and its associated symptoms are common among athletes. In the athlete, GER increases with intensity of exercise, is more common with endurance sports, and worse with postprandial exercise. GER has symptoms that overlap with other upper gastrointestinal (GI) conditions. Symptoms of GER can be difficult to distinguish from cardiac chest pain. GER may exacerbate asthma. Proposed mechanisms causing GER during exertion include altered GI blood flow and motor function, neuroendocrine changes, and mechanical effects. GER symptoms that interfere with activity may respond to lifestyle modification or pharmacologic therapy.

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Weight lifters suffer from the same headache syndromes that affect all human beings. They are also susceptible to headache types brought on by their activity. Three headache syndromes, cervicogenic headache, benign exertional headache, and effort-induced migraine headache, appear to be more common in the weight-lifting athlete. This article discusses the diagnosis and treatment of these headache syndromes.

Objective: The objective of this descriptive study was to evaluate pelvic region avulsion fractures in adolescents, including age of injury, location of injury, activity and mechanism at time of injury, treatments used, duration of treatment, and outcomes. Design: This was a retrospective chart review of patients who presented with pelvic region avulsion fracture over a 19-year period. Setting: Private practice, primary care sports medicine clinic. Patients: All patients younger than 20 years of age diagnosed with an acute pelvic region avulsion fracture. Interventions: There was no set intervention protocol. A variety of interventions and combination of interventions were used and determined by the treating physician on a case-by-case basis. Main Outcome Measures: Clearance for return toward sport activities. Results: Of the 242 cases, 162 were male. Soccer was the most common sport at the time of injury, and running/sprinting was the most common mechanism. Males were generally older at presentation and were more likely than females to have anterior inferior iliac spine injuries, whereas females were more likely to have iliac crest avulsions. Conservative treatment was effective in all cases. Males were treated for a shorter duration than females, but this difference was not statistically significant. Conclusions: Pelvic avulsion fractures are a rare injury in adolescent athletes. Males are twice as likely to experience these injuries and are older at presentation compared to females. Conservative management leads to successful outcomes in most cases.

Anterior cruciate ligament (ACL) injuries occur most frequently in planting and cutting sports such as basketball, soccer, and volleyball. National Collegiate Athletic Association injury data show that female athletes injure the ACL more frequently than their male counterparts do. The greater incidence of ACL injuries in women probably stems from complex, interrelated factors, possibly including hamstring-quadriceps strength imbalances, joint laxity, and the use of ankle braces. Successful treatment often includes surgery.

Joint and soft tissue aspiration and injection techniques are safe and relatively easy to do. A good knowledge of the basic injection techniques and an understanding of the pertinent local anatomy are necessary to perform these procedures. The indications, contraindications, and specific techniques will be discussed. If the physician is uncomfortable with any procedure or any part of a procedure, referral for injection or aspiration is advised.