The FMS has excellent interrater and intrarater reliability. Participants with composite scores of ≤14 had a significantly higher likelihood of an injury compared with those with higher scores, demonstrating the injury predictive value of the test. Significant concerns remain regarding the validity of the FMS.

Given the high prevalence of MRI findings in asymptomatic hockey players, it is necessary to cautiously interpret the significance of these findings in association with clinical presentation. Future investigations will determine whether these asymptomatic findings predict future disabilities.

Previously published studies have found that concussion symptoms are underreported in youth athletics. This study evaluated the likelihood high school soccer players would identify themselves as having concussion related symptoms during game situations. A questionnaire inquiring about past concussion education and the likelihood of notifying their coach of concussion symptoms was administered to 183 high school soccer players. Of the 60 (33%) who completed the survey, 18 (72%) athletes who had acknowledged receiving concussion training responded that they would always notify their coach of concussion symptoms, as compared with 12 (36%) of the players who reported having no such training (P = .01). The results of this study suggest that athletes with past concussion training are more likely to notify their coach of concussion symptoms, potentially reducing their risk for further injury. Concussion education should be considered for all high school soccer players.

Context:The use of creatine as a dietary supplement has become increasingly popular over the past several decades. Despite the popularity of creatine, questions remain with regard to dosing, effects on sports performance, and safety.Evidence Acquisition:PubMed was searched for articles published between 1980 and January 2017 using the terms creatine, creatine supplementation, sports performance, and dietary supplements. An additional Google search was performed to capture National Collegiate Athletic Association–specific creatine usage data and US dietary supplement and creatine sales.Study Design:Clinical review.Level of Evidence:Level 4.Results:Short-term use of creatine is considered safe and without significant adverse effects, although caution should be advised as the number of long-term studies is limited. Suggested dosing is variable, with many different regimens showing benefits. The safety of creatine supplementation has not been studied in children and adolescents. Currently, the scientific literature best supports creatine supplementation for increased performance in short-duration, maximal-intensity resistance training.Conclusion:While creatine appears to be safe and effective for particular settings, whether creatine supplementation leads to improved performance on the field of play remains unknown.

Sleep disturbance is a common problem following concussion. A retrospective chart review was conducted at a regional concussion clinic on patients 13 to 18 years of age between 2005 and 2011. Statistical analysis evaluated sleep disturbance and duration of concussion, as well as the use and effectiveness of melatonin. A total of 417 patients met inclusion criteria. One hundred twenty-three (34%) reported disturbance in sleep. There was no difference in sleep disturbance based on age, gender, or past number of concussions. Sleep disturbance was associated with a 3- to 4-fold increase in recovery time. Non-sport-related concussions were more likely to be associated with sleep disturbance compared to sport-related concussions (45% vs 29%, P = .01). Melatonin improved sleep disturbance in 67% of the patients. Evaluating sleep disorders following concussion is an important part of the assessment. These findings will help clinicians provide anticipatory guidance and treatment for adolescents recovering from concussion.

The results from this study demonstrate that age, height, playing for multiple teams, pitch velocity, and arm fatigue are clear risk factors for throwing arm injuries in adolescent baseball players. Pitches per game appears to be a risk factor for shoulder injuries. Other variables are either inconclusive or do not appear to be specific risk factors for injuries.

Studies have shown that osteoarthritis (OA) is highly associated with obesity, and individuals clinically defined as obese (BMI > 30.0 kg/m2) are four times more likely to have knee OA over the general population. The purpose of this research was to examine if isolated weight loss improved knee symptoms in patients with osteoarthritis. Adult patients (n = 24; age 18–70; BMI > 35 kg/m2) with clinical and radiographic evidence of knee OA participated in a one-year trial in which WOMAC and KOOS surveys were administered at a presurgery baseline and six and twelve months postsurgery. Statistical analysis was performed using Student's t and Wilcoxon Signed Rank tests. Weight loss six and twelve months following bariatric surgery was statistically significant (P < 0.05) compared to presurgery measurements. All variables from both KOOS and WOMAC assessments were significantly improved (P < 0.05) when compared to baseline. Isolated weight loss occurring via bariatric surgery resulted in statistically significant improvement in patient's knee arthritis symptoms at both six and twelve months. Further research will need to be done to determine if symptom relief continues over time, and if the benefits are also applicable to individuals with symptomatic knee arthritis that are overweight but not obese.

Background: Pediatric sports specialization, defined as intense year-round training in a single sport as a result of excluding other sports for more than 8 months per year, is common in the United States. There are demonstrated physical and social risks to early pediatric sports specialization (defined as before age 12 years). While thought to be needed to acquire appropriate experience and excel in a given sport, there remains little information on when athletes at the highest levels of their sport specialized. This study aimed to define when professional and collegiate ice hockey players specialized. Hypothesis: Early sports specialization before age 12 years will not be common among elite-level (professional and collegiate) ice hockey players. Study Design: Retrospective cross-sectional survey study. Level of Evidence: Level 3. Methods: Male professional and collegiate ice hockey players within 1 National Hockey League organization and 2 National Collegiate Athletic Association (NCAA) organizations who were 18 years of age or older completed a survey at training camp detailing their history of sports participation and specialization. Results: A total of 91 athletes participated in the study (mean age, 22.8 years; range, 18-39 years). The mean age at the start of any sports participation was 4.5 years, and the mean age of sports specialization was 14.3 years. The mean age of specialization in the professional group, the NCAA Division I group, and the NCAA Division III group was 14.1, 14.5, and 14.6 years, respectively. Conclusion: Early pediatric sports specialization is not common in elite-level (professional and collegiate) ice hockey players. Clinical Relevance: Early pediatric sports specialization before age 12 years is not necessary for athletic success in professional and collegiate ice hockey. This study provides further evidence supporting the recommendations of the American Medical Society for Sports Medicine, American Academy of Pediatrics, and American Orthopaedic Society for Sports Medicine against early sports specialization.