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Stephan R. Walk

Recent work has suggested that masculinist sport subcultures (e.g., Young & White, 1995) and “conspiratorial” sports organizations (Nixon, 1992a) foster the acceptance of pain and injury by athletes. Using semistructured interviews, this study examined the experiences and beliefs of 22 student athletic trainers at a large university. The study found that student athletic trainers had conflicting alliances to student athletes and to staff trainers, held competing beliefs about athlete pain and injury, and struggled with athletes who did not properly use health care services and advice. It is recommended that future studies focus upon processes of negotiation and conflict, that more attention be directed to medical treatment of injured women athletes, and that recommendations to change medical services for athletes await further research.

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Jacquelyn Allen Collinson

Despite a growing body of research on the sociology of time and, analogously, on the sociology of sport, to date there has been relatively little sports literature that takes time as the focus of the analysis. Given the centrality of time as a feature of most sports, this would seem a curious lacuna. The primary aims of this article are to contribute new perspectives on the subjective experience of sporting injury and to analyze some of the temporal dimensions of sporting “injury time” and subsequent rehabilitation. The article is based on data derived from a 2-year autoethnographic research project on 2 middle/long-distance runners, and concludes with some indicative comments regarding the need for sports physiotherapists and other health-care practitioners to take into account the subjective temporal dimension of injury and rehabilitative processes.

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Dominic Malcolm

In this article I examine the role and working practice of rugby union club doctors in England. While medicine is widely perceived to be one of the most powerful professions in Western societies, sociologists of sport have argued that sport clinicians often wield relatively limited power over their athlete-patients. In this article I therefore attempt to shed further light on the “peculiar” character of sports medicine. Using data drawn from interviews and questionnaires, I argue that this phenomenon can be understood only by looking at the structure of the sports medicine profession, the specificities of the rugby club as a workplace setting, and the relationships club doctors have with clients (coaches and athletes) and other health care providers (physiotherapists).

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Thomas Rowland

Recognizing the cardiac features of athletically trained children bears importance for health care providers and exercise physiologists alike. This literature review reveals that ventricular enlargement and/or hypertrophy are commonly observed in studies of pre- and early-adolescent endurance athletes, yet the magnitude of these features is less than that described in adult athletes. Moreover, the upper range of values in child athletes is sufficiently small that clinical confusion with findings mimicking those in individuals with heart disease should not be expected to occur. In contrast to sex differences in the “athlete’s heart” in adults, cardiac structural findings in child athletes are similar in males and females. The extent that cardiac features observed in trained child athletes reflect a response to training or are influenced by genetic preselection remains uncertain.

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Ross E. Andersen and John M. Jakicic

The aim of this review is to provide a scientific update on the current guidelines for both health and weight management. There has been confusion among health professionals as to which physical activity guidelines should be used to help various specific populations adopt more active lifestyles. We first review the history of the physical activity guidelines. Using the physical activity guidelines in clinical practice is also explored. We also describe common barriers to physical that overweight individuals report and we discuss when it is appropriate for a health care professional to seek a referral from an exercise scientist to help sedentary adults increase their levels of activity. It is important for individuals who care for overweight patients and sedentary adults to understand the current physical guidelines and how these guidelines can be worked into clinical practice.

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Lisa M. Stobierski, Shirleeah D. Fayson, Lindsay M. Minthorn, Tamara C. Valovich McLeod and Cailee E. Welch

Clinical Scenario:

Injuries are inevitable in the physically active population. As a part of preventive medicine, health care professionals often seek clinical tools that can be used in real time to identify factors that may predispose individuals to these injuries. The Functional Movement Screen (FMS), a clinical tool consisting of 7 individual tasks, has been reported as useful in identifying individuals in various populations that may be susceptible to musculoskeletal injuries. If factors that may predispose physically active individuals to injury could be identified before participation, clinicians may be able to develop a training plan based on FMS scores, which could potentially decrease the likelihood of injury and overall time missed from physical activities. However, in order for a screening tool to be used clinically, it must demonstrate acceptable reliability.

Focused Clinical Question:

Are clinicians reliable at scoring the FMS, in real time, to assess movement patterns of physically active individuals?

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Christian C. Evans and Sandra L. Cassady

Objective:

To describe the underlying conditions that predispose athletes to sudden cardiac death (SCD) and review signs and symptoms that indicate an athlete is at risk.

Data Sources:

MEDLINE, the Los Angeles Times and Triathlon Times archives, and other sources identified in the references of articles initially located therein. A total of 43 references were included.

Conclusions:

Most cases of SCD in younger athletes (≤35 years) are attributable to multiple hereditary conditions, with familial hyper-trophic cardiomyopathy being the primary cause, whereas the major cause of SCD in older athletes (>35 years) is coronary artery disease. Health-care professionals evaluating athletes should pay particular attention to past medical and family history. Items in an athlete’s screening that suggest increased risk include a history of chest pain, syncope, excessive shortness of breath, irregular heart rate or murmur, or a history of SCD in an immediate family member.

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Andrew T. Kaczynski and Karla A. Henderson

Background:

The purpose of this study was to review reported associations between parks and recreation settings (PRSs) as features of the built environment and various functions and intensities of physical activity (PA).

Methods:

By searching 4 major databases for the years 1998 to 2005, 50 articles were uncovered that reported quantitative relationships between PRSs and PA.

Results:

Most articles showed some significant positive relationships between PRSs and PA. PRSs were more likely to be positively associated with PA for exercise or utilitarian functions than for recreational PA. Mixed results were observed for the associations between PRSs and both moderate and vigorous PA, but PRSs were commonly associated with walking.

Conclusions:

The studies indicated links between PRSs and PA and provided evidence for the contributions parks and recreation makes as part of the “health care” system within communities. Because of the ubiquity of PRSs and their potential contributions to active living, these relationships merit further exploration.

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James F. Sallis and Kevin Patrick

The International Consensus Conference on Physical Activity Guidelines for Adolescents convened to review the effects of physical activity on the health of adolescents, to establish age-appropriate physical activity guidelines, and to consider how these guidelines might be implemented in primary health care settings. Thirty-four invited experts and representatives of scientific, medical, and governmental organizations established two main guidelines. First, all adolescents should be physically active daily or nearly every day as part of their lifestyles. Second, adolescents should engage in three or more sessions per week of activities that last 20 min or more and that require moderate to vigorous levels of exertion. Available data suggest that the vast majority of U.S. adolescents meet the first guideline, but only about two thirds of boys and one half of girls meet the second guideline. Physical activity has important effects on the health of adolescents, and the promotion of regular physical activity should be a priority for physicians and other health professionals.

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Alan G. Ingham

What follows here is an essay—a rather one-sided viewpoint that is both tentative and, within the limits of a journal article, incomplete. I attempt to understand how our recent preoccupation with our bodies is being mobilized as one solution to the fiscal crisis of the welfare state. The deep-rooted assumptions of voluntarism that characterize liberal ideology, I claim, are surfacing again in the debate over lifestyle. And lifestyle, it appears, has become an ideological construction which diverts attention from the structural impediments to well-being by framing health issues in terms of personal, moral responsibilities—a “pull yourself up by the bootstraps” alternative to state intervention in health care. Some implications of the lifestyle ideology for physical educationists are presented.