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Michael F. Bergeron

In contrast to muscle cramps that are brought on by muscle overload or fatigue, exertional heat cramps seem to be prompted by extensive sweating and a significant sweat-induced whole-body sodium deficit. As a result of a consequent contracted interstitial compartment, axon terminals of selected motor neurons can become hyper-excitable and spontaneously discharge. Barely detectable muscle fasciculations or “twitches” in the affected muscles can rapidly progress to debilitating muscle cramps in just 20 to 30 minutes. To aid recovery, salt (NaCl) and water lost from sweating should be sufficiently replaced so as to restore the extracellular volume and interstitial fluid spaces. Sweat sodium, chloride, and fluid losses incurred during training and competition need to be closely matched by daily salt and fluid intake, in order to prevent an excessive sodium deficit, maintain sufficient fluid balance, and avoid exertional heat cramps.

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Lindsey Eberman, Leamor Kahanov, Thurman V. Alvey III and Mitch Wasik

Edited by Malissa Martin

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Katie Walsh and Morgan L. Cooper

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Laura A. Hayden and Meghan Lynch

Edited by Adam Naylor

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Jeffrey K. Kawaguchi and Robin K. Pickering

Edited by Mary Barnum

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Cailee E. Welch Bacon, Gary W. Cohen, Melissa C. Kay, Dayna K. Tierney and Tamara C. Valovich McLeod

evaluation to full participation clearance/return-to-play.  6. Please explain the baseline concussion assessment testing processes at your secondary school.  7. Please explain the postconcussion assessment testing processes at your secondary school.  8. Please discuss your level of satisfaction with the

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Corey P. Ochs, Melissa C. Kay and Johna K. Register-Mihalik

exposures in football 1 to 1.55/1000 athlete exposures in ice hockey. 2 Professional sports leagues, such as the National Football League (NFL) and National Hockey League (NHL), have instituted policies to assess and manage concussions, including return to play; however, little is known about the

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Jessica St Aubin, Jennifer Volberding and Jack Duffy

activity, is followed until he or she no longer reports concussion-related symptoms, has a normal clinical examination, and performs at or above pre-injury levels of functioning on all objective concussion assessments. Then the patient will begin the Return to Play (RTP) protocol. Phase 2 includes light

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Steven Eustace, Richard Michael Page and Matt Greig

Key Points ▸ Angle-specific isokinetic strength assessments should be conducted at varying angular velocities at the point of return to play. ▸ Isokinetic assessments should consider an angle-specific function strength ratio at the point of return to play. ▸ The slope of the force-velocity curve is