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Ivan Waddington

The development of sports medicine can be understood in terms of a conjuncture involving processes of medicalization and the increasing competitiveness of modern sport. It is also suggested that the growing involvement of sports physicians in the search for championship-winning performances has led them not only to develop improved mechanical and psychological techniques, but also to play an active part in the development of performance-enhancing drugs and techniques. The argument is developed via three case studies: the relationship between sports medicine and drug use in some of the former communist countries of Eastern Europe; the early development of anabolic steroids in the United States; and the development of “blood doping.”

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Douglas R. Keskula

Returning an athlete to functional activity is the primary goal of the sports medicine practitioner. Eccentric exercise may be used throughout the rehabilitation program to improve muscle performance and restore normal function. The selection and progression of eccentric exercise are contingent on treatment goals and the individual's tolerance to activity. Basic concepts of eccentric muscle performance are discussed, and general treatment guidelines with an emphasis on specificity and intensity are presented, to enable the clinician to organize and implement relevant, prudent eccentric exercise within the restrictions of the clinical setting. The use of eccentric exercise in the management of tendinitis is briefly discussed.

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Column-editor : Robert D. Kersey

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Dan Benardot

Athletes are influenced by coaches, other athletes, media, parents, the national sport governing body, members of the sports medicine team, and the athlete's own desire for success. It is impossible, therefore, for one member of the sports medicine team to unilaterally determine workable solutions that enhance performance and diminish health problems in an athlete. A focus on ensuring that the athlete can perform to the best of her ability is a key to encouraging discussion between the nutritionist, athlete, and coach. Using the assumption that health and top athletic performance are compatible, this focus on performance provides a discussion point that all parties can agree to and, if approached properly, also fulfills the nutritionist's goal of achieving optimal nutritional status. Membership on the sports medicine team mandates that the nutritionist know the paradigms and health risks associated with the sport and develop assessment and feedback procedures specific to the athlete's needs.

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Bradley Hack

The purpose of this article is to describe a sport psychology position housed within a sports medicine department at a Division I University. The conditions that brought about the creation of the position will be examined. These will include the relevant history of sport psychology services and the relationship between the athletic department, sports medicine department, and the counseling center. Other issues to be examined include the logistical and administrative hurdles in the development of the position as well as the scope of practice, service delivery model, and the types of presenting problems that are typically assessed and treated. The spirit of this article is to assist practitioners and administrators seeking to bring sport psychology services to their institutions. This model is by no means intended to be comprehensive or authoritative, but rather is to be understood as dynamic and malleable to the particular characteristics and history of other institutions.

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Renee L. Polubinsky and Jennifer M. Plos

Weight training is an excellent example of where coaches need to have acquired knowledge and skills in the realms of sports medicine, strength and conditioning, and risk management for safety and injury prevention. There are several exercises and lifting techniques that may increase the risk of shoulder injuries. This article will focus on the prevalence of injuries from weight training, a brief discussion of shoulder anatomy, three of the more common shoulder pathologies, and weight training modifications to assist in the prevention of these shoulder pathologies.

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William J. Kraemer, N. Travis Triplett, Andrew C. Fry, L. Perry koziris, Jeffrey E. Bauer, James M. Lynch, Tim McConnell, Robert U. Newton, Scott E. Gordon, Richard C. Nelson and Howard G. Knuttgen

The purpose of this study was to provide an in-depth sports medicine profile of women college tennis players and determine the relationships among an array of performance and clinical variables. Thirty-eight non-resistance-trained women from NCAA Divisions I and III collegiate tennis teams participated. A comprehensive battery of performance tests was conducted on each subject, including measurements of dynamic, isometric, and isokinetic strength; joint laxity and flexibility; speed; agility; power and power endurance; peak oxygen consumption; body composition; and ball velocities of the serve, forehand, and backhand. It was found that no single variable strongly explains tennis performance. The low amount of shared variance of strength measures with ball velocities suggests that tennis skills play a large role in producing peak ball velocities in this group. Due to the large range observed in profiled variables, individual evaluation is needed for clinical and conditioning recommendations.

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Diane M. Wiese-Bjornstal, Ayanna N. Franklin, Tara N. Dooley, Monique A. Foster and James B. Winges

Injuries contrast with the overwhelmingly positive benefits of sports participation for female athletes, with estimates of a third or more of all female athletes sustaining injury in any given season. Media headlines convey the impression that female athletes are more vulnerable to sports injuries than male athletes are. This observation led to our first purpose, which was to use evidence from the sports injury surveillance literature to examine the facts about female athlete risks of injury and compare these risks to those of male athletes. In light of Gill and Kamphoff’s (2010) observation that we largely ignore or underrepresent female experiences in the sport and exercise psychology literature, our second purpose was to highlight examples of the psychological, behavioral, and social aspects of female athletes’ injury experiences, and provide comparisons to male experiences within this realm of sports medicine psychology. These evidence-based observations guide our concluding recommendations for injury reporting, prevention, and rehabilitation roles of those in the media and sports professions.

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Kimberly S. Peer

Sports medicine professionals are facing new dilemmas in light of the changing dynamics of sport as an enterprise. These changes have considerable ethical implications as sports medicine team members are placed in challenging ethical decision-making situations that often create values tensions. These values conflicts have the potential to threaten and degrade the trust established through the mutual expectations inherent in the social contract between the health care providers and society. According to Starr,1 the social contract is defined as the relationship between medicine and society that is renegotiated in response to the complexities of modern medicine and contemporary society. Anchored in expectations of both society and the medical professions, this tacit contract provides a strong compass for professional practice as it exemplifies the powerful role and examines the deep responsibilities held by health care providers in our society. Although governed by professional boards and organizational codes of ethics, sports medicine professionals are challenged by the conflicts of interest between paternalistic care for the athlete and autonomous decisions often influenced by stakeholders other than the athletes themselves. Understanding how the construct of sport has impacted sports health care will better prepare sports medicine professionals for the ethical challenges they will likely face and, more importantly, facilitate awareness and change of the critical importance of upholding the integrity of the professional social contract.

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Riana R. Pryor, Douglas J. Casa, Susan W. Yeargin and Zachary Y. Kerr

that these strategies should be implemented to prevent exertional heat stroke deaths. 6 Of the 37% of United States public high schools that hire full-time ATs, the majority only have one AT who is accountable for managing all sports medicine responsibilities for all the athletic teams. 11 The