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Current Reviews in Musculoskeletal Medicine

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07-11-2022 | Care | Injuries in Overhead Athletes (C Camp and J Dines, Section Editors)

Primary Care Considerations for the Baseball Athlete

Authors: Lauren Prisco, Lauren A. Salesi, Kathryn D. McElheny, Doria Weiss, Laura Diamond, Tim Brennan

Published in: Current Reviews in Musculoskeletal Medicine | Issue 6/2022

Abstract

Purpose of Review

To summarize current guidance and best practices surrounding non-orthopedic medical concerns in baseball.

Recent Findings

Discussion of COVID19-related practice changes pertaining to the prevention and screening of communicable respiratory illness, concussion protocol updates, the enhanced role of a multi-disciplinary team of mental health professionals.

Summary

Prevention, appropriate screening, and early identification remain cornerstones of effective primary care both within the general population as well as for the baseball athlete.

Conway JJ, Curriero FC, Camp CL, Toresdahl BG, Coleman S, Kinderknecht JJ. Time out of play due to illness in major and minor league baseball. Clin. J. Sport Med. Off. J. Can. Acad. Sport Med. 2021;31(3):e137–43. https://doi.org/10.1097/JSM.0000000000000756.CrossRef

Boulet L-P, Turmel J, Irwin RS, CHEST Expert Cough Panel. Cough in the athlete: CHEST Guideline and Expert Panel Report. Chest. 2017;151(2):441–54. https://doi.org/10.1016/j.chest.2016.10.054.CrossRef

Capão-Filipe, M., Moreira, A., Delgado, L., Rodrigues, J., and Vaz, M., “Exercise-induced bronchoconstriction and respiratory symptoms in elite athletes,” Allergy, vol. 58, no. 11, p. 1196, Nov. 2003, https://doi.org/10.1046/j.0105-4538.2003.00309.x.

Anderson, S. D. and Holzer, K., “Exercise-induced asthma: is it the right diagnosis in elite athletes?,” J. Allergy Clin. Immunol., vol. 106, no. 3, pp. 419–428, Sep. 2000, https://doi.org/10.1067/mai.2000.108914.

Cox AJ, Gleeson M, Pyne DB, Callister R, Hopkins WG, Fricker PA. Clinical and laboratory evaluation of upper respiratory symptoms in elite athletes. Clin. J. Sport Med. Off. J. Can. Acad. Sport Med. 2008;18(5):438–45. https://doi.org/10.1097/JSM.0b013e318181e501.CrossRef

Boulet L-P. Cough and upper airway disorders in elite athletes: a critical review. Br. J. Sports Med. 2012;46(6):417–21. https://doi.org/10.1136/bjsports-2011-090812.CrossRef

Murray, M. T. et al., “Mitigating a COVID-19 outbreak among major league baseball players - United States, 2020,” MMWR Morb. Mortal. Wkly. Rep., vol. 69, no. 42, pp. 1542–1546, Oct. 2020, https://doi.org/10.15585/mmwr.mm6942a4.

• McElheny, K. D., Little, D., Taylor, D., and Manzi, J. E., “Communicable illness mitigation strategies for traveling elite sporting organizations,” Sports Health, p. 19417381211032224, Jul. 2021, https://doi.org/10.1177/19417381211032226. Guidelines for reducing communicable illness in professional and elite athletes, with special considerations for the pandemic and travel.

Kenealy T, Arroll B. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst. Rev. 2013;(6):CD000247. https://doi.org/10.1002/14651858.CD000247.pub3.

10.

Shulman, S. T. et al., “Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America,” Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am., vol. 55, no. 10, pp. 1279–1282, Nov. 2012, https://doi.org/10.1093/cid/cis847.

11.

Bordeleau, M., Turmel, J., and Boulet, L.-P., “Effects of ipratropium on exercise-induced cough in winter athletes: a hypothesis-generating study,” Phys. Sportsmed., vol. 42, no. 4, pp. 7–13, Nov. 2014, https://doi.org/10.3810/psm.2014.11.2086.

12.

Gong, H., Bedi, J. F., and Horvath, S. M., “Inhaled albuterol does not protect against ozone toxicity in nonasthmatic athletes,” Arch. Environ. Health, vol. 43, no. 1, pp. 46–53, Feb. 1988, https://doi.org/10.1080/00039896.1988.9934373.

13.

Koya, T. et al., “Effect of ciclesonide on bronchial asthma in athletes,” J. Asthma Off. J. Assoc. Care Asthma, vol. 46, no. 10, pp. 1032–1036, Dec. 2009, https://doi.org/10.3109/02770900903229693.

14.

Helenius, I. et al., “No effect of montelukast on asthma-like symptoms in elite ice hockey players,” Allergy, vol. 59, no. 1, pp. 39–44, Jan. 2004, https://doi.org/10.1046/j.1398-9995.2003.00353.x.

15.

Sue-Chu M, Karjalainen EM, Laitinen A, Larsson L, Laitinen LA, Bjermer L. Placebo-controlled study of inhaled budesonide on indices of airway inflammation in bronchoalveolar lavage fluid and bronchial biopsies in cross-country skiers. Respir. Int. Rev. Thorac. Dis. 2000;67(4):417–25. https://doi.org/10.1159/000029541.CrossRef

16.

Snyders, C., Pyne, D. B., Sewry, N., Hull, J. H., Kaulback, K., and Schwellnus, M., “Acute respiratory illness and return to sport: a systematic review and meta-analysis by a subgroup of the IOC consensus on ‘acute respiratory illness in the athlete,’” Br. J. Sports Med., vol. 56, no. 4, pp. 223–231, Feb. 2022, https://doi.org/10.1136/bjsports-2021-104719.

17.

Mitchell JJ, Jackson JM, Anwar A, Singleton SB. Bacterial sport-related skin and soft-tissue infections (SSTIs): an ongoing problem among a diverse range of athletes. JBJS Rev. 2017;5(1):01874474-201701000–00002. https://doi.org/10.2106/JBJS.RVW.16.00006.CrossRef

18.

Decker CF. Skin and soft tissue infections in the athlete. Dis.--Mon. DM. 2010;56(7):414–21. https://doi.org/10.1016/j.disamonth.2010.05.002.CrossRef

19.

Goldstein, A. and Goldstein, B., “Dermatophyte (tinea) infections - UpToDate,” 2022. https://www.uptodate.com/contents/dermatophyte-tinea-infections?search=tinea%20infections&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 (accessed Mar. 27, 2022).

20.

Lee, R. M. et al., “Incubation periods of viral gastroenteritis: a systematic review,” BMC Infect. Dis., vol. 13, p. 446, Sep. 2013, https://doi.org/10.1186/1471-2334-13-446.

21.

Scallan, E. et al., “Foodborne illness acquired in the United States--major pathogens,” Emerg. Infect. Dis., vol. 17, no. 1, pp. 7–15, Jan. 2011, https://doi.org/10.3201/eid1701.p11101.

22.

Robilotti, E., Deresinski, S., and Pinsky, B. A., “Norovirus,” Clin. Microbiol. Rev., vol. 28, no. 1, pp. 134–164, Jan. 2015, https://doi.org/10.1128/CMR.00075-14.

23.

Conway, J. J., Toresdahl, B. G., Ling, D. I., Boniquit, N. T., Callahan, L. R., and Kinderknecht, J. J., “Prevalence of inadequate immunity to measles, mumps, rubella, and varicella in MLB and NBA athletes,” Sports Health, vol. 10, no. 5, pp. 406–411, Oct. 2018, https://doi.org/10.1177/1941738118777726.

24.

• Stenger, T. et al., “Timing of vaccination after training: immune response and side effects in athletes,” Med. Sci. Sports Exerc., vol. 52, no. 7, pp. 1603–1609, Jul. 2020, https://doi.org/10.1249/MSS.0000000000002278. RCT demonstrating timing of vaccination after prior training does not seem to require specific constraints.

25.

•• Sharma, S. et al., “International recommendations for electrocardiographic interpretation in athletes,” Eur. Heart J., vol. 39, no. 16, pp. 1466–1480, Apr. 2018, https://doi.org/10.1093/eurheartj/ehw631. The international criteria guiding EKG interpretation in the athlete.

26.

Ullal, A. J., Abdelfattah, R. S., Ashley, E. A., and Froelicher, V. F., “Hypertrophic cardiomyopathy as a cause of sudden cardiac death in the young: a meta-analysis,” Am. J. Med., vol. 129, no. 5, pp. 486-496.e2, May 2016, https://doi.org/10.1016/j.amjmed.2015.12.027.

27.

Endres, B. D. et al., “Epidemiology of sudden death in organized youth sports in the United States, 2007-2015,” J. Athl. Train., vol. 54, no. 4, pp. 349–355, Apr. 2019, https://doi.org/10.4085/1062-6050-358-18.

28.

Landry, C. H. et al., “Sudden cardiac arrest during participation in competitive sports,” N. Engl. J. Med., vol. 377, no. 20, pp. 1943–1953, Nov. 2017, https://doi.org/10.1056/NEJMoa1615710.

29.

Maron, B. J., “Sudden death in young athletes,” N. Engl. J. Med., vol. 349, no. 11, pp. 1064–1075, Sep. 2003, https://doi.org/10.1056/NEJMra022783.

30.

Winkelmann, Z. K. and Crossway, A. K., “Optimal screening methods to detect cardiac disorders in athletes: an evidence-based review,” J. Athl. Train., vol. 52, no. 12, pp. 1168–1170, Dec. 2017, https://doi.org/10.4085/1062-6050-52.11.24.

31.

Casa, D. J. et al., “National athletic trainers’ association position statement: preventing sudden death in sports,” J. Athl. Train., vol. 47, no. 1, pp. 96–118, Feb. 2012, https://doi.org/10.4085/1062-6050-47.1.96.

32.

Martinez, M. W. et al., “Prevalence of inflammatory heart disease among professional athletes with prior COVID-19 infection who received systematic return-to-play cardiac screening,” JAMA Cardiol., vol. 6, no. 7, pp. 745–752, Jul. 2021, https://doi.org/10.1001/jamacardio.2021.0565.

33.

Guasch E, Mont L. Diagnosis, pathophysiology, and management of exercise-induced arrhythmias. Nat. Rev. Cardiol. 2017;14(2):88–101. https://doi.org/10.1038/nrcardio.2016.173.CrossRef

34.

Priori SG, et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur. Heart J. 2015;36(41):2793–867. https://doi.org/10.1093/eurheartj/ehv316.CrossRef

35.

Siebert DM, Drezner JA. Sudden cardiac arrest on the field of play: turning tragedy into a survivable event. Neth. Heart J. Mon. J. Neth. Soc. Cardiol. Neth. Heart Found. 2018;26(3):115–9. https://doi.org/10.1007/s12471-018-1084-6.CrossRef

36.

Pelto, H. F. and J. A. Drezner, “Design and implementation of an emergency action plan for sudden cardiac arrest in sport,” J Cardiovasc. Transl. Res., vol. 13, no. 3, pp. 331–338, Jun. 2020, https://doi.org/10.1007/s12265-020-09988-1.

37.

Friedman, E., “How to of emergency action planning,” Am College Cardiol, 2021. https://www.acc.org/latest-in-cardiology/articles/2021/09/24/12/05/http%3a%2f%2fwww.acc.org%2flatest-in-cardiology%2farticles%2f2021%2f09%2f24%2f12%2f05%2fhow-to-of-emergency-action-planning (accessed Mar. 18, 2022).

38.

Ramkumar, P. N. et al., “Short-term outcomes of concussions in major league baseball: a historical cohort study of return to play, performance, longevity, and financial impact,” Orthop. J. Sports Med., vol. 6, no. 12, p. 2325967118814238, Dec. 2018, https://doi.org/10.1177/2325967118814238.

39.

• Peterson, J. G., Tjong, V. K., Terry, M. A., Saltzman, M. D., Gryzlo, S. M., and Sheth, U., “Concussion incidence and impact on player performance in major league baseball players before and after a standardized concussion protocol,” Orthop. J. Sports Med., vol. 8, no. 4, p. 2325967120913020, Apr. 2020, https://doi.org/10.1177/2325967120913020. Short-term outcomes after concussion in limited-contact MLB athletes demonstrates that concussions may not decrease career spans but may result in decreased performance.

40.

Sabesan VJ, Prey B, Smith R, Lombardo DJ, Borroto WJ, Whaley JD. Concussion rates and effects on player performance in Major League Baseball players. Open Access J. Sports Med. 2018;9:253–60. https://doi.org/10.2147/OAJSM.S157433.CrossRef

41.

Harmon, K. G. et al., “American Medical Society for Sports Medicine position statement: concussion in sport,” Br. J. Sports Med., vol. 47, no. 1, pp. 15–26, Jan. 2013, https://doi.org/10.1136/bjsports-2012-091941.

42.

Camp, C. L. et al., “Getting hit by pitch in professional baseball: analysis of injury patterns, risk factors, concussions, and days missed for batters,” Am. J. Sports Med., vol. 46, no. 8, pp. 1997–2003, Jul. 2018, https://doi.org/10.1177/0363546518773048.

43.

• Baker, H. P., Volchenko, E., and Athiviraham, A., “Does the MLB’s collision at home plate rule change prevent concussion injuries in catchers?,” Phys. Sportsmed., vol. 48, no. 3, pp. 354–357, Sep. 2020, https://doi.org/10.1080/00913847.2020.1718565. Retrospective cohort study demonstrating that the MLB’s rule limiting home plate collisions significantly reduced the number of concussions suffered by MLB catchers.

44.

Athiviraham, A. et al., “Analysis of baseball-to-helmet impacts in major league baseball,” Am. J. Sports Med., vol. 40, no. 12, pp. 2808–2814, Dec. 2012, https://doi.org/10.1177/0363546512461754.

45.

Cusimano MD, Zhu A. Systematic review of traumatic brain injuries in baseball and softball: a framework for prevention. Front. Neurol. 2017;8:492. https://doi.org/10.3389/fneur.2017.00492.CrossRef

46.

Winter, W. C., Hammond, W. R., Green, N. H., Zhang, Z., and Bliwise, D. L., “Measuring circadian advantage in Major League Baseball: a 10-year retrospective study,” Int. J. Sports Physiol. Perform., vol. 4, no. 3, pp. 394–401, Sep. 2009, https://doi.org/10.1123/ijspp.4.3.394.

47.

Pelham, W. E. et al., “Methylphenidate and baseball playing in ADHD children: who’s on first?,” J. Consult. Clin. Psychol., vol. 58, no. 1, pp. 130–133, Feb. 1990, https://doi.org/10.1037/0022-006X.58.1.130.

48.

Sinusas, K. and Coroso, J. G., “A 10-yr study of smokeless tobacco use in a professional baseball organization,” Med. Sci. Sports Exerc., vol. 38, no. 7, pp. 1204–1207, Jul. 2006, https://doi.org/10.1249/01.mss.0000227303.80783.46.

49.

Davidson JRT. Major depressive disorder treatment guidelines in America and Europe. J. Clin. Psychiatry. 2010;71 Suppl E1:e04. https://doi.org/10.4088/JCP.9058se1c.04gry.CrossRef

50.

Reardon, C. L. and Creado, S., “Psychiatric medication preferences of sports psychiatrists,” Phys. Sportsmed., vol. 44, no. 4, pp. 397–402, Nov. 2016, https://doi.org/10.1080/00913847.2016.1216719.

Title: Primary Care Considerations for the Baseball Athlete
Authors: Lauren Prisco
Lauren A. Salesi
Kathryn D. McElheny
Doria Weiss
Laura Diamond
Tim Brennan
Publication date: 07-11-2022
Publisher: Springer US
Keywords: Care
Traumatic Brain Injuries
Published in: Current Reviews in Musculoskeletal Medicine / Issue 6/2022
Electronic ISSN: 1935-9748
DOI: https://doi.org/10.1007/s12178-022-09798-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Primary Care Considerations for the Baseball Athlete

Abstract

Purpose of Review

Recent Findings

Summary

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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