Abstract:
:In recent years, reproductive disorders in athletes have been observed in increasing numbers and proportions as larger numbers of women are participating in more strenuous athletic activities. Clinical problems with infertility and decreased bone density have been reported in this group, which has prided itself on its health. Hypoestrogenic women, including amenorrheic athletes, should definitely seek medical treatment for the prevention of osteoporosis, but before women sacrifice the many benefits of strenuous exercise, it is appropriate to consider the strength of the evidence that exercise training in particular, rather than other, extraneous aspects of athletic training, is responsible for the hormonal changes associated with reproductive disorders. This review has examined this first link in the postulated causal chain between exercise and these clinical conditions. In this review, only those studies that have compared trained or highly trained women with untrained or less-trained women, either cross-sectionally or longitudinally have been considered. In assessing the credibility of the reported results, we have found that the extensive precautions, painstaking techniques, and powerful protocols required for studying the question have only slowly been appreciated and never fully implemented by investigators. As a result, most of the published results are of little value. The few studies less susceptible to such criticism are consistent in their observations of gonadotropin and ovarian steroid suppression in women participating in athletic training. Nevertheless, even these results may have been biased by confounding factors, and thus at the present time the first link in the causal chain of events from exercise training to infertility and fractures cannot be regarded as proven. If the observed suppression of reproductive hormones is, indeed, due to exercise training, it may be dependent upon either the intensity of exercise training or the rate at which the intensity is increased. A dependence upon the rate at which exercise intensity is increased may explain why large proportions of athletes at all exercise intensity levels remain eumenorrheic. If future studies eliminate the biasing effects of known confounding factors and confirm that the female reproductive system can be suppressed by exercise training in particular, then additional research will be needed to determine the training intensity or rate of change in intensity required for these effects to occur. Research will also be needed to determine how gynecologic age, body composition, diet, and psychologic status may exaggerate or attenuate these effects.(ABSTRACT TRUNCATED AT 400 WORDS)
journal_name
Clin Sports Medjournal_title
Clinics in sports medicineauthors
Loucks ABsubject
Has Abstractpub_date
1986-07-01 00:00:00pages
535-57issue
3eissn
0278-5919issn
1556-228Xjournal_volume
5pub_type
杂志文章,评审abstract::The understanding and treatment of the young athlete's knee has improved and continues to do so as arthroscopy and good long-term follow-up studies guide the process. In the management of epiphyseal fractures about the knee the presence of associated ligament injury and the high likelihood of a growth plate injury is ...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:
更新日期:1988-07-01 00:00:00
abstract::Many components of the immune system exhibit adverse change after prolonged, intense exertion. During this "open window" of impaired immunity (which may last 3-72 h, depending on the immune measure), viruses and bacteria may gain a foothold, increasing the risk for subclinical and clinical infection. The influence of ...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/s0278-5919(05)70167-8
更新日期:1999-07-01 00:00:00
abstract::A high-velocity knee dislocation is a true orthopedic emergency. A high index of suspicion is necessary to identify reduced knee dislocations in multiple trauma patients. Coexisting injuries are common in patients with high-velocity knee dislocations. After an initial assessment, the knee joint should be reduced immed...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/s0278-5919(05)70218-0
更新日期:2000-07-01 00:00:00
abstract::In summary, arthroscopic evaluation of the athlete's knee joint provides a highly accurate means of diagnosing intra-articular lesions. It provides valuable information regarding treatment and prognosis. In addition, if arthroscopic surgical treatment is possible, even greater benefits in regard to more rapid return t...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:
更新日期:1985-04-01 00:00:00
abstract::Anterior cruciate ligament (ACL) reconstruction is a successful procedure with high rates of return to sport. However, some patients experience persistent instability and graft failure. These adverse events have a significant impact, especially on high-level athletes. In an effort to improve outcomes for these patient...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/j.csm.2017.07.006
更新日期:2018-01-01 00:00:00
abstract::An increased knowledge of the biomechanics of normal walking and running will improve our understanding of the possible mechanisms of pathology and ultimately improve the treatment of pathology and injury. Running, a natural extension of walking, involves increased velocities, joint range of motion, forces, muscle act...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-10-01 00:00:00
abstract::Hip instability is uncommon because of the substantial conformity of the osseous femoral head and acetabulum. It can be defined as extraphysiologic hip motion that causes pain with or without the symptom of hip joint unsteadiness. The cause can be traumatic or atraumatic, and is related to both bony and soft tissue ab...
journal_title:Clinics in sports medicine
pub_type: 杂志文章
doi:10.1016/j.csm.2010.12.008
更新日期:2011-04-01 00:00:00
abstract::Traumatic CNS injury is one of the most important health issues in our society and is a risk to all athletes, both in competitive and recreational sports. Our understanding of the pathophysiology has improved tremendously in the last 20 years. This progress has led to the identification of several possible treatments ...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/s0278-5919(02)00107-2
更新日期:2003-07-01 00:00:00
abstract::Rehabilitation of the dysfunction that is associated with rotator cuff tendinopathy should be based on the evidence known about the pathoetiology of the tendinopathy, what is known about the extent of the local anatomic injury, the local and distant physiological and biomechanical alterations, and on the knowledge dev...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/s0278-5919(03)00048-6
更新日期:2003-10-01 00:00:00
abstract::Sports medicine literature often refers to "swimmer's shoulder." Increasingly, however, it is evident that swimmer's shoulder is a spectrum of maladies whose underlying origins may be incidental to athletic activity. Those dealing with the treatment of swimmers should have a thorough understanding of the differential ...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/s0278-5919(05)70150-2
更新日期:1999-04-01 00:00:00
abstract::With the increasing reliance on tissue allografts in orthopedic reconstructive and sports surgery, there is a realistic concern on behalf of both the surgeon and the patient as to the safety of these implanted tissues and the possibility of disease transmission. New Food and Drug Administration guidelines in associati...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/j.csm.2008.08.002
更新日期:2009-01-01 00:00:00
abstract::An increasing number of revision ACL reconstructions are being performed each year. Revision ACL surgery is challenging and cannot be approached in the same manner as primary ACL surgery. Successful revision ACL surgery requires a detailed history, a comprehensive physical examination, appropriate radiologic studies, ...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/s0278-5919(05)70133-2
更新日期:1999-01-01 00:00:00
abstract::The shoulder is the joint most subjected to repetitive microtrauma in swimming. This results in clinical manifestations of subacromial encroachment. The anatomy, radiographic changes, clinical findings, and histopathology of this disease process are discussed. The role of conservative exercises used in prevention as w...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:
更新日期:1986-01-01 00:00:00
abstract::This article addresses the prevalence of various hand and wrist injuries in a variety of sports. Multiple resources and references have been utilized to draw a perception of the types of injuries and the sports with which they are most commonly associated. It is hoped that this article will give the physician a greate...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/s0278-5919(05)70092-2
更新日期:1998-07-01 00:00:00
abstract::Shoulder arthroscopy has undergone dramatic advancements in the past few years. New biomechanical concepts, such as the functional rotator cuff tear, have led to new treatments, such as partial repair of massive rotator cuff tears. Techniques have evolved to repair rotator cuff tears and Bankart lesions arthroscopical...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:
更新日期:1996-10-01 00:00:00
abstract::Presently there are no universally accepted definitions of the grades of concussion or criteria for when to allow the athlete to return to competition after a head injury. What is agreed upon is that in order to avoid cumulative brain damage and the second impact syndrome, no athlete still suffering post-concussion sy...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/s0278-5919(05)70060-0
更新日期:1998-01-01 00:00:00
abstract::Ankle injuries occur frequently in an athletic population. Understanding the anatomy, biomechanics, pathomechanics, differential diagnosis, and special pediatric considerations allows an accurate diagnosis. Treatment with a nonoperative aggressive goal-oriented therapy program has been successful at the United States ...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:
更新日期:1989-07-01 00:00:00
abstract::Although limited literature exists on medial epicondylitis of the elbow, this disorder is an injury affecting many athletes at every level, especially throwing athletes. Care must be taken in diagnosing medial epicondylitis to distinguish it from other possible pathologies of the medial elbow, which may exist concurre...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/j.csm.2004.04.011
更新日期:2004-10-01 00:00:00
abstract::The decision to incorporate ortho-biologics into a clinical practice will ultimately depend on physicians' preferences and the resources available to their practice. It is important to emphasize that different biologics are used for different pathologies/injuries and in different settings, such as the operating room o...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/j.csm.2018.08.008
更新日期:2019-01-01 00:00:00
abstract::Because both the young and aging population are showing increasing interest in sports participation, the number of sports related injuries and in particular anterior cruciate ligament (ACL) injuries have been increasing. Because of these injuries much time and energy has been focused on ACL reconstruction in order to ...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/j.csm.2007.06.002
更新日期:2007-10-01 00:00:00
abstract::The conservative management of shoulder instability depends on a well-defined program that emphasizes early diminution in the patient's symptoms, appropriate immobilization, and a well-defined precise rehabilitation program that can be individually tailored to meet the patient's needs. Immobilization should be conside...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-10-01 00:00:00
abstract::To minimize the risk of subscapularis failure after shoulder replacement, a method of preserving the subscapularis while allowing access to the glenohumeral joint was developed. Only the inferior 30% to 50% of the subscapularis tendon is detached from the humerus, leaving the superior aspect attached to the lesser tub...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/j.csm.2018.05.006
更新日期:2018-10-01 00:00:00
abstract::Several reconstructive techniques exist to treat posterior cruciate ligament (PCL) deficiency. The purpose of this study is to report knee function and clinical stability after PCL reconstruction (PCLR) using an all-inside technique. Thirty-two patients with isolated or combined PCL injuries treated with all-inside PC...
journal_title:Clinics in sports medicine
pub_type: 杂志文章
doi:10.1016/j.csm.2018.11.005
更新日期:2019-04-01 00:00:00
abstract::Female athletes have an increased incidence of ACL rupture. The cause of this increased injury rate is unclear, but it is most likely from a complex interplay between multiple variables. The relative risk of incurring an ACL injury is still low. The increased risk of ACL injury in women compared with men should not di...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/s0278-5919(05)70204-0
更新日期:2000-04-01 00:00:00
abstract::Ulnar collateral ligament injury in the overhead athlete typically presents as activity-related pain with loss of velocity and control. Treatment options range from nonoperative rehabilitation to ligament reconstruction. Surgical reconstruction is frequently required to allow the athlete to return to competition and m...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/j.csm.2016.05.004
更新日期:2016-10-01 00:00:00
abstract::The glenohumeral joint is an inherently unstable joint that relies on the interaction of the dynamic and static stabilizers to maintain stability. Disruption of this interplay or poor development of any of these factors may result in instability, pain, and a loss of function. Rehabilitation will vary based on the type...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/j.csm.2013.07.017
更新日期:2013-10-01 00:00:00
abstract::Stress fractures are common injuries, particularly in endurance athletes. Stress fracture management should take into consideration the injury site (low risk versus high risk), the grade (extent of microdamage accumulation), and the individual's competitive situation. The authors briefly discuss the pathophysiology an...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/j.csm.2005.08.012
更新日期:2006-01-01 00:00:00
abstract::This article provides an understanding of patient-based shoulder outcome tools and the conceptual framework of disablement models from which the patient-based outcome tools are based. To allow for the evaluation of function, disability, and health-related quality of life in patients suffering from shoulder pain and in...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:10.1016/j.csm.2008.03.001
更新日期:2008-07-01 00:00:00
abstract::Racquet sports involve sharp, side-to-side movements and impose significant valgus and rotatory stresses on the knee. Most knee injuries are indirect as a result of these acute stresses and overuse. Some of the more common racquet sport injuries include tennis leg, jumper's knee, patello-femoral pain, meniscal injurie...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:
更新日期:1988-04-01 00:00:00
abstract::As in all other medical evaluations, the evaluation of the cardiovascular system in the competitive athlete or the nonathlete wishing to exercise must begin with a carefully performed history and physical examination. Subsequent studies, including chest radiograph and electrocardiogram, may be waived in certain popula...
journal_title:Clinics in sports medicine
pub_type: 杂志文章,评审
doi:
更新日期:1984-01-01 00:00:00