Timothy L. Miller Editor Endurance Sports Medicine A Clinical Guide 123 Endurance Sports Medicine Timothy L. Miller Editor Endurance Sports Medicine A Clinical Guide Editor Timothy L. Miller Department of Orthopaedic Surgery Ohio State University Wexner Medical Center Gahanna , OH , USA ISBN 978-3-319-32980-2 ISBN 978-3-319-32982-6 (eBook) DOI 10.1007/978-3-319-32982-6 Library of Congress Control Number: 2016943314 © Springer International Publishing Switzerland 2016 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. T he use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. T he publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG Switzerland To my family, in particular my wife Nicole and our children Gavin, Ashton, Avery, and Sydney and my parents Tom and Kathleen, for always believing in me and showing patience and understanding when I take on “yet another project.” To the many endurance athletes who have had their seasons and careers cut short due to overuse injuries, know that your hard work and efforts have not gone in vain and, in fact, were the inspiration for this book. Pref ace Endurance Sports Medicine has been in many ways a labor of love for the authors and the editor. It is the culmination of many years of experience with injuries and conditions as athletes, as researchers, and as sports medicine care providers. This textbook compiles the many concepts, experiences, and tech- niques required to approach and treat the complexities of conditions that affect endurance sports participants. I truly appreciate the contributions of the authors—many of whom are considered pioneers and leaders in the fi eld of sports medicine—who have provided their invaluable insights and pearls. As a developing fi eld of sports medicine, endurance medicine continues to expand its understanding of overuse injuries as athletes continue to push the limits of running, cycling, swimming, wheelchair, skiing, rowing, cross-fi t sports, adventure and obstacle course racing, and many other demanding activities. Traditional strategies for treating overuse conditions such as sim- ply stopping the causative activity or sport are no longer considered an acceptable option for many competitive athletes. Alternative training meth- ods including a holistic approach to the evaluation, treatment, and prevention of activity-related conditions are now the standard of care as is evidenced throughout the 21 chapters of this book. This textbook details strategies for not only treating and preventing injuries and conditions but also for optimiz- ing an athlete’s performance. Though it is too early to determine whether we can obviate the need to have athletes completely abstain from their sport of choice in response to an injury or condition, we can decrease the time lost from training and competition and allow for a more safe and predictable return to full activity. It is my hope that this textbook will be a valuable guide for sports medicine physicians, orthopedists, athletic trainers, physical thera- pists, coaches, offi cials, and athletes in understanding the needs of the deter- mined individuals who participate in endurance sports. Gahanna, OH, USA Timothy L. Miller, MD vii Contents Part I Medical Conditions 1 Cardiovascular Evaluation and Treatment of the Endurance Athlete .............................................................. 3 Jennifer A. Michaud Finch and Aaron L. Baggish 2 Exercise-Induced Bronchoconstriction and Vocal Cord Dysfunction ........................................................ 21 Christopher Kempe and Jonathan P. Parsons 3 Evaluation and Treatment of Heat-and Altitude-Related Illness .............................................................................................. 31 Matthew G ammons , Tarryn Bolognani , and Matt Howland 4 Pregnancy and the Endurance Athlete ....................................... 43 Jacob Michael Bright and Chad A. Asplund 5 Gender Differences: Considerations for the Female Endurance Athlete ........................................................................ 55 Scott Annett , Kyle Cassas , and Sean Bryan 6 Considerations for the Pediatric Endurance Athlete ................. 71 Kelsey Logan and Gregory Walker Part II Musculoskeletal Conditions 7 Treatment of Stress Fractures ...................................................... 79 Timothy L. Miller 8 Evaluation and Treatment of Soft Tissue Overuse Injuries ...... 93 Bryant Walrod 9 Chronic Exertional Compartment Syndrome ............................ 113 Robin West , Joseph Ferguson , and Alexander Butler 10 Shoulder Injuries and Conditions in Swimmers ........................ 127 Tyler R. Johnston and Geoffrey D. Abrams 11 Common Injuries and Conditions in Rowers ............................. 139 Clinton Hartz and Abigail Lang ix