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SPORTS MEDICINE
Examination & Board Review
EDITORS
Francis G. O’Connor, MD, FACSM
Director, Sports Medicine Fellowship Program
Associate Professor of Family Medicine
Department of Family Medicine
Uniformed Services University of the Health Sciences
Bethesda, Maryland
Robert E. Sallis, MD, FAAFP, FACSM
Co-Director, Sports Medicine Fellowship
Kaiser Permanente Medical Center
Fontana, California
Robert P. Wilder, MD, FACSM
Associate Professor Physical Medicine and Rehabilitation
Medical Director the Runner’s Clinic at UVA
Team Physician, UVA Athletics, The University of Virginia
Charlottesville, Virginia
Patrick St. Pierre, MD
Assistant Professor of Orthopedic Surgery
Uniformed Series University of the Health Sciences
Bethesda, Maryland
Associate Director Nirschl Orthopedic
Sports Medicine Fellowship
Arlington, Virginia
SPORTS MEDICINE
Examination & Board Review
Francis G. O’Connor
Robert E. Sallis
Robert P. Wilder


Patrick St. Pierre
McGraw-Hill
Medical Publishing Division
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DOI: 10.1036/0071446303
v
Contents
Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxv
QUESTIONS
SECTION 1. GENERAL CONSIDERATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1. The Team Physician . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Anthony I. Beutler, Christopher B. Ranney, and John H. Wilckens
2. Ethical Considerations in Sports Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Ralph G. Oriscello
3. Legal Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Aaron Rubin
4. Field Side Emergencies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Michael C. Gaertner and Loren A. Crown
5. Mass Participation Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Scott W. Pyne
6. Catastrophic Sports Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Barry P. Boden
7. Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Scott A. Magnes
8. Basics in Exercise Physiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Patricia A. Deuster and David O. Keyser
9. Articular Cartilage Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Stephen J. Bee and Brian J. Cole
10. Muscle and Tendon Injury and Repair. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Bradley J. Nelson and Dean C. Taylor
11. Bone Injury and Fracture Healing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Carlos A. Guanche
12. The Preparticipation Physical Examination. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Robert E. Sallis
For more information about this title, click here
13. Basic Principles of Exercise Training and Conditioning . . . . . . . . . . . . . . . . . . . . . . . . 17
Craig K. Seto
14. Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Nancy M. DiMarco and Eve V. Essery
15. Exercise Prescription . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Mark B. Stephens
16. Exercise and Chronic Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Karl B. Fields, Michael Shea, Rebecca Spaulding, and David Stewart

17. Playing Surface and Protective Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Jeffrey G. Jenkins and Scott Chirichetti
SECTION 2. EVALUATION OF THE INJURED ATHLETE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
18. Diagnostic Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Leanne L. Seeger and Kambiz Motamedi
19. Electrodiagnostic Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Venu Akuthota and John Tobey
20. Exercise Stress Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
David E. Price, Kevin J. Elder, and Russell D. White
21. Gait Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
D. Casey Kerrigan and Ugo Della Croce
22. Compartment Syndrome Testing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
John E. Glorioso and John H. Wilckens
23. Exercise-Induced Asthma Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Fred H. Brennan, Jr.
24. Drug Testing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Aaron Rubin
SECTION 3. MEDICAL PROBLEMS IN THE ATHLETE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
25. Cardiovascular Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Francis G. O’Connor, John P. Kugler, and Ralph P. Oriscello
26. Dermatology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Kenneth B. Batts
27. Genitourinary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
William S. Sykora
28. Ophthalmology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Ronica A. Martinez and Kayvan A. Ellini
29. Otolaryngology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Charles W. Webb
30. Dental . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Elizabeth M. O’Connor

vi Contents
31. Infectious Disease and the Athlete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
John P. Metz
32. Endocrine Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
William W. Dexter and Kevin J. Broderick
33. Hematology in the Athlete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
William B. Adams
34. Neurology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Jay Erickson
35. Gastroenterology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
David L. Brown and Chris G. Pappas
36. Pulmonary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Carrie A. Jaworski
37. Allergic Diseases in Athletes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
David L. Brown, David D. Haight, and Linda L. Brown
38. Overtraining Syndrome/Chronic Fatigue. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Thomas M. Howard
39. Environmental Injuries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Brian V. Reamy
SECTION 4. MUSCULOSKELETAL PROBLEMS IN THE ATHLETE . . . . . . . . . . . . . . . . . . . . . . . . 55
40. Head Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Robert C. Cantu
41. Cervical Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Gerard A. Malanga, Garrett S. Hyman, and Jay E. Bowen
42. Thoracic and Lumbar Spine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Scott F. Nadler and C. Michele Miller
43. Magnetic Resonance Imaging: Technical Considerations and Upper Extremity . . . . 58
Carolyn M. Sofka
44. Shoulder Instability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Augustus D. Mazzocca and Robert A. Arciero

45. Rotator Cuff Pathology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Patrick St. Pierre
46. Sternoclavicular, Clavicle, and Acromioclavicular Injuries . . . . . . . . . . . . . . . . . . . . . . 62
Carl J. Basamania
47. Shoulder Superior Labrum, Biceps, and Pec Tears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Jeffrey S. Abrams
48. The Throwing Shoulder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Carlos A. Guanche
49. Elbow Instability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Derek H. Ochiai and Robert P. Nirschl
Contents vii
viii Contents
50. Elbow Articular Lesions and Fractures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Edward S. Ashman
51. Elbow Tendinosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Robert P. Nirschl and Derek H. Ochiai
52. Soft Tissue Injuries of the Wrist in Athletes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Steven B. Cohen and Michael E. Pannunzio
53. Soft Tissue Injuries of the Hand . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Todd C. Battaglia and David R. Diduch
54. Wrist and Hand Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Geoffrey S. Baer and A. Bobby Chhabra
55. Upper Extremity Nerve Entrapment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Margarete DiBenedetto and Robert Giering
56. Magnetic Resonance Imaging: Lower Extremity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Carolyn M. Sofka
57. Pelvis, Hip, and Thigh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Brett D. Owens and Brian D. Busconi
58. Knee Meniscal Injuries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
John P. Goldblatt and John C. Richmond

59. Knee Instability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Alex J. Kline and Mark D. Miller
60. The Patellofemoral Joint. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Robert J. Nicoletta and Anthony A. Schepsis
61. Soft Tissue Knee Injuries (Tendon and Bursae) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
John J. Klimkiewicz
62. Ankle Instability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
R. Todd Hockenbury
63. Surgical Considerations in the Leg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Gregory G. Dammann and Keith S. Albertson
64. Tibia and Ankle Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Brian E. Abell and Edward S. Ashman
65. Foot Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Mark D. Porter, Joseph J. Zubak, and Winston J. Warme
66. Lower Extremity Stress Fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Michael Fredericson
67. Nerve Entrapments of the Lower Extremity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Robert P. Wilder, Jay Smith, and Diane Dahm
SECTION 5. PRINCIPLES OF REHABILITATION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
68. Physical Modalities in Sports Medicine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Alan P. Alfano
69. Core Strengthening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Joel Press
Contents ix
70. Medications and Ergogenics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Scott B. Flinn
71. Common Injections in Sports Medicine: General Principles and
Specific Techniques. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Francis G. O’Connor
72. Footwear and Orthotics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96

Eric M. Magrum and Jay Dicharry
73. Taping and Bracing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Tom Grossman, Kate Serenelli, and Danny Mistry
74. Psychologic Considerations in Exercise and Sport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Nicole L. Frazer
75. Complimentary and Alternative Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Anthony I. Beutler and Wayne B. Jonas
SECTION 6. SPORTS-SPECIFIC CONSIDERATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
76. Baseball. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
James R. Morales and Dennis A. Cardone
77. Basketball . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
John Turner and Douglas B. McKeag
78. Boxing: Medical Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
John P. Reasoner and Francis G. O’Connor
79. Crew . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Andrew D. Perron
80. Cross-Country Ski Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Janus D. Butcher
81. Bicycling Injuries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Chad Asplund
82. Figure Skating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Roger J. Kruse and Jennifer Burke
83. Football . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
John M. MacKnight
84. Golfing Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Gregory G. Dammann and Jeffrey A. Levy
85. Gymnastics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Julie Casper and John P. DiFiori
86. Ice Hockey Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Peter H. Seidenberg and Tory Woodard

87. Rugby Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Peter H. Seidenberg and Rochelle M. Nolte
88. Running . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Robert P. Wilder and Francis G. O’Connor
89. Soccer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Nicholas A. Piantanida
90. Swimming. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Nancy E. Rolnik
91. Tennis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Robert P. Nirschl
92. Triathlon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Shawn F. Kane and Fred H. Brennan Jr.
93. Weightlifting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
Joseph M. Hart and Christopher D. Ingersoll
94. Lacrosse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Thad Barkdull
95. Wrestling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Michael G. Bowers and Thomas M. Howard
SECTION 7. SPECIAL POPULATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
96. The Pediatric Athlete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Amanda Weiss Kelly and Terry A. Adirim
97. The Geriatric Athlete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Cynthia M. Williams
98. The Female Athlete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Rochelle M. Nolte and Catherine M. Fieseler
99. Special Olympics Athletes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Pamela M. Williams and Christopher M. Prior
100. The Disabled Athlete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Paul F. Pasquina, Halli Hose, and David C. Young
101. The Athlete with a Total Joint Replacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128

Jennifer L. Reed
102. Cancer and the Athlete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Brian Whirrett and Kimberly Harmon
103. The Athlete with HIV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
Robert J. Dimeff and Andrew M. Blecher
ANSWERS AND EXPLANATIONS
SECTION 1. GENERAL CONSIDERATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Chapter 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Chapter 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
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Chapter 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Chapter 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
Chapter 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
Chapter 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Chapter 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
Chapter 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Chapter 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Chapter 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Chapter 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
Chapter 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Chapter 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
Chapter 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Chapter 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Chapter 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Chapter 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
SECTION 2. EVALUATION OF THE INJURED ATHLETE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Chapter 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Chapter 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
Chapter 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Chapter 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160

Chapter 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
Chapter 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162
Chapter 24 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
SECTION 3. MEDICAL PROBLEMS IN THE ATHLETE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Chapter 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Chapter 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Chapter 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Chapter 28 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170
Chapter 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170
Chapter 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
Chapter 31 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Chapter 32 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
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Chapter 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Chapter 34 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Chapter 35 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Chapter 36 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Chapter 37 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
Chapter 38 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Chapter 39 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
SECTION 4. MUSCULOSKELETAL PROBLEMS IN THE ATHLETE . . . . . . . . . . . . . . . . . . . . . . . 189
Chapter 40 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Chapter 41 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
Chapter 42 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Chapter 43 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Chapter 44 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Chapter 45 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
Chapter 46 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196
Chapter 47 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199

Chapter 48 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Chapter 49 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202
Chapter 50 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
Chapter 51 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
Chapter 52 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
Chapter 53 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Chapter 54 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208
Chapter 55 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
Chapter 56 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
Chapter 57 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Chapter 58 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
Chapter 59 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216
Chapter 60 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217
Chapter 61 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218
Chapter 62 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220
Chapter 63 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Chapter 64 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222
Contents xiii
Chapter 65 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223
Chapter 66 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
Chapter 67 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
SECTION 5. PRINCIPLES OF REHABILITATION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
Chapter 68 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
Chapter 69 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228
Chapter 70 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228
Chapter 71 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Chapter 72 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230
Chapter 73 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Chapter 74 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232
Chapter 75 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233

SECTION 6. SPORTS-SPECIFIC CONSIDERATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Chapter 76 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237
Chapter 77 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
Chapter 78 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Chapter 79 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
Chapter 80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
Chapter 81 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
Chapter 82 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
Chapter 83 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
Chapter 84 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246
Chapter 85 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
Chapter 86 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
Chapter 87 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
Chapter 88 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Chapter 89 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252
Chapter 90 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253
Chapter 91 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254
Chapter 92 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Chapter 93 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
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Chapter 94 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
Chapter 95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 258
SECTION 7. SPECIAL POPULATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
Chapter 96 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
Chapter 97 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
Chapter 98 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263
Chapter 99 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Chapter 100 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 266
Chapter 101 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267
Chapter 102 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267

Chapter 103 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 268
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277
xv
Contributors
Brian E. Abell
Orthopedic Resident
Dwight D. Eisenhower Army Medical Center
Augusta, Georgia
Jeffrey S. Abrams, MD
Director
Princeton Orthopedic and Rehabilitative Associates
Attending Orthopedic Surgeon
University Medical Center at Princeton
Princeton, New Jersey
William B. Adams, MD
Senior Medical Officer
Director of Sports Medicine
Officer Candidate School
Quantico, Virginia
Terry A. Adirim, MD, MPH
Associate Professor
Pediatrics and Emergency Medicine
George Washington University School of Medicine
and Health Sciences
Washington, DC
Venu Akuthota, MD
Associate Professor
Department of Rehabilitation Medicine
University of Colorado Health Sciences Center
Aurora, Colorado

Keith S. Albertson, MD
Chief
Orthopedic Service
Dewitt Army Community Hospital
Fort Belvior, Virginia
Alan P. Alfano, MD
Associate Professor of Clinical Physical Medicine
and Rehabilitation
Department of Physical Medicine and Rehabilitation
Medical Director, UVA-Health-South Rehabilitation
Hospital
University of Virginia Health System
Charlottesville, Virginia
Robert A. Arciero, MD
Professor
Orthopedic Surgery
Orthopedic Consultant
University of Connecticut
Department of Orthopedics
University of Connecticut Health Center
Farmington, Connecticut
Edward S. Ashman
Sports Medicine Fellow
Nirschl Orthopedic Center for Sports Medicine
and Joint Reconstruction
Arlington, Virginia
Chad A. Asplund, MD
Chief Resident
Family Practice Residency Program
Dewitt Army Community Hospital

Fort Belvoir, Virginia
Geoffrey S. Baer, MD, PhD
Resident in Orthopedic Surgery
University of Virginia Health System
Charlottesville, Virginia
Thad Barkdull, MD
Clinic Director
US Army Health Clinic
Dugway Proving Grounds, Utah
Copyright © 2005 by The McGraw-Hill Companies, Inc. Click here for terms of use.
xvi Contributors
Carl J. Basamania, MD
Chief
Adult Reconstructive Shoulder Surgery
Division of Orthopedic Surgery
Duke University Medical Center
Durham, North Carolina
Todd C. Battaglia
Resident in Orthopedic Surgery
University of Virginia Health System
Charlottesville, Virginia
Kenneth B. Batts, DO
Chairman
Department of Family Practice and Emergency
Medical Services
Tripler Army Medical Center
Honolulu, Hawaii
Anthony I. Beutler, MD
Director
Sports Medicine

Family Practice Department
Malcolm Grow Medical Center
Assistant Professor of Family Medicine
Uniformed Services University of the Health Sciences
Andrew M. Blecher
Primary Care Sports Medicine Resident
Department of Orthopedic Surgery
Cleveland Clinic Foundation
Cleveland, Ohio
Barry P. Boden, MD
The Orthopedic Center
Rockville, Maryland
Adjunct Associate Professor
Uniformed Services University of the Health Sciences
Bethesda, Maryland
Jay E. Bowen, DO
Attending Physician
Kessler Institute for Rehabilitation
Assistant Professor
Department of Physical Medicine & Rehabilitation
UMDNJ-New Jersey Medical School
West Orange, New Jersey
Michael G. Bowers, DO
Chief Resident
Department of Family Medicine
Dewitt Army Community Hospital
Fort Belvoir, VA
Mark D. Bracker, MD
Founding Director
Primary Care Sports Medicine Fellowship

Clinical Professor
Department of Family and Preventive Medicine
University of California, San Diego
La Jolla, California
Fred H. Brennan, Jr., DO, FAOASM
Director
Primary Care Sports Medicine
Dewitt Army Community Hospital
Ft. Belvoir, Virginia
Assistant Team Physician
George Mason University
Fairfax, Virginia
Kevin J. Broderick, DO
Family Medicine Associates
Middletown, Massachusetts
David L. Brown, MD
Director
Sports Medicine
Madigan Army Medical Center
Fort Lewis, Washington
Linda L. Brown, MD
Director
Allergy and Immunology Clinic
Madigan Army Medical Center
Fort Lewis, Washington
Jennifer Burke, MD
Clinical Assistant Professor
Department of Community and Family Medicine
Team Physician
St. Louis University

Director of Sports Medicine
Forest Park Hospital
St. Louis, Missouri
Brian D. Busconi, MD
Associate Professor of Orthopedic Surgery
University of Massachusetts Medical School
Chief of Sports Medicine
UMass Memorial Medical Center
Worcester, Massachusetts
Contributors xvii
Janus D. Butcher, MD, FACSM
Assistant Professor of Family Medicine
University of Minnesota
Team Physician
US Cross Country Skiing
Staff Physician
Duluth Clinic
Duluth, Minnesota
Robert C. Cantu, MA, MD, FACS, FACSM
Chief
Neurosurgery Service
Director
Services of Sports Medicine
Emerson Hospital
Concord, Massachusetts
Co-Director
Neurologic Sports Injury Center
Brigham and Women’s Hospital
Boston, Massachusetts
Medical Director

National Center for Catastrophic Sports Injury
Research
Adjunct Professor
Department of Exercise and Sport Science
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina
Neurosurgery Consultant
Boston College Football and Boston Cannons
Dennis A. Cardone, DO
Associate Professor
Director
Sports Medicine Fellowship and Sports Medicine
Center
Department of Family Medicine
UMDNJ-Robert Wood Johnson Medical School
New Brunswick, New Jersey
Julie Casper, MD
Clinical Instructor and Sports Medicine Fellow
Department of Family Medicine
David Geffen School of Medicine at UCLA
Los Angeles, California
A. Bobby Chhabra, MD
Assistant Professor of Orthopedic Surgery
Division of Hand, Microvascular, and Upper
Extremity Surgery
Virginia Hand Center
University of Virginia Health System
Charlottesville, Virginia
Scott Chirichetti, DO
Chief Resident

Physical Medicine & Rehabilitation
University of Virginia
Charlottesville, Virginia
Steven B. Cohen, MD
Resident Physician
Department of Orthopedic Surgery
University of Virginia Health Sciences Center
Charlottesville, Virginia
Brian J. Cole, MD, MBA
Associate Professor
Departments of Orthopedics & Anatomy and Cell
Biology
Director
Rush Cartilage Restoration Center
Rush University Medical Center
Chicago, Illinois
Loren A. Crown, MD
Emergency Medicine Fellowship Director
University of Tennessee College of Health Sciences
Covington, Tennessee
Diane Dahm, MD
Assistant Professor
Orthopedic Surgery
Mayo Clinic
Rochester, Minnesota
Gregory G. Dammann, MD
Director
Sports Medicine
Department of Family Medicine
Tripler Army Medical Center

Honolulu, Hawaii
Thomas M. DeBerardino, MD
Chief
Orthopedic Surgery Service
Keller Army Community Hospital
Team Physician
United States Military Academy
West Point, New York
Ugo Della Croce, PhD
Associate Professor
Physical Medicine & Rehabilitation
Systems Engineer
Motion Analysis Lab
University of Virginia
Charlottesville, Virginia
xviii Contributors
Patricia A. Deuster, PhD, MPH
Director, Human Performance Laboratory
Department of Military and Emergency Medicine
Uniformed Services University of the Health Sciences
Bethesda, Maryland
William W. Dexter, MD, FACSM
Director
Sports Medicine Program
Assistant Director
Family Practice Residency Program
Maine Medical Center
Portland, Maine
Margarete DiBenedetto, MD
Professor and Former Chair (retired)

Department of Physical Medicine and Rehabilitation
University of Virginia
Charlottesville, Virginia
Jay Dicharry, MPT, CSCS
Staff Physical Therapist
University of Virginia/HealthSouth
Charlottesville, Virginia
David R. Diduch, MD
Associate Professor of Orthopedic Surgery
Co-Director
Division of Sports Medicine
Director
Sports Medicine Fellowship
University of Virginia Health System
Charlottesville, Virginia
John P. DiFiori, MD
Associate Professor and Chief
Division of Sports Medicine
Department of Family Medicine
David Geffen School of Medicine at UCLA
Los Angeles, California
Nancy M. DiMarco, PhD, RD, LD
Professor
Department of Nutrition and Food Sciences
Nutrition Coordinator
The Institute for Women’s Health
Coordinator
Masters Program in Exercise and Sports Nutrition
Texas Women’s University
Denton, Texas

Robert J. Dimeff, MD
Assistant Clinical Professor of Family Medicine
Case Western Reserve University
Associate Professor of Family Medicine
The Ohio State University
Medical Director
Section of Sports Medicine
Vice-Chairman
Department of Family Practice
Cleveland Clinic Foundation
Cleveland, Ohio
Kevin J. Elder, MD
Bayfront Medical Center Sports Medicine Program
FP Residency
St. Petersburg, Florida
Kayvan A. Ellini, MD
Department of Internal Medicine
University of New Mexico Health Sciences Center
Albuquerque, New Mexico
Jay Erickson, MD
Assistant Professor of Family Medicine
Uniformed Services University School of Medicine
Director
Primary Care Clinics
Robert E. Bush Naval Hospital
Twentynine Palms, California
Eve V. Essery
Doctoral Candidate
Department of Nutrition and Food Sciences
Texas Women’s University

Denton, Texas
Karl B. Fields, MD
Director
Family Medicine
Residency and Sports Medicine Fellowship
Moses Cone Health System
Greensboro, North Carolina
Catherine M. Fieseler, MD
Head Team Physician
Cleveland Rockers
Division of Sports Medicine
Cleveland Clinic Foundation
Cleveland, Ohio
Contributors xix
Scott B. Flinn, MD
Consultant to the Surgeon General
Navy Sports Medicine
Naval Special Warfare Group ONE Logistics Support
Medical Department
San Diego, California
Nicole L. Frazer, PhD
Director of Clinical Psychology
Assistant Professor of Family Medicine
Uniformed Services University of the Health Sciences
Bethesda, Maryland
Michael Fredericson, MD
Associate Professor
Physical Medicine & Rehabilitation
Team Physician
Stanford University

Palo Alto, California
Michael C. Gaertner, DO
Instructor
Emergency Medicine Fellow
University of Tennessee
Tipton Family Practice
Covington, Tennessee
Robert Giering, MD
Fellow
Pain Management
Department of Anesthesiology
University of Virginia
Charlottesville, Virginia
John E. Glorioso, MD
Brigade Surgeon
SBCT Brigade
Second Infantry Division
Fort Lewis, Washington
John P. Goldblatt, MD
Assistant Professor
Division of Sports Medicine
University of Rochester
Rochester, New York
Tom Grossman, ATC
Department of Athletics
University of Virginia
Charlottesville, Virginia
Carlos A. Guanche, MD
Clinical Associate Professor
University of Minnesota

The Orthopedic Center
Eden Prairie, Minnesota
David D. Haight, MD
Department of Family Medicine
Madigan Army Medical Center
Tacoma, Washington
Kimberly Harmon, MD, FACSM
Clinical Assistant Professor
Department of Family Medicine
Clinical Assistant Professor
Department of Orthopaedics and Sports Medicine
Team Physician
University of Washington
Seattle, Washington
Joseph M. Hart, MS, ATC
Athletic Trainer
University of Virginia
Sports Medicine/Athletic Training
Charlottesville, Virginia
R. Todd Hockenbury, MD
Assistant Clinical Professor of Orthopedic Surgery
University of Louisville
Bluegrass Orthopedic Surgeons
Louisville, Kentucky
Halli Hose
Internist
San Diego VA Healthcare System
Assistant Clinical Professor
University of California, San Diego
San Diego, California

Thomas M. Howard, MD
Chief
Department of Family Medicine
Associate Director
Sports Medicine Fellowship
Dewitt Army Community Hospital
Fort Belvoir, Virginia
Garrett S. Hyman, MD, MPH
Sports, Spine, and Musculoskeletal Fellow
Kessler Institute for Rehabilitation
Department of Physical Medicine & Rehabilitation
UMDNJ-New Jersey Medical School
West Orange, New Jersey
xx Contributors
Christopher D. Ingersoll, PhD, ATC, FACSM
Director
Graduate Programs in Sports Medicine/Athletic
Training
University of Virginia
Charlottesville, Virginia
Carrie A. Jaworski, MD
Family Practice and Sports Medicine
Associate Director
Resurrection Family Practice Residency
Team Physician and Medical Director
Athletic Training Program
North Park University
Chicago, Illinois
Jeffrey G. Jenkins, MD
Assistant Professor of Clinical Physical Medicine and

Rehabilitation
University of Virginia School of Medicine
Charlottesville, Virginia
Michael W. Johnson, MD
Primary Care Sports Medicine and Family Practice
Private Practice
Tacoma, Washington
Wayne B. Jonas, MD
Director
Samueli Institute
Associate Professor Family Medicine
Uniformed Services University of the Health Sciences
Bethesda, Maryland
Shawn F. Kane, MD
Primary Care Sports Medicine Fellow
Uniformed Services University of the Health Sciences
Bethesda, Maryland
Amanda Weiss Kelly, MD
Assistant Professor of Pediatrics
Case Western Reserve University
Rainbow Babies and Children’s Hospital
D. Casey Kerrigan, MD
Professor and Chair
Department of Physical Medicine & Rehabilitation
University of Virginia
Charlottesville, Virginia
David O. Keyser, LCDR, MSC, USN
Department of Military and Emergency Medicine
Uniformed Services University of the Health Sciences
Bethesda, Maryland

John J. Klimkiewicz, MD
Associate Professor of Orthopedic Surgery
Director
Sports Medicine
Georgetown University
Washington, DC
Alex J. Kline
Medical Student
University of Virginia Health System
Department of Orthopedic Surgery
Charlottesville, Virginia
Roger J. Kruse, MD
Head Team Physician
University of Toledo
Program Director
Sports Care
Sports Medicine Fellowship at the Toledo Hospital
Vice Chair
Sports Medicine and Sports Science of the U.S. Figure
Skating Association
Toledo, Ohio
John P. Kugler, MD, MPH
Director of Primary Care and Community Medicine
Dewitt Army Health Care System
Fort Belvoir, Virginia
Stephen J. Lee
Medical Student
Northwestern University Feinberg School of Medicine
Rush-Presbyterian-St. Luke’s Medical Center
Chicago, Illinois

Jeffrey A. Levy, DO
Sports Medicine Fellow
Uniformed Services University of the Health Sciences
Bethesda, Maryland
John M. MacKnight, MD
Associate Professor
Clinical Internal Medicine and Orthopaedic Surgery
Medical Director
Sports Medicine
Primary Care Team Physician
University of Virginia
Charlottesville, Virginia
Scott A. Magnes, MD, FACSM
Staff Orthopedic Surgeon
Naval Hospital
Great Lakes, Illinois
Contributors xxi
Eric M. Magrum, PT, OCS, FAAOMPT
Staff Physical Therapist
University of Virginia/HealthSouth
Charlottesville, Virginia
Gerard A. Malanga, MD
Director of Sports, Spine, and Orthopedic
Rehabilitation
Kessler Institute for Rehabilitation
Associate Professor
Physical Medicine & Rehabilitation
UMDNJ-New Jersey Medical School
West Orange, New Jersey
Ronica A. Martinez, MD

Family and Sports Medicine
Kaiser Permanente Fontana
Fontana, California
Augustus D. Mazzocca, MD
Assistant Professor
Department of Orthopedics
University of Connecticut Health Center
John Dempsey Hospital
Farmington, Connecticut
Douglas B. McKeag, MD, MS
AUL Professor and Chair
Department of Family Medicine
Director
Indianapolis University Center for Sports Medicine
Indiana University School of Medicine
Indianapolis, Indiana
John P. Metz, MD
Assistant Director
JFK Family Practice Residency
Edison, New Jersey
C. Michele Miller, DO
Chief Resident
Department of Physical
Medicine & Rehabilitation
UMDNJ-New Jersey Medical School
Newark, New Jersey
Mark D. Miller, MD
Associate Professor of Orthopedic Surgery
UVA Health System
Charlottesville, Virginia

Danny Mistry, MD
Assistant Professor
Physical Medicine & Rehabilitation
Co-Medical Director
University of Virginia Athletics
Charlottesville, Virginia
Kambiz Motamedi, MD
Assistant Professor
Musculoskeletal Imaging
David Geffen School of Medicine at UCLA
Los Angeles, California
James R. Morales, MD
Silver Bay Medical Center
Toms River, New Jersey
Scott F. Nadler, DO
Professor
Physical Medicine & Rehabilitation
UMDNJ-New Jersey Medical School
Newark, New Jersey
Bradley J. Nelson, MD
Chief
Department of Surgery
Keller Army Community Hospital
West Point, New York
Robert J. Nicoletta, MD
Orthopaedic Associates of Rochester
Sports Medicine/Arthroscopy
Rochester, New York
Robert P. Nirschl, MD, MS
Associate Clinical Professor of Orthopedic Surgery

Georgetown University
Founder and Director
Nirschl Orthopedic Sports Medicine Clinic
Medical Director
Virginia Sports Medicine Institute
Arlington, Virginia
Rochelle M. Nolte, MD
Director of Sports Medicine
US Coast Guard Training Center
Health Services Division
Cape May, New Jersey
Derek H. Ochiai
Sports Medicine Fellow
Nirschl Orthopedic Center for Sports Medicine and
Joint Reconstruction
Arlington, Virginia
xxii Contributors
Elizabeth M. O’Connor, DDS
Clinical Associate
Department of Dentistry
St. Joseph’s Hospital Health Center
Syracuse, New York
Ralph P. Oriscello, MD, FACC, FACP
Director
Division of Cardiology
Veteran’s Administration Medical Center
East Orange, New Jersey
Brett D. Owens, MD
Resident in Orthopedic Surgery
University of Massachusetts Medical School

Worcester, Massachusetts
Michael E. Pannunzio, MD
Assistant Professor
Department of Orthopedic Surgery
University of Virginia Health Sciences System
Charlottesville, Virginia
Chris G. Pappas, MD
Department of Family Medicine
Madigan Army Medical Center
Tacoma, Washington
Andrew D. Perron, MD, FACEP, FACSM
Residency Program Director
Maine Medical Center
Portland, Maine
Paul F. Pasquina, MD
Director
Physical Medicine and Rehabilitation Residency
Program
Walter Reed Army Medical Center
Washington, DC
Nicholas A. Piantanida, MD
Director
Primary Care Sports Medicine
Womack Army Medical Center
Fort Bragg, North Carolina
Mark D. Porter
Orthopaedic Service
William Beaumont Army Medical Center
Texas Tech UHS
El Paso, Texas

Joel Press, MD, FACSM
Medical Director
Center for Spine, Sports, and Occupational
Rehabilitation
Rehabilitation Institute of Chicago
Chicago, Illinois
David E. Price, MD
Sports Medicine Fellow
Bayfront Medical Center
St. Petersburg, Florida
Christopher M. Prior, DO
Director
Sports Medicine
Department of Family Medicine
Darnall Army Community Hospital
Fort Hood, Texas
Scott W. Pyne, MD
Team Physician & Director of Sports Medicine
US Naval Academy
Annapolis, Maryland
Christopher B. Ranney, MD
Department of Family Practice
Offut Air Force Base, Nebraska
Brian V. Reamy, MD
Associate Professor and Chair
Department of Family Medicine
Uniformed Services University of Health Sciences
Bethesda, Maryland
John P. Reasoner, MD
Member

USA Boxing Sports Medicine Committee
Clinic Director
Emergicare Medical Clinic
Colorado Springs, Colorado
Jennifer L. Reed, MD
Assistant Professor
PM&R
Eastern Virginia Medical School
Norfolk, Virginia
John C. Richmond, MD
Professor
Orthopedic Surgery
Tufts University School of Medicine
Chairman
Department of Orthopedic Surgery
New England Baptist Hospital
Nancy E. Rolnik
Sports Medicine Fellow
Kaiser Permanente
Fontana, California
Aaron Rubin, MD
Staff Physician and Partner
Southern California Permanente Medical Group
Program Director
Kaiser Permanente Sports Medicine Fellowship
Program
Kaiser Permanente Department of Family Medicine
Fontana, California
Anthony A. Schepsis, MD
Associate Professor of Orthopedic Surgery

Director of Sports Medicine
Boston University Medical Center
Boston, Massachusetts
Leanne L. Seeger, MD, FACR
Professor and Chief
Musculoskeletal Imaging
Medical Director
Outpatient Radiology
David Geffen School of Medicine at UCLA
Los Angeles, California
Peter H. Seidenberg, MD
Director of Sports Medicine
St. Louis University Family Practice Residency
Program
375th Medical Group
Scott Air Force Base, Illinois
Kate Serenelli, MS, ATC, CSCS
Staff Athletic Trainer
Department of Athletics
University of Virginia
Charlottesville, Virginia
Craig K. Seto, MD
Assistant Professor
Family Medicine
University of Virginia Health System
Charlottesville, Virginia
Michael Shea, MD
Sports Medicine Fellowship Program
Moses Cone Health System
Greensboro, North Carolina

Jay Smith, MD
Associate Professor
Physical Medicine & Rehabilitation
Mayo College of Medicine
Rochester, Minnesota
Carolyn M. Sofka, MD
Assistant Professor of Radiology
Weill Medical College of Cornell University
Assistant Attending Radiologist
Hospital for Special Surgery
New York, New York
Rebecca Spaulding, MD
Sports Medicine Fellowship Program
Moses Cone Health System
Greensboro, North Carolina
Mark B. Stephens, MD, MS
Staff Family Physician
Medical Director
Flight Line Clinic
Naval Hospital
Sigonella, Italy
Associate Professor of Family Medicine
Uniformed Services University of the Health Sciences
Bethesda, Maryland
David Stewart, MD
Sports Medicine Fellow
Moses Cone Health System
Greensboro, North Carolina
William S. Sykora, MD
Department of Family Medicine

Uniformed Services University of the Health Sciences
Bethesda, Maryland
Dean C. Taylor, MD
Director
US Army Joint and Soft Tissue Trauma Center
Fellowship
Head Team Physician
United States Military Academy
West Point, New York
John Tobey, MD
Spine and Sports Fellow
Department of Rehabilitation Medicine
University of Colorado Health Science Center
Aurora, Colorado
Contributors xxiii
John Turner, MD, CAQSM
Assistant Professor
Department of Family Medicine
Indiana University
Indianapolis, Indiana
Winston J. Warme, MD
Chief
Orthopedic/Rehabilitation Service
Program Director
Orthopedic Surgery Residency
William Beaumont Army Medical Center
Texas Tech UHSC
El Paso, Texas
Charles W. Webb, DO
Director of Sports Medicine

Department of Family Practice
Martin Army Community Hospital
Ft. Benning, Georgia
Brian Whirrett, MD
Sports Medicine Fellow
University of Washington
Seattle, Washington DC
Russell D. White, MD
Clinical Associate Professor
Department of Family Medicine
University of South Florida College of Medicine
Florida Institute of Family Medicine, P.C.
Assistant Team Physician
Tampa Bay Devil Rays
St. Petersburg, Florida
John H. Wilckens, MD
Assistant Clinical Professor of Orthopedics
Johns Hopkins Bayview Medical Center
Baltimore, Maryland
Cynthia M. Williams, DO, MEd
Assistant Professor of Family Medicine
Uniformed Services University of the Health Sciences
Bethesda, Maryland
Pamela M. Williams, MD
Assistant Professor of Family Medicine
Uniformed Services University of the Health Sciences
Bethesda, Maryland
Tory Woodard, MD
Chief Resident
Department of Family Medicine

Malcolm Grow Air Force Medical Center
Andrews Air Force Base, Maryland
David C. Young, MD
Sports Medicine
The Permanente Medical Group
Department of Orthopedics
South San Francisco, California
Joseph J. Zuback
Orthopaedic Service
William Beaumont Army Medical Center
Texas Tech UHS
El Paso, Texas
xxiv Contributors

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