About the Oxford American Handbooks in Medicine The Oxford American Handbooks are fl exi-covered pocket clinical books, providing practical guidance in quick reference, note form. Titles cover major medical specialties or cross-specialty topics and are aimed at stu- dents, residents, internists, family physicians, and practicing physicians within specifi c disciplines. Their reputation is built on including the best clinical information, com- plemented by hints, tips, and advice from the authors. Each one is carefully reviewed by senior subject experts, residents, and students to ensure that content refl ects the reality of day-to-day medical practice. Key series features • Written in short chunks, each topic is covered in a two-page spread to enable readers to fi nd information quickly. They are also perfect for test preparation and gaining a quick overview of a subject without scanning through unnecessary pages. • Content is evidence based and complemented by the expertise and judgment of experienced authors. • The Handbooks provide a humanistic approach to medicine—it’s more than just treatment by numbers. • A “friend in your pocket,” the Handbooks offer honest, reliable guidance about the diffi culties of practicing medicine and provide coverage of both the practice and art of medicine. • For quick reference, useful “everyday” information is included on the inside covers. • Made with hard-wearing plastic covers, tough paper, and built-in ribbon bookmarks, the Handbooks stand up to heavy usage. This page intentionally left blank Oxford American Handbook of Sports Medicine Published and Forthcoming Oxford American Handbooks Oxford American Handbook of Clinical Medicine Oxford American Handbook of Anesthesiology Oxford American Handbook of Clinical Dentistry Oxford American Handbook of Clinical Diagnosis Oxford American Handbook of Clinical Pharmacy Oxford American Handbook of Critical Care Oxford American Handbook of Emergency Medicine Oxford American Handbook of Geriatric Medicine Oxford American Handbook of Nephrology and Hypertension Oxford American Handbook of Obstetrics and Gynecology Oxford American Handbook of Oncology Oxford American Handbook of Otolaryngology Oxford American Handbook of Pediatrics Oxford American Handbook of Physical Medicine and Rehabilitation Oxford American Handbook of Psychiatry Oxford American Handbook of Pulmonary Medicine Oxford American Handbook of Rheumatology Oxford American Handbook of Surgery Oxford American Handbook of Sports Medicine Edited by Jeffrey R. Bytomski Head Medical Team Physician Associate Professor and Director Primary Care Sports Medicine Fellowship Duke University Medical Center Durham, North Carolina Claude T. Moorman, III Associate Professor Head Team Physician and Director Duke Sports Medicine Duke University Medical Center Durham, North Carolina with Domhnall MacAuley School of Life and Health Science University of Ulster Department of Epidemiology The Queen’s University of Belfast Northern Ireland 1 3 Oxford University Press, Inc. publishes works that further Oxford University’s objective of excellence in research, scholarship and education. Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offi ces in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Copyright © 2010 by Oxford University Press, Inc. Published by Oxford University Press Inc. 198 Madison Avenue, New York, New York 10016 www.oup.com Oxford is a registered trade mark of Oxford University Press First published 2010 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Oxford University Press, Library of Congress Cataloging-in-Publication Data Oxford American handbook of sports medicine / edited by Jeffrey R. Bytomski, Claude T. Moorman with Domhnall MacAuley. p. ; cm. — (Oxford American handbooks) Adapted from: Oxford handbook of sport and exercise medicine / edited by Domhnall MacAuley. 2007. Includes bibliographical references and index. ISBN 978–0–19–537219–9 1. Sports medicine—Handbooks, manuals, etc. I. Bytomski, Jeffrey R. II. Moorman, Claude T. III. MacAuley, Domhnall. IV. Title: Handbook of sports medicine. V. Series: Oxford American handbooks. [DNLM: 1. Sports Medicine—Handbooks. 2. Athletic Injuries—Handbooks. QT 29 O97 2010] RC1211.O938 2010 613.71—dc22 2009023186 9 8 7 6 5 4 3 2 1 Printed in China on acid-free paper This material is not intended to be, and should not be considered, a substitute for medical or other professional advice. Treatment for the conditions described in this material is highly dependent on the indi- vidual circumstances. And, while this material is designed to offer accurate information with respect to the subject matter covered and to be current as of the time it was written, research and knowledge about medical and health issues is constantly evolving and dose schedules for medications are being revised continua lly, with new side effects recognized and accounted for regularly. Readers must therefore always check the product informa- tion and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulation. Oxford University Press and the authors make no representations or warranties to readers, express or implied, as to the accuracy or completeness of this material, including without limitation that they make no representation or warranties as to the accuracy or effi cacy of the drug dosages mentioned in the material. The authors and the publishers do not accept, and expressly disclaim, any responsibility for any liability, loss or risk that may be claimed or incurred as a consequence of the use and/or application of any of the contents of this material. This page intentionally left blank vii PPrreeffaaccee The world of sports medicine is becoming more complex as athletes receive care from a multi-faceted team including physicians, athletic trainers, physical therapists, and sports psychologists, to name a few. Many other professions assist in the care of athletes as well. Sports medicine is unique in balancing a safe return to sports while aggressively treating the problem in the least amount of time. With extensive media coverage of elite athletes, every athlete from children to the average “weekend warrior” expect the same level of care given to their sports elite fi gures. The sports medicine team is stretched on a daily basis to provide cutting-edge care while maintaining a full schedule. The purpose of this Handbook is to have a reliable source readily available to those who are on the frontlines of sports medicine care. It is meant to be a reference as care providers travel from the offi ce, to the training room, to the sideline, and around the world. Our aim for this text is to bridge the gap between comprehensive knowledge and quick access at the point of care by multiple levels of providers. This book is adapted from the original British version and has the advantage of knowledge collected from many experts around the globe. We have provided some practical chapters on procedures and radiology as well as exposure to many of the techniques used in the evolving world of sports psychology. The scope of the text ranges from discussion of event coverage and preparticipation exams to both acute and chronic treatment of common medical and orthopedic problems in athletes. We hope you gain the knowledge and insight needed to take care of your athletes at the highest level, wherever your travels take you. Acknowledgments This Handbook has only come together through the time, effort, and sacri- fi ce of many individuals, not unlike the sports medicine team caring for its athletes at the highest level. The authors did a wonderful job of reviewing the previous text while updating and molding the new chapters to their current version. The clinical experience and knowledge of Dr. Moorman was without equal in assuring a quality text in the orthopedic chapters. Also, Andrea Seils at Oxford University Press has been instrumental in making this publication a high-quality Handbook. I would also like to thank all of the families of the contributors for their sacrifi ce in allowing the contributors to take time away from their schedules to make this a fi ne Handbook. And fi nally, I would like to thank Shanda, Jarek, Trevor, and Alexandra for their patience and sacrifi ce as I spent time away from them in preparing the Handbook you have in front of you. Jeffrey R. Bytomski