Netter's sports medicine

753 Pages·2016·93.71 MB·English

by  Madden Ch.

Gain a better view of medicine!
Exquisitely illustrated and easy to use, Netter resources offer essential
pictorial perspectives on the knowledge you need!
Thompson Hart & Miller
Netter’s Concise Netter’s Musculoskeletal
Orthopaedic Flash Cards
Anatomy, 2nd Edition 978-1-4160-4630-1
978-1-4160-5987-5
Greene Runge & Greganti
Netter’s Orthopaedics Netter’s Internal Medicine,
978-1-929007-02-8 2nd Edition
978-1-4160-4417-8
View more Netter titles and other great
Elsevier resources at www.elsevierhealth.com!
Want Netter images?
Visit Netterimages.com!
Gain a complete perspective
on orthopaedics!
These state-of-the-art resources from Elsevier complement Netter’s Sports Medicine, providing all the
know-how you need to meet your daily clinical challenges!
DeLee, Drez, & Miller Noyes Rockwood, Matsen,
Wirth, & Lippitt
DeLee & Drez’s Noyes Knee Disorders:
Orthopaedic Sports Surgery, Rehabilitation, The Shoulder, 4th Edition
Medicine: Principles and Clinical Outcomes Expert Consult — Online and
Print (2 Volumes and DVD)
Practice, 3rd Edition Expert Consult — Online
Expert Consult — Online and Print (with DVD) ISBN: 978-1-4160-3427-8.
and Print (2 Volumes) ISBN: 978-1-4160-5474-0.
ISBN: 978-1-4160-3143-7.
Visit
www.elsevierhealth.com
today and view
our entire
orthopaedics list!
Reider & Terry Andrews, Wilk, & Reinold
Operative Techniques: The Athlete’s Shoulder,
Sports Medicine Surgery 2nd Edition
(Book, Website, and DVD) ISBN: 978-0-443-06701-3.
ISBN: 978-1-4160-3277-9.
PH90363
Netter’s
Sports
Medicine
CHRISTOPHER C. MADDEN, MD
MARGOT PUTUKIAN, MD, FACSM
CRAIG C. YOUNG, MD
ERIC C. McCARTY, MD
Illustrations by F rank H. Netter, MD
CONTRIBUTING ILLUSTRATORS
Carlos A. G. Machado, MD
John A. Craig, MD
James A. Perkins, MS, MFA
Kristen Wienandt Marzejon, MS, MFA
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
NETTER’S SPORTS MEDICINE ISBN: 978-1-4160-4922-7
Copyright © 2010 by Saunders, an imprint of Elsevier Inc. ISBN (online): 978-1-4160-5924-0
All rights reserved. No part of this book may be produced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording or any information storage and retrieval
system, without permission in writing from the publisher. Permissions for Netter Art fi gures may be
sought directly from Elsevier’s Health Science Licensing Department in Philadelphia PA, USA: phone
1-800-523-1649, ext. 3276 or [phone]; or email H [email protected] .
Notice
Knowledge and best practice in this fi eld are constantly changing. As new research and experience
broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or
appropriate. Readers are advised to check the most current information provided (i) on procedures
featured or (ii) by the manufacturer of each product to be administered, to verify the recommended
dose or formula, the method and duration of administration, and contraindications. It is the responsi-
bility of the practitioners, relying on their own experience and knowledge of the patient, to make di-
agnoses, to determine dosages and the best treatment for each individual patient, and to take all ap-
propriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Editors
assume any liability for any injury and/or damage to persons or property arising out of or related
to any use of the material contained in this book.
The Publisher
International Standard Book Number: 978-1-4160-4922-7
Editor: Elyse O’Grady
Developmental Editor: Marybeth Thiel
Project Manager: Mary Stermel
Editorial Assistant: Julie Goolsby
Design Direction: Ellen Zanolle
Illustrations Manager: Karen Giacomucci
Marketing Manager: Jason Oberacker
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Dedication

Netter’s Sports Medicine is dedicated to the Team Physician’s Handbook and to the many thousands
of sports medicine physicians and health professionals who have loyally followed and evolved
with its content over three spectacular editions. Netter’s Sports Medicine is the formal heir to the
Team Physician’s Handbook and all that the text has embodied for sports professionals through
the years. The new title brings with it topic re-organization, the addition of many new chapters
and authors, cutting-edge Netter and other graphics, and a new, colorful, user-friendly format.
Netter’s Sports Medicine invites a much broader audience of sports medicine professionals and
promises to be a premier-ready reference and a detailed resource for the sports medicine fi eld
as a whole. We thank everyone who has followed and supported the past editions of the Team
Physician’s Handbook, and we look forward to sharing many more years and sports medicine
experiences with all who endeavor to use this new text to transcend to a new level of quality
sports medicine care.
This book is dedicated with respect and honor to the original creators of the Team Physician’s
Handbook, W. Michael Walsh, MD, and Morris B. Mellion, MD, whose vision and wisdom
made this work possible. May their love of sports medicine, conduct in the fi eld, and integrity
as human beings set an example for us all to follow.
And, to the most wonderful, loving family I can imagine: Jessica, my beautiful wife, and Sage,
my energetic and inquisitive daughter. They are both my best teachers, and they bring me in-
fi nite happiness.
— Christopher C. M adden, MD
This book is dedicated to my parents, John and Elissa, who taught me to work hard and respect
other people; to my brother, Peter, and sister, Lisa; and to my husband and best friend, Joe
Hindelang. I treasure the time and memories we’re able to spend together. I have learned so much
in my career through my mentors, including my fellowship directors Dave Hough and Doug
McKeag, as well as so many colleagues (many of whom are contributors). I feel fortunate that I’ve
had an opportunity to participate in this book with such great contributors and editors.
— Margot Putukian, MD, FACSM
This is dedicated to my parents, Margaret and Jimmie, who instilled in me the thirst for knowl-
edge, and to my teachers who had the patience to give me that knowledge, especially to Drs.
Jim Puffer, Bob Dimeff, and John Bergfeld. And fi nally, and most importantly, to my beautiful
and wonderful wife, Sharon Busey, who has given me the love, support, and time to complete
this project—I couldn’t have done this without you.
— Craig C. Young, MD
My dedication of this book goes to my best friend and loving wife, Miriam, who is ever sup-
portive, patient, and enduring in her love, especially in an effort such as this book, with the
hours it takes and late nights to make it happen. To my dear children, Madeleine, Cleveland,
Shannon, and Torrance, who are the light and diversion to the busy life as an academician,
surgeon, and team physician. To my parents, Cleve and Jackie, who gave me great inspiration
in pursuing excellence. To my many teachers, mentors, coaches, and orthopedic partners who
along the way have taught me so much and continue to live within me. Finally, to my ultimate
mentor and the one who gave so much, my savior, Jesus Christ.
— Eric C. McCarty, MD
Editors
Christopher C. M adden, M D Craig C. Y oung, M D
Assistant Clinical Professor Professor of Orthopaedic Surgery and Community and
University of Colorado Health Sciences Center Family Medicine
Department of Family Medicine Medical Director of Sports Medicine
Sports and Family Medicine Physician, Private Practice Medical College of Wisconsin
Longs Peak Family Practice Team Physician
Longmont, Colorado Milwaukee Ballet, Milwaukee Brewers, U.S. National
Team Physician Snowboard Team
Niwot High School President 2007-2008
Niwot, Colorado American Medical Society for Sports Medicine
Milwaukee, Wisconsin
Margot P utukian, M D, FACSM
Director of Athletic Medicine Eric C. M cCarty, M D
Head Team Physician Associate Professor
Princeton University Chief of Sports Medicine and Shoulder Surgery
Associate Clinical Professor Department of Orthopaedics
Robert Wood Johnson, UMDNJ University of Colorado School of Medicine
University Health Services Fellowship Director
Princeton, New Jersey Colorado Sports Medicine and Shoulder Fellowship
Team Physician, U.S. Soccer Director of Sports Medicine
President 2004-2005 University of Colorado Department of Athletics
American Medical Society for Sports Medicine Head Team Physician
University of Colorado
Head Team Physician
University of Denver
Denver, Colorado
About the Editors
Christopher C. Madden, MD, is in private practice on the Front Craig C. Young, MD, is a professor and the Medical Director of
Range of the Rocky Mountains in Colorado. His sports medicine Sports Medicine at the Medical College of Wisconsin. He received
practice is broad, and he has special interests in head injuries, bio- a BS degree (cum laude) in Biological Sciences from the University
mechanics, environmental and altitude medicine, backcountry of California, Irvine. He is a graduate of the University of Califor-
sports, endurance and ultra-endurance medicine, snowboarding nia, San Diego School of Medicine. He completed a residency in
injuries, and cycling and mountain biking injuries. Chris edits and family medicine at UCLA and a sports medicine fellowship at the
authors a variety of topics in sports publications, ranging from Cleveland Clinic Foundation. Dr. Young has served as a team phy-
previsit patient education to professional textbooks. He also teaches sician for the Milwaukee Brewers since 1994 and company physi-
sports medicine to primary care residents from Rose and the Uni- cian for the Milwaukee Ballet since 1992. He has also served as a
versity of Colorado Family Medicine Residency Programs, in ad- team physician at the U.S. Olympic Training Center (Chula Vista)
dition to out-of-state residents. He is active in the American and is a team physician for the U.S. National Snowboard Team. In
Medical Society for Sports Medicine, where he is on the Board of 2007, he was appointed by the U.S. Olympic Committee as a team
Directors, is past annual meeting Program Chair, has served on the physician for the 23rd World Winter University Games in Torino,
Program Planning and Public Relations Committees, and cur- Italy. Dr. Young is board certifi ed in both family practice and
rently chairs the Economics Committee, where he has developed sports medicine. He was the President of the American Society for
various sports medicine economics and business practice tools, Sports Medicine (AMSSM) from 2007 to 2008. His clinical inter-
workshops, and national presentations for the membership. Chris ests include dance medicine, wilderness medicine, female athletes,
is also involved with the American College of Sports Medicine, adolescent athletes, and endurance athletes. His research interests
where he has served on the Education Committee and has served include dance medicine, in-line skating, and injury prevention.
on and chaired panels at various annual meetings. An avid back-
country enthusiast, Chris loves to tackle epic rides and ultra- Eric C. McCarty, MD, is a board-certifi ed and fellowship-trained
endurance, cross-country, and Super D races on his mountain orthopaedic surgeon with a longtime interest in sports medicine
bikes, snowboard and telemark in pristine, off-piste, and back- and athletics. He attended college at the University of Colorado,
country powder, trail run, hike, mountaineer and rock climb, ride where he excelled and received numerous honors for his exploits in
motocross, practice yoga, and spend time with his family. the classroom, as well as on the football fi eld, where he was an All
Big-Eight linebacker and also was an Academic All-American. Af-
Margot Putukian, MD, FACSM, received her BS degree in Biol- ter medical school at the University of Colorado, he completed his
ogy from Yale University, where she participated in soccer and la- training in orthopaedic surgery at Vanderbilt University in Nash-
crosse. She received her MD from Boston University School of ville, Tennessee. From there he completed an intensive year of
Medicine and then did both her internship and residency at the fellowship training in sports medicine and shoulder surgery at the
Primary Care Internal Medicine Program at Strong Memorial internationally renowned Hospital for Special Surgery in New
Hospital in Rochester, New York. She completed her fellowship in York City. He subsequently returned to Vanderbilt as a faculty
sports medicine at Michigan State University in East Lansing, member in the department of orthopaedics. In 2003, Dr. McCarty
Michigan. Margot worked as the Director of Primary Care Sports was recruited from Vanderbilt University to take over the sports
Medicine at Penn State University before starting her current medicine and shoulder program and to serve as the head team
position in January 2004 as the Director of Athletic Medicine and physician for the University of Colorado and University of Denver
Head Team Physician for Princeton University. Margot also serves athletic programs. His specialized practice involves the care of
as a team physician for U.S. Soccer. Margot is a charter member of these collegiate athletes, as well as recreational and highly com-
the American Medical Society for Sports Medicine, where she petitive athletes from the community. In addition to his busy
served as President from 2004 to 2005, and is currently on the clinical practice, Dr. McCarty is very active in research, teaching,
Board of Trustees for the American College of Sports Medicine and writing articles in the fi eld of sports medicine and knee and
(ACSM). She served previously on the NCAA Competitive Safe- shoulder surgery. He has received grants for his research and fre-
guards and Medical Aspects of Sport Committee and is currently quently gives talks at both the national and international level.
serving as the chair of the Sports Science and Safety Committee Since his playing days, Dr. McCarty continues to maintain a very
for U.S. Lacrosse. Margot has participated in the Position State- active lifestyle with his family. He enjoys the activities he grew up
ment on Concussion by the NATA, several Team Physician Con- with in Colorado, including hiking, cycling, climbing, and skiing.
sensus Statements, and the Third International Concussion Con- This carries over into his unbridled dedication to returning his
ference in Zurich, Switzerland. She serves on the editorial board patients to their desired activity/sport.
for both Medicine and Science in Sports & Exercise, the Journal of

Athletic Training, the Physician and Sports Medicine, and Athletic
Training and Sports Health Care. She is the proud recipient of the
2007 Dr. David Moyer Team Physician’s award presented by the
Eastern Athletic Trainer’s Association.
About the Artists
Frank H. Netter, MD, was born in 1906, in New York City. He The Netter illustrations are appreciated not only for their aes-
studied art at the Art Student’s League and the National Academy thetic qualities, but more importantly, for their intellectual con-
of Design before entering medical school at New York University, tent. As Dr. Netter wrote in 1949 “… clarifi cation of a subject is
where he received his MD degree in 1931. During his student the aim and goal of illustration. No matter how beautifully painted,
years, Dr. Netter’s notebook sketches attracted the attention of the how delicately and subtly rendered a subject may be, it is of little
medical faculty and other physicians, allowing him to augment his value as a medical illustration if it does not serve to make clear
income by illustrating articles and textbooks. He continued illus- some medical point.” Dr. Netter’s planning, conception, point of
trating as a sideline after establishing a surgical practice in 1933, view, and approach are what inform his paintings and what make
but he ultimately opted to give up his practice in favor of a full- them so intellectually valuable.
time commitment to art. After service in the United States Army Frank H. Netter, MD, physician and artist, died in 1991. Learn
during World War II, Dr. Netter began his long collaboration with more about the Netter Collection of Medical Illustrations at
the CIBA Pharmaceutical Company (now Novartis Pharmaceuti- www.netterimages.com .
cals). This 45-year partnership resulted in the production of the
extraordinary collection of medical art so familiar to physicians and Carlos A. G. Machado, MD, was chosen by Novartis to be Dr.
other medical professionals worldwide. Netter’s successor. He continues to be the main artist who contrib-
In 2005, Elsevier Inc. purchased the Netter Collection and all utes to the Netter collection of medical illustrations.
publications from Icon Learning Systems. There are now over 50 Self-taught in medical illustration, cardiologist Carlos Machado
publications featuring the art of Dr. Netter available through Else- has contributed meticulous updates to some of Dr. Netter’s origi-
vier Inc. nal plates and has created many paintings of his own in the style of
Dr. Netter’s works are among the fi nest examples of the use of Netter as an extension of the Netter collection. Dr. Machado’s
illustration in the teaching of medical concepts. The 13-book photorealistic expertise and his keen insight into the physician/
Netter Collection of Medical Illustrations, which includes the greater patient relationship inform his vivid and unforgettable visual style.
part of the more than 21,000 paintings created by Dr. Netter, be- His dedication to researching each topic and subject he paints
came and remains one of the most famous medical works ever places him among the premier medical illustrators at work today.
published. T he Netter Atlas of Human Anatomy, fi rst published in Learn more about his background and see more of his art at
1989, presents the anatomical paintings from the Netter Collec- http://www.netterimages.com/artist/machado.htm.
tion. Now translated into 18 languages, it is the anatomy atlas of
choice among medical and health professions students the world
over.
Contributors
Joanne B. “Anne” Allen, M D, FAAPMR, FACSM Kevin E. B urroughs , MD, ABFP, CAQSM
Orthopedic Specialist Assistant Professor
Clinical Adjunct Faculty Department of Family Medicine
University of North Carolina at Wilmington UNC Chapel Hill
Wilmington, North Carolina Director
Cabarrus Sports Medicine Fellowship
Annunziato A mendola, M D Director of Sports Medicine
Director UI Sports Medicine Cabarrus Family Medicine Residency
Department of Orthopaedics and Rehabilitation Team Physician
University of Iowa Health Care Catawba College
Iowa City, Iowa JM Robinson High School
Concord, North Carolina
Jeff rey M. A nderson, M D
Director of Sports Medicine J. W. Thomas Byrd, M D
University of Connecticut Student Health Services Nashville Sports Medicine Foundation
Head Team Physician Nashville, Tennessee
Division of Athletics
Medical Director for Research Lisa R. C allahan, M D
Human Performance Laboratory Associate Attending Physician
Storrs, Connecticut Hospital for Special Surgery
Associate Professor of Clinical Medicine
Eric J. A nish, M D, FACP, FACSM Weill Medical College of Cornell University
Assistant Professor of Medicine New York, New York
Division of General Internal Medicine
University of Pittsburgh School of Medicine William G. Callahan, M D
Pittsburgh, Pennsylvania Clinical Fellow
UC Davis/UC Berkeley Sports Medicine Fellowship
Brian A ros, M D Program
Sports Medicine Fellow Sacramento, California
The Ohio State University
Columbus, Ohio Dennis C ardone, M D
Holly J. B enjamin, M D, FAAP, FACSM John C. C arlisle, M D
Associate Professor of Pediatrics and Surgery Chief Resident
Section of Orthopedic Surgery and Rehabilitation Department of Orthopaedic Surgery
Medicine Washington University School of Medicine
Director of Primary Care Sports Medicine St. Louis, Missouri
University of Chicago
Chicago, Illinois Michael C ase, M D
Department of Otolaryngology
Kris B erg, E dD Gundersen Lutheran Medical Center
Professor LaCrosse, Wisconsin
School of Health, Physical Education, and Recreation
University of Nebraska at Omaha Cindy J. C hang, M D, CAQSM, FACSM
Omaha, Nebraska Staff Physician
Musculoskeletal and Sports Medicine Specialist
O. Josh B loom, M D Former Head Team Physician
Carolina Family Practice & Sports Medicine University of California, Berkeley
Cary, North Carolina Assistant Clinical Professor
Department of Family and Community Medicine
Michael B roton, M D University of California, San Francisco, and University of
Department of Family Med and Community Health California, Davis
Minneapolis, Minnesota
Leon Y. C heng, M D
Mercy Medical Group
Department of Internal Medicine
Folsom, California