Biomedical subjects

J D Butcher

Publications and source records attributed to J D Butcher.

5 recordsLinked to original sources

PubMed1998

Comparison of injuries in classic and skating Nordic ski techniques.

OBJECTIVE: To compare types and anatomic distribution of injuries between cross-country skiers using the classic and skating ski techniques. DESIGN: Descriptive self-administered survey. SUBJECTS: Midlevel competitors in the 1996 American Birkebeiner cross-country ski marathon (55 km). DESCRIPTION OF SURVEY: A self-administered 21-item questionnaire regarding skiing-related injuries occurring during training before the race or during the marathon. The respondent was asked for information regarding any skiing-related injury or complaint that occurred during training or while participating in the American Birkebeiner ski race. This tool also collected information regarding training habits, equipment selection, and skier demographics. Responses were coded on a Mark-Sense form and compiled by a computerized code reader. MAIN RESULTS: A total of 833 surveys were returned for an overall response rate of 55%. The overall self-reported injury rate for the surveyed group was 234 per 1000 skiers (i.e., 23.4% of skiers sustained an injury during the race). Most of these injuries were minor; only 4.6% of all skiers reported lost training time because of a race injury, and only 2.8% of all skiers sought treatment from a health care provider for a race-related injury. There was no statistically significant difference between the two techniques either in overall injury rate (p=0.33) or in the location of the injury (p=0.158). The injury rates were 23% and 27%, respectively, for skating and classical techniques. The incidence of more serious injuries (those requiring medical attention) was 2.7% for skaters and 3.1% for classical skiers. No statistically significant relation was found between pole length and the development of injuries. In addition, the likelihood of sustaining an injury was independent of age and training distance. CONCLUSIONS: The overall injury rates in this study were much higher than those previously reported in the literature, but no significant difference in injuries between the two skiing techniques was found. The incidence of more severe injuries, defined as those requiring medical treatment, was consistent with previous reports. Prior assumptions regarding equipment relationships to injuries were not substantiated by the findings. In spite of significant changes in the equipment and technique designed to enhance speed, cross-country skiing remains a safe sport, with its participants relatively free of serious injuries. Further investigation is required to determine whether other aspects of the sport, such as pole grip design, ski construction, and skier skill level, have any relation to injury patterns.

Adolescent↗

PubMed1997

Upper extremity bursitis.

Upper extremity bursae are injured through a number of processes, including overuse, hemorrhage, crystal deposition, autoimmune diseases and infection. These injuries may be disabling and can pose significant diagnostic and therapeutic challenges for the clinician. Treatment of the most common forms is directed at pain management and functional rehabilitation through a structured exercise program. Early recognition of infectious bursitis, followed by appropriate surgical and antibiotic treatment, is critical to prevent severe sequelae in these cases. This article reviews the pathophysiology, evaluation and treatment of the three most commonly involved upper extremity bursae: the subacromial, the olecranon and the subscapular bursae.

Bursitis↗

PubMed1996

Lower extremity bursitis.

Bursitis is a common cause of lower extremity pain in patients presenting to primary care physicians. Several bursae in the lower extremity account for most of these injuries, including the ischiogluteal, greater trochanteric, pes anserine, medial collateral, prepatellar, popliteal and retrocalcaneal. Often the symptoms are mild, with the patient successfully self-treating through activity modification and other conservative measures. A systematic approach to the evaluation and treatment of patients with bursitis, including prevention, relative rest, ice, compression, elevation, anti-inflammatory medication and treatment modalities such as ultrasound and electrical stimulation, combined with a structured rehabilitation program, will greatly facilitate the healing process.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed1996

Patient profile, referral sources, and consultant utilization in a primary care sports medicine clinic.

BACKGROUND: Sports medicine has matured as a focused discipline within primary care with the number of primary care sports medicine physicians growing annually. The practices of these physicians range from "part-time" sports medicine as a part of a broader practice in their primary specialty, to functioning as a full-time team physician for a university or college. Managed care organizations are increasingly incorporating primary care sports medicine providers into their organizations. The optimal role of these providers in a managed care system has not been described. METHODS: A descriptive analysis was made of patient contacts in a referral-based, free-standing primary care sports medicine clinic associated with a large managed care system. This study describes patient information including demographic data, referral source, primary diagnosis, specialized diagnostic testing, and subsequent specialty consultation. RESULTS: A total of 1857 patient contacts were analyzed. New patients were referred from a full range of physicians both primary care (family practice, internal medicine, pediatrics, and emergency physicians) and other specialists, with family practice clinic providers (physicians, physician assistants, and nurse practitioners) accounting for the largest percentage of new referrals. The majority of patient visits were for orthopedic injuries (95.4%); the most frequently involved injury sites were: knee (26.5%), shoulder (18.2%), back (14.3%), and ankle (10%). The most common types of injury were: tendinitis (21.3%), chronic anterior knee pain (10.6%), and ligament sprains (9.9%). Specialized testing was requested for 8% of all patients. The majority of patients were treated at the Ft Belvoir Sports Medicine Clinic by primary care sports medicine physicians without further specialty referral. CONCLUSIONS: Primary care sports medicine physicians offer an intermediate level of care for patients while maintaining a practice in their primary care specialty. This dual practice is ideal in the managed care setting. This study demonstrates the complementary nature of primary care sports medicine and orthopedics, with the primary care sports medicine physician reducing the demand on orthopedists for nonsurgical treatment. This study also demonstrates the need for revision in the orthopedic curriculum for primary care physicians.

Adolescent↗

PubMed1993

Runner's diarrhea and other intestinal problems of athletes.

Lower gastrointestinal tract symptoms occur frequently in runners. The most common complaints are bowel urgency and diarrhea. Many etiologies have been proposed, including enteric fluid and electrolyte imbalance, autonomic nervous system stimulation, ischemia and mechanical trauma. The evaluation should include a review of the athlete's training program and diet, as well as a review of any preexisting gastrointestinal disease. A stool examination for occult blood should be performed in the athlete who complains of diarrhea. Treatment begins with a reduction in the intensity of workouts, followed by a gradual return to the previous level of training after the symptoms resolve. In most cases, symptoms do not recur. Dietary manipulation or antimotility agents may be helpful in some athletes. Bloody diarrhea, usually related to hemorrhagic gastritis, can be effectively treated with histamine H2-receptor antagonists.

Diarrhea↗