What's New in November 2019!
In the November 2019 edition of Sidelines you will find the following content:
From the President: Shawn Kerger, DO, FAOASM
Late fall and early winter – that time of year when sports medicine REALLY begins to heat up. I’m sure you’re all busy with the transition, and for those who have championships and bowl games coming up – congratulations! The old saw of “…be careful what you wish for, for you may surely get it!” comes to mind….

OMED was a great time! Baltimore was beautiful the whole weekend and Mike Sampson, DO, FAOASM, put together a fantastic program in which I learned much while having a lot of fun…thanks much to The Rees Group and all the AOASM members who supported the program with their expertise and time. I got to many of you, but not all – and that’s the one thing I regret! OMED is always wonderful for seeing colleagues and classmates from all specialties, and I heard from many students that they really enjoy the multiple specialty topics as they still have not narrowed their focus yet. That’s a strength for our programs as we are primary care specialists, and fairly unique!

I would like to bring a few bits of governance in which the AOASM is representing you at a national level…the first is HR 1608 sponsored by one of my home state’s senators, Sherrod Brown, D-OH, and also Roger Wicker, R-MS, and a related bill HR 2891. We were asked for support of one of these – and the AOASM Executive Committee supported 1608 for a variety of reasons. The Senate HELP Committee met on Oct. 31 st in regard to this and seven other bills which they supported, and passed all eight bipartisan bills. 

The second bit of governance that has come up lately was from the Committee on Osteopathic CME (COCME), Resolution 17 – this resolution for incorporation into the AOA Bylaws seeks to remove any CME credit for being an osteopathic table trainer for any ‘hands-on’ workshops. The resolution stated that their explanation for their resolution was: “The COCME believes that Category 1-A should not be awarded for table training for physical examination or OMM labs as this is not a method for formal delivery of medical education lectures in osteopathic and allopathic medical colleges for teaching; nor for the formal delivery of medical education to students, interns, residents, fellows and staff. Category 1-A is designed to enhance clinical competence and improve patient care.” The AOASM Board found that the first paragraph was completely erroneous –– quite the opposite is true –– and such a resolution would impair the ability to adequately teach hands-on skills in both COMs and for CME programs for future learners of all levels. We also did not understand how table trainers for a hands-on program could not enhance clinical competence and improve patient care and, therefore, not only object to the removal of CME credit for table trainers, but indeed support that such CME credit deserves 1-A status, as is consistent with the AOA standards for 1-A CME being face-to-face teaching. In follow up, the AOA has taken down the resolution and promised that if this concept should be pursued in the future, they will "seek input from key stakeholders prior to resubmitting this for open comment." I have requested that the AOASM be considered one of these "key stakeholders" from whom input would be sought.

Finally, there was a recent letter published in JAMA Internal Medicine that found that among the 1,121 NCAA universities during the 2018-19 school year, only 11.2% of head team physicians and 31.7% of head team trainers were women. The point of the letter was that while female physicians comprise about 35% of the physician population, those in leadership are a smaller percentage. This got me thinking about the AOASM physician data and I found that we don’t have adequate data to answer this question yet. I invite those of you reading this letter to voluntarily (and anonymously) participate in an informal poll to gain an insight into how many of our physicians: 1) identify as male vs. female (or other); 2) which are team physicians for an NCAA participating college; and 3) are in head team physician roles for whatever sector of sports medicine they are serving. It would be my goal to work with Brian Hainline, MD (CMO for the NCAA), to help support equal opportunities for our osteopathic sports medicine physicians into roles of leadership within the NCAA. Please help us understand where we are currently, so that we can normalize the ratios!
AOASM Board of Directors Nominations
Please nominate up to five individuals you feel would be excellent candidates for the 2020-2021 Board of Directors. Elected candidates will serve a five-year term, beginning after the close of the Clinical Conference in May 2020. Candidates should be physician members. Self nominations are encouraged. The Nominating Committee will reach out to each potential candidate to determine if that individual is willing to serve.

Submission Deadline: December 16, 2019.
AOASM 2020: Save the Date!
Attendee conference registration for AOASM 2020 will open mid-late January 2020!
Know a vendor who would be interested in exhibiting at AOASM 2020? We encourage you to send your contact this link to apply as an exhibitor in Anaheim, California!
DOs in Action!
Drs. Andrew Martin, Michael Smolka, and Mathew Sykes covering the United States Freestyle Mogul Team in Zermatt, Switzerland, and conducting performance-based biomechanics testing. The ski course was set up on a glacier in the Swiss Alps near the famous Matterhorn peak.
Drs. Andrew Martin, Michael Smolka, and Brian Shiple in Cancun, Mexico, in October during an Ultrasound Injection Mission Trip through the AAOM.
SAOASM in Action!
First-year students from the Touro COM Middletown SAOASM club along with Dr. Angela Cavanna helped out at the Liberty League Cross Country Championships on November 2, 2019. The event was hosted by Bard College and included a field of 124 total runners.

(From left to right: Matthew Bankert, Monica Mikhael, Benjamin Baylyl, Alton Daley, Dr. Angela Cavanna, Natasha Nazir, Jillian Wong, Adam Smith
Athletes and the Arts:
Powerhouse Strength in Dancers

Written by Dr. Becca Rodriguez Regner
The gluteal muscles exist for a greater purpose than looking amazing in a pair of jeans. In fact, the gluteals are the dream team. Let me introduce you to the MVP gluteus maximus, gluteus medius, and gluteus minimus. In many athletes and especially dancers, these group of muscles get turned off and don't fire properly to help the posterior chain work. The general functions of the three powerhouse muscles include extension, abduction, lateral (external) rotation, and medial (internal) rotation of the hip joint.

In dancers, the three gluteal muscles are important for hip extension (arabesque), abduction (lifting leg side), and external and internal rotation. The pelvis, including the lower abdominals and gluteals, are essential for stability and strength. For these athletic dancers, the gluteals give power to jumps and leg extensions. Basically, the hips contain a very powerful network of muscles. Understanding the gluteals can unleash power in dancers and also improve turnout.

In an article from the January 2019 issue of Dance Teacher, a physical therapist works with the Australian Ballet on gluteal strength for rehabilitation of injuries in all of the lower extremity. The PT notes that dancers think that in order to have a better turnout they have to under tuck which then locks down or clenches the gluteals. Many dancers also clench the gluteals in trying harder to accomplish a certain movement. A clenched gluteal muscle is stuck in a contracted place, turned off, and not able to contract and release normally. This disrupts the posterior chain and can have effects on the lower extremity joints with repetitive training motions.
 
The PT educates to unlock or unclench the gluteals with being aware of a certain posture and cross training with a few exercises. Dancers should think about the pelvis along a vertical axis and understand/imagine how orientation, alignment, and movement potential can change the way dancers work in class and dance onstage. The correct posture should be shoulders back and down and belly button to spine to hold in the core. The pelvis should point downward and not with under tucking to have a lean back posture and not to have pelvis tilt anterior allowing lumbar hyperextension (arched back). Please see below for suggested cross training exercises per the physical therapist from Australian Ballet to suggest to dancers to keep their gluteals firing for power and performance!
Exercise 1:
  1. Loop a resistance band around something stable, like a table leg, and your ankle. Begin in a kneeling position, with knees under hips and hands under shoulders, set up far enough away from the table leg so the band gently pulls your leg into internal rotation. Make sure it's in a straight line from anchor point to ankle. 
  2. In the kneeling position, work against the resistance of the band to externally rotate your leg and focus on turning the thigh bone in the hip socket.
  3. Maintain a long spine, head to tail, that allows for a natural low-back curve. Do 10-15 reps, be sure to keep the hip flexors, hamstrings, and glutes soft, and to not tuck your tail under.
Exercise 2:
  1. Lie on your side, with your top leg propped up at hip level on a Pilates box or a couple of firm pillows, knee bent.
  2. With your bottom leg internally rotated, lengthen and lift your bottom leg up toward the ceiling, taking care not to slouch in your spine or collapse the underside of the rib cage into the ground.
  3. Lift your lower leg 10 to 15 times. Repeat on other side.
Exercise 3:
  1. Lie on your back with knees bent, feet at hip distance, in parallel. Float one leg up to a tabletop.
  2. Press the other footprint into the floor and float hips up.
  3. Lower your hips down and repeat 5 to 10 more times, trying to maintain a level pelvis. Repeat with the other leg.
SAOASM Update
Greetings, SAOASM!

As we move into the end of the year and look forward to 2020, we have some exciting news about our upcoming Regional SAOASM Conferences!

Stay tuned for more information on the rest of the regional conferences, last fall webinar of the semester, and the AOASM Clinical Conference 2020! If you have any questions please reach out via email at studentaoasm@gmail.com

Megan Boyer
AOASM National Student Chair
If there is ever anything you would like to learn about or see happen through the SAOASM, please reach out to our Executive Board at  studentAOASM@gmail.com

We love hearing from you and providing you with the best opportunities to learn and have fun in sports medicine!
SAOASM Student Spotlight - Kristina Fraser
UNTHSC-TCOM, OMS-III, Class of 2021
What made you interested in Sports Medicine and how has SAOASM impacted you as a medical student?
I feel most at home on the sidelines because I spent my high school and college years on the sidelines of sporting events as a cheerleader. SAOASM has provided me with the opportunity to continue to watch from the sidelines, except now I am watching through a new lens: I get to cheer on the team as well as provide medical coverage. These experiences have allowed me to learn more about the field and other sports that I have never been exposed to. I have also met many Physical Medicine and Rehabilitation doctors, and I have decided I would like to pursue that as my residency before sports medicine fellowship.

What are your goals moving forward into the upcoming academic year?
During this academic year, first I would like to focus on my third-year rotations, and in my extra time continue to broaden my exposure to sports medicine. I will not be able to be a great sports medicine physician unless I have a solid foundation in medicine. In regards to sports exposure, specifically I would like more exposure to volleyball and basketball medical coverage.

Kristina has volunteered at multiple sporting events including 5K runs, marathons, high school football, bicycle races, boxing and judo tournaments, sit volleyball, and wheelchair rugby. She has earned the Gold Level Recognition for 100+ hours of eligible service from the COSGP TOUCH program. She has stayed involved with SAOASM through attendance at the Midwestern Regional last year and plans to continue participating in opportunities to learn more about sports medicine through AOASM.
OMED 2019 Recap!
We hope everyone enjoyed OMED this year in Baltimore, Maryland! Please enjoy the photos below. For this year's presentations, please visit the AOASM website under the OMED tab .
Future OMED Conference Schedule
  • OMED 2020: Friday, October 16 - Monday, October 19 in Austin, Texas
  • OMED 2021: Friday, October 22 - Monday, October 25 in Phoenix, Arizona
  • OMED 2022: Thursday, October 27 - Sunday, October 30 in Boston, Massachusetts
Journal Article Spotlight: Clinical Journal of Sports Medicine
Journal Article Spotlight: British Journal of Sports Medicine
Relative Head Impact Exposure and Brain White Matter Alterations After a Single Season of Competitive Football - A Pilot Comparison of Youth Versus High School Football
Beneficial associations of low and large doses of leisure time physical activity with all-cause, cardiovascular disease and cancer mortality: a national cohort study of 88,140 US adults
Bonus Journal Article Spotlight: The New England Journal of Medicine
Neurodegenerative Disease Mortality among Former Professional Soccer Players