Call For Abstracts for Medicine of Cycling Conference 2013

Posted on January 2, 2013 by hwoodhull

Medicine of Cycling is pleased to announce the Call for Abstracts for this year's medical conference to be held September 20-22, 2013 in Colorado Springs, CO.  Medicine of Cycling and UCSF invite you to submit your original research papers now through February 28, 2013.

We encourage abstract proposals in wound care, physical therapy/rehabilitation and recovery, general health and cycling and cycling with disabilities.  However, our program is not limited to these topics. We welcome all topics that address medical issues seen in cycling.

Abstract proposals are sought for both oral and poster presentations.  Abstracts should generally be no longer than 300 words and must cite quantitative data from representative studies.

Oral abstract presentations will involve a 10-minute presentation followed by a 5-minute Q&A.

Poster abstracts will be displayed at the conference.  The poster should be clear and organized for viewing measuring no larger than 4’ x 4’.  The presenting author of the poster will be assigned a time slot during which he/she is expected to be physically present at the poster to answer any questions.

Abstracts must address the following:

  • Objective
  • Methods
  • Results
  • Significance to Cycling Medicine

Submitters will be notified by e-mail of their submission status in May 2013.

Abstracts may be submitted via email to Anna Abramson, MD at anna (at) medicine of cycling dot com or via regular mail to:

Medicine of Cycling, Inc.
30 Liberty Ship Way, Suite 3110
Sausalito, CA 94965

We look forward to your submissions!

Call For Proposals for Medicine of Cycling Conference 2013

Posted on January 2, 2013 by hwoodhull

Medicine of Cycling is pleased to announce the Call for Proposals for this year's medical conference to be held September 20-22, 2013 in Colorado Springs, CO.  Medicine of Cycling and UCSF invite you to submit proposals now through February, 28, 2013.

Proposals are sought for all interactive sessions.  We hope to include some new topics this year, and proposals are encouraged in wound care, physical therapy/rehabilitation and recovery, general health and cycling and cycling with disabilities.  Please note that our program is not limited to these topics. We welcome all proposals that address medical issues seen in cycling.

Proposals will be accepted in one of the following formats: lectures or workshops. To be considered, proposals must contain the following items:

  • A complete outline of the presentation
  • Five learning objectives for the presentation
  • A speaker resume/CV
  • A list of references from past conferences where the speaker has presented

Submitters will be notified by e-mail of their submission status in May 2013.

Proposals can be submitted via email to Anna Abramson, MD at anna (at) medicine of cycling dot com or via regular mail to:

Medicine of Cycling, Inc.
30 Liberty Ship Way, Suite 3110
Sausalito, CA 94965 USA

We look forward to your submissions!

Medicine of Cycling Looking Back and Seeing Forward – Performance Conditioning interviews Anna Abramson Co-Chair, Medicine of Cycling

Posted on January 2, 2013 by hwoodhull

As appeared in Performance Conditioning - http://performancecondition.com/

Dr. Anna Abramson is a physician at UCSF who enjoys improving processes that can have a meaningful impact on the way tasks are accomplished in the medical world.  In her free time, she loves to ride her bike. She’s married to Mark Abramson, current vice chairman and past president of the Board of Directors of USA Cycling. 

PC: What is Medicine of Cycling and how/why did you start it?
AA:
Medicine of Cycling began organically. Initially it was a grass roots group of doctors and other medical professionals who wanted to improve the medical care of cyclists. The group needed a more cohesive way to interact since we came from so many different disciplines and specialties. Medicine of Cycling was cofounded in 2009 when past USA Cycling President Mark Abramson and trauma surgeon James Watkins MD became energized after a collective effort to improve care for a traveling collegiate athlete with a pelvic fracture. The complexities and success of his case seeded an idea for making a national care model for cyclists. I enjoyed hearing their ideas and thought it may be an interesting problem to tackle.
We surveyed and met with professional team physicians, owners, and managers, and realized the problem was much more complex than previously expected. We learned that about half of the professional road cycling teams, and many more mountain and amateur teams do not have a medical provider the athletes trust; many go to a non-traditional provider to manage medical problems. Most races do not have medical professionals, medical emergency plans, or evaluation standards for the most common types of injury.
After defining the problem, the solution seemed unattainable. At that point, we decided to form the Medicine of Cycling organization to improve the medical knowledge and exchange of expertise among the varied group of providers for this large and geographically dispersed group. We started by having an annual medical conference with experts in cycling related medical fields give talks, and simply give medical professionals the ability to meet and discuss their experiences. Now that we've had three conferences and have had tremendously positive feedback, we look for new opportunities and challenges to tackle towards our educational and outcome goals.

PC: You have already reached several important accomplishments which would be the most significant, impacting the sport of cycling the most?
AA:
It's hard to say what will have the greatest impact in the sport, but the two accomplishments to date that I'm most excited about are the groups work in concussion awareness and our Medical Emergencies in Cycling Course.
We have a group of 15 medical professionals including concussion experts, race and team doctors, working on improving concussion evaluation and care for cyclists in an out of races. We have both an adapted concussion consensus statement specific to our population, and a concussion card that help in the assessment of a down athlete suspected of head injury. Both are available on our website www.medicineofcycling.com under guidelines for use. The concussion documents have been translated into several languages and are in wide use both in the US and in several other countries.
Additionally, we have an amazing group of emergency personnel who teach a hands on course called Medical Emergencies in Cycling Course annually for medical professionals who want to become more involved with races and teams locally or nationally. Drs. James Watkins and Aaron Goldberg put together a high-yield curriculum and organize the course.

PC: What on your radar for the future directions of the organization?
AA:
We have a number of goals that we have set for near term and some for longer term. I'll mention the ongoing projects and their near-term goals.
1.   Medicine of Cycling Membership - We invite everyone to support our organization and help us fund the various projects our group would like to do. Also medical providers who have attended our conference and/or hands on course can now feature their interest and support in being medical providers in their local and national community on our website. Our members will soon have a secure forum where they can discuss complicated medical care issues and share experiences to further their education and ability to manage patient care.
2.   Bike Fit Task Force headed by Curtis Cramblet DPT has started an amazing collaboration of bike fitters, manufacturers, coaches, and medical experts to define features of bike fit and demystify the process for cyclists and medical professionals.
3.   Bicycle Safety is one of my greatest commitments. I love to ride, but realize the hazards that come with the sport. We are working on improving race day safety and awareness of higher risk areas for falls and injury. This is a longer term goal.
4.   Education is often one of the most basic key interventions. Kristin Wingfield MD and I are planning a 6-week Mini-Medical School for the Public in Cycling Medicine through University of California, San Francisco. There are many other opportunities for local and national education, we are very committed to making these opportunities happen.
5.   Research in cycling medicine in the US is lagging behind other countries and other sports. Research requires time, funding, and mentorship. We started having a research presentation portion to our conference with the hopes of fostering the research that is ongoing and encouraging those who have considered starting or finishing a project attain their goals. I want to clarify that the research is medical research - concussion, urological trauma, long term injury, etc.

PC: Let’s talk about the coach-cycling physician relationship. I look at it as a multi-dimensional situation. The coach may recommend a qualified physician for a specific medical issue. What is the decision making process?
AA:
At this point most cycling networking occurs on a very personal level. An athlete may have referred to a doctor who either has identified as a cycling enthusiast or has treated another cyclist in the past. In reality, sometimes this may not be the best person for the job, but this may be the person the coach trusts, and this goes a long way. This is one of the reasons why orthopedic surgeons and pediatric radiologists come to our conference and learn about primary care, asthma, and dermatology. If they ride with a team or are active in their local cycling community, they may be asked questions which are out of their practice scope but are personally trusted. This is a very complex problem and a large part of why we started MOC. We now have some providers listed on our website for all to see and seek, but for now we continue to work on education and hope our network grows large and robust for coaches and cyclists soon.

PC: The coach may be working with a non cycling savvy physician for a pre-existing condition of one of their athletes. How does the coach navigate through this to the best interest of the athlete?
AA:
One of the saddest things I hear from cyclists is "I went to a primary care because my knee hurt. She told me to stop riding so I never went back to her." Non-cycling savvy medical providers may not perceive the extreme commitment most cyclists have to the sport. It is very important to be straightforward with the medical provider, for example "If I don't ride my bike, I will get fat and depressed, so it's important for my well-being to manage the knee pain on the bike." If the provider does not understand this quality of life feedback, it's appropriate to ask for a referral to a sports medicine provider. The athlete should be encouraged to continue to seek care and not let one or even two negative interactions become an obstacle to their health maintenance.

PC: Then there’s the rehab process of diagnosis, surgery/treatment therapy and balanced reconditioning of integrating the injured area to the rest of the body to avoid re-injury. How does the coach/physician role change during this process?
AA:
This is great challenge. Rehabilitation is a frustrating and expensive process that wears down even the most fastidious athlete. Many insurances don't cover significant outpatient rehabilitation needs and disaster only plans cover none. This is the time that coaches can significantly improve the odds of an athlete returning to the sport. Depending on the injury, there are various long term consequences from inconsistent or insufficient rehabilitation. If the athlete doesn't remain off a broken bone or take contraindicated medications such as ibuprofen to get through the pain to start training early, the bone may heal more slowly or form an insufficient callous, predisposing to repeat fractures. Tendon and soft tissue injuries heal slowly, and jumping into training instead of rehabilitation early can significantly prolong the healing process and alter body symmetry to accommodate for pain or lack of flexibility that results from injury. In short, you as a coach have to stress the importance of rehab to your athletes, no one other than their mother can possibly nag them into doing the right thing as much as you.

UCSF Medicine of Cycling 2013 Mini-Medical School Flyer

Posted on December 24, 2012 by mabramson

Here is the official flyer for the 2013 Mini Medical School on the UCSF Mission Bay Campus, Feb-Apr 2013!

UCSF Medicine of Cycling 2013 flyer

UCSF Mini-Medical School Presents “Medicine of Cycling” Series for the Public Feb-Apr 2013 #cme #medschool

Posted on December 21, 2012 by mabramson

Thursday evenings, February 28 – April 4 2013

7:00 to 8:45 p.m., Mission Bay Campus, 600 16th Street

Cycling is a unique sport shared by kids and adults, used for recreation and transportation, and enjoyed by people of many fitness and ability levels. Kids, bike racers and commuters alike share the joy of adventure, speed, and accessibility the bike provides. All cyclists also share the pain of falling off the bike, overuse injuries, fear associated with injury, and other medical consequences that
result from exposure to the elements. This course, led by a multidisciplinary team of experts and cyclists in fields of neurology, psychology, urology, dermatology, nutrition, bike fit, and sports medicine, will cover a wide range of topics which affect every cyclist. Join us and the cycling community to discuss the ups and the downs of living and loving the bike.

Course chair:
Anna Abramson, MD, Assistant Clinical Professor of Medicine; Co-Chair, Medicine of Cycling
Kristin Wingfield, MD, CCFP, Diploma Sports Medicine (CASEM)

 

More Information, speakers and syllabus @ UCSF

Registration @ UCSF Continuing Medical Education

 

WADA Publishes Sport Physician’s Tool Kit for Local Anti-Doping Education

Posted on December 18, 2012 by mabramson

The World Anti-Doping Agency WADA-ADA has published a "Sport Physician's Tool Kit" that contains materials to help sport physicians develop their own education programs. From the WADA Site:

Page on WADA's website

Direct link to the tool kit

As with a real ''tool kit'', the material contained in the Sport Physician’s tool kit is intended to help sport physicians develop anti-doping education programs which can be adapted and customized to suit local cultures, conditions and resources.

You are encouraged to adapt the tools to your specific program needs and reproduce them so that they may be shared as widely as possible with other sport physicians within your region.

The Tool Kit contains:

Ready-to-use PowerPoint presentations
Short articles
Case studies to test your knowledge

The following modules are included:

1. Introduction
2. Doping and Sports Medicine Ethics
3. Health Consequences of Doping
4. The Doping Control Process
5. The Prohibited List and TUEs
6. Performance Enhancement without Doping
7. Athlete’s Biological Passport
8. An Introduction to Gene Doping
9. Practical Issues – Case Studies

New York Times: To Encourage Biking, Cities Lose the Helmets

Posted on October 2, 2012 by mabramson

Is the importance of city bike usage more important than wearing a helmet?  The New York Times takes a look a bike sharing programs, helmet usage and the adoption of these programs.  The real question is: do the benefits of getting more people on bikes outweigh the risks of not wearing a helmet while doing so?

"In the United States the notion that bike helmets promote health and safety by preventing head injuries is taken as pretty near God’s truth. Un-helmeted cyclists are regarded as irresponsible, like people who smoke. Cities are aggressive in helmet promotion.

"But many European health experts have taken a very different view: Yes, there are studies that show that if you fall off a bicycle at a certain speed and hit your head, a helmet can reduce your risk of serious head injury. But such falls off bikes are rare — exceedingly so in mature urban cycling systems."

Read the full article here.

 

 

Nutrition, Facial Injuries, Lower Extremity Conditions in Cycling, and the Female Cyclist headline Day 3 of the 2012 Medicine of Cycling Conference

Posted on August 27, 2012 by mabramson

COLORADO SPRINGS, Colo. (August 26, 2012) Hip injury, sweat rate, cardiac screening, disordered eating, and dental care were just a few of the topics discussed today at the third annual Medicine of Cycling Conference. Medical experts presented a range of diverse topics from their respective fields and, casting the cyclist-as-patient into the spotlight, each presentation exposed medical issues specific to cyclists.

With the help of modern technology, Mark Greve, MD, medical director of Team Type 1, started the day with a check-in from the USA Pro Challenge. He discussed what it's like to be a team physician for a team in a major race. While this year's race was largely uneventful from a team physician perspective, Dr. Greve discussed his medical kit, how often he gets to ride his bike during events (rarely, if ever), and how he manages the language barrier with TT1 athletes from around the world.

Claudette Lajam, MD of New York University Langone Medical Center started off the day with her presentation on Lower Extremity Conditions in Cycling. Dr. Lajam highlighted IT Band Syndrome, hip dysfunction, labral tears, arthritis, and hip arthroplasty, as well as hip impingement and knee problems that affect all ages of the cycling population.

Next up Monique Ryan MS, RD, CSSD, LDN, HFS, brought her decades of experience working with endurance athletes to bear in her talk on Nutrition Strategies Designed for the High Performance Cyclist. In her presentation, Ryan detailed optimal foods for after, during, and before training, plus emphasized the need to jumpstart recovery immediately post training and racing. To support her topic, Ryan cited many studies and literature that examined carbohydrate absorption rates and sweat rates in cyclists to determine optimum intakes of carbohydrates and fluids when training and racing.

Michael Giudici, MD continued with his presentation on Pre-participation Cardiovascular Screening for Competitive Athletes. His talk examined the answer to the question, "What are the causes of sudden death in young competitive athletes, and what can we do to identify them?" and named myocarditis, coronary artery anomalies, and heat stroke effect on the heart as some of the threats to competitive athletes. He concluded with current American Heart Association recommendations for pre-participation cardiovascular screening of competitive athletes.

Gloria Cohen, MD finished off the morning sessions with The Female Cyclist, where she discussed The Female Athlete Triad: Eating Disorders, Amenorrhea and Osteoporosis. In addition, Dr. Cohen pointed out to participants that estimates of disordered eating are unknown, they vary from 4-39 percent; it is still a widely under-reported condition.

The afternoon sessions began with conference organizer, Anna Abramson, MD, announcing the results of a survey-based study of team physicians, team owners and team captains.

Paul Abramson, MD, gave a talk on Integrative Medicine and Cycling, which was followed by a presentation on Evaluation and Field Management of Traumatic Facial Injuries.  Aaron Liddell, MD DMD and John Tannyhill MD DDS drew attention to the many headlines in the cycling media about serious facial crashes in the pro peloton, including facial/head lacerations and mid-face trauma, both of which are some of the hardest things to fix. They also emphasized the importance of dental care, citing a couple top pro racers who were out for a significant portion of season due to wisdom tooth infections.

Margarita Sevilla, MD offered advice on how to prevent deaths in triathlon during her presentation on Triathlon Medicine. Preparedness and education are key, according to Dr. Sevilla. She also added general tips on how to prevent injury, such as core strengthing, proper bike fit, treadmill analysis, incorporating rest, and cross training.

The third annual Medicine of Cycling Conference concluded with a presentation by Matthew Fedoruk, PhD, Science Director of the US Anti-Doping Agency, whose talk on Cycling and Anti-Doping: A Health Professional's Perspective detailed educational efforts to explain the health ramifications of doping in cycling. To help conference participants become better informed, Fedoruk offered attendees many resources for medical practitioners, athletes, and coaches, as well as websites, phone numbers.

Dates for the fourth annual Medicine of Cycling Conference will be forthcoming, please check the website for more information.

Concussion in cycling, skin care, legal issues, bike fit and research at Medicine of Cycling Conference 2012

Posted on August 25, 2012 by mabramson

COLORADO SPRINGS, Colo. (August 25, 2012) Post-crash management during a bike race can make the difference between retiring from the race and continuing under potentially life-threatening circumstances. A cyclist with a concussion may keep on racing for the sake of his team, sponsors, and sometimes, his paycheck. The lively topic of concussions in cycling started off Day 2 of the third annual Medicine of Cycling Conference, where attendees learned how to determine if an athlete has suffered a concussion and what are the current tools and different methods to diagnose a potentially concussed athlete. Neurologist Jeffrey Kutcher, MD and researcher Steven Broglio PhD of the University of Michigan Neurosport presented the latest findings from the fast-moving field of research of brain injury.

The attendees were also reminded about life-threatening issues that may be elevated in cyclists through improper skin care. Timothy Berger, MD, a professor of clinical dermatology at UCSF, presented some of the most important skin-related issues facing cycling: sun exposure and protection, road rash, saddle sores, skin cancer and poison oak/poison ivy.

"The sessions so far have been great, and I was particularly impressed with the dermatology lecture," said Rozanne Puleo, a family nurse practitioner and registered clinical exercise physiologist from Boston. "The skin is our largest organ, and one frequently impacted by the sport of cycling, but because it is seemingly non life-threatening, it gets under-emphasized in sports medicine circles. But today's talk reminded us of the great risk our cyclists face in terms of skin cancer, and also provided practical tips for prevention that can apply to every cyclist in every discipline."

Stephen Hess Esq. addressed the legal ramifications of practicing telemedicine, which he defined as any audio/video/data communication that occurs in the physician's presence with the patient. From a legal standpoint, Hess explained that the "practice of medicine" varies from state to state and advised attendees to check the law before traveling.

The afternoon set the stage for the controversial topic of bike fit, in which Curtis Cramblett, PT delivered an overview of bicycle fitting tools, technologies, theory, and practice. The fact that bike fitting is not yet a licensed profession has created a legion of self-described bike fit experts and unvalidated theories on "proper bike fit." To address this, the newly-formed Medicine of Cycling Bike Fit Task Force commenced panel discussions in order to build some consensus on this topic of great importance. The task force and panelists include some of the foremost experts on bicycle fitting from the diverse stakeholder groups of the bicycle industry, physical therapy, bicycle retailers and physicians.

The conference continues tomorrow at 8 a.m. (MST) with presentations on lower extremity conditions in cycling, nutrition for high performing cyclists, cardiovascular screening, the female cyclist, triathlon medicine, and cycling and doping. For more information, visit http://www.medicineofcycling.com/syllabus-for-2012-medicine-of-cycling-cme-conference/

Stretching Routine for Cyclists

Posted on July 10, 2012 by hwoodhull

Laurie Kramer PT, DPT of University of California, San Francisco recommends these stretches for cyclists.

  • Hold each stretch for 30 -90 seconds
  • You should feel a stretch but it should never be painful
  • Breathe into the stretch and try to relax as much as possible to allow for elongation of the tissue 

    Hip/Buttock Stretch


    • Place your R ankle on your L knee
    • Reach through and bring your L knee to your chest
    • Feel the stretch in the R hip/buttock are

      Hamstring Stretch

    • Grab the back of your thigh/calf or hook a towel over your foot
    • Pull your leg towards your head until you feel a stretch

      Calf Stretch

    • Place foot on step or floor
    • Lean forward at the hips until you feel a stretch behind your knee
    • Flat back (stick butt out) to increase the stretch

      Calf Stretch

    • Place both hands on the wall
    • Step back with R foot keeping the R knee straight
    • Slight bend in L knee, should feel stretch in R calf

      Deep Calf Stretch

    • Place both hands on the wall
    • Step back with R foot keeping the R knee slightly bent
    • Feel the stretch deep in the R calf

      Hip Quad Stretch

    • Kneel on your L knee with a 90 degree angle between your R foot and hip
    • Grab your L ankle and pull your foot towards your bottom until you feel a stretch in your L hip and quad
    • Tuck your pelvis (posterior pelvic tilt) to achieve a deeper stretch

      Spinal Twist

    • Place R leg over L
    • Twist to the R placing the back of the L arm outside the R leg to create a larger spinal twist
    • Keep L leg engaged by squeezing the quad and bringing the toes up towards the nose (dorsiflex ankle)

      Back Stretch

    • Lie on your back with arms and legs straight
    • Bring L knee to chest, squeeze and let it fall to the R side
    • Bring both arms out the side in a T and turn head to the L

      Back of Leg Stretch

    • Standing, grab your L foot and bring it towards your bottom
    • Keep knees next to one another
    • Posterior pelvic tilt will deepen the stretch

      Shoulder Stretch

    • Interlace fingers, cross wrists and straighten arms
    • Feel the stretch between the shoulder blades

      Neck Stretch

    • Look over your shoulder
    • You can place your hand on your chin to increase the stretch but avoid pain
    • Tilt ear to shoulder
    • Roll neck around from L side through the middle (looking down) to the R side

      Shoulder Blade Stretch

    • Roll shoulders forward and backward
    • Focus on squeezing between shoulder blades (shoulders up, back, down and squeeze)

      Quad /Glut Stretch

    • Roll back and forth over IT band
    • May be painful but well worth it
    • Can also roll over quads and gluts

      Hip Stretch

    • cross R leg in front of L
    • lean trunk to the R, pushing L hips out to the side
    • feel the stretch on the outside of the L hip

      Round Back Stretch

    • Round your back as if you were trying to hug something in front of you
    • Without pulling your arms behind you, squeeze only the muscles between your shoulder blades and hold for 8 slow counts
    • Keep your abdominal muscles tight as you squeeze the muscles between your shoulder blades so that your back does not arch