Primary Care Sports Medicine.

McKeag DB, Hough DO, Zemper ED. Dubuque, IA 52001, Brown & Benchmark, 1993, hardback, 609 pp, illus, $125.

This text is written for primary care physicians as an adjunct to the curriculum in Family Practice Sports Medicine at Michigan State University, East Lansing. Its purposes are to serve as a reference text for practicing physicians, learning tool for students, and study guide for Board certification for primary care physicians. It completely covers the broad topic of sports medicine, addressing the areas of most interest to the primary care physician specializing in sports medicine.

The book contains 20 chapters and is divided into three parts. Part 1, chapters 1 through 3, covers basic and behavioral sciences. Chapter 1 is an introductory chapter on the perspective of the primary care physician with regard to their involvement in sports medicine. Chapter 2 gives a review of basic sciences and epidemiology in sports medicine, covering such topics as exercise physiology, nutrition, and pharmacology. Chapter 3 covers sports psychology.

Part 2, chapters 4 through 8, covers the area of preventive sports medicine. There is a well-written chapter on preparticipation screening, addressing the screening needs of all athletes, from the prepubescent athlete to the, elderly athlete. Other factors related to preseason screening examinations, such as implementation, frequency, timing, content of the exam, and assessment and injury prediction value of the screening results are also addressed. The chapter on conditioning and training for athletes and nonathletes covers the general principles of conditioning as well as training considerations for specific populations such as the young athlete, the female athlete, the pregnant athlete, the older athlete, and the sedentary adult. This chapter references the American College of Sports Medicine's position statement on recommended quantity and quality of exercise (presented as an appendix). This position statement, however, is now outdated and the reader needs to be aware of the new American College of Sports Medicine guidelines for exercise. The chapter on exercise and chronic illness contains some good information on exercise and typical chronic diseases such as diabetes, asthma, and chronic obstructive pulmonary disease. It also contains a section on athletes who are handicapped that is somewhat superficial and inaccurate. It is unfortunate that opportunities for athletes with disabilities to compete in the Paralympic Games are not mentioned, although the inference was made that all athletes with disabilities compete in the Special Olympics.

Part 3, chapters 9 through 20, addresses various topics related to clinical sports medicine. The chapter on acute management of emergency conditions is only 15 pages long, but provides adequate, general information. Chapters 11 through 16 present an organ, system, or anatomic area approach to the evaluation, diagnosis, and treatment of common sports-related injuries. Each injury is cross-referenced by sport in the index to allow the reader to refer to the information by either specific injury, by organ, system, or anatomic area, or by sport or activity. The chapter on radiology of sports injuries is a nice addition for those with minimal background in viewing radiographs, bone scans, computed tomography scans, or magnetic resonance imagings. The chapter on rehabilitation presents some solid, basic concepts regarding therapeutic management of sports-related injuries. Specific rehabilitation protocols presented, however, are conservative and may not follow some of the more aggressive rehabilitation programs now being used. It is unfortunate that such chapters are not at least cowritten by those directly involved in the rehabilitation process, such as the physical therapist and/or the athletic trainer. This may have helped provide a more contemporary perspective on specific rehabilitation protocols.

The text contains many valuable tables and figures. Some of the figures, however, such as those in chapter 2, are difficult to understand without in-depth reading. It would also be helpful to have some color photographs in chapter 15 to complement the information on common skin conditions. Each chapter is well referenced, and most contain a suggested reading list. This would be more valuable if both the references and the reading list were up-to-date. There are very few, if any, references newer than 1987. Perhaps the greatest strength of this book is the information presented in the appendixes that follow each chapter. These indexes are a valuable reference source for any clinician using this book.

Overall, the book is well written and easy to read. Anyone involved in sports medicine, from the physician to the physical therapist or athletic trainer, would find some aspect of this text useful in their everyday practice. I would recommend it as a supplemental reference to complement other texts in sports medicine.