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Textbook of sports medicine
  1. C Milne
  1. Sports Physician, 87 Clarence Street, Hamilton, New Zealand;

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    Edited by M Kjaer, M Krogsgaard, P Magnusson, et al. Oxford: Blackwell Publishing, 2003, £89.50, pp 808. ISBN 0632065095

    I have long been impressed by the Scandinavian contribution to sports medicine and exercise science. Therefore a textbook that is the product of leading Scandinavian authors is eagerly awaited. This one does not disappoint. It should appeal to both sports scientists and clinicians.

    The first section of the book is devoted to basic science—exercise physiology, biomechanics, and tissue repair processes. The chapters are well written and up to date, but, as a clinician, I found the information was not as well presented as in Wilmore and Costill, which for me remains the benchmark for presentation style.

    The second section deals with aspects of human performance and is both detailed and accurate. In the analysis of overtraining, there is appropriate mention of the work of major contributors such as Eric Newsholme and Laurel McKinnon. In the section on altitude training, there is discussion of the live high, train low concept, which is the product of relatively recent research. This demonstrates the contemporary nature of this text.

    Moving on, there are well written contributions on exercise in acute and chronic disease states. Some of the major pioneering research on osteoarthritis and sports participation was done in Finland, and this work is given due mention in the textbook. There is a 25 page chapter on imaging of sports injuries, which provides a good analysis of the strengths and weaknesses of the various imaging modalities. The images and diagrams that accompany the text are well chosen.

    For sports physicians, the bulk of clinical work involves injury diagnosis and treatment, which occupies the final 250 pages of the book. Here the content is mixed. There is a good description of common and less common causes of leg pain—for example, popliteal artery entrapment. However, tendinopathy is not mentioned as such in this section of the book—rather the term tendinosis is used. Alfredson’s concentric then eccentric strengthening regimen is mentioned, but no specifics are given, such as appears in the textbook of Brukner and Khan. There are only two paragraphs devoted specifically to diagnosis and treatment of stress fracture of the navicular, which is a bit light in a textbook of this size. Sadly, there is no mention of the Vienna conference consensus on concussion held in 2002.

    In summary, this is a useful textbook that successfully combines sports science and medicine into a unified body of work. Its strength is the close linkage and reference to original research (each chapter starts with a reference to a classic paper). Its weakness is that, for clinicians, more detail on diagnosis and management of certain injuries would be required for those wanting a text to consult for specific advice.

    It’s a very good book, but in my view Brukner and Khan remains a better text for clinicians.

    Evidence basis19/20