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Lessons from Monaco, the IOC and BMJ
The slang term ‘to be hip’, meaning fashionably current and in the know, probably has its origins in African-American Vernacular English and became popularly used in the African-American dominated jazz scene of the 1930s and 1940s.1 This year's Fourth International Conference on Injury Prevention hosted by the IOC in Monaco was the place for ‘hip’ sport and exercise clinicians to be seen. Fireworks over the harbour, a reception at the palace and an opening address by the Prince may have left many star struck, but it was the networking with the ‘who's who’ of Sport and Exercise Medicine (SEM) during and in between the insightful sessions that would have had the most impact, especially with so many established faces mingling with young clinicians and up-and-coming researchers.
South African Sports Medicine Association—1 of 13 Super ‘Hipsters’
Somewhat lower in profile, but equally momentous, was the networking workshop hosted by BJSM the day before the IOC meeting. The 13 associate societies (whose members have free access to the journal as part of their association subscriptions) met to discuss successes and challenges in promoting SEM among their national and continental memberships. In addition, Claire Bower, BMJ's digital communications manager, provided great insight into how societies could tap into BMJ's array of social media platforms to communicate with members and access BMJ and BJSM's educational modules (follow @clairebower for great ideas and sage advice).
Savvy use of social media
The South African Sports Medicine Association (SASMA), as part of the ‘Super 13’, gained appreciably. Our current mantra of ‘Learners to Leaders’ defines SASMA's transition phase in which we are actively promoting participation by a new generation of young clinicians to international standard SEM and the presence of three ‘generations’ of leaders at the meeting was significant. We left understanding that the penetrative strength, speed of access and reach of social media is appealing to generations Y and Z and slipstreaming in BJSM's well-established platforms of website, Twitter, podcasts and YouTube is an excellent (but underutilised) way to spread the SEM gospel. In fact, a recurring theme during the IOC meeting was that a social media strategy is now an integral part of practice as a sports and exercise physician. What was initially trendy is now essential and SASMA will be addressing its social media strategy as a result of this productive workshop in order to remain ‘hip’ and relevant. Look out for more from http://www.sasma.org.za and @sasmadiscuss!
Are clinicians currently too ‘hip happy’?
A theme for this edition of the journal is ‘hip and groin’, perennially enigmatic areas in injury diagnosis and management. With the emergence of better imaging techniques and having breached what Dr Mark Hutchinson terms the ‘last frontier’ of hip arthroscopy, are we operating on too many young hips? We open with editorials led by two of South Africa's (SA's) foremost sports medicine orthopaedists. Josep Cakic, President of the SASMA-aligned South African Society for Hip Arthroscopy (SASHA), discusses the concept of femoroacetabular impingement (FAI), balancing the need for surgical intervention with a proposed South African screening programme to identify young athletes before they require surgery (see page 1073). Sports traumatologist Mark Ferguson hypothesises that mechanical loading patterns may explain FAI-related and sports-related groin pain (see page 1074).
Honing in on the hip
Joanne Kemp's group, in their cohort of 100 patients undergoing hip arthroscopy, describes early-onset hip osteoarthritis as being associated with increasing age, coexisting labral pathology and FAI (see page 1102). Significantly, other ‘hip’ papers in this edition explore the kinematic relationship between the hip, groin and other joints. Andreas Serner, working with Per Holmich, describes and illustrates eight exercises that, based on electromyographical measures, enable a deliberate choice of exercises appropriate to the phase of groin injury management (see page 1108). Ryan et al (see page 1089) explore the risk factors for hip and groin injuries while Rathleff et al in their high-quality review (see page 1088) look at the evidence for a kinematic relationship between hip muscle strength and patellofemoral pain (PFP) concluding that, on the basis of prospective studies, it may be the hip pain that results from PFP. On this theme, readers are referred to the latest Consensus Statement on PFP featuring real ‘hip’ patella experts Witvrouw, McConnell, Powers et al.2
…and the groin
The Position Statement from the British Hernia Society (see page 1079) is likely to be a frequently referenced paper and is complemented by Adam Weir's insightful and critical editorial (see page 1076). Adam is chairing the organising committee for November's Groin Conference in Qatar (http://www.aspetar.com/WCGP2014 @AspetarQatar)
South African ‘flavour’
SA's Professor Tim Noakes (@ProfTimNoakes) seems to have half the country and a good number of medical disciples (follow @PeterBrukner) eating low-carbohydrate high-fat diets (#LCHF). Ever thought-provoking (provocative), this South African edition provides an appropriate forum for Tim to elucidate why this approach is relevant for sportspersons and stir the proverbial carbohydrate pot (see page 1077). Louis Holtzausen, a previous SASMA President, weighs in with his strategic framework for SEM in SA (see page 1120).
The appearance of South African Springbok Rugby captain Jean de Villiers on the cover of this edition reflects our national passion for the sport, and an area of increasing research in rugby injury prevention and intervention with significant data emanating from SA rugby's BokSmart (@BokSmart and http://www.boksmart.com) programme. With an injury incidence of up to 218 injuries/1000 player hours, rugby leads the collision sport injury stats.3 (Could we suggest a Rugby-dedicated edition @BJSM_BMJ?) The scrum remains the most important, controllable aspect of the game in which the occurrence of injury can be influenced and Hendricks discusses the evidence behind modifying scrum laws (see page 1115) while Brown looks in-depth at more accurate ways of determining the incidence of scrum-related neck injuries (see page 1127), a key focus of the BokSmart programme. Guermazi et al (see page 1097) describe the features of thoracic injuries in Rugby focusing on the mechanisms and imaging characteristics.
Beyond the last frontier…
The search for hip and groin solutions continues. Perhaps the First International Congress on Groin Injuries in Doha this year will provide more answers to the ‘groin issue’. SASMA will host a day-long ‘Hip Seminar’ dedicated to exploring surgical and conservative management options at the next SASMA Congress (Johannesburg, 20–22 October 2015). We hope to continue contributing in this and other areas, exploring social media and interacting with our fellow ‘Super 13’ BJSM associate members. If your SEM association is not yet part of the club, we would endorse joining. What better way to be hip…without being too hip happy?
Contributors JP conceived the theme, reviewed the articles and drafted the manuscript. PZ reviewed the papers submitted for the edition and edited the draft.
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.
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