The 4 physician editors of this textbook have a well-recognized interest in sports medicine. Virtually all chapters have been updated or rewritten for this edition, which will be of major interest to all of those who are concerned with or who have made a career in caring for the injured athlete. It will provide an ideal knowledge base for students of sports medicine, particularly those who are university based.
The text begins with a philosophical view of man as an athlete by Per-Olaf Astrand. This is a particularly interesting chapter, which looks at the athlete from evolutionary and biologic viewpoints. It asks why sports records are improving and answers this in the changes made in many areas, from physiological to psychological. The marked changes in training methods, techniques, rules and equipment are emphasized.
The first 400 pages relate to the scientific basis for sports medicine and include detailed treatises on cardiorespiratory responses to exercise and training, adaptations in skeletal muscle with endurance programs and anaerobic metabolism during prolonged and high-intensity exercise. It provides a scientific basis for nutrition and fluid electrolyte replacement after exercise. There is a new chapter on nutritional and ergogenic aids and supplements to optimal exercise performance. Eating disorders among athletes are discussed and programs recommended. There is an excellent section on kinesthesiology and anthropometry and the assessment of body composition. There is a special section on sports and environmental factors. This chapter deals with the athlete performing in extremes of temperature and altitude and considers the impact of underwater exercise. It is topped off by a discussion of circadian rhythms and how they might affect the modern athlete.
The second section deals with acute sports injuries, and the first major components cover the knee, shoulder and ankle in a comprehensive fashion. Each joint is dealt with on the basis of the acute injuries possible, methods of diagnosis, treatment and rehabilitation. Although these chapters are not as conclusive as in many formal orthopedic texts, they give the reader an excellent overview of the best management of these 3 commonly injured joints. There is a useful section on chronic and overuse sports injuries and an excellent new chapter on the female athlete and the impact of pregnancy on exercise.
The final chapter is entitled “Special considerations” and deals with specific emergencies in the athlete. It basically examines the fallen athlete from emergency management of the major musculoskeletal injuries, axillofacial injuries, and injuries to the head, neck and spine. Although all the necessary information is contained in this section, some of it is hidden, so some reorganization of the section would make for easier reading. A more general handling of the life-threatening injuries earlier in this acute sports injury section would provide a more effective presentation. The chapters on the wrist and hip would be better related to the section on the knee, ankle and shoulder.
All in all, this is an excellent book. Its strengths lie in the very scientific presentation on exercise physiology, followed by detailed and practical discussions of virtually all acute sports injuries. I believe this is a textbook that should be in the library of all sports medicine departments in Canadian universities and will be helpful as a reference text for all physicians, athletic trainers and others who are interested in sports medicine or who look after an athletic team at any level. I very much enjoyed reading this book.