Editor's Notes
Advocating Injury Prevention:The Team Physician's Role
GORDON O. MATHESON, MD, PHD

Best of the Literature
Beyond the (Playing) Surface: Analyzing Injuries Among High School Football Players • Biking to Work and Other Physical Activity Lower Colon Cancer Risk • Lifestyle Changes to Prevent Type 2 Diabetes: A Good Investment for All Ages

News Briefs
Lacrosse Participation Surges: Exploring the Medical Issues • Experts Issue Hyponatremia Consensus

Complete Rupture of Large Tendons
Risk Factors, Signs, and Definitive Treatment
Though complete ruptures of large tendons are rare, they can occur in predictable patterns, particularly in active, middle-aged men and in athletes in certain sports. Treatment, except for Achilles tendon ruptures, is often operative. Ongoing medical issues to consider are comorbid conditions and the patient's return to activity.
KYLE R. FLIK, MD; CHARLES A. BUSH-JOSEPH, MD; BERNARD R. BACH, JR, MD

Diabetes, Exercise, and Foot Care
Minimizing Risks in Patients Who Have Neuropathy
Physicians walk a fine line when prescribing exercise for patients who have diabetes. Exercise can help regulate blood sugar levels and slow the progression of complications; however, improper footwear and foot care can present disabling obstacles. Physician-driven safety strategies keep patients in the benefit zone.
SHEILA A. WARD, PHD, MPH

Pneumomediastinum and Subcutaneous Emphysema in a Synchronized Swimmer
When spontaneous pneumomediastinum occurs in a sports setting, the cause is usually related to blunt trauma. However, activities that involve Valsalva's maneuver can also lead to this injury. Breath holding in synchronized swimming is one such scenario, as described in the case of a girl who presented the morning after swimming practice with pain and a cracking sensation in her neck. Oxygen therapy helped her symptoms resolve. Patients can usually resume activity in 7 to 10 days.
MAJ JAMES D. LEIBER, DO; CAPT NGHIA T. PHAN, DO

Lost in Translation
Evidence-Based Interventions in Physical Activity and Nutrition
Researchers have done an excellent job determining what causes and resolves obesity; however, the interventions are slow to filter down to patients. The good news is that a new research trend may help bridge the gap: a focus on practical clinical trials and translational research.
PHILLIP B. SPARLING, EDD

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