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COVID-2019 Alert

The latest information about the 2019 Novel Coronavirus, including vaccine clinics for 12-17 year-olds.

La información más reciente sobre el nuevo Coronavirus de 2019, incluidas las clínicas de vacunación para jóvenes de 12 a 17 años.

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Emily Kraus, MD

I love helping injured young athletes get back to the activities and sports they love, and I enjoy working with players, coaches and trainers to prevent sports injuries before they happen. I work with a multidisciplinary team that includes orthopedic surgeons, athletic trainers, physical therapists and more to provide my patients with seamless, connected care.

I’ve had the good fortune of finding a job that allows me to not just manage sports injuries but truly treat the entire athlete. In sports medicine, it’s essential that we think about every aspect of healing and injury prevention, including nutrition, stress, training and sports psychology. When an athlete walks into my clinic, he or she will be welcomed with a smile, treated with respect and given the most individualized care I can provide. I embrace questions and interactive visits!

I especially enjoy those moments when I see the fire return to the eyes of an athlete who’s recovering from injury. That’s when I know the athlete gets it and is committed to the treatment plan.

Specialties

Orthopedics

Physical Medicine & Rehab

Work and Education

Professional Education

University of Nebraska College of Medicine, Omaha, NE, 05/12/2012

Internship

University of Nebraska Medical Center Internal Medicine Residency, Omaha, NE, 06/30/2013

Residency

Stanford University Physical Medicine and Rehabiliation, Redwood City, CA, 06/30/2016

Fellowship

Stanford University Sports Physical Med and Rehab Fellowship, Redwood City, CA, 07/31/2017

Board Certifications

Physical Medicine & Rehab, American Board of Physical Medicine & Rehab

Sports Medicine, American Board of Physical Medicine & Rehab

Conditions Treated

ACL Tears

Bone Health

Broken Bones

Concussions

Cycling

Fractures

Injury Prevention

Running

Sports injuries

Torn Ligaments

All Publications

Prevalence and Factors Associated with Bone Stress Injury in Middle School Runners. PM & R : the journal of injury, function, and rehabilitation Tenforde, A. S., DeLuca, S., Wu, A. C., Ackerman, K. E., Lewis, M., Rauh, M. J., Heiderscheit, B., Krabak, B. J., Kraus, E., Roberts, W., Troy, K. L., Barrack, M. T. 2021

Abstract

INTRODUCTION: Bone stress injury (BSI) in youth runners are clinically important during times of skeletal growth and are not well studied.OBJECTIVE: Evaluate the prevalence, anatomical distribution, and factors associated with running-related BSI in boy and girl middle school runners.DESIGN: Retrospective cross-sectional study.SETTING: Online survey distributed to middle school runners.METHODS: Survey evaluated BSI history, age, grade, height, weight, eating behaviors, menstrual function, exercise training, and other health characteristics.MAIN OUTCOME MEASUREMENTS: Prevalence and characteristics associated with history of BSI, stratified by cortical-rich (eg, tibia) and trabecular-rich (pelvis and femoral neck) locations.PARTICIPANTS: 2107 runners (n=1250 boys, n=857 girls), age 13.20.9y.RESULTS: One hundred-five (4.7%) runners reported a history of 132 BSIs, with higher prevalence in girls than boys (6.7% vs 3.8%, P=0.004). The most common location was the tibia (n=51). Most trabecular-rich BSIs (n=16, 94% total) were sustained by girls (pelvis: n=6; femoral neck: n=6; sacrum: n=4). In girls, consuming <3 daily meals (OR=18.5, 95%CI=7.3, 47.4), eating disorder (9.8, 95%CI=2.0, 47.0), family history of osteoporosis (OR=6.9, 95%CI=2.6, 18.0), and age (OR=1.6, 95%CI=1.0, 2.6) were associated with BSI. In boys, family history of osteoporosis (OR=3.2, 95%CI=1.2, 8.4), prior non-BSI fracture (OR=3.2, 95%CI=1.6, 6.7), and running mileage (OR=1.1, 95%CI=1.0, 1.1) were associated with BSI. Participating in soccer or basketball 2years was associated with lower odds of BSI for both sexes.CONCLUSION: While family history of osteoporosis and prior fracture (non-BSI) were most strongly related to BSI in the youth runners, behaviors contributing to an energy deficit, such as eating disorder and consuming<3 meals daily, also emerged as independent factors associated with BSI. While cross-sectional design limits determining causality, our findings suggest promoting optimal skeletal health through nutrition and participation in other sports including soccer and basketball may address factors associated with BSI in this population. This article is protected by copyright. All rights reserved.

View details for DOI 10.1002/pmrj.12673

View details for PubMedID 34251763

Prevalence of Female and Male Athlete Triad Risk Factors in Ultramarathon Runners. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine Hoeg, T. B., Olson, E. M., Skaggs, K., Sainani, K., Fredericson, M., Roche, M., Kraus, E. 2021

Abstract

OBJECTIVE: To identify the prevalence of male and female athlete triad risk factors in ultramarathon runners and explore associations between sex hormones and bone mineral density (BMD).DESIGN: Multiyear cross-sectional study.SETTING: One hundred-mile ultramarathon.PARTICIPANTS: Competing runners were recruited in 2018 and 2019.ASSESSMENT OF RISK FACTORS: Participants completed a survey assessing eating behaviors, menstrual history, and injury history; dual-energy x-ray absorptiometry for BMD; and laboratory evaluation of sex hormones, vitamin D, and ferritin (2019 cohort only).MAIN OUTCOME MEASURE: A Triad Cumulative Risk Assessment Score was calculated for each participant.RESULTS: One hundred twenty-three runners participated (83 males and 40 females, mean age 46.2 and 41.8 years, respectively). 44.5% of men and 62.5% of women had elevated risk for disordered eating. 37.5% of women reported a history of bone stress injury (BSI) and 16.7% had BMD Z scores <-1.0. 20.5% of men had a history of BSI and 30.1% had Z-scores <-1.0. Low body mass index (BMI) (<18.5 kg/m2) was seen in 15% of women and no men. The Triad Cumulative Risk Assessment classified 61.1% of women and 29.2% of men as moderate risk and 5.6% of both men and women as high risk.CONCLUSIONS: Our study is the first to measure BMD in both male and female ultramarathon runners. Our male population had a higher prevalence of low BMD than the general population; females were more likely to report history of BSI. Risk of disordered eating was elevated among our participants but was not associated with either low BMD or low BMI.

View details for DOI 10.1097/JSM.0000000000000956

View details for PubMedID 34232162

The Male Athlete Triad-A Consensus Statement From the Female and Male Athlete Triad Coalition Part 1: Definition and Scientific Basis. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine Nattiv, A., De Souza, M. J., Koltun, K. J., Misra, M., Kussman, A., Williams, N. I., Barrack, M. T., Kraus, E., Joy, E., Fredericson, M. 2021

Abstract

ABSTRACT: The Male Athlete Triad is a syndrome of 3 interrelated conditions most common in adolescent and young adult male endurance and weight-class athletes and includes the clinically relevant outcomes of (1) energy deficiency/low energy availability (EA) with or without disordered eating/eating disorders, (2) functional hypothalamic hypogonadism, and (3) osteoporosis or low bone mineral density with or without bone stress injury (BSI). The causal role of low EA in the modulation of reproductive function and skeletal health in the male athlete reinforces the notion that skeletal health and reproductive outcomes are the primary clinical concerns. At present, the specific intermediate subclinical outcomes are less clearly defined in male athletes than those in female athletes and are represented as subtle alterations in the hypothalamic-pituitary-gonadal axis and increased risk for BSI. The degree of energy deficiency/low EA associated with such alterations remains unclear. However, available data suggest a more severe energy deficiency/low EA state is needed to affect reproductive and skeletal health in the Male Athlete Triad than in the Female Athlete Triad. Additional research is needed to further clarify and quantify this association. The Female and Male Athlete Triad Coalition Consensus Statements include evidence statements developed after a roundtable of experts held in conjunction with the American College of Sports Medicine 64th Annual Meeting in Denver, Colorado, in 2017 and are in 2 parts-Part I: Definition and Scientific Basis and Part 2: The Male Athlete Triad: Diagnosis, Treatment, and Return-to-Play. In this first article, we discuss the scientific evidence to support the Male Athlete Triad model.

View details for DOI 10.1097/JSM.0000000000000946

View details for PubMedID 34091537

The Male Athlete Triad-A Consensus Statement From the Female and Male Athlete Triad Coalition Part II: Diagnosis, Treatment, and Return-To-Play. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine Fredericson, M., Kussman, A., Misra, M., Barrack, M. T., De Souza, M. J., Kraus, E., Koltun, K. J., Williams, N. I., Joy, E., Nattiv, A. 2021

Abstract

ABSTRACT: The Male Athlete Triad is a medical syndrome most common in adolescent and young adult male athletes in sports that emphasize a lean physique, especially endurance and weight-class athletes. The 3 interrelated conditions of the Male Athlete Triad occur on spectrums of energy deficiency/low energy availability (EA), suppression of the hypothalamic-pituitary-gonadal axis, and impaired bone health, ranging from optimal health to clinically relevant outcomes of energy deficiency/low EA with or without disordered eating or eating disorder, functional hypogonadotropic hypogonadism, and osteoporosis or low bone mineral density with or without bone stress injury (BSI). Because of the importance of bone mass acquisition and health concerns in adolescence, screening is recommended during this time period in the at-risk male athlete. Diagnosis of the Male Athlete Triad is best accomplished by a multidisciplinary medical team. Clearance and return-to-play guidelines are recommended to optimize prevention and treatment. Evidence-based risk assessment protocols for the male athlete at risk for the Male Athlete Triad have been shown to be predictive for BSI and impaired bone health and should be encouraged. Improving energetic status through optimal fueling is the mainstay of treatment. A Roundtable on the Male Athlete Triad was convened by the Female and Male Athlete Triad Coalition in conjunction with the 64th Annual Meeting of the American College of Sports Medicine in Denver, Colorado, in May of 2017. In this second article, the latest clinical research to support current models of screening, diagnosis, and management for at-risk male athlete is reviewed with evidence-based recommendations.

View details for DOI 10.1097/JSM.0000000000000948

View details for PubMedID 34091538

Narrative Review - Knee Pain in the Pediatric Athlete. Current reviews in musculoskeletal medicine Kuwabara, A., Kraus, E., Fredericson, M. 2021

Abstract

PURPOSE OF REVIEW: This review article seeks to highlight common youth athlete knee conditions due to overuse or trauma and elucidate differences from the adult populations.RECENT FINDINGS: Overuse conditions presented include apophysitis, osteochondritis dissecans plica syndrome, and discoid meniscus. Traumatic conditions presented include patellar instability, patellar sleeve fracture, and patellofemoral osteochondral fractures. Knee injuries affect a significant proportion of youth athletes. These injuries place athletes at higher risk of chronic pain and potentially osteoarthritis. We have reviewed common overuse and traumatic knee injuries and differentiating factors between the adult population to improve and expedite the diagnosis, treatment, and prognosis for youth athletes with knee injuries.

View details for DOI 10.1007/s12178-021-09708-5

View details for PubMedID 33818701

Dietary Supplement Use According to Sex and Triad Risk Factors in Collegiate Endurance Runners. Journal of strength and conditioning research Barrack, M., Fredericson, M., Dizon, F., Tenforde, A., Kim, B., Kraus, E., Kussman, A., Singh, S., Nattiv, A. 2020

Abstract

Barrack, MT, Fredericson, M, Dizon, F, Tenforde, AS, Kim, BY, Kraus, E, Kussman, A, Singh, S, and Nattiv, A. Dietary supplement use according to sex and Triad risk factors in collegiate endurance runners. J Strength Cond Res XX(X): 000-000, 2020-This cross-sectional study evaluated the prevalence in the use of dietary supplements among elite collegiate runners among 2 NCAA Division I cross-country teams. At the start of each season from 2015 to 2017, male and female endurance runners were recruited to complete baseline study measures; the final sample included 135 (male n = 65, female n = 70) runners. Runners completed a health survey, web-based nutrition survey, and Triad risk assessment. The prevalence of dietary supplement use and Triad risk factors, including disordered eating, low bone mass, amenorrhea (in women), low body mass index, and stress fracture history, was assessed. A total of 78.5% (n = 106) runners reported taking 1 or more supplements on 4 days per week over the past month, 48% (n = 65) reported use of 3 supplements. Products used with highest frequency included multivitamin/minerals 46.7% (n = 63), iron 46.7% (n = 63), vitamin D 34.1% (n = 46), and calcium 33.3% (n = 45). More women, compared with men, used iron (61.4 vs. 30.8%, p < 0.001) and calcium (41.4 vs. 24.6%, p = 0.04); men exhibited higher use of amino acids and beta-alanine (6.2 vs. 0%, p = 0.04). Runners with bone stress injury (BSI) history, vs. no previous BSI, reported more frequent use of 3 supplements (61.5 vs. 32.8%, p = 0.001), vitamin D (49.2 vs. 19.4%, p < 0.001), and calcium (47.7 vs. 19.4%, p = 0.001). Low bone mineral density was also associated with higher use of vitamin D and calcium. Most runners reported regular use of 1 or more supplements, with patterns of use varying based on sex, history of BSI, and bone mass.

View details for DOI 10.1519/JSC.0000000000003848

View details for PubMedID 33278271

Identifying Triad Risk Factors In Ultramarathon Runners Skaggs, K. F., Fredericson, M., Miller, E. K., Roche, M., Hoeg, T. B., Sainani, K., Kraus, E. LIPPINCOTT WILLIAMS & WILKINS. 2020: 68
Relationship Between Dynamic Limb Symmetry And Subjective Limb Confidence Post ACL Reconstruction In Youth Athletes Morgan, J. J., Lyons, S. M., Chan, S. K., Chan, C. M., Shea, K. G., Kraus, E. A. LIPPINCOTT WILLIAMS & WILKINS. 2020: 23
Dietary Intake Patterns And Risk Of Energy Deficiency In Ncaa Endurance Athletes Hernandez, C., Fredericson, M., Nattiv, A., Kraus, E., Kussman, A., Gravani, K., Miller, B., Papanos, L., Roche, M., Agans, D., Grohmann, E., Brotman, C., Barrack, M. LIPPINCOTT WILLIAMS & WILKINS. 2020: 753
Genetic Predictions Of Bone Mineral Density In Ultramarathon Runners: For Men, But Not For Women Miller, E. K., Fredericson, M., Roche, M., Skaggs, K., Hoeg, T., Sainani, K., Kraus, E. LIPPINCOTT WILLIAMS & WILKINS. 2020: 78384
Food Accessibility And Eating Patterns In Elite Collegiate Endurance Runners Agans, D., Barrack, M., Fredericson, M., Kraus, E., Kussman, A., Gravani, K., Miller, B., Papanos, L., Roche, M., Hernandez, C., Grohmann, E., Brotman, C., Nattiv, A. LIPPINCOTT WILLIAMS & WILKINS. 2020: 757
Predictors And Prevalence Of Low Bone Mineral Density And Bone Stress Injuries In Ultramarathon Runners Hoeg, T. B., Fredericson, M., Sainani, K. L., Skaggs, K. F., Roche, M. D., Miller, E., Kraus, E. LIPPINCOTT WILLIAMS & WILKINS. 2020: 492
Youth running consensus statement: minimising risk of injury and illness in youth runners. British journal of sports medicine Krabak, B. J., Roberts, W. O., Tenforde, A. S., Ackerman, K. E., Adami, P. E., Baggish, A. L., Barrack, M. n., Cianca, J. n., D'Hemecourt, P. n., Fredericson, M. n., Goldman, J. T., Harrast, M. A., Heiderscheit, B. C., Hollander, K. n., Kraus, E. n., Luke, A. n., Miller, E. n., Moyer, M. n., Rauh, M. J., Toresdahl, B. G., Wasfy, M. M. 2020

Abstract

Despite the worldwide popularity of running as a sport for children, relatively little is known about its impact on injury and illness. Available studies have focused on adolescent athletes, but these findings may not be applicable to preadolescent and pubescent athletes. To date, there are no evidence or consensus-based guidelines identifying risk factors for injury and illness in youth runners, and current recommendations regarding suitable running distances for youth runners at different ages are opinion based. The International Committee Consensus Work Group convened to evaluate the current science, identify knowledge gaps, categorise risk factors for injury/illness and provide recommendations regarding training, nutrition and participation for youth runners.

View details for DOI 10.1136/bjsports-2020-102518

View details for PubMedID 33122252

Prevalence of Female Athlete Triad Risk Factors and Iron Supplementation Among High School Distance Runners: Results From a Triad Risk Screening Tool. Orthopaedic journal of sports medicine Skorseth, P. n., Segovia, N. n., Hastings, K. n., Kraus, E. n. 2020; 8 (10): 2325967120959725

Abstract

Investigations of the female athlete triad (Triad) in high school athletes have found that 36% had low energy availability, 54% had menstrual abnormalities, and 16% had low bone mineral density (BMD). Limited data are available showing the prevalence of these risk factors in high school distance runners or regarding best practice on screening for the Triad in the adolescent population.To (1) evaluate the prevalence of Triad risk factors and iron supplementation in high school distance runners and (2) pilot a screening tool for Triad risk score.Descriptive epidemiology study.The study population included female high school athletes who participated in cross-country/track. Participants completed a survey including questions regarding dietary habits, menstrual history, and bone stress injury (BSI) history. They then underwent evaluation of 25-hydroxyvitamin D, free triiodothyronine (T3), and dual-energy x-ray absorptiometry scan to measure body fat and BMD through use of age-, sex-, and ethnicity-matched Z scores. Triad scores were calculated. Relationships were analyzed using Spearman correlation coefficient.There were 38 study participants (mean age, 16.9 years). Average body mass index was 19.8 kg/m2. Disordered eating or eating disorders were reported in 76.3% of runners; in addition, 23.7% reported delayed menarche, 45.9% had a history of amenorrhea or oligomenorrhea, 42.1% had low BMD (Z score < -1.0), and 15.8% reported prior BSI. Low free T3 was significantly associated with higher Triad risk scores (rS = -0.36; P = .028). More than 42% of athletes were supplementing iron.The prevalence of Triad risk factors in high school distance runners was high. Free T3 was inversely associated with Triad score, which may serve as an indicator of low energy availability. Nearly half of the athletes were using iron supplementation.

View details for DOI 10.1177/2325967120959725

View details for PubMedID 33195716

View details for PubMedCentralID PMC7605010

Impact of Adaptive Sports Participation on Quality of Life. Sports medicine and arthroscopy review Diaz, R., Miller, E. K., Kraus, E., Fredericson, M. 2019; 27 (2): 7382

Abstract

The health benefits of regular recreational physical activity are well known in reducing secondary health consequences of a sedentary lifestyle in the general population. However, individuals with physical disabilities participate less frequently in recreational activity compared with those without disabilities. Although evidence on the impact of recreational physical activity on quality of life in this population is in its infancy, regular recreational and sports activity participation has shown to have a positive association with improvements in quality of life, life satisfaction, community reintegration, mood, and employment in those with disabilities. Facilitators of participating in adaptive sports include a desire to improve social support, physical fitness, health, and fun. Unfortunately, those with disabilities face numerous barriers to participate in adaptive sports including accessibility, transportation, awareness, finances, and physical and cognitive impairments. Further studies are needed to investigate facilitators and barriers to participating in adaptive sports to capitalize on the physical and psychosocial benefits of regular recreational activity. The aim of this article is to review the available literature on the effects of adaptive sports participation on quality of life.

View details for DOI 10.1097/JSA.0000000000000242

View details for PubMedID 31046012

Iron Supplementation and the Female Athlete Triad in High School Distance Runners Skorseth, P., Dingel, A., Hastings, K., Segovia, N., Kraus, E. LIPPINCOTT WILLIAMS & WILKINS. 2019: 736
Bone stress injuries in male distance runners: higher modified Female Athlete Triad Cumulative Risk Assessment scores predict increased rates of injury. British journal of sports medicine Kraus, E., Tenforde, A. S., Nattiv, A., Sainani, K. L., Kussman, A., Deakins-Roche, M., Singh, S., Kim, B. Y., Barrack, M. T., Fredericson, M. 2018

Abstract

OBJECTIVES: Bone stress injuries (BSI) are common in runners of both sexes. The purpose of this study was to determine if a modified Female Athlete Triad Cumulative Risk Assessment tool would predict BSI in male distance runners.METHODS: 156 male runners at two collegiate programmes were studied using mixed retrospective and prospective design for a total of 7years. Point values were assigned using risk assessment categories including low energy availability, low body mass index (BMI), low bone mineral density (BMD) and prior BSI. The outcome was subsequent development of BSI. Statistical models used a mixed effects Poisson regression model with p<0.05 as threshold for significance. Two regression analyses were performed: (1) baseline risk factors as the independent variable; and (2) annual change in risk factors (longitudinal data) as the independent variable.RESULTS: 42/156 runners (27%) sustained 61 BSIs over an average 1.9 years of follow-up. In the baseline risk factor model, each 1 point increase in prior BSI score was associated with a 57% increased risk for prospective BSI (p=0.0042) and each 1 point increase in cumulative risk score was associated with a 37% increase in prospective BSI risk (p=0.0079). In the longitudinal model, each 1 point increase in cumulative risk score was associated with a 27% increase in prospective BSI risk (p=0.05). BMI (rate ratio (RR)=1.91, p=0.11) and BMD (RR=1.58, p=0.19) risk scores were not associated with BSI.CONCLUSION: A modified cumulative risk assessment tool may help identify male runners at elevated risk for BSI. Identifying risk factors may guide treatment and prevention strategies.

View details for PubMedID 30580252

Corrigendum to "A little bit faster: Lower extremity joint kinematics and kinetics as recreational runners achieve faster speeds" [J. Biomech. 71 (2018) 167-175]. Journal of biomechanics Orendurff, M. S., Kobayashi, T., Tulchin-Francis, K., Tullock, A. M., Villarosa, C., Chan, C., Kraus, E., Strike, S. 2018

View details for PubMedID 30442429

Team Approach: Bone Health in Children and Adolescents. JBJS reviews Kraus, E., Bachrach, L. K., Grover, M. 2018

View details for PubMedID 30325758

Utilization And Efficacy Of The "Run Fueled" Smart-phone Application Among Collegiate Endurance Runners Barrack, M., Fredericson, M., Kraus, E., Kim, B., Singh, S., Gravani, K., Miller, B., Nativ, A. LIPPINCOTT WILLIAMS & WILKINS. 2018: 82
A Review and Proposed Rationale for the use of Ultrasonography as a Diagnostic Modality in the Identification of Bone Stress Injuries. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine Fukushima, Y., Ray, J., Kraus, E., Syrop, I. P., Fredericson, M. 2018

Abstract

Bone stress injuries are common in military personnel and athletes. The delayed diagnosis of a bone stress injury can lead to a more severe injury that requires a longer period of treatment. The early detection of bone stress injuries is a central part of management. Currently, the reference standard for detecting bone stress injuries is magnetic resonance imaging. However, the expanding use of point-of-care ultrasonography (US) may enable the early detection of bone stress injuries in the clinical setting. In this article, we review the US detection of bone stress injuries, as well as discuss the rationale for the use of US in the diagnosis of these injuries.

View details for PubMedID 29655254

Nutrition Goals Prioritized By Elite Endurance Runners Undergoing A Nutrition Education Intervention Barrack, M., Fredericson, M., Adam, T. S., Kraus, E., Kim, B., Singh, S., Kussman, A., Gravani, K., Ansari, Y., Miller, B., Nattiv, A. LIPPINCOTT WILLIAMS & WILKINS. 2017: 852
Preliminary Results from a Prospective Study Using the Female Athlete Triad Cumulative Risk Assessment Kraus, E., Nattiv, A., Tenforde, A., Kussman, A., Barrack, M., Kim, B., Deakins-Roche, M., Mistra, N., Singh, S., Fredericson, M. LIPPINCOTT WILLIAMS & WILKINS. 2017: 1098
Integrating Musculoskeletal Education and Patient Care at MedicalStudent-Run Free Clinics. PM & R : the journal of injury, function, and rehabilitation McQuillan, T., Wilcox-Fogel, N., Kraus, E., Ladd, A., Fredericson, M. 2017

Abstract

Student-run free clinics (SRFCs) have emerged as an important educational component of United States (US) medical schools. Despite the prevalence of musculoskeletal (MSK) problems presenting to SRFCs, students and clinics are often unprepared to diagnose and to treat common MSK complaints.We sought to determine the scope of diagnosis and treatment at a medical student-run free clinic specializing in musculoskeletal care using physical medicine and rehabilitation (PM&R) residents. Secondary goals included reviewing student satisfaction and determining the appropriateness of the clinic in medical education.Retrospective chart review, anonymous online survey.Primary care, free student clinic affiliated with tertiary academic medical center.A total of 20 medical student volunteers, 6 PM&R residents, and 91 community patients.We established a musculoskeletal clinic as a specialty referral clinic for the 2 primary care SRFCs with institutional support from a partner medical school. We then reviewed clinical operations retrospectively using electronic medical records and student satisfaction based on an online survey.We analyzed patient demographics and chief complaints, referrals provided, and medical services rendered. We also used a 5-point Likert scale to assess student satisfaction.A monthly musculoskeletal referral clinic was established with the oversight of PM&R attendings and residents. The clinic received 91 referrals and managed 61 unique patients over a 2.5-year study period. The most common presentations to the clinic involved knee pain (n = 17, 27.9%) and back pain (n = 16, 26.2%). Pro bono relationships with community and institutional partners enabled all patients to receive medical examinations, physical therapy visits, plain film radiographs, and insurance consultations free of charge. Student satisfaction with teaching and patient care was high, with 19 of 20 students reporting their experience as "good" or "excellent."SRFCs represent an underused opportunity to enhance MSK education among medical students by treating a variety of common MSK complaints in an underserved population.To be determined.

View details for DOI 10.1016/j.pmrj.2017.03.008

View details for PubMedID 28389399

Poster 155 Higher Cumulative Risk Assessment Scores Are Associated with Delayed Return to Play in Division I Collegiate Distance Runners. PM & R : the journal of injury, function, and rehabilitation Kraus, E. A., Kim, B., Nattiv, A., Tenforde, A., Barrack, M., Deakins-Roche, M., Kussman, A., Singh, S., Morkos, J., Fredericson, M. 2016; 8 (9S): S212-S213

View details for DOI 10.1016/j.pmrj.2016.07.196

View details for PubMedID 27672919

Piriformis Syndrome With Variant Sciatic Nerve Anatomy:ACaseReport. PM & R : the journal of injury, function, and rehabilitation Kraus, E., Tenforde, A. S., Beaulieu, C. F., Ratliff, J., Fredericson, M. 2016; 8 (2): 176-179

Abstract

A 68-year-old male long distance runner presented with low back and left buttock pain, which eventually progressed to severe and debilitating pain, intermittently radiating to the posterior thigh and foot. A comprehensive workup ruled out possible spine or hip causes of his symptoms. A pelvic magnetic resonance imaging neurogram with complex oblique planes through the piriformis demonstrated variant anatomy of the left sciatic nerve consistent with the clinical diagnosis of piriformis syndrome. The patient ultimately underwent neurolysis with release of the sciatic nerve and partial resection of the piriformis muscle. After surgery the patient reported significant pain reduction and resumed running 3 months later. Piriformis syndrome is uncommon but should be considered in the differential diagnosis for buttock pain. Advanced imaging was essential to guide management.

View details for DOI 10.1016/j.pmrj.2015.09.005

View details for PubMedID 26377629

Bone Stress Injuries in Runners. Physical medicine and rehabilitation clinics of North America Tenforde, A. S., Kraus, E., Fredericson, M. 2016; 27 (1): 139-149

Abstract

Bone stress injuries (BSIs) are common running injuries and may occur at a rate of 20% annually. Both biological and biomechanical risk factors contribute to BSI. Evaluation of a runner with suspected BSI includes completing an appropriate history and physical examination. MRI grading classification for BSI has been proposed and may guide return to play. Management includes activity modification, optimizing nutrition, and addressing risk factors, including the female athlete triad. BSI prevention strategies include screening for risk factors during preparticipation evaluations, optimizing nutrition (including adequate caloric intake, calcium, and vitamin D), and promoting ball sports during childhood and adolescence.

View details for DOI 10.1016/j.pmr.2015.08.008

View details for PubMedID 26616181