30-Second Takeaway
- Use early, criterion-based PT for adolescent lumbar spondylolysis instead of prolonged rest-then-PT.
- Post-ACLR decisions should incorporate quadriceps power and real-world activity load, not strength or PROs alone.
- Women’s and para-football demand sport-specific concussion and cardiac screening protocols.
- Middle-aged and recreational endurance athletes can harbor clinically relevant arrhythmias and fibrosis despite high fitness.
- Single-dose sodium bicarbonate adds little to continuous running performance and often provokes GI distress.
Week ending December 20, 2025
Sports med updates: spondylolysis rehab, ACLR loading, and evolving cardiocerebral risks in modern sport
Immediate, criterion-based PT outperforms rest-first care for adolescent lumbar spondylolysis
Adolescent athletes with active lumbar spondylolysis were randomized to start PT within 7 days versus rest until symptoms resolved before PT. Immediate PT yielded substantially better Micheli Functional Scale scores at 1 month than rest-then-PT. Athletes starting PT immediately returned to sport 38 days sooner and had fewer 12-month low back pain recurrences (3% vs 29%). No adverse events occurred, supporting early, supervised, symptom-guided rehabilitation instead of prolonged initial rest.
Quadriceps power lags strength for 4–12 months after ACL reconstruction
Collegiate athletes 4, 8, and 12 months post-ACLR showed persistent between-limb asymmetries in quadriceps peak torque and rate of torque development (RTD). Several RTD limb symmetry indices were 7–16% lower than peak torque symmetry, indicating greater power than strength deficits. These RTD impairments persisted across 4–12 months without meaningful variable-by-time interactions. Rehabilitation and return-to-sport decisions should include assessments and training of rapid force production, not peak strength alone.
High-increasing MVPA after ACLR worsens lateral femoral cartilage despite better sport scores
Device-measured MVPA from 2 to 12 months post-ACLR identified two patterns: consistent MVPA and high-increasing MVPA. The high-increasing group accumulated more MVPA at all time points and showed greater worsening of lateral femoral condyle T1ρ cartilage composition. They reported higher KOOS sport scores than the consistent activity group despite these deleterious cartilage changes. Clinicians should caution against rapid early MVPA escalation even when PROs look favorable.
References
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Additional Reads
Optional additional studies from this edition.