Nonsurgical Sports Medicine—Preparticipation Exam Through Rehabilitation. By N. Nichole Barry, Michael F. Dillingham, and James L. McGuire. 336 pp, illustrated. Baltimore, Johns Hopkins University Press, 2002. $28.50 (paper). ISBN 0-8018-5896-3

The authors of Nonsurgical Sports Medicine stress that “non-operative sports medicine has reached proportions unimaginable just a decade ago.” Underscoring their point is the dramatic increase in journals and textbooks related to primary care sports medicine. The relevance of this area to family physicians continues to increase as evidence that physical fitness leads to better overall health and longevity appears in the medical literature.

This text is organized into 12 relatively brief chapters beginning with the preparticipation physical examination. The next sections discuss common medical conditions, including ergogenic aids. The authors then review common injuries to the head, spine, upper extremity, and lower extremity and provide an overview of overuse problems. The final section of the text addresses special situations, such as older and younger athletes, female athletes, environmental conditions, and medical coverage of events. Supplementing this information are a number of useful tables. Most illustrations are simple drawings, and no photographs or detailed illustrations are included.

Unfortunately, although the authors applaud the advances in nonsurgical sports medicine, and the cover of the book advertises this guide as comprehensive, the text falls short of reaching this goal. The authors cannot produce a comprehensive text in a brief publication. In this sense, the discussion in most chapters occurs at a depth appropriate for medical students or practitioners with limited experience in sports medicine and orthopedics. The experienced family physician or physician who emphasizes primary care sports medicine would find little new information.

References are also weak, and many chapters do not have updated information from recent literature. The preparticipation examination chapter, for example, should include the preparticipation monograph endorsed by most major medical societies. Current National Collegiate Athletic Association regulations regarding participation with illnesses and infectious diseases and newer treatment strategies as they relate to sports medicine would add to the text. Another example is the section on diabetes, which does make a number of good points, but it should guide physicians to use newer medications in the treatment of the athletic patient. The section on exercise-induced asthma addresses concerns of patients who have classic exercise-induced asthma but not those who would need a greater focus on anti-inflammatory medications as a part of their treatment regimen. Chapters would also be improved by inclusion of clear return-to-play guidelines for the various illnesses, injuries, and topics discussed in the text.

In summary, this brief volume, authored by experienced sports medicine physicians, might have a useful role in introducing medical students and inexperienced physicians to the area of nonsurgical sports medicine. The paperback is affordable, and the chapters are readable and concise. Experienced physicians, however, would likely choose from the more comprehensive textbooks that already exist in the market.