Featured Presentations:

1. Select Issues In Pain Management For The Youth & Adolescent Athlete
2. Revisiting The Science Of Altitude Training
3. Overview Of The Endocannabinoid System And Exercise

Additional Note-Worthy Presentations: 

1. Synergistic Perspectives Of Exercise And Other Non-Opiate Treatments For Patients With Chronic Pain
2. How To Approach The Athletic Body Ideal? Prevention And Treatment Of Eating Disorders
3. Post-Competitive Athlete Health (Joint and MSK Health In Retired NBA Players, Cardiovascular Risks In Retired NFL Players)

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   This past week, I had the opportunity to both attend and present at the ACSM Annual Meeting. Orlando, Florida played host this year, as it relocates on an annual basis. Being my first experience at ACSM, it was a new and very rewarding experience. In this article I am going to break down my experience, the topics of interest I chose to pursue, the overall world of research and data sharing as well as where this fits into today’s “age of information” and how you may be able to gain a better understanding of topics related to your goals.

Select Issues In Pain Management For The Youth & Adolescent Athlete

   This symposium was the most comprehensive and insightful “talk” I’ve heard regarding acute and chronic pain, especially regarding individuals ages 10-18. Rarely do you get orthopedists, physical therapists, physical trainers, psychologists etc. all on the same page. This doesn’t need to be explained to someone who has spent time in one or more of these areas…it’s an unfortunate reality that these professions at times, but not always, butt heads on how to resolve issues.
   However, this symposium was the exact opposite of that. How refreshing! An orthopedist, a neurobiologist, and clinical psychologist… all working TOGETHER and formulating a comprehensive report on their experiences. Largely based around on the biopsychosocial model of medicine, an expert in each area offered their expertise and insight. Although the material they spoke on is not yet published, Dr. Stan Herring out of Washington is finalizing their work and is set to be published yet this year (2019). As mentioned, this “consensus group” discussed multiple areas, all deserving of their own individual talks. But for the sake of time and efficiency, below are listed the main takeaways I got from attending:

1. There are multiple types of pain (nociceptive, neuropathic, and nociplastic). A proper diagnosis, from a qualified individual, is step 1 before beginning the appropriate treatment plan.
2. Pain medication should rarely be used. If used, the amount and duration of use is a conversation that should happen before administering the patient with medication. Their future depends on it. 
3. Various modalities (resistance training, psychotherapy, passive therapies, etc.) have their place and are likely dependent on each individual’s response. The relationship they form with the provider is important and their belief, not necessarily mindset, is a pivotal aspect to pain management/recovery.

Revisiting The Science Of Altitude Training

   Any endurance athlete will tell you they are familiar with altitude training… the perceived benefits, the do’s, the don’ts, the latest and greatest of performance enhancing techniques etc. But what, if anything is proven, new and reproducible with high level performers?
   This symposium again brought together the brightest minds and most well-recognized researchers in the science of altitude training. Led by Dr. Benjamin Levine, years of experience, theories put to the test and trial and error have led to the science-based altitude training that high-level performers and Olympians alike benefit from. Whether uniquely created in the lab environment (Colorado Springs Olympic Training Center) or relocating to highly sough after natural training environments (San Moritz and Chiavenna) these individuals reap the benefits of strategically implemented altitude based training interventions.

Summary:

• USA coaches and athletes have successfully been using Live High (LH) + Train High (TH) and Live High (LH) + Train Low (TL) Methods.
• USA coaches and athletes take advantage of both “domestic” and “international” altitude training network.
• It’s not easy but it does work!

Overview Of The Endocannabinoid System And Exercise

   Dr. Cecilia Hillard lead a very in-depth presentation on the relatively newly studied endocannabinoid system, specifically the CB1 and CB2 receptors. Receptor’s that remained relatively unknown and certainly unclear only a few decades ago, are now appreciated for both their shear quantity within the human body but also their profound role as mediators of the exercise behavioral reward relationship.
   Like most pathways within the human body, it is the responsiveness and “quality” of the receptors that dictates an efficient physiological process. The CB1 receptor is most prevalent on neurons and is one the most, if not the most present receptor within the central nervous system (CNS). The other receptor of interest, CB2, is primarily present on the immune cells.
Without getting into the weeds, the main takeaways were:

1. Exercise activates the CB1 and CB2 receptors and as a result, it is evident the endocannabinoid system does mediate the behavioral reward systems elicited by exercise.
2. Like all things, the dose (of exercise) is important. Too little = not optimal to elicit desired response. Too much = no additional receptor activity but lower reported behavioral/enjoyment.
3. The body has an intrinsic reward system for being healthy and active. The endocannabinoid system is likely to thank for that...thc not needed.

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   The above highlights are meant to spark your interest, if you find the area/topic particularly intriguing. In the upcoming weeks, I will further break down each area with more in-depth information provided by the presenting Drs. I highly encourage you to follow these individuals and work (they are not hard to track down online). Being able to attend the symposiums, presentations, and lectures of professionals who have spent a considerable amount of time working toward specific problem solving (many of these having already spent 20,30, 40 or more years) is an invaluable experience and one I am eager to follow up on and continue to learn from.

More to come soon!…….