MSK-19 · Sports Medicine

Sports Medicine. Topics: Environmental Illness, Rhabdomyolysis, and Special Populations. Part of the Musculoskeletal series of the Reflex PM&R Board Review podcast. Audio corrections: (1) In the audio: Once you go above 3,000 meters, roughly 10,000 feet, you should not increase your sleeping altitude by more than 300 meters or 1,000 feet per day. — Correct: The ceiling is 500 meters of sleeping-altitude gain per day above 3,000 meters, not 300. The mandatory rest day for every 1,000 meters gained is right as stated (some sources phrase the same rule as a rest day every third or fourth day of ascent). (2) In the audio: The new mantra is "drink to thirst," and whenever possible, use sodium containing sports drinks rather than plain water during ultra-endurance events. — Correct: Drinking to thirst is right, and it is the only prevention strategy that carries a strong evidence grade. Sodium-containing sports drinks are not preventive: most are hypotonic relative to plasma, so over-drinking them dilutes serum sodium exactly as over-drinking water does. Sodium supplementation during events shorter than roughly 18 hours has not been shown to prevent exercise-associated hyponatremia. The written chapter is correct. Full correction register: https://www.reflexpmr.com/errata. The full companion chapter and a linked board-style Q-bank set for this topic are at https://www.reflexpmr.com/read/MSK-19.