William O Roberts

University of Minnesota | UMN · Department of Family Medicine and Community Health

Endurance events are popular worldwide and have many health benefits. However, runners and Para athletes may sustain musculoskeletal injuries or experience other health consequences from endurance events. The American Medical Society for Sports Medicine (AMSSM) Runner Health Consortium aimed to generate consensus-based survey items for use in prosp...

Context Among American sports, football has the highest incidence of exertional heat stroke (EHS), despite decades of prevention strategies. Based on recent reports, 100% of high school and college EHS football fatalities occur during conditioning sessions. Linemen are the at-risk population, constituting 97% of football EHS deaths. Linemen heat up...

A 23-year-old woman completing her first marathon collapsed near the finish line at 4 hours 6 min with a rectal temperature of 41.8°C. She was in good health before the race with no recent illness, had completed a full training program, and was taking no medications or supplements. On the initial exam, she was unconscious with a response to painful...

Mass participation events include endurance events ( e.g. , marathon, triathlon) and/or competitive tournaments ( e.g. , baseball, tennis, football (soccer) tournaments). Event management requires medical administrative and participant care planning. Medical management provides safety advice and care at the event that accounts for large numbers of...

The prevalence of sexual abuse in competitive sports is increasing worldwide and requires a united call to action. The underreporting of such abuses gained media attention resulting from recent high-profile cases. In this article, we report the results of a systematic literature review, identifying root causes of underreporting sexual abuse in comp...

Objective Assessment of physical activity and exercise prescription has been widely supported by many organizations, yet provision of such services remains limited in the United States. We sought to uncover why such services have not been widely adopted. Design The American Medical Society for Sports Medicine organized a task force to canvas physi...

Dehydration and exercise-associated hyponatremia can occur during training and competition. Dehydration during training and competition is common but rarely a cause of the collapse in supported sports settings. Exercise-associated hyponatremia is rare but is a known cause of death in endurance activities and American football. It is essential for s...

The COVID-19 pandemic has created many challenges to ensure a safe environment for competitive sport. While modern medicine has already developed effective protocols for the treatment and prevention of the disease, there are seriousconcerns about hosting a sporting event of the scale of the Olympic Games, where more than 11000 athletes from over 20...

Mass participation events include endurance events (e.g., marathon, triathlon) and/or competitive tournaments (e.g., baseball, tennis, football (soccer) tournaments). Event management requires medical administrative and participant care planning. Medical management provides safety advice and care at the event that accounts for large numbers of part...

A 23-year-old professional distance runner with several years of exertional calf pain was diagnosed with a unique mixed type III and functional popliteal artery entrapment syndrome (PAES). Surgical reduction of the obstructing tissue allowed her to return to professional running. This case highlights the importance of including PAES in the differen...

Objective To compare self-reported osteoarthritis of the knee and hip in adults who ran at least 1 marathon as a child with adults who ran high-school cross country (HSCC). Design Subject self-recall retrospective survey. Setting Electronic survey. Participants 319 adults who either ran a marathon under age 18 or ran HSCC recruited from running...

Exertional heat stroke is a true medical emergency with potential for organ injury and death. This consensus statement emphasizes that optimal exertional heat illness management is promoted by a synchronized chain of survival that promotes rapid recognition and management, as well as communication between care teams. Health care providers should be...

Objectives: : Assess the relationships between wet bulb globe temperature (WBGT) and physiologic equivalent temperature (PET) at the start of a northern latitude marathon and their associations with medical stress and transfers to the emergency room (ER) when the race environment is unexpectedly warm, and participants are not acclimatized. Design...

This Viewpoint examines youth marathon participation through the collective perspectives of clinicians and researchers invested in optimizing health, safety, and performance in young runners.

New findings: What is the topic of this review? The treatment of exertional heat stress, from initial field care through the return-to-activity decision. What advances does it highlight? Clinical assessment during field care using AVPU and vital signs to gauge recovery, approaches to field cooling and end of active cooling, and shared clinical dec...

Climate change has contributed to increases in the Earth's temperature since the beginning of the industrial age and the warming has accelerated in the last four decades. While climate change has negative impacts on overall global health, more recent events have highlighted the effects on endurance athletes. Endurance athletes primarily train and c...

Objective: To assess the effectiveness of coronavirus disease 2019 (COVID-19) prevention strategies used during sports participation. Design: To analyze prospective reports of student-athletes with COVID-19-positive tests to assess prevention strategies and risk factors by sports and seasons. Setting: Minnesota high schools. Participants: Fa...

Sports participation is an important factor in the mental health of athletes. A change in sports participation affects athlete mental health, in addition to other components of the athlete's life, including overall health and fitness, future career plans, current and future financial status, and available social network. Athletes should be encourag...

The American Medical Society for Sports Medicine (AMSSM) convened an expert panel to address the current evidence, knowledge gaps, and recommendations surrounding the COVID vaccination in athletes during the SARS-CoV-2 pandemic. The group held a series of meetings beginning in July 2021 and reviewed the available literature while using an iterative...

The American Medical Society for Sports Medicine (AMSSM) convened an expert panel to address the current evidence, knowledge gaps, and recommendations surrounding the COVID vaccination in athletes during the SARS-CoV-2 pandemic. The group held a series of meetings beginning in July 2021 and reviewed the available literature while using an iterative...

Exertional heat stroke (EHS) is a true medical emergency with potential for organ injury and death. This consensus statement emphasizes that optimal exertional heat illness management is promoted by a synchronized chain of survival that promotes rapid recognition and management, as well as communication between care teams. Health care providers sho...

Sport is historically designated by the binary categorization of male and female that conflicts with modern society. Sport’s governing bodies should consider reviewing rules determining the eligibility of athletes in the female category as there may be lasting advantages of previously high testosterone concentrations for transwomen athletes and cur...

A correction to this paper has been published: https://doi.org/10.1007/s40279-021-01467-0

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 sur...

Participation in ultra-endurance running (UER) events continues to grow across ages, including youth athletes. The 50- and 100-km are the most popular distances among youth athletes. Most youth athletes are between 16–18 years; however, some runners younger than 12 years have successfully completed UER events. Parents, athletes, coaches, race direc...

Introduction Understanding the prevalence and factors associated with running-related injuries in middle school runners may guide injury prevention. Objective To determine the prevalence of running-related injuries and describe factors related to a history of injury. Design Retrospective cross-sectional study. Setting Survey distributed online t...

Background and objectives: Learning to balance the clinical, educational, and scholarly elements of an academic career is challenging for faculty. To increase research output amongst family medicine faculty with limited to no publications, we developed the Collaborative Scholarship Intensive (CSI) to provide participants with intensive instruction...

: Transmittable skin infections in sport are a concern, especially for wrestlers. Current methods for limiting tinea gladiatorum transmission in United States high school wrestling include a required skin inspection protocol. Tinea prevalence before and after the skin inspection protocol was instituted is not widely known. We prospectively determin...

Concussion remains a common injury among sports participants. Implementing risk-reduction strategies for sport-related concussion (SRC) should be a priority of medical professionals involved in the care of athletes. Over the past few decades, a multifaceted approach to reducing SRC risk has been developed. Protective equipment, rule and policy chan...

The American Medical Society for Sports Medicine (AMSSM) convened a writing group to address the current evidence and knowledge gaps regarding preparticipation evaluation of athletes during the SARS-CoV-2 pandemic. The writing group held a series of meetings beginning in April 2020. The task force reviewed the available literature and used an itera...

The American Medical Society for Sports Medicine (AMSSM) convened a writing group to address the current evidence and knowledge gaps regarding preparticipation evaluation of athletes during the SARS-CoV2 pandemic. The writing group held a series of meetings beginning in April 2020. The task force reviewed the available literature and used an iterat...

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...

The American Medical Society for Sports Medicine (AMSSM) convened a group of experts to develop a Position Statement addressing the problem of sexual violence in sport. The AMSSM Sexual Violence in Sport Task Force held a series of meetings over 7 months, beginning in July 2019. Following a literature review, the Task Force used an iterative proces...

The American Medical Society for Sports Medicine (AMSSM) convened a group of experts to develop a position statement addressing the problem of sexual violence in sport. The AMSSM Sexual Violence in Sport Task Force held a series of meetings over 7 months, beginning in July 2019. Following a literature review, the task force used an iterative proces...

The American Medical Society for Sports Medicine (AMSSM) convened a group of experts to develop a Position Statement addressing the problem of sexual violence in sport. The AMSSM Sexual Violence in Sport Task Force held a series of meetings over 7 months, beginning in July 2019. Following a literature review, the task force used an iterative proces...

The American Medical Society for Sports Medicine (AMSSM) convened a group of experts to develop a Position Statement addressing the problem of sexual violence in sport. The AMSSM Sexual Violence in Sport Task Force held a series of meetings over 7 months, beginning in July 2019. Following a literature review, the task force used an iterative proces...

The SARS-CoV-2-caused COVID-19 pandemic has resulted in a devastating threat to human society in terms of health, economy, and lifestyle. Although the virus usually first invades and infects the lung and respiratory track tissue, in extreme cases, almost all major organs in the body are now known to be negatively impacted often leading to severe sy...

Objective: To summarize the literature relating to prehospital care at 5 km through marathon distance road races and present the epidemiology of common medical encounters, significant medical complications, and medical outcomes. Data sources: We searched PubMed and Google Scholar for the published literature pertaining to road race medical tent...

As road races are typically warm weather events, runners are at risk for heat-related illnesses, including exertional heat stroke. On-site medical care provides timely treatment to afflicted runners as well as help to prevent overwhelming community emergency medical services. This chapter will discuss the organization of a medical team including st...

Objectives: The Ice Hockey Summit III provided updated scientific evidence on concussions in hockey to inform these 5 objectives: (1) describe sport related concussion (SRC) epidemiology; (2) classify prevention strategies; (3) define objective, diagnostic tests; (4) identify treatment; and (5) integrate science and clinical care into prioritized...

During the past several decades, the incidence of exertional heat stroke (EHS) has increased dramatically. Despite an improved understanding of this syndrome, numerous controversies still exist within the scientific and health professions regarding diagnosis, pathophysiology, risk factors, treatment and return to physical activity. This review exam...

Youth running is defined as participation below age 18. Jumping/multidirectional loading sports (soccer, basketball) may optimize bone health. Psychological development requires monitoring to reduce risk of injuries and burnout. Adequate energy availability is essential for health; screening for disordered eating and optimizing nutrition is importa...

Mass participation endurance sports events are popular but a large number of participants are older and may be at risk of medical complications during events. Medical encounters (defined fully in the statement) include those traditionally considered ‘musculoskeletal’ (eg, strains) and those due to ‘illness’ (eg, cardiac, respiratory, endocrine). Th...

Sport-related concussion (SRC) is a common injury in recreational and organised sport. Over the past 30 years, there has been significant progress in our scientific understanding of SRC, which in turn has driven the development of clinical guidelines for diagnosis, assessment and management of SRC. In addition to a growing need for knowledgeable he...

Running is a popular sport for children in the United States. However, review of available literature on health effects and safety recommendations for youth running has not been previously conducted. Unique factors for injury include periods of growth during puberty and potential for growth plate injury. Youth runners may benefit from activities th...

Sport-related concussion (SRC) is a common injury in recreational and organized sport. Over the past 30 years, there has been significant progress in our scientific understanding of SRC, which in turn has driven the development of clinical guidelines for diagnosis, assessment, and management of SRC. In addition to a growing need for knowledgeable h...

Objectives The Ice Hockey Summit III provided updated scientific evidence on concussions in hockey to inform these five objectives: (1) describe sport related concussion (SRC) epidemiology, (2) classify prevention strategies, (3) define objective, diagnostic tests, (4) identify treatment and (5) integrate science and clinical care into prioritized...

Removing fighting from ice hockey is an essential concussion prevention strategy that will improve the safety of the game at all levels.

The Ice Hockey Summit III provided updated scientific evidence on concussions in hockey to inform these five objectives: 1) describe sport-related concussion (SRC) epidemiology, 2) classify prevention strategies, 3) define objective, diagnostic tests, 4) identify treatment, and 5) integrate science and clinical care into prioritized action plans an...

Heat acclimation or acclimatization (HA) occurs with repeated exposure to heat inducing adaptations that enhance thermoregulatory mechanisms and heat tolerance leading to improved exercise performance in warm-to-hot conditions. HA is an essential heat safety and performance enhancement strategy in preparation for competitions in warm-to-hot conditi...

Objective: To present evidence-based recommendations that promote optimized fluid-maintenance practices for physically active individuals. Background: Both a lack of adequate fluid replacement (hypohydration) and excessive intake (hyperhydration) can compromise athletic performance and increase health risks. Athletes need access to water to prev...

Introduction/purpose: Many male marathon runners have elevated coronary artery calcium (CAC) scores despite high physical activity. We examined the association between CAC scores, cardiovascular risk factors, and lifestyle habits in long term marathoners. Methods: We recruited men who had run ≥1 marathon annually for 25 consecutive years. CAC wa...

Marathon and other road races are popular events in the United States with record participation that inspire people to pursue physical activity and are an opportunity for personal growth and accomplishment. However, the wide attention and large participation may make some events targets for terrorist attacks with the risk of mass casualties beyond...

Objective: This review provides an update on sport-related concussion (SRC) in ice hockey and makes a case for changes in clinical concussion evaluation. Standard practice should require that concussions be objectively diagnosed and provide quantitative measures of the concussion injury that will serve as a platform for future evidence-based treat...

Introduction: Marathon running is presumed to improve cardiovascular risk, but health benefits of high volume running are unknown. High resolution coronary computed tomography angiography (CCTA) and a cardiac risk factor assessment were completed in women with long term marathon running histories to compare to sedentary women with similar risk fac...

Cardiovascular screening in young athletes is widely recommended and routinely performed prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athlete...

Cardiovascular (CV) screening in young athletes is widely recommended and routinely performed before participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for CV screening in athletes remains...

Cardiovascular screening in young athletes is widely recommended and routinely performed prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athlete...

Purpose of review: The purpose of the review is to provide recommendations to improve clinical decision-making based on the strengths and weaknesses of commonly used hydration biomarkers and clinical assessment methods. Recent findings: There is widespread consensus regarding treatment, but not the diagnosis of dehydration. Even though it is gen...

Exertional heat stroke (EHS) occurs in distance runners and is a life-threatening condition. A 30-year-old healthy recreational male distance runner (CR) collapsed at the 12-mile mark in two half marathon races six weeks apart in fall 2009. In both episodes, CR was found on the ground confused, incoherent, sweaty, and warm-to-touch. The emergency m...

Risk of injury in cold environments is related to a combination of athlete preparedness, preexisting medical conditions, and the body's physiologic response to environmental factors, including ambient temperature, windchill, and wetness. The goal of this section is to decrease the risk of hypothermia, frostbite, and nonfreezing cold injuries as wel...

Participation in wilderness and adventure sports is on the rise, and as such, practitioners will see more athletes seeking clearance to participate in these events. The purpose of this article is to describe specific medical conditions that may worsen or present challenges to the athlete in a wilderness environment.

Risk of injury in cold environments is related to a combination of athlete preparedness, preexisting medical conditions, and the body's physiologic response to environmental factors, including ambient temperature, windchill, and wetness. The goal of this section is to decrease the risk of hypothermia, frostbite, and nonfreezing cold injuries as wel...

Endurance events are increasing in popularity in wilderness and remote settings, and participants face a unique set of potential risks for participation. The purpose of this article is to outline these risks and allow the practitioner to better guide the wilderness adventurer who is anticipating traveling to a remote or desert environment.

As the participation in wilderness events becomes more popular, the likelihood of participation by those with existing medical conditions will also increase. It is important for safety and for the enjoyment of the participant that medical conditions, especially those that could worsen in remote or extreme environments, be addressed and optimized be...