You don't need to be signed in to read BMJ Blogs, but you can register here to receive updates about other BMJ products and services via our site.

Call for Papers

Call for papers – The ECOSEP BJSM Judo and Martial Arts Issue 2013

2 Apr, 13 | by Karim Khan

ECOSEP  Invites  Submissions for December BJSM Issue (open to authors from all countries)

JudoWe are putting together articles for an ECOSEP Judo and Martial Arts issue which will be published by the BJSM in December, 2013. We are particularly interested in articles that may influence the current practice of sports medicine and welcome submissions on a broad range of topics. Our main focus will be on Judo, but we are also interested in the other martial arts, and hope to cover sports injuries, as well as nutritional and weight management issues in these sports.

However, we also encourage any sports scientists who have done research in this area to submit articles for consideration. 

Original research involving Judo, as well as reviews and educational pieces relevant to other martial arts are welcome.  All authors will have to comply with the normal BJSM online submission process and all articles will be subject to peer review.

If you have a paper you would like to submit (or are in the process of completing relevant research) please contact Nikos Malliaropoulos (

NB. All articles must to be submitted online via the BJSM website by July 1st 2013 –  (click the ‘Submit a paper’ tab)

We look forward to hearing from you and to an excellent ECOSEP Judo and Martial Arts issue!

Nikos Malliaropoulos – ECOSEP Secretary

ECOSEP label

Ireland’s Call! A student perspective on SEM in Ireland – now and the future

4 Mar, 13 | by Karim Khan

Undergraduate perspective on Sports & Exercise Medicine  a BJSM blog series

By Stuart O’Flanagan (@SROFlanagan)

Considerable momentum was gathered this past year from students in the UK, championing the cause of Sport and Exercise Medicine (SEM).  As is often the case with close neighbours, such great noises have not gone unnoticed by your Irish colleagues! With the world’s greatest sporting event so close to our own door step, the positive effects of London 2012 have been palpable nationwide, not least amongst a generation of medical students who bore witness to a new potential career path (with many thanks to the BJSM Blog Series!).

FSEM Annual Scientific Meeting, Dublin, September 2012:  Left to right: Dr Nicholas Mahony, FSEM Board Member and MSc SEM co-ordinator in Trinity College Dublin, Dr Andrew-Franklyn-Miller, SEM Consultant, Sports Surgery Clinic, Santry, Stuart O’Flanagan, and Dr Eanna Falvey, FSEM Board Member and Director of SEM, Sports Surgery Clinic, Santry, IRFU National Team Doctor.

FSEM Annual Scientific Meeting, Dublin, September 2012:
Left to right: Dr Nicholas Mahony, FSEM Board Member and MSc SEM co-ordinator in Trinity College Dublin, Dr Andrew-Franklyn-Miller, SEM Consultant, Sports Surgery Clinic, Santry, Stuart O’Flanagan, and Dr Eanna Falvey, FSEM Board Member and Director of SEM, Sports Surgery Clinic, Santry, IRFU National Team Doctor.

Current State of Play

So how to pursue a career in Sports and Exercise Medicine in Ireland? The Faculty of Sports and Exercise Medicine Ireland, via the Irish Medical Council, offer access to the Specialist Register of Sport and Exercise Medicine to doctors who satisfy a number of requirements outlined under criteria here. There are a number of routes to obtaining this certificate of specialisation but unlike the UK, a dedicated SEM postgraduate training programme is not yet in place. The FSEM are actively working to address this and the most recent public update on their plans was published online in the BJSM here.

Many of the doctors currently practicing SEM have spent time abroad to pursue such training, with others having undertaken one of the recognised SEM MSc courses available in Ireland Although this speciality is very much in its infancy in Ireland, advances are being made at a rapid pace.

Immediate potential

Ireland boasts several world-class sporting facilities, which lend themselves to future opportunities in SEM, one such example being the University of Limerick (UL). UL is home to the country’s first Olympic standard swimming pool, the national strength and conditioning centre as well as acting as a hub to several national, Olympic and Paralympics standard athletes who come to train from home and abroad. The campus is also home to professional athletes such as Munster Rugby and occasional training camps for the Irish national rugby team. With faculties in Medicine, Physiotherapy, Physical Education and a Sports Science department that is world renowned for its research, UL provides an outstanding environment for the development of a Sports and Exercise Medicine hub. This example is not unique in Ireland however. Several other Universities with similar quality environments are in operation such as the Institute for Sport and Health at University College Dublin and the High Performance Unit in Dublin City University, amongst others.

So how can this help me as a medical student in Ireland? Other student contributors and SEM practitioners have disseminated some very solid advice via these blog series and podcasts, and the message here is no different. Seeking volunteer work in aforementioned facilities (you are Basic Life Support trained!), applying for mini-electives with SEM practitioners, choosing SEM related topics for your special study modules (performing audits or collecting data) are all realistic options. Perhaps one of the most underrated approaches (yet most accessible while at university) is to engage in multidisciplinary collaboration with students of other faculties (your future sports science and physiotherapy colleagues!). Providing evidence of this in the form of projects, such as initiatives to promote physical activity in the local community, would lay a great stepping-stone in the pursuit of future career opportunities in SEM.

The future is bright!

Though still early days here in Ireland, the advent of London 2012 and the work of our colleagues at the FSEM UK and BASEM are quickly charting new territory, further stimulating growth on this side of the Irish Sea. The FSEM Ireland will be establishing affiliation with a dedicated SEM student body in 2013, which it is hoped, will be linked via a network of student groups across the 6 medical schools in Ireland. Students that are interested in participating are invited to contact us at the address below. With a training scheme on the horizon, now is time to get active in SEM in as many ways you can. A good start would be to attend the FSEM Annual Scientific Conference 2013 in Dublin and maybe even to submit your research, or a poster to present for the poster competition! A new movement in SEM is gathering pace here in Ireland and it is time for the students to have their rightful presence on the map!


Stuart O’Flanagan is a 3rd year graduate entry medical student at the University of Limerick, Ireland. He is a practicing Chartered Physiotherapist and obtained an MSc in the Science and Medicine of Athletic Performance at the University of Oxford. Stuart is working with FSEM Ireland to establish Ireland’s first nationwide Sports and Exercise Medicine group for students and is actively recruiting medical students with an interest in this area. For more information please contact SEM Students Ireland or follow Stuart on Twitter @SROFlanagan.

Liam West BSc (Hons) is a final year medical undergraduate student at Cardiff University, Wales. He coordinates the “Undergraduate Perspective on Sports & Exercise Medicine” Blog Series for BJSM.

2nd International Scientific Tendinopathy Symposium, Sept 27-29, 2012, Vancouver, Canada – Call for Abstracts

5 Mar, 12 | by Karim Khan

For more information:

3rd Congress of the ECOSEP – Make your plans for Frankfurt, April 2013. (yes, 13!)

4 Jan, 12 | by Karim Khan

The link to the ECOSEP home page is here

And the February 2012 issue of BJSM (next issue) is guest edited by ECOSEP’s Nikos Malliaropolous, Carl Askling and Nicola Maffulli – it focuses on Hamstring injuries!

The 28th International Jerusalem Symposium on Sports Medicine – 2 more weeks to submit abstracts!

2 Sep, 11 | by Karim Khan

For more information go to:

Call for papers: Tendinopathies!

5 Nov, 10 | by Karim Khan

The April 2011 edition of BJSM will focus on Tendinopathy.

Authors with manuscripts that clarify treatment options, improve the basic understanding of the condition or have an innovative perspective are invited to submit their papers by January 15 2011.
Enquiries about suitability of manuscripts for this issue can be directed to

Spring into action!

Reader Response: Rotator cuff tendinopathy

7 Feb, 09 | by Karim Khan

Hutch checks the shoulder
Photo by Lisa Bettany.

By Nicola Maffulli, Umile Giuseppe Longo, Vincenzo Denaro, Consultant Trauma and Orthopaedic Surgeon, University Hospital of North Staffordshire, Keele University School of Medicine

We read with interest the Review Article “Rotator cuff tendinopathy: A review”, by Lewis.

This manuscript may have been submitted before the publication of our investigations. Nevertheless, we would like to call your attention to the fact that we have performed several studies on the aetiology, histopathology and management of rotator cuff tendinopathy.

We investigated supraspinatus tendon samples obtained from patients undergoing arthroscopic repair of a rotator cuff tear to examine the distribution of tendinopathic changes associated with this condition. At arthroscopy, a full thickness supraspinatus tendon biopsy was harvested close to the tear edge. We found more frequent tendon changes on the articular side of the rotator cuff 4.

We found more cartilage-like changes in patients affected by rotator cuff tears, but not in our control group.Recent biomechanical data suggest that the stress-shielded and transversely-compressed side of the enthesis has a distinct tendency to develop cartilage-like or atrophic changes in response to the lack of tensile load 2,7,9,10. Over a long period, this process may develop into a primary degenerative lesion in that area of the tendon. This may explain why the tendinopathy is not always clearly activity related, and can be strongly correlated with age. In this manner, it could almost be considered an ”underuse” injury rather than an overuse injury as a result of stress-shielding 7,9,10. The formation of cartilage-like changes in the enthesis in many ways can be considered a physiological adaptation to the compressive loads 12-14. It may not allow the tendon to maintain its ability to withstand high tensile loads in that region of the tendon.

As the stress-shielding may have led to tensile weakening over time, an injury may occur more easily in this region. In this manner, insertional tendinopathy could be considered an overuse injury, but predisposed by pre -existing weakening of the tendon 12-14.

In another study 3 to evaluate the histopathological features of macroscopic intact tendon portion of patients with rotator cuff tears, we demonstrated that the supraspinatus tendons of patients undergoing arthroscopic repair for a rupture show profound histopathologic changes, while the tendons of aged persons with no known tendon abnormalities have, as a group, little histological evidence of pathological changes.

Moreover, tendon changes are not only localized at the site of rupture, but also in the macroscopic intact tendon portion.

Several centres are undertaking studies on tendinopathy 11,16,17, and the individual studies are unlikely to be large enough to result in adequate power for reliable evaluation. Therefore, combining the data from those studies with a similar study design will be essential. Consistent high- quality pathology data are thus remarkably important for the success of the studies. Two scoring systems can be used for classification of the histopathological findings of tendinopathy: the Movin score 15 and its validated modifications 4,6,12, and the Bonar score 1. We performed a study to answer the question whether these two scores of abnormal tendon tissue were comparable 8. In our hands, Movin and Bonar scores assess the same characteristics of tendon pathology.

In an frequency-matched case-control study we determined the plasma glucose levels in non diabetic patients with rotator cuff tear 5. We found that normal, but in the high range of normal, increasing plasma glucose levels may be a risk factor for rotator cuff tear.

Lastly, although it is likely that the histopathology of tendinopathy is similar, of not the same, regardless of its location, this has only been shown in a formal fashion in the Achilles and patellar tendons 12: we were slightly surprised of the fact that a number of papers dealing with pathology of other tendons (i.e., patellar tendon, Achilles Tendon, and extensor carpi radialis brevis tendon (tennis elbow) are quoted referring to rotator cuff tendinopathy (references n°23,24,25,26,81,94,96,97,98, 147,148).

1. Cook, J.; Feller, J.; Bonar, S.; and Khan, K. Abnormal tenocyte morphology is more prevalent than collagen disruption in asymptomatic athletes’ patellar tendons. J Orthop Res 2004;22:334-338.
2. Gardner, K.; Arnoczky, S. P.; Caballero, O.; and Lavagnino, M. The effect of stress-deprivation and cyclic loading on the TIMP/MMP ratio in tendon cells: An in vitro experimental study. Disabil Rehabil 2008:1-7.
3. Longo, U. G.; Franceschi, F.; Ruzzini, L.; Rabitti, C.; Morini, S.; Maffulli, N.; and Denaro, V. Histopathology of the supraspinatus tendon in rotator cuff tears. Am J Sports Med 2008;36:533-8.
4. Longo, U. G.; Franceschi, F.; Ruzzini, L.; Rabitti, C.; Morini, S.; Maffulli, N.; Forriol, F.; and Denaro, V. Light microscopic histology of supraspinatus tendon ruptures. Knee Surg Sports Traumatol Arthrosc 2007;15:1390-4.
5. Longo, U. G.; Franceschi, F.; Ruzzini, L.; Spiezia, F.; Maffulli, N.; and Denaro, V. Higher fasting plasma glucose levels within the normoglycemic range and rotator cuff tears. Br J Sports Med 2008;
6. Maffulli, N.; Barrass, V.; and Ewen, S. W. Light microscopic histology of achilles tendon ruptures. A comparison with unruptured tendons. Am J Sports Med 2000;28:857-63.
7. Maffulli, N.; Khan, K. M.; and Puddu, G. Overuse tendon conditions: time to change a confusing terminology. Arthroscopy 1998;14:840-3.
8. Maffulli, N.; Longo, U. G.; Franceschi, F.; Rabitti, C.; and Denaro, V. Movin and Bonar scores assess the same characteristics of tendon histology. Clin Orthop Relat Res 2008;466:1605-11.
9. Maffulli, N.; Reaper, J.; Ewen, S. W.; Waterston, S. W.; and Barrass, V. Chondral metaplasia in calcific insertional tendinopathy of the Achilles tendon. Clin J Sport Med 2006;16:329-34.
10. Maffulli, N.; Sharma, P.; and Luscombe, K. L. Achilles tendinopathy: aetiology and management. J R Soc Med 2004;97:472-6.
11. Maffulli, N.; Testa, V.; Capasso, G.; Bifulco, G.; and Binfield, P. M. Results of percutaneous longitudinal tenotomy for Achilles tendinopathy in middle- and long-distance runners. Am J Sports Med 1997;25:835-40.
12. Maffulli, N.; Testa, V.; Capasso, G.; Ewen, S. W.; Sullo, A.; Benazzo, F.; and King, J. B. Similar histopathological picture in males with Achilles and patellar tendinopathy. Med Sci Sports Exerc 2004;36:1470-5.
13. Maffulli, N.; Waterston, S. W.; and Ewen, S. W. Ruptured Achilles tendons show increased lectin stainability. Med Sci Sports Exerc 2002;34:1057-64.
14. Maffulli, N.; Wong, J.; and Almekinders, L. C. Types and epidemiology of tendinopathy. Clin Sports Med 2003;22:675-92.
15. Movin, T.; Gad, A.; Reinholt, F.; and Rolf, C. Tendon pathology in long-standing achillodynia. Biopsy findings in 40 patients. Acta Orthop Scand 1997;68:170-5.
16. Murrell, G. A. Oxygen free radicals and tendon healing. J Shoulder Elbow Surg 2007;16:S208-14.
17. Murrell, G. A. Using nitric oxide to treat tendinopathy. Br J Sports Med 2007;41:227-31.

Physical Activity Guidelines for the US

5 Oct, 08 | by Karim Khan


On Tuesday, October 7, the U.S. Department of Health and Human Services will launch “The Physical Activity Guidelines for Americans” in Washington, D.C. This occasion marks the first time the federal government has released guidelines on physical activity.

The American College of Sports Medicine (ACSM) formally called for the creation of such guidelines as part of an ACSM health policy conference in 2006 at the National Press Club in Washington. ACSM first published physical activity and public health guidelines with the U.S. Centers for Disease Control and Prevention in 1995, and just last year updated those guidelines in a joint publication with the American Heart Association. And ACSM has been working with Congress to ensure the review and publication of these physical activity guidelines every five years.

ACSM and the American Heart Association will support the new federal guidelines, as they are expected to reflect our previously published recommendations. Both are based on the most relevant science that links physical activity to improved health and wellness. Please look for additional details following the launch to help you in your professional translation and communication of physical activity guidelines.

Reminder: Tendinopathy Theme Issue of BJSM

28 Apr, 08 | by Karim Khan

runners tendon bjsm

Call for Tendon Papers

Just a reminder of BJSM ‘Tendinopathy Theme Issue’ which will be published in 2009. This edition will concentrate on clinical perspectives of diagnosing and managing tendinopathy.

Specifically, we are looking for papers that have direct or inferred clinical application that will help clinicians manage patients with tendon injury. We encourage you to submit original papers as well as novel opinion pieces based on clinical experience and scientific evidence.

Submissions close August 15th, 2008

Enquiries to Jill Cook:

Don’t forget the BMJ Theme Issue! Closes April 8th!!

20 Mar, 08 | by Karim Khan

This is your chance for fame in one of the world’s leading general medical journals.

The BMJ is planning a theme issue on sport and exercise medicine in July 2008. Send high quality original research to the BMJ online editorial office at by Tuesday 8 April 2008.

The BMJ is particularly interested in clinical research and will give priority to reports of randomised controlled trials or other original quantitative research that will help doctors and patients to make better decisions. The BMJ also loves translational research that is relevant to clinical decision making. Resources for authors are on and an editorial provide answers to common questions about submitting research to the BMJ.

All submissions should follow the standard requirements for BMJ articles and are subject to standard editorial and peer review processes. For additional advice on possible submissions for this theme issue, please email Domhnall MacAuley.

BJSM blog homepage


A peer review journal for health professionals and researchers in sport and exercise medicine. Visit site

Creative Comms logo

Latest from British Journal of Sports Medicine

Latest from British Journal of Sports Medicine