Throwing events in track and field are among the oldest sporting events in recorded history and include shot put, discus, hammer, and javelin. All throwing athletes use the kinetic chain to transfer energy from the lower extremities, through the pelvis, trunk, shoulder, arm, wrist, hand, and finally into the implement to generate maximum force. Throughout this sequential activation, mobilization, and stabilization of body segments, there is opportunity for breakdown in the chain, which can lead to injury. This review describes the biomechanics and kinetic chain components of each event and highlights injuries common among all throwers as well as injuries unique to each event. The cornerstone of prevention is practicing and competing with proper technique. It is important to understand the breadth of injuries that can affect these athletes to develop evidence based diagnosis, treatment, and prevention strategies.

IV.

Objectives The Achilles tendon is the strongest tendon in the human body, and Achilles tendinopathy is common in athletes due to the stress imparted by repetitive forces. The prevalence of Achilles tendon abnormalities in asymptomatic elite runners is unknown. Since there is a substantial risk of developing symptomatic tendinopathy in those with abnormal tendons, identifying those asymptomatic athletes with abnormal tendons and characterizing baseline characteristics of elite runners using ultrasound (US) are valuable injury prevention tools. Methods This study used US to evaluate the Achilles tendons of 27 asymptomatic National Collegiate Athletic Association Division I cross‐country athletes and performed correlations between dominant and nondominant side tendon size (cross‐sectional area [CSA] and thickness) and athlete characteristics. Tendons were also assessed for signs of abnormalities that were suggestive of Achilles tendinopathy. Results The prevalence of tendon abnormalities in asymptomatic collegiate runners was 11%. Among the participants included in this study, dominant and nondominant Achilles tendons did not vary significantly in thickness or CSA (P > .05). The CSA was found to correlate with height, weight, sex, body mass index, and miles run per week (P < .05). Thickness was found to correlate best with miles run per week (P < .05). Conclusions A US evaluation of the Achilles tendon has potential to identify changes in tendon size in addition to abnormalities consistent with tendinopathy. As more normative values are identified among various populations, tendon size may have prognostic value for collegiate athletes in the evaluation of Achilles tendinopathy.

Introduction We provide an updated analysis of data about U.S. Physical Medicine and Rehabilitation (PM&R) residency program applicants collected by the National Resident Matching Program (NRMP). Objective Analyze trends within NRMP data for PM&R residency match rates, compare matched to unmatched applicants, and compare PM&R applicants to other medical specialties. Design Secondary analysis of NRMP data. Setting NRMP data set. Participants Residency program applicants who participated in the NRMP Match, 2007 to 2018. Interventions Not applicable. Main Outcome Measures Number of applicants, match rates, difference in characteristics including rank order list (ROL), U.S. Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) scores, publications, Alpha Omega Alpha (AOA) status, PhD degree, and experiences in research, volunteer, and work. Results Number of applicants and residency positions increased from 2007 to 2018. Length of ROL increased and was longer for matched compared to unmatched applicants, with maximum mean difference of 7.4 in 2016 (95% confidence interval [CI] 5.6‐9.2). Matched U.S. Allopathic Seniors had higher USMLE scores compared to unmatched, with a mean difference of 12.7 for Step 1 (95% CI 8.3‐17.0) and 12.6 (95% CI 8.6‐16.6) for Step 2 CK (P < .001). Number of publications and volunteer experiences were higher for matched U.S. Allopathic Seniors (0.64, 95% CI 0.09‐1.2 and 1.5, 95% CI 0.65‐2.3, respectively). PM&R USMLE Step 1 and 2 CK scores increased at a significantly faster rate than for all other specialties, with estimated rate differences of 0.46 (95% CI 0.21‐0.71) and 0.69 (95% CI 0.45‐0.93) points per year, respectively. Conclusions PM&R residency has become more competitive. USMLE Step 1 and 2 CK scores have outpaced the inflation of scores in other specialties. ROL length has increased, suggesting more ranked programs to successfully match. These analyses update our knowledge about PM&R residency applicants and suggest surrogate markers for a successful match.