Nonsteroidal antiinflammatory drugs (NSAIDs) are frequently used in the treatment of acute athletic injuries, often for analgesic purposes as the evidence to support enhanced healing is limited. However, the current evidence on NSAID use in athletic injury is slowly growing. On the basis of animal models and limited human studies, some practical management guidelines can be drawn to assist the sports physician. Specifically, NSAIDs are not recommended in the treatment of completed fractures, stress fractures at higher risk of nonunion, or in the setting of chronic muscle injury. The only exception may be very short-term use (eg, a few days) for analgesic purposes only. Judicious use of NSAIDs may be more appropriate in the management of acute ligament sprains, muscle strains, tendinitis, and eccentric muscle injury. However, length of treatment should always be kept as short as possible, with consideration of the specific type of injury, level of dysfunction, and pain.

Athletes from NCAA Division II and Division III sports appear to use nonprescription pain medication for sports-related pain less often and have lower rates of misuse than do Division I-A football athletes. Division I-A football athletes may be more likely to misuse nonprescription pain medication than non-Division I-A athletes. Special attention should be paid to this population to help reduce adverse event risks.

No abstract

This case study presents a 14-year-old boy with a 5-day history of neck pain, temporary upper extremity paresthesia, and worsening back pain after doing sled drills in football. Diagnostic imaging revealed a T1 clay-shoveler fracture and associated cervical-thoracic epidural hematoma. To the best of our knowledge, there are no previous reports of a clay-shoveler fracture that involve a spinal epidural hematoma which demonstrates an unusual version of the condition that requires surgical consultation.