McLachlan, Madison L.

A healthy 15-year-old right-hand dominant football player presented to the clinic for a preparticipation examination (PPE) with an exam notable for reduced right shoulder range of motion. The patient reported no complaints, including no pain. Upon questioning, he noted a remote non-sports related injury to that shoulder with unremarkable radiographs at that time. Subsequent X-ray imaging showed a bony abnormality thought to be consistent with an osteochondroma. However, advanced imaging identified it as a heterotrophic ossification center that required a complex, multidisciplinary surgical team to correct. This case of a high school football player’s routine PPE that resulted in surgery highlights not only whether sport participation is safe, but also the importance of direct, specific language that asks about the history of any injuries, rather than specifically sports related.

Introduction: More than 50% of primary care physicians’ practice involves sedentary desk work. Growing evidence suggests a link between sedentary workplace behaviors and increased morbidity and mortality. Research on the effects of sit-stand desks in the workplace suggests that sit-stand desks reduce sedentary behaviors. This study examined the use and satisfaction of adjustable desks with a height of sit-stand and their association with physical self-care behaviors among family medicine residents. Methods: We conducted a longitudinal cohort survey study at a 9-9-9 family medicine residency after the clinic installed height-adjustable sit-stand desks in January 2020. Standardized questions about the use and satisfaction of adjustable sit-stand desks and physical self-care behaviors were administered in June 2020, December 2020, and December 2021. The survey also included an open text box for feedback. Results: Median time spent standing at the sit-stand desks was 55.0%. The percentage of time standing was similar across June 2020, December 2020, and December 2021. The average satisfaction rate with the desks across all time points was 71.4%. We did not observe significant differences in the proportion of residents’ satisfaction with the adjustable desks over time. Residents who reported standing at the adjustable desk reported increased satisfaction with the desks (Kendall’s τ=.38, P<.001) and with physical self-care behaviors (Kendall’s τ=.25, P<.05). Themes associated with desk dissatisfaction revolved around limited desktop space. Conclusion: Over a nearly 1.5-year period, more than half of family medicine residents reported standing at their adjustable desks and being satisfied with them. Residents who reported standing at adjustable desks also reported increased physical self-care behaviors. Residency programs investing in sit-stand desks may consider options that allow for increased desktop surface space.