Tag Archives: SEM

DMacA_ski_resizeDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK, recently returned from attending CASEM-OMA Sports Medicine symposium in Ottawa.

 

Myth busters could be a regular session at any medical conference. But sports medicine seems particularly susceptible to suggestion, quackery or placebo as everyone looks for an easy answer. Jamie Kissick took us on an entertaining trip around the dubious evidence base surrounding interventions such as functional movement prediction of injury; managing muscle soreness; glucosamine and chondroitin; ice baths in recovery and many others. I was delighted to hear praise for my colleague Chris Bleakley’s work. And, indeed, mention of the POLICE acronym.

Should my child play contact sports? It is a question asked by many parents following the discussions about trauma in professional sport. J. Scott Delaney outlined many of the arguments, focusing on the short and long term risks associated with concussion. My view of Delaney's talk is that the evidence is unclear- and it can be difficult, even for you as the doctor, to be objective. ...continue reading

DMacA_ski_resizeDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK. This week he is attending the CASEM-OMA Sports Medicine symposium in Ottawa.

 

Edu-tainment is how we need engage audiences, according to Andrew Pipe, chair of the opening session of the CASEM-OMA 2015 meeting in Ottawa. And what a superb opening session. Ian Shrier and Pierre Frémont introduced their five key sports medicine papers and debates of the last year. From a CMAJ perspective, it was great to hear Ian cite our systematic review on arthroscopic surgery for degenerative tears of the meniscus as a key paper. He made a very important point that the outcome was the minimally important difference to patients. The authors had used the average but, looking at the minimally important difference distribution, this may not be entirely reflective, and some people may have had a benefit in the short term although, in the long term, there was no effect.

Concussion is a major issue and Pierre reminded us of a paper emphasising that concussion management protocols should include cervicovestibular evaluation ...continue reading

Domhnall MacAuleyDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK, and recently in Edinburgh for the British Association of Sport and Exercise Medicine conference 2014

 

Why are the Jamaicans so dominant in world sprinting? And, it’s not just Jamaicans, but those of Jamaican origin representing other countries such as Canada and the UK. Is there a genetic component? Yannis Pitsiladis, a world expert with access to the world’s largest biobank, found no unique genetic trait. Jamaicans’ believe that this dominance is from the eugenic effects of the slave trade - only the fittest and strongest survived ...continue reading

Domhnall MacAuleyDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

Taking your nine year old to climb Mont Blanc (altitude 4810m), seeking the record for the youngest ascent, is high risk on a mountain where about 100 people die each year. At what point on the scale of encouragement-to-achieve do we stray into the red zone? Take a look at this clip from ABC News in the US showing Paul Sweeney and his two children aged eleven and nine climbing in the snow and, watch as one child, then another, slip off the mountain. The children were unhurt but the mayor of St Gervais les Bains, which includes Mont Blanc, was highly critical. While there are non-medical questions about who controls the wilderness and when we should intervene when adult behaviour puts others, such as the rescue services, at risk, there are other deeper ethical questions when children are involved.

An underage athlete was also one of the main medical stories at the Commonwealth Games. Chika Amalaha, a 16year old female Nigerian weight lifter was stripped of her gold medal when, according to the BBC, amiloride and hydrochlorothiazide, both prohibited as diuretics and masking agents, were identified in her urine sample.

While this clearly transgresses the ethical and legal boundaries, and is particularly serious when it involves a minor, other sporting situations involving children are less clear. To achieve excellence in sport requires immense commitment with intensive skills training from a young age. Children are vulnerable and may well not be making informed decisions for themselves so, although we are generally impressed by outstanding underage performance, we might also sometimes feel uncomfortable.

Other random Commonwealth Games medical thoughts- while I marvelled at English diving sensations Victoria Vincent (13) and Matthew Dixon (14), on the 10m board, I wondered if repetitive diving risks damaging the developing brain. I have no idea if there is significant impact on striking the water. (Perhaps someone might respond.)
In boxing, blood streaming from cuts made dramatic, if rather unsavoury, television. Amateur boxing has shed head protection making head clashes more likely. Head gear may not reduce repetitive impact but it will reduce potential blood injury. Medicine struggles with boxing. It is difficult to defend a sport where the ultimate aim is to inflict direct injury but the sport is generally well regulated and undoubtedly benefits many young men and women. There is no body contact in squash but the ball is a perfect fit for the orbit and I was impressed with the eye protection worn by squash players in those amazing externally transparent courts. Good sports medicine should be in the background. If it is makes headlines, it usually means there is something wrong so we should acknowledge the outstanding work of the host medical team since among the non-stories were a well contained potential outbreak of gastroenteritis and an Ebola virus scare.

On Monday, as the athletes left the airport in a swirl of bagpipes, we gathered in another part of Glasgow for a memorial service celebrating the life of Professor Stewart Hillis, a cardiologist and one of pioneers of Sport and Exercise Medicine. Long-time Scotland Team doctor, he contributed much to soccer, including introducing cardiovascular screening of referees, worked enthusiastically with UEFA and FIFA medical committees, and was a close friend and confidante of many soccer legends, including Sir Alex Ferguson who gave one of the eulogies. In his academic role, he was a key to introducing the BSc and MSc in sport and exercise medicine to the University, and educating a generation in sport and exercise medicine, many of whom worked on the Games and some of whom came in their team kit. His was a life spent in the service of others – a witty, inspirational, and incredibly committed professional, and a wonderful colleague and friend.