CAS vs. IAAF — the Dutee Chand decision


The Court of Arbitration in Sport (CAS) made a major ruling yesterday with broad implications. Dutee Chand, an Indian sprinter, had been fighting the International Association of Athletics Federation (IAAF) policy which would have required her to undergo surgery, take medicine, and agree to other interventions if she were to compete as a female. Ms. Chand has naturally higher levels of testeosterone than most women; she had never identified in her life as anything but female.  She and her legal team fought the IAAF policy in the CAS, and won.

The CAS questioned the advantage of naturally high levels of testosterone in women’s sport, and ruled that Ms. Chand must be allowed by the IAAF to compete as a woman, essentially overturning the current IAAF policy. A New York Times article makes for fascinating reading.

This is a victory for Ms. Chand, and many would argue that it is a victory for women’s sport, and for sport in general. Nevertheless, many athletes, including marathoner Paula Radcliffe, supported the IAAF policy and worry that women’s sport may now be conducted on a less level playing field, if you will.

Issues of gender in society are front page news this summer in the USA. Sports, as a mirror of society at large, offer up a narrative within this larger story — the Dutee Chand story has been ongoing for well over a year, and we’ve discussed her story and the overall story of ‘Too Much T’ at different times here in the blog.

We thought we’d repost (below) a very popular commentary which includes discussion of this issue of testosterone in women’s sport: ‘The Sports Gene: How Olympians are made (or born).’ And we thought we’d include a poll on what you, the reader, think of this most recent CAS decision on IAAF policy. Vote, and let us know what you think!

Take Our Poll (function(d,c,j){if(!d.getElementById(j)){var pd=d.createElement(c),s;;pd.src='';s=d.getElementsByTagName(c)[0];s.parentNode.insertBefore(pd,s);} else if(typeof jQuery !=='undefined')jQuery(d.body).trigger('pd-script-load');}(document,'script','pd-polldaddy-loader'));

Originally posted on Clinical Journal of Sport Medicine Blog:

The venues at Sochi are still, it seems, a work in progress.  Nevertheless, before the week’s end, we will (should?) see the Winter Olympic games start up.  Soon, we’ll get to watch some of the finest athletes in the world compete at their sport.

There has been a lot of talk about the on-going construction at the most expensive games in Olympic history, as well as the issue of gay rights and cultural sensibilities in Russia;  and there have been worries about the potential for terrorism.  But soon, when the competitions begin, I hope the focus will justifiably be on the athletes on the snow and ice.

Or in Tweet speak: #LetGamesBegin

I’ve not been consciously preparing for this elite sporting event, but rather coincidentally recently picked up a book that highlights elite athletes and has received a great deal of positive ‘buzz':  The Sports…

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CJSM Changes


The CJSM Team (L to R): yours truly, Executive Editor Chris Hughes, Publisher Kivmars Bowling

2015 has been a very good year for CJSM.  As we pass the halfway point, I think it is time to sit back and reflect for a brief moment.

We are celebrating our 25th anniversary at CJSM:  yes, 2015 represents our 25th year as a leading sports medicine journal!  We were ‘born’ 25 years ago on January 1 1991. Check out our first issue here.  I must confess, I only recognize the name of one of the authors, and it turns out he is a good friend of mine, and a frequent contributor to the journal and visitor here on the blog.

Dr. Avery Faigenbaum, who knew you were so long in the tooth?  I suspect you had a little less gray hair when you authored ‘Physiologic and symptomatic responses of cardiac patients to resistance exercise?’ Thank you for that submission and thank you for the continued work you have done in your career on the health benefits of resistance exercise.  In my world of pediatric sports medicine, your work has been huge.  I am old enough to remember the old saw that lifting weights as a child would stunt growth or cause physeal injury.  Dr. Faigenbaum’s work here in the pages of CJSM and elsewhere has helped disabuse mainstream thinking of these notions.

But enough about Dr. Faigenbaum and more about CJSM!  :)

We anticipate some more celebrating as we approach our 25th birthday.  Our Executive Editor and Publisher have some things in the works as we turn the corner toward our next quarter century.  Keep your eyes open for these celebratory flourishes!

We have also begun a Continuing Medical Education (CME) program for selected articles in the journal and have just named an Associate Editor for CME:  Holly Benjamin, M.D.   The Editorial Board is honored to have her join the crew. Dr. Benjamin has played major roles in one of our partner societies, the American Medical Society for Sports Medicine (AMSSM), as well as the American Academy of Pediatrics (AAP).  With her leadership, we anticipate some exciting CME offerings for readers with upcoming featured studies.

Finally, as I finish my coffee and wrap up these reflections, I am happy to say that our podcast efforts, which began just a year ago, continue to expand and will be a significant part of our overall mission as we head into these next 25 years. The world of media in general, and sports medicine journals in particular, is changing all the time.  Journals, blogs, podcasts, social media, CME, eTOC….on and on it goes.

Who knows how we’ll all be interacting in 25 years?



mo and me beaver island

The joys of summer!

July 4th is in the rear-view mirror, and for those of in the USA, that means the glass is half empty (or full): summer has hit the halfway mark.

In many respects, in the sports medicine world we’re well past the halfway point, because August two-a-days and hitting in football begin, at least here in Ohio, precisely four weeks from today.  Then the ‘busy season’ begins.

But we still have July to enjoy – in a slightly more leisurely fashion – such offerings as Wimbledon, the Open golf championship at St. Andrews, and, of course, the new issue of CJSM: Volume 25, issue #4 was published one week ago.

Do check this out, as there are several significant offerings on board this issue.  First and foremost is the publication of the statement from the 3rd International Exercise-associated Hyponatremia (EAH) Consensus Development Conference. This statement has been gathering a lot of buzz in the mainstream and social media, as has the accompanying editorial written by Dr. Mitchell Rosner of the Univ. of Virginia.   The Washington Post published a good review of the statement’s published findings, for instance, and the message to “Drink To Thirst” and avoid overhydration is making its way over various media channels…..including iTunes!  If you haven’t checked out the podcast conversation I had with the statement’s lead author, Dr. Tami Hew, by all means listen in here.

There is, as ever, some exciting original research in this issue as well, including a study of the incidence of EAH in ultramarathoners: in work coming out of Australia, a 2% incidence of EAH was found in ultramarathoners competing in the Cradle Mountain Run in Tasmania, Australia.  And so……EAH may be seeing us more than we are seeing it!!!!

Another very exciting study in this month’s journal is a high quality (Level 1), randomized clinical trial comparing various techniques of ACL reconstruction, with patient-reported and clinical outcomes with 2+ years of follow-up. This is fabulous stuff–no spoiler alert here, as the offering is currently FREE – and so click on that link and read the study yourself to see what differences there may be between double bundle, patellar tendon, and hamstring tendon grafts.

Whether you’re by the pool, a lake, the ocean….or you’re in clinic (as some of us must still be!)–enjoy your summer, and enjoy the July 2015 CJSM.

#Stampede2015 – Cheers to the Calgary Stampede!



O Canada! The Mounties parade through the streets of Calgary as part of the Stampede festivities.

The Calgary Stampede starts tomorrow, and we are excited to re-post this popular offering on rodeo: “The most dangerous sport in the world?”

Ironically, another candidate sport for that dubious distinction, calcio storico, has been underway in Florence this past week; the New York Times just had a nice piece on this brutal sport.  Ouch.

But the topic of this post, and the focus of the Stampede, is on the sport of rodeo. Over the years, CJSM has published numerous studies on the subject. Take the time to read this post and connect with the studies, and learn more about this exciting (and injury-producing) sport.

From all of us here at CJSM, to the organizers and participants in the Stampede: we wish we were there, and have a #SafeStampede

Originally posted on Clinical Journal of Sport Medicine Blog:

Bull_Tamer A Bull Tamer in Australian Rodeo Event. Photo: Amcilrick

TheByrdsSweetheartoftheRodeo “Sweetheart of the Rodeo”

I’ll confess I don’t know much about rodeo.  To the extent the word triggers a response in my mind, I think of Gram Parsons and the Byrds:  “Sweetheart of the Rodeo.” Click on the link and take a listen:  it’s a great album!

Back to sport….it’s my own cultural myopia that overlooks rodeo when I think of the word ‘sport.’ I didn’t grow up participating in it, and in central Ohio I have not attended to any rodeo injuries (equestrian, yes; bull riding, no). I imagine my situation would be different if I practiced in Wyoming or Alberta…..or parts of Mexico, Argentina, and Australia (rodeo is truly international).

As I grow older, I delight in learning more about other sports; my involvement with CJSM certainly has expanded my horizons. Last year, for instance, I…

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