Jet Lag

One of the more popular studies we have published in the last few years has been ‘Jet Lag and Travel Fatigue:  A Comprehensive Management Plan for Sport Medicine Physicians and High-Performance Support Teams.’  The paper was written by Charles Samuels, M.D., the Medical Director of the Centre for Sleep and Human Performance, Calgary Alberta and published in our May 2012 CJSM.  It has been ‘hit’ on-line and emailed many, many times.  If you have not had the chance to read it yet, it remains freely available; my colleague Chris Hughes previously reviewed the study in depth on this blog as well.

I am thinking about this study quite a bit right now, as I recover from 24+ hours of travel making my way back from SE Asia to my home in Columbus, Ohio, where I resume work seeing patients tomorrow a.m.  I’m using melatonin to help re-adjust my circadian rhythm so that I can be as ‘sharp’ as possible taking care of the athletes I’ll see soon.  I began taking 0.5 mg melatonin each morning in Thailand 2 days before departing; and now that I am back in the USA I will continue taking 0.5 mg melatonin each night for five nights.  So far, so good.

I thought it high time that I post a poll on this blog.  I have been remiss in not doing so for several months.  And so, whether you are a clinician who manages teams doing a lot of long-distance travel, or whether you are only responsible for yourself, I have written this poll for you!  Let me know your management of this common problem–and if you have not had the chance to read this study previously, by all means do so!!!


Team Physician Consensus Statement: 2013 Update


Nationwide Children’s Hospital Staff Physicians and ATCs
in “the Horseshoe” at the Ohio State University, prior to game.

Earlier this week, several sports medicine organizations released a statement with which all sports medicine clinicians should familiarize themselves:  the “Team Physician Consensus Statement:  2013 Update.”

The Statement represents, in its own words, “…an ongoing project-based alliance” of the major professional associations associated with sports medicine  in the United States.  These include the American Academy of FamilyPhysicians (AAFP), the American Academy of Orthopaedic Surgons (AAOS), the American College of Sports Medicine (ACSM), the American Orthopaedic Society for Sports Medicine (AOSSM), the American Osteopathic Academy of Sports Medicine (AOASM), and this journal’s affiliated professional group, the American Medical Society for Sports Medicine (AMSSM).

This is an update of a statement first published in 2000.  It includes sections which define the role of ‘team physician’;  describe the requisite education and qualifications; enumerate the medical and adminstrative duties and responsibilities; and explore the relevant ethical and medicolegal issues.

The entire statement is worth a read, but I find the ‘ethical issues’ section most interesting.  Read more of this post

Le Tour et La Corse


Les montagnes de L’Île de Beauté: La Corse

…et La Centieme:  The 100th edition of Le Tour, the Tour de France, begins today, with the Grand Start in Corsica for the first time in the race’s history.


Who needs the Tricolor? The Flag of Corsica: once an independent republic, now part of France, still with its own language and distinct customs.

What a way to celebrate the centennial of the Tour!

Corsica, or La Corse, is a French island in the Mediterranean, and is comprised of two of that nation’s departments: Haute-Corse and Corse-du-Sud.  It is the only region of France which has not previously hosted a stage of Le Tour.

The island has a long history, perhaps best told in one of the finer travel books I have ever read, The Granite Island, by Dorothy Carrington.  The island has passed through many hands over its history:  the Carthaginians, Romans, Genoans and others have all claimed the island for their own.  The island even enjoyed an independent existence for some years:  the Corsican Republic was formed in 1755 under the leadership of Pasquale Paoli.  Corsica’s most famous son, Napoleon, was born there in 1769.  And it was during the time of the “Napoleonic wars” that he set loose on Europe that the island became part of France.  It has remained a part of that country ever since.

I have a special fondness for this land, known by the French as  L’Île de Beauté:  the Isle of Beauty.  I have visited Corsica twice, and was smitten with the island from the first my eyes lay sight on the port of Calvi. (Some readers may recognize Calvi as the site of the 2011 IOC Advanced Team Physician course.)

Corsica is quite simply arresting:  from its mountains and trails, to its beaches, to the very smell of the island (its vegetation, known as the ‘maquis’, has a distinctively lovely fragrance), it can put anyone under its spell.

That said, I suspect the cyclists in Le Tour this year may be smitten in a different way than I was on my visits.  Like any beauty, Corsica has its caprices.  The mountains I found lovely will almost certainly pose extraordinary challenges to the competitors.


Cirque de la solitude: in the mountains of central Corsica


The capital of Corsica: Corte, through which the 2nd stage of the Tour will pass











The second stage of the Tour this year will traverse the mountains that form a spine through the center of the Island, heading from Bastia on the east coast, through the mountainous capital of Corte, and ending on the west coast in Ajaccio, the birthplace of Napoleon.  The Tour’s website describes the ride as a rollercoaster; “Expect some real damage,” the site boasts menacingly!    Let’s hope no one meets his ‘Waterloo’!

Read more of this post

The Greatest Show on Earth gets off to a flier – London 2012 Olympics Opening Ceremony

And so to the Games of the XXX Olympiad – London 2012. The self-styled ‘Greatest Show on Earth’ was declared open by Her Majesty Queen Elizabeth the Second following a spectacular opening ceremony culminating in a fireworks display.

Having been shrouded in secrecy prior to the opening night, there had been much debate and rumour as to the nature of the ceremony, and in particular who would be lighting the cauldron. Danny Boyle, a local resident to Olympic Park and perhaps more famous for his movies including blockbusters such as Slumdog Millionaire, was tasked as artistic director of the opening ceremony. His previous experience as a theatre director was probably more relevant and useful to his role in shaping the vision for the ceremony, and this was conducted with a British flavour and sense of humour.


Watched by billions of people around the World, the so-called ‘Isles of Wonder’ ceremony was a triumph. Particular highlights for me included the forging of the Olympic rings during the Industrial Revolution sequence,  the dancing doctors and nurses section highlighting the important role of the NHS and the work of the World-famous pediatric hospital Great Ormond Street, Mr Bean and the ‘Chariots of Fire,’ a skydiving James Bond and ‘Her Majesty the Queen,’ the historical walk through Britain’s music, and a quite beautiful sequence of the lighting of the Olympic cauldron which was performed by seven young future Olympic hopefuls – each sponsored by a British Olympic medalist. The cauldren itself was made up of 204 copper petals representing the number of competing Nations in the Games.

The vast majority of the performers during the Ceremony were Games Maker volunteers, and the diversity of representation made the overall performance very special, as this truly was an inspired welcome from the British people to the World.

Now the serious business of the Games themselves begins. There have already been some powerful performances, including a World record for Kiwi rowing men’s pair Hamish Bond and Eric Murray who demolished the previous World’s best time held by Great Britain rowers Matthew Pinsent and James Cracknell by almost 6 seconds – a huge margin in this event.

On a sadder note, the first doping offences of the Games have already led to withdrawals for two athletes. World indoor High Jump Champion, Dimitris Chondrokoukis, one of Greece’s top hopes for an athletics medal, tested positive for stanozolol. Although he denies ever taking this substance, he withdrew himself from the team. In addition, Hungary’s 2004 Olympic silver medallist Zoltan Kovago refused to take an out-of-competition test. Kovago becomes the second Hungarian discus thrower this year to commit a doping offence, following the news of Robert Fazekas testing positive.

Hopefully, these will be the first and last doping offences of the Games, and the Spirit of the Olympic Games will prevail.There is much to look forward to, and the host Nation, Great Britain, is hoping for a record haul of medals.

Alongside many other medical Games Maker volunteers, I will be working together with my colleagues to provide medical support for the athletes during the Games. This is a great opportunity for Sports Physicians in the UK to be involved with the provision of care during a home Games, and one that I am looking forward to relishing.

The last word on the Games here goes to Baron Pierre de Coubertain, second  President of the International Olympic Committee from 1896-1925, who said that “The most important thing in the Olympic Games is not winning but taking part; the essential thing in life is not conquering but fighting well.”

Enjoy London 2012.

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