The Polls are Open: Vote Early, Vote Often

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Starting young on the skis

I’m on vacation, and will return next week to write more about the world of clinical sports medicine.  There will be new studies to report on, new injuries (unfortunately) in athletes to profile.  August is a wonderful month for sport:  The PGA Championship in golf commences; the U.S. Open in Tennis as well.  The English Premiership season kicks off, as does the Collegiate American Football season.

In the mean time, I wanted to offer those of you not lounging on a beach to visit some of the polls we’ve profiled in this blog over the last several months.  If you haven’t been able to share your opinion on some crucial questions in the world of clinical sports medicine, now is your chance!

So, it’s not November, and in American politics it’s an ‘off’ year for elections.  But the polls that really matter to sports medicine clinicans are open right here, right now:

1) We recently asked your thoughts on Baseline Computerized Neurocognitive Tests

and on the existence of “Second Impact Syndrome”

2) A month ago, we asked if you thought gluten-free diets enhanced athletic performance.

3) And at the beginnng of the summer, we asked you which you thought was the safer playing surface for footballers:  turf or grass?

When I return from my northern lake idyll, I’ll check on these polls and see what you all think, and I’ll be sure to report the results in an upcoming blog post.  Keep your eyes peeled to this site:  we’ll be profiling concussions in August, the start of the football (both soccer and American football) seasons here in North America and Europe.  I’m sure you, like me, will be expecting a tsunami of concussed athletes coming into your clinics this month.

Ramadan

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The Crescent Moon rising at sunset, marking the start of the month of Ramadan

The month of Ramadan begins tomorrow, July 9, and lasts until August 7.  As many of this blog’s readers will know, observant Muslims will fast from dawn until sunset:  no food, no liquids…..no sports drinks or power bars.  The questions of ‘carb loading’ or ‘gluten free’, (‘should i drink some chocolate milk after my workout?‘) can all be put on the table until the evening.  The diet is one of pure abstinence, morning until night.

Muslim athletes are not unique in observing a fast: Catholic Christians will consume much less than usual if observing the prescribed tenets of Lent on Ash Wednesday and Good Friday, and Jewish athletes will go a full 24 hours consuming nothing on Yom Kippur: friends have told me they will be loath to brush their teeth or even shower, lest anything whatsoever pass into their mouths on that, the holiest day in the Jewish calendar.

And, of course, there are athletes who experiment with fasts, juices and cleanses that have nothing to do with religious observance (I’ve tried the “Master Cleanse” myself once).

What may be unique, however, to Islam  is the duration of the practice:  a full 30 days, where an observant Muslim will forego all food and drink from dawn (Sahur) to dusk (Iftar).

I admire the discipline the act of fasting requires.  As a sports medicine clinician, I have often wondered how athletes observing such fasts might be impacted.  Of course, I am  not alone in this, as the subject of the Ramadan fast and its effect on athletes was, for instance, a subject of considerable interest in the 2012 London Olympics, which took place during Ramadan.  The effects of Ramadan on sports performance have even been discussed in this blog in a 2011 post.  And now  the most recent issue of the CJSM, which rolls out today, highlights a study looking at this very practice of fasting and its impact on footballers:  “Does Ramadan Affect the Risk of Injury in Professional Football.” Read more of this post

Novak Djokovic: Gluten-free and Gumbyesque

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Novak Djokovic at the Aussie Open

The Wimbledon Championships end tomorrow, with the Gentleman’s Singles Final pairing now set:  either Novak Djokovic or Andy Murray will raise the Championship Silver Cup by day’s end, barring rain delay or marathon tennis match…..

It has been another great fortnight of tennis, highlighted by Djokovic’s historic semi-final win over Juan Martin del Portro yesterday.  Djokovic seems to get involved in these epic five-set Grand Slam matches, having just been on the losing end of such a match at the French Open.  His opponent that day, Rafael Nadal, was quoted as saying:  “‘I learnt during all my career to enjoy suffering, and these kind of matches are very special….I really enjoy suffering.” This statement was given, mind you, by the victor!

I remain impressed with Djokovic’s supreme athleticism and his ability to inflict suffering on others on the tennis court!  It got me to thinking yesterday:  what are the sources of his talents?

There have been interesting discussions of at least two of his singular attributes:   his flexibility and his devotion to his gluten-free diet. Read more of this post

Ramadan and the 2012 Olympics

When it was revealed back in 2006 that the 2012 Olympic Games would take place in London during the period of Ramadan, there were strong criticisms aimed at Olympics organisers from a number of Muslim groups from around the World. Massoud Shadjared, Chairman of the Islamic Human Rights Commission, said ‘This is going to disadvantage the athletes and alienate the Asian communities by saying they don’t matter. It’s not only going to affect the participants, it’s going to affect all the people who want to watch the Games.’

In 2010, the New Statesman published an article posing the question ‘Is Ramadan a threat to Muslim success at London 2012.’ Joanna Manning-Cooper, spokeswoman for the London 2012 Olympic Games, seems to think not, having stated that ‘we have always believed that we could find ways to accommodate it.’

Ramadan is the ninth, and the most holy, month of the Islamic calendar. It is one of the five Pillars of Islam, and during this period Muslims do not eat or drink anything from dawn to dusk. Muslims fast for the sake of Allah, and to teach themselves about patience, spirituality, humility and submissiveness to Allah.

The dates of Ramadan in 2012 are from the 21st of July to August the 20th, which coincides with the Olympic Games which takes place between the 27th of July and the 12th of August. The 2012 Paralympics runs from the 29th of August until the 9th of September. Whilst the dates of the Olympics were designed to fall into the traditional six-week’s summer holidays in the UK in order to make it easier to find the required number of volunteers, the clash with Ramadan is proving a difficult problem for those athletes and support staff who will be directly affected during this period.

Around a quarter of the total number of athletes competing in the 2004 Athens Olympics were from predominantly Muslim countries, and it is estimated that there could be in excess of 3000 athletes observing the period of Ramadan during the 2012 Olympics. Not only are eating and drinking affected, but sleeping and training schedules also have to be fitted around the religious commitments during this period of time.

In their paper in this month’s CJSM, Brisswalter and colleagues assessed the effect of intermittent fasting during Ramadan on 5000m running performance in 18 well-trained middle-distance runners and concluded that their results suggested that Ramadan changes in muscular performance and oxygen kinetics could indeed adversely affect performance during middle-distance events. With many middle and long-distance runners being Muslims from North Africa, the potential for underperformance might seem to be significant amongst those competitors who are observing the period of Ramadan during competition.

The available evidence suggests that performance effects are likely to be variable according to environmental conditions, the length of fasting, and the time of day in which the event is occurring, together with the length and type of event in which the athlete is competing. For example, Chaouachi and colleagues assessed the effect of Ramadan intermittent fasting on aerobic and anaerobic performance and perception of fatigue in male elite judo athletes and concluded that fasting had little adverse effect on these parameters during very short duration sprinting and jumping test performance in this group.

It is likely that the London 2012 organisers have learned from the scheduling during the 2010 Youth Olympic Games which also took place during the period of Ramadan that year.

For those wishing to read more on the subject of Ramadan and issues related to perparation and participation in athletic competition, a series of papers was published in the Youth Olympic Games edition of the British Journal of Sports Medicine, which included some advice on nutritional strategies during the Ramadan period for athletes. In addition, the International Association of Athletics Federations have produced a booklet on eating and exercise during Ramadan written in both French and English which is well worth a read.

CJSM would like to hear of your strategies and planning for Muslim athletes competing during Ramadan in the 2012 Olympics.

(Image of Ramadan lanterns in Egypt by B. Simpson )

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