Welcome to the Clinical Journal of Sport Medicine Blog

For those of you who might be new to all this, blogs (or web-logs as they were once known) have evolved from online diaries where individuals recorded their accounts of their personal lives. At the last count, there were over 180 million blogs in existence and now it is the turn of CJSM to enter the Blogosphere.

With the advent of the internet and social networking sites such as Facebook and Twitter and their unique ability to allow for almost instantaneous communication and interaction, the ever-improving availability and affordability of electronic devices, and the move towards paperless methods of communication, these are exciting times for CJSM.

We have three main ambitions for the CJSM blog :

1) To inform, signpost, and educate readers about topics and current issues in the world of Sport and Exercise Medicine ;

2) To stimulate debate and discussion  ;

3) To create a vibrant and active online community where readers can share their knowledge and experience so that we can learn from each other.

We will be highlighting recent research from the world of Sport and Exercise Medicine, with links to both our current and past Journal content and to other sources including both peer-reviewed Journals and websites. In addition, we will be discussing up-to-date current affairs in the world of Sport and Medicine.

Both subscribers and non-subscribers to CJSM will be able to read and respond to blog posts on the CJSM Blog, and we hope to engage a wider Sport and Exercise Medicine community in order to advance the Practice of Sport and Exercise Medicine.

From time to time, we will have guest bloggers to discuss topics of particular relevance, and we would be happy to hear of your ideas for topics for discussion. Let us know if there’s anyone in particular you’d like to hear from, and we’ll do our best to make it happen.

Most of all, we hope that you will find the blog useful, that you will engage with our blog and take an active part in the discussion, and that you will have fun along the way.

Looking forward to getting to know you better. Let the blogging commence!

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Pre-game intravenous hyperhydration, anyone?

The editorial in this month’s CJSM by Coombes and colleagues on Intravenous Rehydration in the National Football League highlights the widespread prevalence of the practice of pre-game hyperhydration as reported in the study by Fitzsimmons and colleagues, also in this month’s Journal here .

Fitzsimmons and colleagues surveyed the head athletic trainers of 32 NFL teams using an online survey tool and managed to achieve an impressive 100% response rate. They found that 75% of all teams had used pre-game hyperhydration with iv fluids, with an average of 5 to 7 players per team per game receiving intravenous fluids prior to play. The most common reasons for this strategy cited by trainers were to prevent muscle cramps (23 out of 24), prevent dehydration (19), at the request of the player (17), to prevent heat illness (14), and to improve player exercise tolerance (8).

It is somewhat alarming to find out that this practice is so widespread, especially in view of the fact that iv fluid administration pre-competition and intra-competition is clearly prohibited under the prohibited methods category of the 2011 WADA anti-doping code , and as discussed by Coombes and colleagues, it will be interesting to see how WADA and the NFL react to the results of this study.

An additional point to note, again as highlighted by Coombes and colleagues, is that there is practically no evidence that pre-game hyperhydration actually achieves any of the desired outcomes cited by trainers.

This study highlights yet another example of a dubious and potentially dangerous practice being adopted by elite teams in the absence of evidence of effectiveness of the intervention to achieve desired outcomes.

One wonders why such widespread practice is allowed to occur without action being taken against individual Clubs and players engaging in the use of these methods, or why the practice is not specifically banned under the code of the NFL.

Surely now is the time for a formal investigation into this issue?

CJSM would like to hear your views.

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