Head guards in boxing — the podcast

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Dr. Mike Loosemore, lead author of new CJSM boxing study

We open 2017 with a new podcast on the new (non)-intervention in Olympic-style boxing:  head guards, or the lack thereof.

Our guest is Dr. Mike Loosemore MBBS MSc PhD FFSEM(UK), a consultant in sport and exercise medicine at the Institute of Sport, Exercise and Health, University College London.  Dr. Loosemore is currently the doctor to the British Olympic Boxing team, and a well known figure in the boxing medicine world.

He is, as well, the lead author of a highlighted study in our January 2017 issue: The Use of Head Guards in AIBA Boxing Tournaments — A Cross-Sectional Observational Study.  The team of researchers included Julian Bailes, whose name will be familiar to most people who study and treat sport-related concussions [or familiar to those who watched the movie Concussion in 2016].

Rio 2016 was the first Olympic competition since the 1984 games in Los Angeles where male boxers did not wear head guards , a rules change which generated a lot of controversy. Research like Dr. Loosemore’s was instrumental in making the determination to stop 52 years of practice.jsm-podcast-bg-1

Just before Christmas, we chatted with Dr. Loosemore, and he shared what he and his team found in their study and the back story behind the use, and now discontinuation, of headguards in Olympic-style boxing.

Be sure to listen to the podcast here and read the study (free access currently) here…..and, as ever, let us know what you think, or give Dr. Loosemore a shout out on Twitter @doctorloosemore

 

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5 Questions with Dr. Jane Thornton — what is the physical activity prescription?

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Jane Thornton MD, PhD (2nd from left) — Canadian Olympian and Lead Author of CASEM Position Statement

We are having a sit down with Jane Thornton, MD PhD today as part of our recurring  blog offering, ‘5 Questions with CJSM.’  Among many other things, Dr. Thornton is the lead author of the new Canadian Academy of Sport and Exercise Medicine (CASEM) Position Statement on the ‘Physical Activity Prescription.’  This article, published in our July 2016 issue, has already drawn an immense amount of interest — it is currently free, so do not hesitate to check it out and print out/download the PDF to fully appreciate its contents.

Dr. Thornton is an extraordinarily accomplished individual who is finishing up her family medicine/sport medicine training at the University of Western Ontario.  Besides a medical degree, she has earned a Masters and PhD, doing her studies CJSM Associate Editor Connie Lebrun while at the Fowler Kennedy Sports Medicine Clinic.

With the Rio Olympics set to begin in a few days, it is perfect timing to conduct this interview with Dr. Thornton.  While doing all of that academic work noted previously, she was also training for the Canadian national rowing team. She rowed in the 2008 Olympics in Beijing with the Canadian women’s eight.  She knows a thing or two about physical activity, no doubt. In addition to her authorship of the CJSM manuscript, Dr. Thornton has co-created along with Dr. Mike Evans a website about how to #MakeYourDayHarder, advancing the notion that our every day activities offer abundant opportunity to get in meaningful levels of physical activity.

At CJSM, we have had an abiding interest in research on various aspects of physical activity (e.g. check out our recent post on #PEPA16 and Ann Gates, another mentor of Dr. Thornton’s), and so it is with great pleasure that we share with you our ‘chat’ with Jane Thornton.

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1) CJSM: How effective is an ‘exercise prescription’?  What is the evidence for this intervention?

JT: It may sound like common sense that physical activity is good for us, but it has taken us a long time to understand just how important it really is as a component of treatment. When we understand that it can lead to improved clinical outcomes in over 30 different chronic diseases, and can be as effective as medication in many instances (hypertension, stroke, and mild-to-moderate depression, to name a few), then we can’t ignore the fact that it should be something we talk about with our patients.

To best illustrate its effectiveness, though, let’s compare exercise prescription with smoking cessation counseling.  When we examine the number needed to treat (NNT), studies tell us that we need to counsel 50-120 patients to see one patient successfully quit smoking. When it comes to getting one patient to meet the globally agreed upon physical activity guidelines (150 minutes per week of moderate-to-vigorous physical activity), however, that number drops to 12 – meaning we have an incredible opportunity to help patients make a life-changing adjustment in their lives. No one, including me, would argue that smoking cessation counseling is not incredibly important. But given the recent findings that being inactive is almost as bad for you as smoking, we really should be expanding the conversation at each clinical encounter to include exercise.

2) CJSM: What are the barriers to its use?  Why aren’t more physicians actively engaged in giving their patients an exercise prescription?

JT: The most oft-cited barriers are time constraints, lack of education and training, complex comorbidities… and the most honest among us will also bring up the point that we just don’t think patients are motivated enough or willing to change. Interestingly, if we demonstrate a belief in patients, they will usually rise to the challenge. It may also come as no surprise that doctors who are active themselves are also more likely to counsel their patients to be active. A big obstacle in many countries is, of course, remuneration. It’s hard for some to justify time spent counseling on exercise if there is no billing code they can tack on. That one is a tougher nut to crack. Policy makers should take comfort in the fact that the practice of exercise prescription is also cost-effective.

3) CJSM: You are active on Twitter – if you could compose a 140 character Tweet for the CASEM position statement, what would it be?  Read more of this post

Open Water Swimming

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Sunrise over Lac St. Jean, site of FINA 10K and 32K open water swimming events

Amazing to think that the Rio Olympics opening ceremony takes place a mere week from now.

I am, currently, enjoying the good fortune of mixing with Olympians from several countries who will be headed there for the open water swim events.  This weekend I am in Roberval, Canada (3 hours north of Quebec City), at Lac St. Jean — where the FINA/HOSA 10K marathon World Cup and 32K Gran Prix events are taking place.

I am a FINA medical delegate at these events.  I have written about this experience before in a 2013 blog post:  the 32K Gran Prix event coincides with an historic open water swim that has been done for decades on this lake, the Traversee internationale du lac St-Jean.

It is a great pleasure to be involved in an international sporting event like this one.  The local organizing committee does fabulous work.  I am privileged to work with fellow FINA representatives from New Zealand and France. Outside of the work hours, we get to socialize some and partake in the hospitality of the Roberval community.

I also greatly enjoy working for the athletes, watching out for their health and safety.  I genuinely enjoy getting to know them and experience vicariously the thrill of their competition. The joy and challenges of sport are a special dimension of human culture —  I am sure this is what leads many of us to sports medicine.

I think it is those broader, aspirational aspects of sport that lead many of us in the sport medicine community to push back on efforts toIMG_2210 cheat, such as doping.  And it’s no surprise that for an elite, international event like this one FINA has doping surveillance as part of its core mission.  One of the roles I play during my time on site is to supervise the excellent work done by representatives of the Canadian Centre for Ethics in Sport, which conducts post-race testing on select individuals many of whom, as I have indicated, will be swimming soon in Rio, where we already have had headline-making doping news before the games have even begun!

We have published frequently on the issue of doping in the pages of CJSM and these blog pages.  We hope you take this chance to click on those links and look at some of that work, in advance of the upcoming Olympics.  And, since it’s Friday, it’s time to follow something new — I would suggest the Facebook page of FINA, which is so well done, and will be hopping with information about this weekend’s Traversee and next month’s Olympics.

Enjoy the Games!  Let them be competitive, safe, and clean.

Sochi and Quebec City: Memory and Desire

The first days of summer are almost here, the longest days of the year in the Northern Hemisphere.  I have been looking forward to this since the dark days of December and January.

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Dr. Connie LeBrun, at opening ceremonies, Sochi 2014 Winter Olympics

Summer carries its intrinsic sweetness with it every year, but this year my anticipation of these days has been wrapped up with dreams of Quebec City, where the 2014 Canadian Academy of Sport and Exercise Medicine (CASEM) will have its annual meeting concurrently with the XXIII FIMS World Congress of Sports Medicine.

There is much to look forward to, including catching up with old friends.  Connie Lebrun–who will be familiar to several readers of this blog–will be among the folks I see.  Aside from communiques via email, I will typically only get the chance to see Connie at such conferences (I saw her last in Orlando, at the ACSM meeting). Among the many hats she wears, she is on this journal’s editorial board, and I enjoy her frequent contributions to the CJSM journal club feature.

Connie was the head physician for the Canadian Olympic team that traveled to Sochi earlier this year. I asked her to give a quick run down of her experiences in sports medicine at the 2014 Winter Olympics, and she has graciously obliged.

What did T.S. Eliot say about mixing memory and desire?  I’m no poet, but I think it’s a natural combination to combine the two; and so here’s to the memories of Sochi, and the anticipation of what is to come in Quebec.

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Memories of Sochi – Dr. Connie Lebrun

 

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Alexey Pleskov and Connie LeBrun, 2014 ACSM Orlando

Just back last week from the American College of Sports Medicine Annual Meeting in Orlando Florida. The last session that I attended was a Special Event entitled “SOCHI 2014:  Sports Medicine Challenges, Strategies and Solutions. It was submitted by the ACSM Olympic and Paralympic Issues Committee, of which I am a member, and Chaired by Dr. Margo Mountjoy, member of the IOC Medical Commission. She later spoke about the International Olympic Committee (IOC) and the Injury and Illness Surveillance system that they have been using at Olympic Games since 2008. A highlight for me, though, was hearing Dr. Alexey Pleskov, the Chief Medical Officer (CMO) for the Sochi 2014 Olympics and Paralympics – discussing Medical Services at the Games. Then Dr. Paul Piccinnini (DDS), also from the IOC Medical Commission, enlightened us about Management of Dental Disease and Oro-Facial Trauma during the 2014 Winter Olympics, which apparently accounts for ~ 40% of all athlete-treatments in the Polyclinic(s) at the Olympics. This was followed by a “tag-team” of Dr. Randy Wilber (PhD, USOC Training Center, Colorado Springs) and Dr. Nanna Meyer (PhD, RD) discussing the preparation of the US Speed Skating team, in terms of physiology and training, as well as outlining some of the sports nutrition challenges and strategies.

The presentations and photos brought back many memories for me, as I was honored to have been the Chief Doctor for the Health and Science Team (HST) for the Canadian Olympic Team. Read more of this post

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