A Sharapova Moment

The world of sports medicine is never boring, but who knew things could get this interesting?

In the first weeks of March, there have been at least two major stories that have transcended the borders of ‘sports medicine’ and become topics of debate for the world at large — I speak of the proposed ban on tackling in schoolboy rugby (and the continued debate on tackling in American football) and Maria Sharapova’s admission that she failed a drug test at the recent Australian Open.  For both stories, the boundaries of the discussion have gone well beyond the lines of the playing fields and the walls of the academy.

Social media has seen these topics trending. The mainstream media have been profiling the issues as well.  The Economist weighed in on the debate about tackling. And this morning I found the New York Times prominently featuring Ms. Sharapova’s story, including articles on the drug meldonium [for which Sharapova tested positive] and on the issue of the World Anti-doping Agency’s (WADA) use of emails to notify individuals about changes on WADA’s banned substance list.

Many people have an opinion on the subjects.   We’ve been running a poll on this blog regarding the issue of tackling, while our friends at the British Journal of Sports Medicine (BJSM) have been running a Twitter poll on the Sharapova issue: who is responsible, the player or her support staff [currently the poll is 74%/26% stating it’s the athlete’s responsibility].

In the New York Times article and in the BBC, former WADA-president Dick Pound has stated his opinion that Sharapova’s failed drug test was ‘reckless beyond description.’

I must say I take issue with this and empathize with Ms. Sharapova, who stated that she received in December the WADA email noting that meldonium was now on the banned substance list, but “…I did not look at that list.”  Meldonium was a PED legal until 2016, when it was placed on the ‘banned substances list.’ As a professional inundated with emails, alerts, pronouncements, and more, I confess to a certain degree of information overload even when it comes even to items vital to my licensure and ability to practice.  Have I ever received an email from the Medical Board that I have deleted?  Have I ever received notification from my hospital staff office of some new change in policy which I glossed over?  Yes and yes.

Regarding the WADA emails, other athletes in the NY Times article have offered this opinion: “Some dismissed the messages as irrelevant to their own regimens or too complicated to be useful.”  That certainly resonates with me and my professional world.

I am not writing this to absolve Ms. Sharapova, and I applaud her for her prompt and open admission of personal responsibility. That stance is right and proper.  But I would hardly deem her action “reckless beyond description.”

In CJSM we have published over the years several studies on banned substances. One of the pieces of original research just published in our March CJSM sheds some further light on this issue, I think: Dietary Supplements: Knowledge and Adverse Event Reporting Among American Medical Society for Sports Medicine Physicians.  Read more of this post

Breakfast at Wimbledon

2012_Olympic_Tennis_Men's_singles

2012 Olympics Men’s Tennis medalists. In 2014 Wimbledon, only Federer remains.

The 4th of July here in the States, where I live, has for me always gone hand in glove with something so very British….

I do not refer to the Revolution, to Washington and King George, to Yorktown……No, it’s Wimbledon that is on my mind!!!

Growing up in the late 70’s there were many, many “Fourths’ which I spent in front of the television, with a bowl of cereal, watching some tennis greats in either the semi-finals or finals of the tournament:  Borg, McEnroe, Evert, Navratilova, Connors, Vilas…..and later Becker, Graff, Seles, Wilander, Edberg…..When my friends and I would later go to the public courts to play in those holiday afternoons, we’d imitate the serve and volley style we had just watched, using the contemporary technology of wood or aluminum rackets!  What great memories!

On this holiday, with the men’s first semi-final already begun, I will be brief.  It’s time to get out those Froot Loops and find out if Djokovic and Federer will book their ticket to an epic men’s final; to see if youth will be served:  might Dmitrov or Raonic win it all?  For that matter, will Eugenie Bouchard or Milos Raonic bring home a Wimbledon trophy to Canada?

During the bathroom breaks on court, you may want to hone your own sports medicine tennis knowledge.  I’d encourage you to take a look at the excellent epidemiologic study on tennis injuries treated in U.S. emergency departments, written by a group including the senior author, a frequent contributor to CJSM, and my colleague at Nationwide Children’s Hospital, Dr. Gary A. Smith.  Or you may want to catch up on our most recent podcast, a conversation with Dr. William Meehan on the relative safety of Chiari malformations in athletes.  And by all means, take a peek at the July 2014 issue of the journal, with the headlining article on cardiovascular screening practices of U.S. team physicians.

If you reside in the USA:  happy Independence Day.  And for all our other friends and colleagues around the globe, may you have a safe, active, and happy weekend.  Enjoy Wimbledon, enjoy the World Cup, and enjoy your own sporting activity!

Nadal’s Knees

The men’s semi-finals are upon us at the 2014 French Open, and lo and behold who is still in the bracket?  The incomparable Rafael Nadal of course.

It seems appropriate to re-visit our 2013 blog post on Rafa and his knees.  Let’s hope they hold out, and that sport (and not injury) determines the Men’s champion at Roland Garros!

(speaking of knees, in that ‘other’ big sporting event known as the World Cup, let’s hope Cristiano Ronaldo’s knees hold out!)

Clinical Journal of Sport Medicine Blog

715px-AFONSONADAL Rafael Nadal, invincible on clay, just might be beaten by this man in table tennis (Portuguese Table Tennis Coach Afonso Vilela)

What a great week it has been at the French Open in Paris.  As I write, I see that Serena Williams has just closed out Maria Sharapova in straight sets to regain the title she last held 11 years ago in 2002.  The men’s final is set for tomorrow, with the incomparable Rafael Nadal facing his Spanish countryman David Ferrer after outlasting Novak Djokovic in an epic five-set semi-final match.

Like many of this blog’s readers, I have been amazed and entertained by men’s tennis over the last decade.  It truly is a golden era for the sport, with Federer and Nadal and Djokovic and Murray each seeming to outdo the other in feats of tennis heroics.  Just yesterday Nadal made an amazing between the legs shot in…

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Novak Djokovic: Gluten-free and Gumbyesque

The season for Grand Slam tennis is upon us, and at CJSM we are duly excited!

The draw for the French Open is set. We’re looking  forward to the Men’s and Women’s competitions at Roland Garros, which begin tomorrow. The top two seeds in the Men’s draw (Rafael Nadal and Novak Djokovic respectively) have had some difficulty in the run up to Roland Garros.  Is it Nadal’s knees?  Is it Djokovic’s wrist?

Tennis is a sport for which I have great admiration, and is a regular subject on this blog.  It’s a regular subject in the journal as well (take a look at the May issue’s epidemiologic study on tennis-related injuries in the United States).

Today, we re-visit a post from 2013 where I explored some factors which might account for Djokovic’s supreme athleticism and give you all a chance to weigh in on the poll:  gluten-free diets, helpful, harmful, or neutral for the athlete?

Have a great weekend.

Clinical Journal of Sport Medicine Blog

djokovic aussie open 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!…

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