The New Nation - Internet Edition

Dr. Moin Uddin Ahmed

Every occupation has some health hazards. We call it occupational disease. These health hazards are particular to that type of occupation. For example, Silicosis caused by inhalation of silica/ silicon oxide is seen in the mine industry workers, and Byssinosis cause by inhalation of cotton fiber is found in textile industry.

The players are similarly prone to specific types of injuries. During watching a football game you may observe an ankle injury while tackling a ball from an opponent; but this type of injury may not be seen in the swimmers. So, like the occupational diseases there are also sports specific traumas.

Obviously the medical personnel are responsible to take care of these problems. He/she gives the first aid treatment in the spot i.e in the playground/ gymnasium / swimming pool. This is one of the duties of a doctor for the players.. In this regard doctors working in the playground should have sufficient knowledge to solve the medical emergencies. This injury may be in the head ( causing unconsciousness) , neck ( causing spine injury) , face( epistaxis, blow out fracture), chest , abdomen ( causing rupture of the liver/ spleen/kidney/ hollow viscous followed by shock), the extremities( e.g. ankle sprain, dislocation of shoulder). There may also be soft tissue injury like echymoses, hematoma, compartment syndrome( followed by amputation of limb)., muscle strain. In these situation the team physician will give the decision that whether the injured play will continue the game or not.

Besides this he/she has to assess the player prior to participate in playing nay games. This pre session medical assessment is very important for example, any cardiac problem or respiratory diseases like bronchial asthma may aggravate during / after playing. Sometimes these are life threatening. Any physical deformity should also be noted. The measurements of body such as height, weight, length of the limbs, , and the calculation of body fat density (based on skinfold thickness in 8 different parts of the body are also noted.

A sport physician should have proper knowledge about the mechanism of injuries and risk factor of injuries. He/she will train up the players accordingly such a way that the incidence of injuries decreases. During the training session by teaching the preventive measures (either by using protective equipments such as gloves, pads, helmet in cricket & hockey or special physical exercise) . He/she can guide and prepare the players to withstand the injuries.

The players are assessed for the physical capacities / performances through a series of tests. The objective are to evaluate the player for selection in the match and to design the training schedule for further improvement of his/her physical fitness.. It also provides the information about his/her weakness.. The injured player is examined whether he/she has returned to the baseline levels. The team physician together with the coach prepare and organize the fitness tests which is specific for particular sport. For example, a continuous run without changing the direction or speed is of minor relevance to a footballer, as he/she frequently shows high intensity and maximal speed run resulting in a change in activity in every six seconds.

The players do not only get injuries, but also may suffer any infectious disease like diarrhoea, RTI ( running nose, pharyngitis, tonsillitis) ,STI & AIDS, fever, allergy or skin disease.. These actually happen when there is a change of weather or food habit, sharing the clothing, beds, towels etc. during staying in the clubs/camps/ hotels in abroad. It is very important to prevent and control such diseases.

A wide variety of food consumed for physical performances. Due to ignorance of the purpose and necessity of food intake an imbalanced diet (e.g. high protein and low carbohydrate diet for the runner, swimmer, footballer etc) is often chosen by the players. A diet which does not contain sufficient carbohydrate ( rice, bread, potato) will not be able to replace the needs of the player during higher intensity activities.(running, jumping). The planning of energy intake is made on the basis of the demand during training and matches. Plenty of fluids must be consumed in order to delay dehydration and to prevent heat illness. With a balanced diet from a variety of sources including fruits and vegetables, the need for vitamins and minerals supplement is of no use. Some woman may benefit from an iron supplement if medically suggested. So , a team physician has a great role for recommendation of nutrition according to the need of the athletes. The interaction of 3 factors : nutrition, menstruation, and bony health (the female athlete triad) is considered in case of training in woman.

Respect to others ( opponents, teammates, referees, officials, spectators) is part of the game and one of the criteria of fair play. But sometimes it is overlooked. The players often tease & misbehaves the opponent. What we knew through papers , Matarezzii (Italy) told some slang to Zidane(France) in the final match of the World Cup football 2006. .This was certainly a violation of fair play and against the spirit of game , which they were committed for. Think about what a mean mind attitude in such a big international competitions ! besides this some player play foul intentionally, some can not control his anger ( like Zidane pushing Matarezzi by head) and emotion, some has lower level of concentration, and some become nervous. All these psychological behavior should be recognized and improved accordingly.

The age determination is an important issue for organizing various age group related competitions. Radiological investigations is not permitted for age determination except in medico-legal conditions. The International Atomic Energy Agency (IAEA) & WHO has banned to perform X-ray on a healthy person due to possibility of radiation. The body growth , development of axillary hairs, pubic hairs, beard an other secondary sexual characteristics , number of teeth can give a rough estimation of age. An MRI of the wrist joint ( the grading of fusion of the epiphyses & diaphyses of the distal end of radius) is used for age determination in the international competitions. But this is too expensive ( at least Tk 3500/ or $ 50 for every player) to detect the age randomly in the developing countries like Bangladesh.

In conclusion it is realized that a service of a team physician is one stop medical service for the players.

The doctors working in the different medical college hospitals, clinics, district & upazillas should be aware about the concept of sports medicine through seminar and symposiums. so that they become interested. The pharmaceutical companies can sponsor to organize such program.

The sport is not only a part of recreation. It helps to build up, restore and promote the health. It also helps to rehabilitate . So in essence it is also a part of health. Like army medical core (which is an integral part of the army) sports medicine is an essential parts of sports. So, we should think about the sports medicine when we think the health and sports of the nation.

The government of Bangladesh and the different related organizations like World Health Organization (WHO) and other international sports committees; federation and associations may help to set up an institute of sports medicine.