Stressing the importance of sports medicine

``PLAY SAFE'' and ``Prevention is better than cure'' are familiar phrases and coming from sports medicine experts they are pearls of wisdom. It is good for sportspersons to be ambitious and wanting to excel but keeping realistic goals can ensure a trouble-free career. Coming as it did from an Indian specialist in a field that is still nascent in the country, it truly puts the life of an Indian sportsperson in the right perspective. Dr. Tushar Mankad and Dr. Bharath Mody are two enterprising orthopaedic specialists from Baroda, the city which has given India, cricketers of note like Anshuman Gaekwad, Kiran More, Nayan Mongia and the latest wonder Zaheer Khan and a few roller skater champions. Not surprising then that they should be closely involved with the problems of knee and shoulder among sportspersons, the prime points in any cricket and roller skater exponent and be concerned as well with instances of poor awareness in training methods that form the cause of many a problem.

Like a few others in the field of sports medicine in India, both these enterprising men seemed keen to put in their knowledge and experience to remove the travails of sportspersons. Theirs may be a small effort yet to popularise the message of sports medicine in a world where several countries in Europe apart from U.S. are streets ahead. But the good news is that an effort is being made in India to streamline sports medicine so that society is better off and sportspersons in particular get rid of those nagging injury problems which often signal the end of a career. And here no praise can be too high for Dr. David V. Rajan and Dr. Sripathi Rao, two Ortho specialists from Coimbatore and Manipal, respectively, for their drive and interest to spread the message of sports medicine through an international conference held in Chennai.

`Challenges in the New Millenium: International standards in the treatment of sports injuries', which was the theme of the one-day conference evoked good response from various sections connected with sports. There were doctors, coaches, trainers, players, physical education students in the packed audience and in the end none, to use Dr. Mankad's remark: ``was nauseated by the overdose of lectures''. Instead it proved absorbing as was reflected from the lively interaction, with one participant who had come all the way from Visakhapatnam, wanting such conferences to be organised at various places in the country to make the impact more effective. Ultimately it is Indian sports that will be the biggest gainer.

Comparison is odious but if ever a study is made on why sports is a lot more vibrant in developed countries as compared to the rest of the world then one probable reason is `sports medicine expertise'. Ask Dr. Mark Fergusson, the specialist from Johannesburg or Dr. Alwin Jager from Frankfurt, who alongwith Dr. Dann Duplessis from Pretoria formed the international experts in the conference and it becomes clear that no sports programme in their countries is without a sports medicine expert. ``A coach, trainer and sports medicine doctor work in close cooperation'', said Dr. Jager of Germany where keeping the footballers in shape for instance is serious business. It is not for treatment of injuries alone that their services are needed but for scientific evaluation of performance, identifying the grey areas and help the sportspersons save injuries from lack of toning up of the weak areas.

In short it is a job that involves deep research for it is not a simple uncomplicated routine surgery or treatment that is called for but handling of limbs and arms of sportspersons with God- given talent and ensuring that they are back in their chosen field. ``Rehabilitation procedures now can assure a 95 per cent recovery for sportspersons from the 80 per cent earlier'', Dr. Fergusson was to state and there is still much more to be done. As was the theme of his topic on `Causes of pubic pain in the athlete' where he pointed out that injuries in the groin area continue to baffle the experts in so far as pin pointing the exact source of discomfort. An evolving science that sports medicine is, specific answers are bound to surface for sure even as fresher challenges surface.

A revelation from this conference, atleast from the Indian point of view was how little emphasis was given to `evaluation and preventive aspects of injuries' in several of the training programmes. True, at the Tata Football Academy, the `footballers of tomorrow' are brought up on scientific lines with periodical evaluation but as Dr. Mankad was to reveal from his experience in Baroda after examing a host of junior cricketers aspiring to don the state and national colours, that `most of them had a tender rotator cuff of the dominating arm (the throwing arm) as compared to the other'. While Dr. Mody felt that for proper all round muscular balance, sports-minded children should not be driven to early specialisation in sports in the formative years to avoid what he called the problems stemming from `chronic overuse and acute overload'. On the other hand, Dr. David Rajan emphasised the vital need for use of proper equipment in sports to avoid ortho-related injuries. ``Withdraw a child from a competition if the facilities are poor'' was his advice to one parent and that could be the universal truth for anyone in pursuit of sports excellence.

Among the foreign specialists, the focus was on Dr. Fergusson because cricket and his patient Javagal Srinath's recovery from rotator cuff injury had put him in a different pedestal. Incidentally he was the cause for a brief ripple at the venue when Anil Kumble, the star spinner, dropped in just to have his sore shoulder examined by the South African. Details of the examination were sought to be kept in wraps but the jovial man was clear he had picked up a fresh challenge. ``I am already delighted hearing of Srinath's progress and the way he took three wickets in the Dhaka Test. I am sure to hear more from him'', said Dr. Fergusson on his first visit to India. Cricketers and rugby players occupy his attention in South Africa and like any South African interested in cricket, he was shocked on Cronje's fall. ``He was such a good captain'', he said, signing off wistfully.

The, leg, heel, knee and shoulder, injury prone areas were touched upon to provide a variety of views but the end message was simple and clear: for a new generation of specialists to emerge and uplift the level of proficiency in sports. That is the bright side of sports medicine but as Dr. Fergusson and Dr. Jager mused: ``our prayer is that it should remain that way'', alluding to the sinister angles being attached to sports performances lately through drug therapy and the like. ``It is ugly and dangerous'' but politics is everywhere, Dr. Jager said. ``I will say gene therapy for instance will revolutionise the treatment and rehabilitation process in injured sportspersons but there are inherent dangers too'', he opined, preferring to leave the unimaginable left unsaid.

S. R. SURYANARAYAN

Chennai

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