Tag: sports medicine

Head Games

Unecessary Roughness

Concussions are the talk of sports these days.  Ex-NFLers are filing suits against the league saying it is clear that the league knew about the dangers of head trauma, knew them a long time ago but, did nothing.  Parents in the U.S. and Canada are starting to pull their elementary and junior high kids out of tackle football and hockey leagues that permit body-checking.  Even the President has talked about his own experience with concussions (mild he was quick to note!) and convened a high level summit at the White House of all the movers and shakers in the field to discuss the problem.

The NFL is so freaked out about the threat concussions pose to the long-term profitability of the sport that they are trying to calm worried moms with ad campaigns that tout the certification of coaches who teach the ‘safe’ way to play (good luck with that).  And arguments are breaking out about whether there is too much emphasis on football and men’s hockey when wrestling, lacrosse, soccer, martial arts, and women’s basketball have their own problems with keeping player’s heads intact (kind of an odd form of anti-discrimination).  Some sports experts are even bemoaning the fact that the emerging obsession with preventing, diagnosing and treating concussions is diverting too much attention and resources away from other serious health issues that athletes face including bullying, eating disorders, orthopedic injuries and the abuse of legal and illegal drugs.

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A Modest Proposal for Dealing with Cheating in Professional Sports: Fuhgettaboutit.

Watching pro sports today is nothing more than gazing from one high-priced moral train wreck to another. To wit, Ryan Braun, the disgraced Milwaukee Brewers outfielder, has finally been bounced from baseball for use of performance enhancing drugs. Braun and his duplicitous, two-wheeled compatriot, Lance Armstrong, have not only made fools of us but succeeded in making perpetual fools of themselves through excuses (“I didn’t do it!”) and accusations (“They’re picking on me!”) that would embarrass a fourth grader.

How easily we cleave morality from the athletic excellence. How often have you heard commentators decry the cheating, but then soften the blow by saying “but, he’s not a bad guy,” or, in the case of Armstrong, “he’s done so much for the cancer community?” The inescapable conclusion is that you can be a liar, a jerk, and a cheat (an ignominious trifecta true of both Braun and Armstrong, as well as their predecessor in sleaze, Barry Bonds), but the absolution of milquetoast praise from an airy talking head is only as far away as your latest convivial act, regardless of whether any actual contrition or repentance took place.

This is an all new kind of dualism (but, I think, just as repugnant and ludicrous as the original foisted upon us by Descartes). I prefer to think of people as integrated beings, whose behaviors and speech accurately reflect both who they are and what they are capable of. I know of no body of work describing Braun and Armstrong as anything other than not-so-bright, raging egomaniacs. Maybe that’s what you need to succeed at professional sports, with a little chemical assist, of course.

The way to handle this crisis of faith is to remove all controls. On my own blog, I once proposed a more market-based approach to dealing with sports cheats. I have thought better of that now, and I believe it’s time to actually undo all restraint. I say that all professional sports just unchain the chemists and let the athletes use whatever they want, whenever they want. We’ll find out quickly who passed high school chemistry and who didn’t. Even better, turbo charge the free-for-all by statutorily shielding product manufacturers and complicit medical professionals, so that 20 years from now we are spared the “they didn’t tell me it would cause congestive heart failure and brain cancer” lawsuits.

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Think NCAA Athletes Shouldn’t be Paid? What the Kevin Ware Story Says About the Risks of College Sports

In many ways, it had been an exemplary few days for the NCAA and its signature basketball tournament—a weekend that put the madness back in March.

On Friday, Michigan and star guard Trey Burke completed an epic comeback over Kansas. On Saturday, Cinderella team Wichita State crashed the Final Four.

But for many people watching the Louisville-Duke game unfold, a disturbing injury to Louisville guard Kevin Ware illustrated a different sort of madness: the continued lack of compensation for the players who make the tournament so special.

“Pray for [Ware],” columnist Dave Zirin tweeted. “There is no safety-net for the injured NCAA athlete.”

Injury worst seen on TV

Ware’s broken leg—”about the most gruesome injury I’ve seen in a basketball game,” bemoaned analyst Seth Davis—came on a routine play, as he landed awkwardly after trying to block a shot by Duke’s Tyler Thornton.

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Heroes and Villains

“Lance Armstrong is a bad guy who has done some very good things.”

These are the words of a sports radio personality I listened to yesterday. He was obviously commenting on the confession (to my pal Oprah) by Armstrong about his use of performance enhancing drugs. The sportscaster, along with many I heard talk on the subject, were not as upset by the fact that Armstrong used the banned substances, or his lies on the subject, but the way he went after anyone who accused him of what turned out to be the truth. Armstrong used his position of fame and power, along with his significant wealth, to attack the credibility of people in both the media and in the courtroom. The phrase, “he destroyed people’s lives” has been used frequently when describing his reaction to accusations.

It’s a horrible thing he did, and shows an incredibly self-centered man who thought the world should bend to his whim. It’s more proof to the adage: absolute power corrupts absolutely.

But simply dismissing Lance as a cad or a horrible person would be far easier if not for the other side of his life. In his public battle against cancer, he inspired many facing that disease to not give up their battle. Even for those who eventually lost, the encouragement many got from Armstrong’s story was significant. On top of that, the Livestrong foundation did much to raise money and awareness for cancer and for other significant health issues. This foundation exists because of the heroic story of Lance’s successful battle to beat cancer, as well as his subsequent cycling victories. Whatever the lies he told in the process, he did beat cancer and he did win the Tour de France multiple times.

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The PED Question

I am a fan of the Olympic Games and look forward to them every four years.   I was an All-American sprinter myself, having competed against some Olympic medalists, and have a special interest in Track and Field. This is the perfect example of a sport that doesn’t get so much exposure outside of the Summer Olympics, so the events become a stage for athletes in these fields to shine in the rarer-than-usual limelight. The 2012 Olympic Games are underway and as a former athlete and fan, I am looking forward to some amazing performances.

But I am also a sports medicine physician and have treated many elite level athletes, including Olympic Champions. This adds an additional perspective for me as an onlooker- layered within a former athlete, fan, and doctor-and one that I have a hard time coming to grips with. The 2012 Olympic Games are underway and I am looking forward to some amazing performances. The question is, will I believe them?

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You Want to Sue Me?

“I’d be lookin’ to sue you.”

I’m sorry, what?? That is what I heard from the mother of one of my patients. I was evaluating a high school athlete who had recurrent stingers (nerve injury that affects an upper limb, usually resolves with time) and a possible episode of transient quadriparesis (affecting all limbs this time). I wasn’t on the sidelines for these injuries, so I had to go on the reports given to me by the athlete and the school’s athletic trainer. However, with that information, I did not want to clear this player to return to football until I could be certain he didn’t have any cervical stenosis or any other abnormality that might put him at risk for permanent damage if he suffered another neck injury.

I told the athlete and his mother that I needed to get an MRI of his cervical spine (neck) in order to determine this. The athlete was understandably upset with my decision, but his mother supported my decision to proceed with caution. She explained to me that if her son played again, sustained another injury, and something “bad” happened, she would be more than happy to take legal action against me. Fantastic.

First of all, I can’t say that I would blame her for being angry (at the very least) if I screwed up. But to tell me in my office, to my face, that she’s already thinking about suing me? I found that ridiculous. I must be in the minority, however. If you Google “how to sue a doctor,” an abundance of information follows. There’s an “ehow” on the subject, and even CNN offers an opinion.

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