Editor-in-Chief Dr Peter N. Sperryn I - I _ MB,FRCP,FACSM, DPhysMed AV ~ Editor Emeritus Dr Henry Evans Robson if iA qfif Adf~ Editors Surgery: Mr Paul G. Editorial Board Prof. Tim D. Noakes, Dr David A. Cowan, MD,FACSM (Cape Town, South Africa) Stableforth BPharm, PhD, MRPharmS (London, UK) Prof. Qu Mian-Yu, MB,FRCS (Bristol, UK) Dr Wendy N. Dodds, (Beijing, China) Science: Dr Ron Maughan BSc,MRCP (Bradford, UK) Dr Allan J. Ryan, PhD (Aberdeen, UK) Dr Adrianne Hardman, (Edina, Minnesota, USA) PhD (Loughborough, UK) Prof. Roy J. Shephard, Physiotherapy: Mr Julius Sim Mr Basil Helal, MD,PhD (Toronto, Canada) BA,MSc,MCSP MCh(Orth), FRCS (London, UK) Prof. Harry Thomason, (Coventry, UK) Dr G.P.D. Hermans, MSc,PhD (Loughborough, UK) MD (Hilversum, Netherlands) Dr Dan S. Tunstall Pedoe, Statistical Consultants Prof. Ludovit Komadel, MA, DPhil, FRCP (London, UK) Mr F.M. Holliday, MA,DLC,FSS MD (Bratislava, Czechoslovakia) Prof. Clyde Williams, (Loughborough, UK) Prof. W.P. Morgan, PhD (Loughborough, UK) Mr Simon Day, BSc (London, UK) EdD,PhD (Madison, Wisconsin, USA) Dr William F. Webb, MB,BS (Sydney, Australia) Regional Corresponding Editors Belgium: Prof. M. Ostyn, Hong Kong: Dr J.M. Chan, New Zealand: Dr Chris Milne, MD Leuven. FRCS (Hong Kong). MB,ChB,DipSportsMed (Hamilton). Brazil: Prof. Eduardo DeRose, Hungary: Dr Robert Frenkl, Pakistan: Dr Nishat Mallic, MD (Porto Allegre). MD (Budapest). MB,BS,DPMR (Karachi). Bulgaria: Dr Virginia Michaelova, India: Dr D.P. Tripathi, Spain: Dr J.J. Gonzalez Iturri, MD (Sofia). MB,BS,MCCP (Patna). MD (Pamplona). Cote D'Ivoire: Prof. Constant Roux, Indonesia: Dr Hario Tilarso, Thailand: Dr Charoentasn Chintanaseri, MD (Abidjan). MD (Jakarta). MD (Bangkok). France: Dr Pierre Berteau, Malaysia: Dr Ronnie Yeo, Uganda: Dr James Sekajugo, MD (Rouen). MD (Kuala Lumpur). MB,Dip.SportsMed. (Kampala). Groupement Latine: Maroc: Dr Naima Amrani, USSR: Dr Sergei Mironov, Dr Francisque Commandr6, MD (Rabat). MD (Moscow). MD (Nice).

Publishing director: Charles Fry UK and Overseas subscription orders Copyright: All rights reserved. No part of Managing Editor: Mary Korndorffer should be sent to Westbury Subscription this publication may be reproduced, stored Executive Editor: Nick Mowat Services, P.O. Box 101, Sevenoaks, Kent in a retrieval system or transmitted, in any Editorial Assistant: Anne Thomas TN15 8PL, UK. Tel (0732) 885833; Telex: form or by any means (electronic, Production controller: Margaret Smith 95678; Facsimile: (0732) 884079; Cable: mechanical, photocopying, recording or Westbury, Sevenoaks, Kent. otherwise) without the written permission of the Publisher. Readers who require Advertisement Information: Display North American subscriptions orders copies of papers published in this journal advertisement space is offered within the should be sent to Journals Fulfilment may either purchase reprints or obtain British Journal of Sports Medicine with a Department, Butterworths, 80 Montvale permission to copy from the publisher. For comprehensive range of advertisement Avenue, Stoneham, MA 02180, USA. Tel: readers in the USA, permission to copy is options available. Loose and bound-in (617) 438 8464; Telex: 880052. given on the condition that the copier pay inserts are also invited. For further the stated per copy fee through the information please contact Mark Butler. Annual Subscription to the British Journal Copyright Clearance Center, Inc., 21 of Sports Medicine (4 issues): Congress Street, Salem, MA 01970 for UK £35.00. copying beyond that permitted by Sections The British Journal of Sports Medicine is Overseas £42.00. 107 and 108 of the US Copyright Law. Fees published quarterly by Butterworth appear in the code that appears at the foot of Scientific Limited on behalf of the British Some Back issues prior to the current the first page of each paper. Association of Sports Medicine. Editorial, volume are available from: Dr Henry Evans Robson, 43 Westfield Lane, Rothley, Advertisement and Reprint Offices, (©1989 British Association of Sport and Butterworth Scientific Limited, P.O. Box 63, Leicester LE7 7LH, UK. Medicine. Westbury House, Bury Street, Guildford, ISSN 0306-3674 Surrey, GU2 5BH, UK. US mailing agents: Application to mail at CODEN: BJSMDZ Telephone (0483) 300966 second class postage rates is pending at Telegrams and Telex 859556 SCITEC G Rahway, NJ, USA. Postmaster: Send Facsimile (0483) 301563 address corrections to British Journal of Typeset by Enset (Photosetting), Midsomer Registered office: Butterworth Scientific Sports Medicine, c/o Mercury Airfreight Norton, Bath, Avon. Limited, 88 Kingsway, London WC2 6AB, International Ltd, 2323 Randolph Avenue, Printed by the Cambridge University Press, UK. Avenel, NJ 07001, USA, for further details. Cambridge, UK. From the Governing Bodies Development cooperation

I The aim of IAAF's development co- programmes. These courses are the The IAAF has cooperated with the operation is to raise the general primary activities at the IAAF's Reg- International Athletic Foundation to standard of athletic performances ional Development Centres. The produce two special booklets. The throughout the world, primarily by RDCs, which serve as focal points for first, entitled Save the future - Save promoting improvements in coaching, athletic development within the six yourself covers the subject of doping officiating and administration. IAAF areas of Africa, Asia, Europe, in sport. The second, entitled Too thin To achieve this aim, the IAAF De- North and Central America, Oceania to win examines the problem of velopment Department works together and South America, are the IAAF's anorexia nervosa and bulimia in ath- with a number of individual, institu- most ambitious development letics. Both booklets are available free tional and governmental partners. The scheme. At this moment four such of charge from the IAAF. variety of means used include: centres are functioning, one in Asia In addition, the IAAF medical com- 1 Short coaching courses (7-21 Jakarta), two in Africa (Nairobi and mittee has supported two medical days) These courses are designed to Cairo) and one in North and Central congresses, the first at Helsinki on the introduce all events of the sport and America (Puerto Rico). Other RDCs occasion of the 1st World Champion- then increase knowledge ofcoaching are planned for South America, ships in Athletics in 1983, and the techniques and theory in order to Oceania, Portuguese speaking Af- second at Canberra, during the IVth build a base of competent coaches in rica and French speaking Africa. World Cup in Athletics in 1987. Infor- the country or countries involved. 5 The production and dissemina- mation on obtaining the proceedings The number of lecturers on these tion of coaching and officiating liter- from these congresses can be obtained courses is generally two to three and ature and audio-visual aids, primar- from the IAAF Development Depart- the number of participants between ily for use during courses and semi- ment, 3 Hans Crescent, Knights- 30 and 40. nars but also for sale at a low cost to bridge, London SW1X OLN, . 2 Short officiating courses (3-5 coaches, officials and the general days) These courses are generally public. held on the two to three days pre- The main targets for all IAAF de- ceeding an important championship velopment cooperation projects are the News snips meeting, with the IAAF experts stay- developing countries, with the prim- ing on to advise during the actual ary objective being to help these coun- We congratulate our active member athletic meeting. The lecturers gen- tries to stand on their own feet and to Archie Young Jnr. on his appointment erally number two and participating develop their own well structured to the new Chair of Geriatric Medicine officials between 30 and 50. coaching and officiating schemes. By at the Royal Free Hospital, London. 3 Administration courses (3-7 days) concentrating on increasing both the These courses will normally be held quality and quantity of coaches and We are delighted to receive the first on occasions when the officers from officials it is hoped that eventually a annual report of the Zimbabwe Sports IAAF Member Federations are sufficiency of capable and enthusiastic Medicine Association, to whom BASM gathered together; e.g. at the time of athletic leaders and developers within has offered fraternal links. It was an Area or IAAF Congress or a major each country will be achieved. This will formed following the successful IOC championships. The purpose of reduce the dependence of these coun- continental sports medicine course in these courses is to assist the federa- tries on the more advanced countries Harare in 1987, organized by Prof tions to fulfil their responsibilities to and even allow them to assist other Constant Roux of Cote D'Ivoire, BJSM the IAAF and the sport of athletics in countries within their area. regional contributing editor, with the their country by informing them Many of the graduates from the participation of BASM's Craig Sharp about proper and up to date adminis- IAAF diploma courses are involved in and Peter Sperryn as visiting lecturers. trative and organizational setting up and running their national techniques. development programmes and some A WHO/FIMS position statement on Last year, some 52 of these three have already served successfully as AIDS and sports has been issued and types of courses, attended by more IAAF lecturers outside their home- will be printed in full (p. 132 this issue). than 2000 coaches or officials under lands. They have given us a taste of In abstract, there is a very low trans- the instruction of 70 expert lecturers, what we may expect in the future, pro- mission risk for AIDS in sport, no case were organized under the auspices vided that the initial momentum is for screening athletes, no danger from of the IAAF Development Depart- maintained. swimming pools, communal baths or ment. The IAAF recognizes the value of a showers. The now standard precau- 4 Diploma coaching course (3-4 sound knowledge of the relevant as- tions should be followed in dealing months) and Specialist event coach- pects of sports medicine to both with open wounds or blood, with ing courses (21 days) These courses coaches and officials and includes, in particular reference to body-contact are designed to give coaches a strong its course syllabuses, adequate time for sports. general background and specialist instruction and discussion of such knowledge of a particular event topics as Prevention and treatment of in- group in order that they may return juries, Diet, Doping control, Femininity has also to their countries and serve as ex- control, The physiology of exercise and linked with the Royal College of Sur- perts in national coaching education Sports psychology. On most occasions, it geons of Edinburgh to do research in is possible to use the services of sports medicine, initially into the (C) 1989 Butterworth & Co (Publishers) Ltd specialists in sports medicine from the relationship between injuries and 0306-3674/89/020069-01 $03.00 host country for this purpose. playing surfaces.

Br. J. Sp. Med., Vol. 23, No. 2 69 From the Journals

90N sPb medicine awareness service Sports current %. .'

Prepared by the London (e.g. high intensity galvanic part in mild to moderate recreational stimulation, ultrasound). Successful and work-related physical activity with Sports Medicine Institute management depends on the active proper education and precautions. (LSMI) Library involvement of the patient in the The current public health guidlines rehabilitation programme. regarding transmission of Human Athletes are exposed to a whole The following summaries are taken Immunodeficiency Virus (HIV) also spectrum of skin diseases that may or to from a selection of recent journals apply recreational and professional indexed in the LSMI database. A full may not be unique to a particular sport athletes. The increasing scientific data listing is published monthly in Sports or activity, (Kantor G.R. and Bergfeld concerning AIDS (Calabrese L.H. and Medicine Bulletin. W.F. Common and uncommon Kelley D. AIDS and athletes Physician dermatologic diseases related to sports and Sportmedicine 1989, 17(1), 126-130) activities Exercise and Sport Sciences supports the position that most It is well known that progressive Review 1988, 16, 215-253). These individuals infected with HIV can and weight loss occurs during high disorders may be classified into the should remain physically active and mountain expeditions. However, it is broad categories of physical factors may participate in most sports. In unknown whether this loss occurs due (e.g. blisters, calluses, abrasions, situations where transmission of HIV to hypoxia, inadequate diet, frostbite and sunburn), infections and may be of concern, prudent action or malabsorption or environmental infestations (bacterial and viral), intervention is all that is needed to stress. In Operation Everest II: contact dermatitis and exacerbation of alleviate the risk. Nutrition and body composition pre-existing disease. These diseases Head injuries in soccer have featured (Rose, M.S. et al., Journal ofApplied are usually minor, with the exception in the recent literature. Two articles Physiology 1988, 65(6), 2545-2551) it is of infections, which may prevent an describe a computer simulated reported that prolonged exposure to athlete from participating in specific estimation of risk of head injury increasing hypobaric hypoxia is activities such as contact sports. (Schneider K. and Zernicke R.F. associated with a large reduction in Clinical aspects and treatment of Computer simulation of head impact: body weight and decreased preference common skin diseases is described, as Estimation of head injury risk during for carbohydrates. This study suggests well as newly recognized soccer heading International Journal of that hypoxia alone can be a sufficient dermatological diseases related to Sport Biomechanics 1988 4(4), 358-371 cause for the weight loss and decreased sports activities. and Schneider K. A computer- food consumption reported by The medical debate and controversy simulated estimation of the risk of mountain expeditions at high altitude. concerning the ethics of boxing is once injury from soccer 'Headers' The physiological and anatomical again highlighted in Boxing and the Sportwissenschaft 1988, 18(4), 421-7 In changes that occur with ageing are brain (Corsellis J.A.N. British Medical German). The authors suggest that the reviewed in Exercise and the elderly journal 1989, 298(6666), 105-109). risk of injury can be reduced most (Stamford B.A. Exercise and Sport Clinical and pathological aspects of substantially by increasing the mass Sciences Reviews 1988, 16, 341-379). A 'punch drunkenness' and the resultant ratio between head and impacting selective presentation of the literature neurological damage is examined. body. A third article, Head injuries in gives scope to the broad array of New results confirm what many soccer (Fields K.B. Physician and inherent problems and body doctors have suspected for years-that Sportmedicine 1989, 17(1), 69, 72-73) knowledge concerning physical pronounced brain damage in boxers discusses the mechanisms of injury, performance and the elderly. may go completely undetected if an such as heading the ball improperly, Diagnosis and management of examination is limited to traditional making head to head contact or perhaps the most troublesome, tests . The author outlines his collision injuries when the head strikes ubiquitous overuse syndrome in the opposition to continuation of the sport. the goalpost, the playing field, or sports world is discussed in Anterior In recent years there has been another player's elbow, foot or head. knee pain (Chondromalacia patellae) considerable interest in the interactions The author contends that rule changes Garrick J.G. Physician and Sports of exercise, physical training and the and other measures may be more Medicine 1989, 17(1), 75-6, 81-4). diabetic state. In Exercise and type I appropriate than the use of helmets to Complaints of insidious onset of diabetes mellitus (Vitug A, Schneider prevent head injuries. vague, activity-related pain coupled S.H. and Ruderman N.B. Exercise and It appears that physical activity has a with evidence of wasting the vastus Sport Sciences Reviews 1988, 16, 285-304) range of effects on both female and medialis muscle usually establish the the effects are found to differ among male reproductive function depending diagnosis. The alleviation of symptons different subgroups of patients with upon the intensity and duration of and strengthening of the vastus diabetes. The risks and benefits, while activity and fitness of the individual. medialis are the two major goals of somewhat controversial, are Two recent articles in Sports Medicine treatment, which may include dependent on the specific type of have reviewed this controversial area. nonsteroidal anti-inflammatories, diabetic syndrome, as well as the state In The effects of exercise on icing, and physical therapy modalities of metabolic control. This review reproductive function in men concludes that most patients with type (Cumming D.C. Wheeler G.D. and 1989 Butterworth & Co (Publishers) Ltd I diabetes mellitus who do not have McColl E.M. Sports Medicine 1989, 7(1), 0306-3674/89/020070-02 $03.00 major vascular complications can take 1-17) it was found that strenuous

70 Br. J. Sp. Med., Vol. 23, No. 2 exercise and training influence the controversial underlying mechanisms minimising the adverse effects of short-and-long-term function of the suggesting further research is dehydration. There remains current reproductive axis in men in a manner necessary. debate over the effects of drink volume which appears similar to the changes in The resting bradycardia of and electrolyte concentration on gastric women. While there is increasing endurance training is a well- emptying and fluid absorption during acceptance that changes do occur, established phenomenon. However, prolonged exercise under warm there is little consensus as to the the mechanisms responsible have not ambient conditions. mechanisms of the specific changes. been conclusively resolved. In Exercise Medial tibial syndrome is a common Further investigation within the training bradycardia: The role of overuse injury which mainly effects various hormonal systems influencing autonomic balance (Smith M.L. et al., endurance athletes and joggers reproductive function in men is Medicine and Science in Sports and (Jarvinnen M, Aho H. and Niittymaki essential. In Athletic amenorrhea: An Exercise 1989, 21(1), 40-44) it was found S. Results of the surgical treatment of update of aetiology, complications that endurance trained subjects the medial tibial syndrome in athletes and management (Highet R. Sports adapted to exercise training with a International Journal of Sports Medicine Medicine 1989, 7(2) 82-108) a review of decrease in the intrinsic heart rate 1989, 10(1), 55-7). Fasciotomy of the current literature examines the many (determined by selective deep posterior compartment may be factors associated with and pharmacological blockage) and an beneficial if conservative treatment disturbances resulting from increase in the predominance of fails. This paper reports on 34 patients overtraining, strenuous exercise and parasympathetic autonomic control at on whom a fasciotomy was performed competition in female athletes. As rest. This change was reflected by a between 1975-1984. In 21 patients (78 increasing numbers of women become moderate increase in parasympathetic per cent) of those 27 who could be involved in strenuous exercise it is influence which was augmented by a followed up, the final result was apparent that reproductive function slight decrease in sympathetic control. excellent or good, in four (15 per cent) may be affected. The results may range In the study Gastric emptying fair and only in two (7 per cent) poor. from various forms of menstrual during prolonged cycling exercise in Fasciotomy is a simple operation and dysfunction, including delay in the heat (Ryan A.J. et al., Medicine and can be performed as an outpatient menarche, altered pubertal Science in Sports and Exercise 1989, 21(1), procedure under local anesthesia. For progression, defective luteal phase, 51-58) it was found that cardiovascular bilateral symptoms, the authors anovulation, amenorrhoea and and thermoregulatory function were recommend two separate procedures infertility. The primary factors well maintained by ingesting eitherfive with a time interval ofabout two weeks associated with these disturbances per cent carbohydrate drinks or water. to avoid postoperative haematoma and include body composition, training With sweat rates as high as 1.0 litre/ difficulties in mobilization often seen intensity and diet. Research evaluating hour, large volumes of either of these when operated simultaneously. the neuroendocrinological background liquids helped achieve a balance to these disturbances has produced between rehydration and fluid loss,

* Sports Medicine Bulletin is a monthly specialist bibliography pro- viding an ideal way of keeping up- to-date with current research and ideas dicine in sports medicine and applied physiology. Bulletin * Sports Medicine Bulletin con- tains citations from the international sports medicine literature and from a Medicine Institute and the British Lib- wide range of scientific and medical rary Medical Information Service. publications. * Subscriptions to Sports Medicine * Sports Medicine Bulletin is divided Bulletin are £30.00/annum (12 issues). into subjects sections and includes Cheques should be made payable to author and subject indexes. London Sports Medicine Institute. * A photocopy service is offered in The Library, conjunction with Sports Medicine London Sports Medicine Institute, Bulletin. c/o Medical College of St Bartholomew's Hospital, * Sports Medicine Bulletin is pro- Charterhouse Square, duced jointly by the London Sports London EC1M 6BQ.

Br. J. Sp. Med., Vol. 23, No. 2 71 Marathon finishers and pre-race drop-outs: P.J. Clough et al. 4 Brown, R.S., Ramirez, D.E. and Taub, J.B. -The pre- 8 Dishman, R.K. 1988 Exercise Adherence: Its impact on scription of exercise for depression Phys Sports Med public health Champaign, Illinois, Human Kinetics 1978, 1, 34-45 9 Stephens, T. Secular trends in adult physical activity: 5 Kaufman, S., Kaufman, B., Reynolds, D., Trayner, I. exercise boom or bust? Res Q Exerc Sport 1984, 58, 94- and Thompson, G.R. Effects of jogging on serum low 105 density lipoprotein cholesterol Artery 1980, 7, 99-108 10 Fletcher, K.P. and Eadie, D. Pre-race drop-out from 6 Summers, J.J., Machin, V.J. and Sargent, G.I. Psycho- the Glasgow marathon Br I Sports Med 1986, 20, 74-76 social factors related to marathon running J of Sports 11 Clough, P.J., Dutch, S., Maughan, R.J. and Shepherd, Psychol 1983, 5, 314-331 J. Pre-race drop-out in marathon runners: reasons for 7 Roskamm, H. Optimum patterns of exercise for withdrawal and future plans Br I Sports Med 1987, 21, healthy adults Canad Med Ass 1967, 96, 895-900 148-149

Physiological and Clinical Problems Following Cold Water Immersion BASM Symposium: Saturda ber 1989 The Lo H ospital, chapel

Pro

1230- w ~ . L g fo

Briish icMedical Northwick ParkHospital 1.00-1.30 p.m. Open Forum All queries concerning the symposium should be addressed to: Ms. Nancy Laurenson, Education Officer, BASM, C/O London Sports Medicine Institute, St. Bartholomews Medical College, Charterhouse Square, London, EC1M 6BQ, UK. Tel: 01-253-3244

Br. J. Sp. Med., Vol. 23, No. 2 101 Endurance running and asthmatics: W. Freeman et al. 24 Henrikssen, J.M. Training induced adaptation of Changes in V02 max and running performance with skeletal muscle and metabolism during submaximal training Eur I Appl Physiol 1978, 34, 249-254 exercise J Physiol 1977, 270, 661-675. 30 Schnall, R., Ford, P., Gillam, I. and Landau, L. Swim- 25 Ekblom, B., Astrand, P.O. Saltin, B., Stenberg, J. and ming and dry land exercises in children with asthma Wallstrom, B. Effect of training on circulatory response Aust Paediatr J 1982, 18, 23-27 to exercise I AppI Physiol 1968, 24, 518-528. 31 Eggleston, P.A. Laboratory evaluation of exercise- 26 Skinner, J.S. and McClellan, T.H. The transition from induced asthma: Methodologic considerationsj Allergy aerobic to anaerobic metabolism Res Quart 1979, 51, Clin Immunol 1979, 64(6), 604-608 234-248 32 Shapiro, G.G., Pierson, W.E., Furukawa, C.T. and 27 Flint, M., Drinkwater, B. and Horvath, S. Effects of Bierman, C.W. A comparison of the effectiveness of training on womens response to submaximal exercise free running and treadmill exercise for assessing exer- Med Sci Sports 1974, 6, 89-94 cise induced bronchospasm in clinical practice JAllergy 28 Smith, D.P. and Stransky, F.W. The effect of training Clin Immunol 1979, 64(6), 609-611 and detraining on the body composition and cardio- 33 Bake, B., Milllqvist, E., Bengtsson, B. and Lowhagen, vascular response of young women to exercise J Sports 0. A breathing filter preventing exercise-induced Med 1975, 16, 112-120 asthma Bull Europ Physiopath Resp 1986, 22, (Suppl 8), 29 Daniels, J.T., Yarborough, R.A. and Foster, C. 99s British AssociationSof Sport and Medicine ANNUAL CONGRESS 1989 will be held at the SELSDON PARK HOTEL Addington Road, South Croydon, Surrey Friday 10 November to Saturday 12 November A full programme is planned including Ethics, Treatment, Imaging and Diet. The package costs include all meals and the gala dinner on Saturday evening with VIP speaker. Details will be sent to members. FEES: BASM members: full weekend £180 sharing, £190 single room Non-members: £195 sharing, £205 single room Sessional attendance: £35 daily members, £40 non-members includes dinner Friday; lunch Saturday; lunch Sunday Gala dinner Saturday £15.50 extra. Enquiries to: Honorary Secretary, BASM, Dr. Peter L. Thomas Reading Clinic 10 Eldon Rd Reading RG1 4DH Tel. 0734-502002

122 Br. J. Sp. Med., Vol. 23, No. 2 Continuous shortwave diathermy: Geoffrey C. Goats 36 Vanharanta, H., Eronen, I., Videman, T. Shortwave 40 Wright, V. Treatment of osteoarthritis of the knee Ann diathermy effects on S3-sulfate uptake and Rheum Dis 1964, 23, 389 glycosaminoglycan concentration in rabbit knee tissue 41 Clarke, G.R., Willis, L.A., Stenners, L., Nichols, P.J.R. Arch Phys Med Rehabil 1982, 63, 25-28 Evaulation of physiotherapy in the treatment of osteo- 37 Lehmann, J.F., Masock, A.J., Warren, C.G., Koblanski, arthritis of the knee Rheumatol Rehabil 1974, 13, 190-197 J.N. Effect of therapeutic temperatures on tendon extens- 42 Hamilton, D.E., Bywaters, E.L.G., Please, N.W. A con- ibility Arch Phys Med Rehabil 1970, 51, 481-487 trolled trial of various forms of physiotherapy in arthritis 38 Warren, C.G., Lehmann, J.F., Koblanski, J.N. 1976. Heat Brit Med.11959, 1, 542-544 and stretch procedures: an evaluation using rat tail ten- 43 Quirk, A.S., Newman, R.J., Newman, K.J. An evalu- don Arch Phys Med Rehabil 1976, 57, 122-126 ation of interferential therapy, shortwave diathermy and 39 Gibson, T., Winter, P.J., Grahame, R. Radiotherapy in exercise in the treatment of osteoarthrosis of the knee the treatment of osteoarthritis of the knee Rheumatol Physiotherapy 1985, 71, 55-57 Rehabil 1973, 12, 42

BASM Introductory Sports Medicine Course Hall National Sports Centre 1 October-6 October, 1989

This is an intensive residential introductory course in Sports Medicine designed primarily for general practitioners and physiotherapists. Previous ex- perience in Sports Medicine is not essential. The course will focus on the various disciplines within Sports Medicine including: Exercise physiology; Travel medicine; Injury diagnosis and treatment; Rehabilitation; Nutrition; Acclimatization; Sport biomechanics; Sports psychology; Team care. Lilleshall Hall is one of the Sports Councils National Sports Centres new Newport, and is about 30 miles North West of Birmingham. Accom- modation is in single and twin-bedded rooms. The course fee includes a reception and dinner for all the delegates. In addition, the sporting facilities at Lilleshall are open to residents on the course. Course Fee: £220.00 BASM member ... inclusive of accommodation and food £255.00 Non-member ... inclusive of accommodation and food £155.00 Non-resident Applications should be sent to: Ms. Nancy Lauren- son, Education Officer BASM, London Sports Medicine Institute, St. Bartholomews Medical Col- lege, Charterhouse Square, London, EC1M 6BQ, UK. Tel: 01-253-3244 *A provisional programme will be sent upon return of the book- ing form and receipt of deposit. *Closing date is 31 August, 1989. Olt is advisable to apply early as this course usually has a long waiting list. *A nonrefundable deposit of £50.00 is required when booking a place on the course. *The remaining balance will be due no later than 31 August, 1989. *Please make cheques payable to British Association of Sport and-Medicine.

Br. J. Sp. Med., Vol. 23, No. 2 127 Position Statements- World Health Organization (WHO) World Federation of Sports Medicine (FIMS) Consensus statement on AIDS and sports

Sports physicians, officials of sports tact and other sports where bleeding bility of any athlete participating organizations and public health profession- may be expected to occur. In such in a combative sport with direct als are frequently asked about AIDS and sports, the following procedures body contact who has a wound or sports activities. To provide guidance on should be considered: other skin lesion to report it im- these questions, a consultation on AIDS (a) If a skin lesion is observed, it mediately to a responsible official, and sports was convened in Geneva on 16 should be immediately cleansed and to report for medical atten- January 1989 by the World Health Or- with a suitable antiseptic and sec- tion. ganization's Global Programme on AIDS in urely covered. (c) HIV is not transmitted through collaboration with the International Federa- (b) If a bleeding wound occurs, the saliva, sweat, tears, urine, tion of Sports Medicine. Participants individual's participation should respiratory droplets, hand-shak- included representatives of the Medical be interrupted until the bleeding ing, swimming pool water, com- Commission of the International Olympic has been stopped and the wound munal bath water, toilets, food or Committee, the International Federation of is both cleansed with antiseptic drinking water. Sports Medicine, the International Federa- and securely covered or occluded. 5 There is no medical or public health tion for Wrestling and the International 3 As in other health care settings, for justification for testing or screening Rugby Football Board, several experts on the safety of personnel drawing for HIV infection prior to participa- epidemiological and public health aspects of blood samples from athletes, pro- tion in sports activities. AIDS, and staff of the Global Programme tective gloves should be worn. 6 Persons who know they are HIV-in- on AIDS. 4 Sports organizations, sports clubs fected should seek medical counsel- and sports groups have -special ling about further participation in 1 No evidence exists for a risk of trans- opportunities for additional mean- sports in order to assess risks to their mission of the human immunodefi- ingful AIDS education of athletes, own health as well as the theoreti- ciency virus (HIV) when infected sports officials and ancillary person- cally possible risk of transmission of persons engaging in sports have no nel. The following should constitute HIV to others. bleeding wounds or other skin le- the core of information provided: 7 Sports organizations, sports clubs sions. There is no documented in- (a) HIV can be transmitted through and sports groups should be aware stance of HIV infection acquired sexual intercourse, blood, and of the above recommendations and through participation in sports. from infected mother to child. ensure that all participants, sports However, there is a possible very Sexual transmission can be either officials and ancillary personnel are low risk of HIV transmission when man to woman, woman to man or aware of them. In addition, this may one athlete who is infected has a man to man, and transmission by provide the opportunity for review- bleeding wound or a skin lesion with blood can be through any injec- ing general hygienic practices relat- exudate and another athlete has a tion practice in which non-sterile ing to sports. skin lesion or exposed mucous mem- needles and/or syringes are used. 8 National level sports organizations brane that could possibly serve as a (b) For transmission of HIV through are urged to contact national AIDS portal of entry for the virus. blood to occur during sport, the committees or programmes for 2 The possible very low risk of HIV blood of an infected person must further information regarding HIV transmission through sports partici- contaminate a lesion/wound or infection and AIDS. pation would principally involve the mucous membrane of another combat sports with direct body con- person. It should be the responsi-

shire, or from Miss Ann Williams, BASM delegates to international meet- News snips Lederle Laboratories, Fareham Road, ings were assisted by £158. Gosport, Hants P013 OAS. The US Olympic Committee ap- The British Sports Council's Report proved its budget of US$13.2m for The Football Association and for 1987/8 reveals expenditure of sports medicine and science program- Lederle Laboratories have established £279 353 on doping control, £105 691 mes for the 1989-1992 quadrennium. a residential weekend course for GPs on sports medicine and sports science This includes the following: doping on sports injuries and rehabilitation at including the start of the BASM educa- tests and education $6m; sports the FA's national centre at Lilleshall tion officer support grant (£50 000 over science, including physiology, Hall, Shropshire (venue also of many three years). There is continuing fund- biomechanics, psychology, computer of BASM's week-long basic courses). ing of the TOYA (Training of Young science and engineering and coach Details can be had from Mr Graham Athletes) study of Elm over six years; education $4.06m; $500 000 for support Smith, Director of Rehabilitation, FA the British Olympic Medical Centre at of scientific research; $245 000 for National Centre, Lilleshall Hall, Shrop- Northwick Park Hospital received special sports medicine programmes (© 1989 Butterworth & Co (Publishers) Ltd £65 000 and the ABA £8000 for screen- including nutrition and vision; $1.2m 0306-3674/89/020132-01 $03.00 ing and preparation of Olympic boxers. for library and education services.

132 Br. J. Sp. Med., Vol. 23, No. 2 Notes for Authors

Scope References The British Journal of Sports Medicine covers all aspects These should be indicated in the text by superscript of sports medicine and science - the management of Arabic numerals which run consecutively through the sports injuries; all clinical aspects of exercise, health and paper. The references should be grouped in a section at sport; exercise physiology and biophysical investigation the end of the text in numerical order and should take the of sports performance; sports psychology; physio- form: author's names and initials; title of article; abbre- therapy and rehabilitation in sport; and medical and sci- viated journal title; year of publication; volume number; entific support of the sports coach. page numbers. If in doubt authors should always write the journal title in full. References to a book should take Types of paper the form: authors' surname, followed by initials; title of Original papers (not normally over 3000 words, full book in single quotes; editors (if any); volume number/ length accounts of original research) edition (if any); name of publishers; place of publication; Review articles (up to 4000 words, providing concise in- year of publication and page number. Where a paper is depth reviews of traditional and new areas in sports cited more than once in the text, the same superior medicine) numeral should be used on each occasion. e.g. Case reports (up to 1000 words, describing clinical case 21 Sperryn, P.N. SpoA and Medicine Butterworths, UK 1983 histories with a message). 22 Ellitsgaard, N. and Warburg, F. Movements causing ankle frac- tures in parachuting. Br J. Sports Med 1989, 23, 27-29 Refereeing Tables All contributions are studies by referees whose names Tables should be typed on separate sheets together with are not normally disclosed to authors. On acceptance for a suitable caption at the top of each table. Column head- publication papers are subject to editorial amendment. If ings should be kept as brief as possible, and indicate rejected, papers and illustrations will not be returned. units of measurement in parentheses. Tables should not Authors are solely responsible for the factual accuracy of duplicate information summarized in illustrations. their papers. Footnotes Manuscripts Footnotes should be used sparingly. They should be in- dicated by asterisks (*), daggers (t), and double daggers Authors are urged to write as concisely as possible. (t), in that order. In the manuscript, a footnote should be Three copies should be submitted, typed on only one placed at the bottom of the page on which it is referred to side of the paper (quarto or A4) in double spacing with a and separated from the main text by a horizontal line margin of 30 mm at the top and bottom and on both above the footnote. Footnotes to tables should be placed sides. Papers should be arranged in the following order at the bottom of the table to which they refer. of presentation: title of paper; names of the authors; address of the place at which the work was carried out; Drugs, Abbreviations and Units an abstract of the paper (100-200 words in length; 4-6 Drugs should be referred to by their approved, not pro- keywords; the text; acknowledgements (if any); refer- prietary, names, and the source of any new or experi- ences; tables; and abbreviated title for use as a running mental materials should be given. If abbreviations are headline; captions to figures (on separate sheet of used these should be given in full the first time they are paper). mentiohed in the text. Scientific measurements should be.given in SI units, but blood pressure should continue Illustrations to be expressed in mm Hg. Drawings and graphs should be on heavy white per! Proofs card or blue-lined coordinate paper using blac ink. Authors are responsible for ensuring that all manu- Label axes appropriately and clearly. Please use a selec- scrips (whether original or revised) are accurately typed tion of the following symbols: +, x, Z, 0, A, VI Of , before final submission. Two sets of proofs will be sent to A, V. Photographs should be of fine quality, large the author before publication, one of which should be glossy prints suitable for reproduction and the top returned promptly (by Express Air Mail if outside UK). should be indicated. Negatives, transparencies or x-ray The publishers reserve the right to charge for any films should not be supplied, any such material should changes made at the proof stage (other than printers be submitted in the form of photographic prints. errors) since the insertion or deletion of a single word Authors are asked where possible to draw diagrams to may necessitate the resetting of whole paragraphs. one of the following widths, including lettering, 168 mm, 354 mm. During photographic reproduction, Submission the diagrams are reduced to 1h their size. The maximum Three copies of the complete manuscript and illus- depth at drawn size is 500 mm. Authors are asked to use trations should be sent to Dr P.N. Sperryn, The Editor, the minimum amount of descriptive matter on graphs British Journal of Sports Medicine, Butterworth Scien- and drawings but rather to refer to curves, points etc. by tific Ltd, PO Box 63, Bury Street, Guildford, Surrey GU2 symbols and place the descriptive matter in the caption. 5BH, UK. Three copies of each illustration are required and these All material submitted for publication is assumed to be should be numbered in a consecutive series of figures submitted exclusively to the British Journal of Sports using Arabic numerals. Legends should be typed in Medicine. All authors must consent to publication. The double spacing on a separate page but grouped together. editor retains the customary right to style and if neces- Each figure should be identified on the back - figure sary shorten material accepted for publication. Manu- number and name of the author. Figures which have scripts will be acknowledged on receipt. Authors should been published elsewhere should be accompanied by a keep one copy of their manuscript for reference. Authors form of permission to reproduce, obtained from the should include their names and initials and not more original publisher. than one degree each.