Let's Provide Differing Perspectives in the Interest of Athlete Care
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Warm up Br J Sports Med: first published as 10.1136/bjsports-2020-102305 on 4 May 2020. Downloaded from AN ECLECTIC EDITION… Diversity among our disciplines: let’s In recognition of the benefits of diversity, this 10th SASMA- led edition of BJSM is provide differing perspectives in the deliberately eclectic—in terms of both topic and global authorship. Contribu- interest of athlete care tions come from Australasia, Europe, North America and, of course, South Jon Patricios 1,2 Africa. Those who have been quarantined in a bomb shelter by COVID-19 and still Zwide, a flat and dusty township on the do not recognise the benefits of exer- outskirts of Port Elizabeth, where the cise in every facet of health should read apartheid government’s utter disdain for Dr Wong’s paper (See page 582)— residents … had stranded people in a people with the highest levels of physical seemingly endless cycle of poverty and unemployment.1 activity have 27% lower risk of advanced colorectal cancer. Excerpt, from “Against all odds”, biography The surgeons have their say too and describing where South African rugby we highlight rigorous work from two world cup winning captain, Siya Kolisi Scandinavian groups. Dr Bjarke Viberg’s (Figure) grew up. group from Southern Denmark report Strength… AND PERSPECTIVE IN on the differences in knee osteoarthritis, DIVERSITY secondary surgery, laxity and PROMs You can get a glimpse of a team talk 10 years after ACL reconstruction versus given during the Rugby World Cup 2019 non- surgical treatment (See page 592). (https://www. youtube. com/ watch? v= Dr Barbara Snoeker and colleagues from GU5K3rGS6yo) by Springbok coach Sweden found that early ACL reconstruc- Johan ‘Rassie’ Erasmus. He explains to the tion was associated with better outcomes national team the benefits of the diverse for the medial meniscus (See page 612). backgrounds from which the Springbok Figure 1 Rugby world cup winning BJSM’s Irish correspondent, Dr Ronan players come—from remote and under- captain—Springbok Siya Kolisi. Credit: Steve Kearney and his team bring us “High- resourced rural areas such as Zwide to Haag lights from other journals” and they are top private rugby schools with world class continuing this issue’s heterogeneous facilities. His take-home message was that theme (See page 623). Topics include open the Springbok’s strength lies partly in the kinetic chain rehabilitation of ACLs (from diverse contributions from every team http://bjsm.bmj.com/ medicine (SEM)? First, exercise, with all Journal of Orthopaedic & Sports Physical member, influenced by their differing its well- researched, documented and indis- Therapy), kinetic factors in running inju- backgrounds. putable benefits, is a commonly accessible For many past decades, South Africa’s ries (Scandinavian Journal of Medicine (free!) and potentially unifying interven- legislated discriminatory policies had hand- & Science in Sports), the necessity for tion across the demographic spectrum. icapped the country and prevented it from defibrillators at sports facilities (Heart) Physical activity is a wonderful equaliser. benefiting from the diverse talents of all and the benefits of dexamethasone in It still seems bizarre that the “Exercise is of its people. The presence of an assorted 2 acute mountain sickness (Chest). Medicine” concept is not a 101 course on September 30, 2021 by guest. Protected copyright. cohort of 2019 World Cup players provided Aussie stalwart Dr John Orchard—who on the medical undergraduate curriculum. perspective on the supposed ‘hardships’ of recently earned that nation’s national Second, the diverse network of exercise- professional sport, when compared with the gong (AM)—takes a justifiably cynical associated disciplines, skills and expertise adversity endured for a lifetime by players view of rheumatological guidelines for clinicians (and athletes) have available to such as Springbok captain Siya Kolisi. This corticosteroid injections (See page 564). them, strengthens (or should!) our method proved unifying in the players’ motivation My fellow BJSM-community sport docs, of practice. to unite the population across South Afri- let’s admit that the short- term benefits of Alas, we have all experienced the ca’s demographic. CSI are tempting! Where do you fall on exact opposite of diversity in our various the “glass half- full” Orchardometer? SHOULD WE AS CLINICIANS professional arenas. I am painfully DELIBERATELY SEEK OUT DIVERSE aware that referral to a neurologist can Leaving the best until last (!), our own PERSPECTIVES? result in a neurologically focused solu- South African contributors are the irre- Can we make comparisons between tion, an orthopaedic surgeon—a surgical pressible Professor Martin Schwellnus rugby and our field of sport and exercise outcome, the dietician—a low-fat diet, reporting on a mass- participation event the chiropractor—the predictable manip- (102 251 race starters!) where investi- 1 Waterfall Sports Orthopaedic Surgery, Netcare ulation. All too often. In a recent BJSM gators evaluated medical encounters, Waterfall Hospital, Midrand, South Africa cardiac events and deaths (See page 605), 2Faculty of Health Sciences, University of the editorial, Millar et al argued how the Witwatersrand, Johannesburg, South Africa ‘silo’ approach compromised effective and Dr Sharief Hendricks, a rugby- injury outcomes in tendinopathy management.3 researcher par excellence, whose group Correspondence to Professor Jon Patricios, Waterfall Sports Orthopaedic Surgery, Netcare Waterfall Hospital, Where are the true multidisciplinary clin- advanced rugby injury video analysis Midrand 1682, South Africa; jpat@ mweb. co. za ical methodologies? research parameters (See page 566). Patricios J. Br J Sports Med May 2020 Vol 54 No 10 561 Warm up Br J Sports Med: first published as 10.1136/bjsports-2020-102305 on 4 May 2020. Downloaded from FUELLING SUCCESS excellent editorial on how SEM research Provenance and peer review Commissioned; Did the World Cup–winning Springboks can protect athlete health is not to be internally peer reviewed. drink copious quantities of coffee? The missed (See page 563). Their reference to This article is made freely available for use in meta- analysis from Dr Jozo Grgic’s group the controversial issue of defining gender accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until from Melbourne suggests that caffeine is has particular (and painful) relevance in otherwise determined by BMJ. You may use, download ergogenic, in more ways than you perhaps South African sport. and print the article for any lawful, non- commercial thought. Just two cups of joe promote Interestingly, the newly appointed purpose (including text and data mining) provided that muscle endurance, muscle strength, anaer- Springbok rugby coach, Jacques Nienaber, all copyright notices and trade marks are retained. 4 5 obic power and aerobic endurance. Or is a physiotherapist by qualification who © Author(s) (or their employer(s)) 2020. No commercial perhaps it was the protein supplements in cut his teeth as a sports clinician in Super re- use. See rights and permissions. Published by BMJ. the Bok’s locker room? Kerry O’Bryan’s Rugby. Through six seasons of working excellent paper (See page 573) illumi- together, I know first-hand that he is a nates the benefits of pure protein versus team player. Just as the Springbok captain To cite Patricios J. Br J Sports Med 2020;54:561–562. multi- ingredient protein supplements in understands the benefits of diversity, Nien- strength and fat free mass gains in trained aber knows how a medical team needs to Accepted 18 March 2020 and untrained individuals across different collaborate in the player’s best interests. Br J Sports Med 2020;54:561–562. ages. If a truly diverse and multidisciplinary doi:10.1136/bjsports-2020-102305 approach led to winning the Rugby World ORCID iD Cup, shouldn’t we make sure we give that MENTORING IS A MUST Jon Patricios http:// orcid. org/ 0000- 0002- 6829- 4098 approach more than just lip service in our Siya Kolisi can attest to the benefit that own practice? mentorship can play in guiding a career REFERENCES and points to his coach at Emsengeni 1 Daniel J, Kolisi S. Against all odds. Johannesburg, South Twitter Jon Patricios @jonpatricios Primary, Eric Songwiqi, as a pivotal figure. Africa P14: Jonathan Ball Publishers. 2 Health care providers. Available: https://www. Sports medicine is no different. So, who Contributors JP conceived, researched, wrote and edited the manuscript before submitting to BJSM. exerciseismedicine. org/ support_ page. php/ health- care- better to mentor a young researcher in providers/ [Accessed 15 Mar 2020]. groin injury prevention than Denmark’s Funding The authors have not declared a specific 3 Millar NL, Murrell GAC, Kirwan P. Time to put down the grant for this research from any funding agency in the professor of sports physiotherapy Dr Kris- scalpel? the role of surgery in tendinopathy. Br J Sports public, commercial or not- for- profit sectors. Med 2020;54:441–2. tian Thorborg? Martin Wollin’s excellent 4 Grgic J, Grgic I, Pickering C, et al. Wake up and PhD on a complementary strategy for Competing interests Board member of the Concussion in Sport Group (est. 2002). Sports smell the coffee: caffeine supplementation and groin and hamstring injuries in elite foot- Concussion advisor to South African Rugby Senior exercise performance—an umbrella review of 21 ball is the outcome (See page 620). Many Associate Editor of BJSM. Associate Editor of Current published meta- analyses. Br J Sports Med 2019:bjsp orts-2018-100278. of us have come across two stalwarts (and Sports Medicine Review (all unpaid) Director of Sports 5 Grgic J, Grgic I, Pickering C, et al. Infographic. Wake Concussion South Africa. great mentors) in our field—Drs Margo up and smell the coffee: caffeine supplementation and Mountjoy and Lars Engebretsen. Their Patient consent for publication Not required. exercise performance. Br J Sports Med 2020;54:304–5. http://bjsm.bmj.com/ on September 30, 2021 by guest.