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The use of drugs and nutritional supplements in top-level track and field athletes. Tscholl P, Alonso JM, et al. American Journal of Sports Medicine

2010;38(1):133-140

An analysis was made of 3887 doping control forms completed by track and field athletes during one season of out of competition testing and 12 International Association of Athletics Federations World Championships. The results revealed

that 6523 nutritional supplements (1.7 per athlete) and 3237 medications (0.8 per athlete) were reported. Nonsteroidal anti- inflammatory drugs (NSAIDs; 0.27 per athlete, n = 884), respiratory drugs (0.21 per athlete, n = 682), and alternative analgesics (0.13, n = 423) were used most frequently. Medication use increased with age (0.33 to 0.87 per athlete) and decreased with increasing duration of the event (from sprints to endurance events; 1.0 to 0.63 per athlete). African and Asian track and field athletes reported using significantly fewer supplements (0.85 versus 1.93 per athlete) and medications (0.41 versus 0.96 per athlete) than athletes from other continents. Compared with middle-distance and long-distance runners, athletes in power and sprint disciplines reported using more NSAIDs, creatine and amino acids, and fewer antimicrobial agents. In addition to the results above this study also compared track and field results with those reported form other sports and found that the use of NSAIDs was less than that reported for team-sport events but nutritional supplements are used more than twice as often as they are in soccer and other multisport events.

sportEX comment Whatever the merits of these

substances the danger for sports people is that contamination of supplements has previously lead to positive results in doping controls. The most telling statistic however was that the final ranking in the championships was unrelated to the quantity of reported medications or supplements taken. So were they doing any good?

Predictors of running-related injuries in novice runners enrolled in a systematic training program. Buist I. Bredeweg SW et al. American Journal of Sports Medicine 2010;38(2):273-280

The popularity of running is still growing. As participation increases, running-related injuries also increase. Until now, little has been known about the predictors for injuries in novice runners. Two hundred and twenty six men and 306 women novice runners preparing for a recreational four mile (6.7-km) running event completed a baseline questionnaire and underwent an orthopaedic examination. They were followed

during a 13 week training period. A running-related injury (RRI) was defined as any self- reported running-related musculoskeletal pain of the lower extremity or back causing a restriction of running for at least one week. Twenty one percent of the runners had at least one RRI during follow-up. For the males body mass index (BMI), previous injury in the past year, and previous participation in sports without axial load were associated with RRI. For the females, only navicular drop remained a significant predictor for RRI. Type A behaviour and range of motion (ROM) of the hip and ankle did not affect risk.

sportEX comment That’s the men sorted but surely there must be more predictors for women?

Effect of graft selection on the incidence of postoperative infection in anterior cruciate ligament reconstruction. Barker JU, Drakos MC et al. American Journal of Sports Medicine 2010;38(2):281-286

A retrospective medical record review was performed to determine the incidence

of infection, offending organism, time after surgery until presentation, infection treatment, and graft salvage as an outcome of graft choice. A total of 3126 procedures were identified; 1777 were autografts and 1349 allografts. Eighteen infections were identified (0.58%). Infections occurred in six of the 1349 allografts (0.44%), seven of the 1430 bone-patellar tendon-bone (BPTB) autografts (0.49%), and five of the 347 hamstring autografts (1.44%). Five grafts were removed because of graft incompetence or loosening,

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three hamstring tendon, one BPTB, and 1one allograft. The most common organism isolated was Staphylococcus aureus. Hamstring tendon autograft had an increased incidence of infection compared with both BPTB autograft and allograft, with a trend toward a more common need for graft removal. Allograft reconstructions were equally likely to have graft salvage as autograft reconstructions.

sportEX comment So, hamstring tendon autografts come top of the infection tree. The big question is why?

sportEX medicine 2010;44(Apr):4-6