J O U R N A L o f t h e s a s p o r t s m e d i c i n e A S S O C I A T I O N t y d s k r i f • Kaffei'en in urine •Soccer injuries cont • Gesondheidsbevordering • Rastioneel-emotiewe terapie VOL 2 NO 4 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) Reg. tlo./nr. tV5. In sports injury and trauma. ® didophen C lin ic a lly w e ll to le ra te d ttifliM m tndl— M l ■**•01.100 Voltaren GT 50 Geigy 'coated tablets) lots tre a te d worldwide* •Statistics on file R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) CONTENTS W M EDITORIAL COMMENT Alternative Medicine W M PENSEES Herewith the Baton FEATURE Soccer Injuries cont. W M ULTRA MAN Ultra Man Faces Intense Competition E l GLANSARTIKEL Die Plek van Oefening in Gesondheidsbevordering |£1 GLANSARTIKEL Konsentrasies van Kaffei’en in Urine f S GLANSARTIKEL Rasioneel-EmotieweTerapievirSportlui m£ A s a s m a u p d a t e SASMA News |£J RUGBYNEWS Prevention of Rugby Injuries ED PHYSIOTHERAPY COLUMN Basic Conditioning for Rugby Editor in Chief DR C NOBLE MBBCh.FCS(SA) Associate Editors PROFTNOAKESMBChB.MD DR DAW IE VAN VELDEN MB ChB (Stell), M Prax Med(Pretoria) Advisory Board MEDICINE: Dr I COHEN MB ChB D ObSt, RCOC ORTHOPAEDIC TRAUMATOLOGY: DR P FIRER BSc (Eng) MB BCh (Wits) M Med (OrthoXWits) BRIC E HUGO MB ChB, MMed (Chir) Orthopaedics DR JC USDIN MB BCh, FRCS (Edin) CARDIOLOGY: COL DP MYBURGH SM MB ChB, FACC PHYSICAL EDUCATION: HANNES BOTHA D Phil (Phys Ed) GYNAECOLOGY: DR JACK ADNO MB BCh (Wits) MD (Med) Dip O&G (Wits) Front Coven Transparency courtesy o f Colour Library. The Journal o f the SA Sports Medicine Association is exclusively sponsored by Ciba-Geigy (Pty) Ltd. The journal is produced by Commedica PO Box 3909, Randburg 2125. The views expressed in this publication are those of the authors and not necessarily those of the sponsors or publishers. ^ P o rtb e s e rio g s - s *1 | S p o rt In ju ry an d • w f io r B h a W it a s ie C a rd ia c R eh ab dita bo n P rcxyam P ro g ra m m e JOURNAL OF THE SA _ SPORTS MEDICINE TYDSKR/F VAN DIES A SPORTOENEESKUNDE- VERENIOINO 11-13 18-20 CIBA-GEIGY R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) ALTERNATIVE MEDICINE: CLIVE NOBLE, MBCHB. FCS (SA) Editor in Chief. EDITORIAL BOARD MEETING As regards running injuries it can safe­ ly be said that most of these will get better themselves. Most of the time this will be within a few days of the on­ set of injury, but may take weeks or even months. Usually there is a reduc­ tion of activity as a protection of the part due to pain which allows healing to take place. In my own practice many cases who had to wait for an appoint­ ment for a few weeks, phone to say that the problem got better while they were waiting for the appointment. Whoever happens to be treating the patient at the time he is recovering spontaneously, will claim the cure no matter how unscientific the treatment has been. Reflexology, homeopathy, naturopathy, chiropractic and a host of other modes of alternate medicine all claim out­ standing results in sports injuries. Acupuncture has long been used in treating sportsmen including Provincial rugby players. Only with a careful clini­ cal trial will we ever be able to evalu­ ate alternate medicine as a form of treatment. Dr "Ponky" Firer has donated a prize of R500 for the best original article pub­ lished in this Journal each year. We thank him for his generosity. her friend, went to see Ronald Holder who describes himself as a Kinesthisiologist. He apparently diagnosed her problem as a muscle imbalance and proceeded their shoes which would surely aggravate the bio­ mechanical problem, but have nevertheless been successful. Has his success been due to the fact that most of these cases would have got better by themselves, as on recent investigation into injuries in­ curred in the training for a British Marathon would suppose? Has it been a placebo effect? The answers to these questions may equally apply to all forms of alternate medicine or even sometimes to “scien­ tific" medicine itself. A meeting of the Sponsors, Ciba-Geigy, the Publishers, Commedica; and mem­ bers of the Editorial Board o f this Jour- j nal was recently held in Johannesburg. At this meeting it was decided to have a Physiotherapy column as well as a nutrition column which should be of great interest to our Readers Another innovation will be a philosophy column | a la Ceorge Sheehan which should also be most enjoyable. It was decided that both scientific articles as well as p ra c tic a l, easily understood articles will also be used. This is in keeping with the previous format. If you, the Reader, have any suggestions we will welcome them. Our aim is to increase knowledge in S p o rts Medicine. ^ DECEMBER 1987 V O L 2, NO 4,19* ecently Zola Budd sus­ tained a running injury which threatened her career She received treatment from a variety of Sports Physicians in­ cluding laser and injec­ tion therapy from a German clinic, but all to no avail. She finally returned to South Africa where she consulted more doctors, but still with no improvement. Finally, on advice of to make a support from the "Yellow Pages" which is held together with tape and inserted into her running shoe. Almost immediately she was rendered pain-free and was able to recommence her running career. Was this a miracle; was it just a fluke, or was it a scientifi­ cally accurate assessment of her mus­ cle imbalance corrected by a (usually) 2-3mm thickness of "Yellow Pages" placed in her shoe7 I have seen many of his successes, but also many of his failures so I think it is extremely difficult to answer the question, strongly doubt his scientific credibi­ lity Many of his cases (if not all) are told they have a leg length dis­ crepancy. A number of these cases have had scientifically accurate radiological leg length measurements that revealed equal leg lengths. Other cases have had sup­ ports put in R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) HEREWITH THE BATON/ # have pleasant memories of some of the restaur­ ants that I have had the good fortune to visit over the last two decades. As a visual experience still burnt into an unaffected part of my brain none surpasses the one at High Wycombe in England. There, in the late afternoon summer sun, was the archetypal English scene, trees with lush foliage, spontaneously combusting into all the imaginable shades of green. The village-green itself dotted with cricketers, and a very old, very English pub. It sported a proprie­ tor who delighted in walking you through the kitchen to show the sim­ mering menu, allowing you to savour each delicate aroma. Then there was the restaurant in Dur­ ban that out-colonized anything the colonies even in their heyday could CHRIS KLOPPER "I came across the rather pleasant, somewhat sparsely distributed, tradition of consuming the merest hint of vanilla sorbet to clear the palate before the arrival o f the next course." Readable scientific fare packaged in that special ambience that only sport can provide. What then, do you ask, clears the palate between the heavy numbers on the academic menu? renewed readiness for more action. Here is a man (also a father, a physician, runner/pot hunter, a cyclist, an excel­ lent speaker and a columinist of sta­ ture) who when speaking to an au­ dience of research chemists about the problems of research and the Eureka experience, captured the nett worth of every drop o f perspiration that I had ever shed. "Play' he said, "is the problem solv­ er. Running — or any of the other exercises I proposed — is a celebra­ tion of the body and a holiday for the soul.” (Here the sorbet becomes the main course.) This column, by way of contributions that will be made by those not content to blindly practice sportsmedicine but to reflect upon its implicit paradigms meditatively, is unreservedly inspired by George Sheehan's Running Wild. This is one marathon though, in which a . offer aS an alternative Here for the tlme 1 came across the rather Pleasant, somewhat sparsely distribut­ ee, tradition of consuming the merest b t l ^ anil,a sorbet to clear th e Pa- before the arrival of the next course, already hovering in the wings, ^ m a n y w a ^ this journal strains awards offering the same experiences i 1987 VOL 2, NO 4,1987 George Sheehan M.D in his regular column Running Wild, which appears monthly in the Physician and Sports Medicine does for sportsmedicine jour­ nalism what vanilla sorbet does for the most carefully crafted cuisine.- a mo­ ment of freshness, the sheer delight of which explodes against the overworked 'taste buds', surprising them into he will probably remain for the most part far out in front; but then, as in marathons, to use his words again "we will never discover the truth second­ hand." He went on to say; if l am to write the truth, or know it when I read it, I must first live it. Let these contri­ butions be our living truth. Herewith the baton. ^ R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) CONTINUED FROM VOL 2 NO 3 SOCCER INJURIES I. Surve 4th Year Medical Student, J. Ranchod 4th Year Medical Student, A N Kettles Registrar From: The Department of Community Health, University of Cape Town. ield conditions F AII fields on which matches were played were graded according to a checklist with a maxi­ mum score of 40. The number of injuries and of player hours for each field was deter­ mined, and the injury incidence per 1000 hours was calculated. It would be expected that higher field grading scores would correlate nega­ tively with injury incidence However an anomaly arose with field A, which is the best field. On this field most of the Pre­ mier division matches were played. It was in this division that most injuries occurred. If field A is excluded in cal­ culating correlation, the correlation coefficient r = 0,84 (p< 0,01). If field A is included, then r = 0,31. Although it may be concluded that quality of fields determine to some extent the risk of injuries, other factors may override such influence. Weather conditions did not appear to influence the incidence of injuries markedly; 93% occurred dur­ ing sunshine and 71% on dry fields. injuries related to referee grading The number of matches controlled by each grade of referee, and the number of injuries sustained in these matches is shown in Table VI. Table V: Relationship of injuries to Field Grading Grade Games Played Player Hours No. of Injuries Incidence Injuries per 1000 Player Hours TOTAL R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) Table VI: Number of matches controlled per graded referee and the injuries sustained. Number Number Injuries o f of per Grade Matches Injuries Match ” 1 54 35 (48%) 0,65 2 95 5 (7%) 0,05 3 78 33 (45%) 0,42 Considering the fact that 54 (24%) matches played by the Premier and 1st division ac­ counted for 35 (48%) of all the Injuries and that these “2* matches were led by top grade referees, it would •, appear that the grade of S referee has no material in­ fluence on the occurrence of injuries as determined by other variables Most matches (95 or 42%) were controlled by Grade 2 referees There were only 5 (7%) injuries in these matches, at a rate of 1 injury per 20 matches. 300 injuries per 1000 game hours, 16,9 in- w juries per 1000 player hours.1 However, / j Ekstrand defined ■ v J ^ injury differently as "an injury - A causing a player ' to miss the next game", not: "having to i leave the field". The results from the studies of Bass; v Muckel8 and Weightman- > \ Browne9 show an incidence I \ of H 30, and 3,6 per 1000 game hours re- 7 ’ spectively. Renstrom \ and Peterson10 re- ^ ported an incidence of 1 injury in every 23 games, or about 200 per 1000 game hours. Different defini­ tions for injury make com­ parison of these results ex­ tremely difficult. The Premier division repre­ sents the highest level of i competition in this study, This division also recorded / K the highest incidence of ( injury (27 per 1000 man hours played), which cor­ responds to data reported \ from other studies in Fin- \ land5 and Norway'1 Peter­ son and Renstrom,10 how­ ever, found no difference I in the incidence of injury \ between the players in \ different divisions in . \ their study in Sweden. 3 < The low 'nciclence r . injuries in the 2nd division (2,2 injuries per i 1000 man hours) may J reflect a lower level of f competitiveness in this / division; although other factors may also play a ; role in this low incidence. Types of injury The commonest type of injury is sprains (42% which is consistent with other studies. 3:12 However, the number of fractures recor­ ded is much lower than that in other studies.'” ’-'' The high number o f sprains in the forward and midfield posi­ tions could be due to the skil­ ful dribbling involved in these positions, especially since 16 of the 22 sprains recorded were ankle sprains Anatomical Site of injury Lower limb injuries were found to be the commonest accounting for 74% of all injuries. Wilkinson/ Ekstrand,1-12 Sandelin5 and Mach- lum et al2 confirm this in their studies. In their studies ankle and knee injuries were the commonest of all lower limb injuries, in this study ankle injuries are the com­ monest. J Protective Equipment , None of the players with shin ^ lacerations (12% of all injuries) were wearing shinguards. ) Ekstrand12 found 50% of lacera- f tions occurring in those players I not wearing shinguards.12 It is in- i teresting to note (since we do not know the total number of players wearing shinguards) that all shin lacerations and ankle injuries occur- i red in players not wearing shin- I guards and ankle taping respectively Condition of Field j The results show a significant cor­ relation between lower grading of fields and higher incidence of injuries. This is only so if the Premier division matches played on the top- graded A field are excluded. These showed the highest injury incidence rate, which may be ascribed to con­ founding variables rather than to the good condition of the field. The lowest incidence of injury oc­ curred on the I field (high grade 26). Most games played on this field were second division y " fT^artres, a division with a low ^^•^Tncidence of injury. The impor­ tance of field quality or surface has been emphasized by Wilkinson4 and Muckel8 in their studies amongst English soccer players. Sandelin in Fin­ land, however, found that the field sur­ face did not influence the injury fre­ quency or pattern.5 Our data does not permit to separate decisively the pos­ Playing Position Sandelin5 and Ekstrand1 have shown in their studies in Finland and Sweden re- , J spectively that playing po- M M sition did not correlate J T with any difference in the distribution of injuries. In / this study, if no correction L for position is made, the data are similar to the above studies. However, if the data are corrected, for "number at risk" there is a higher incidence of in­ jury involving the goalkeeper (37% compared to 15%). This could be partly due to the intensity of 1987 VOL 2, NO 4,1987 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) sible determining influence of division from that of quality (grading) of the field. Player's opinions The opinion of players was at variance with the objective results of the study in some respects. Players thought that fields are the most important factor in causing injuries — this is supported in this study by the strong negative correlation between injury incidence and grading of fields if field A is exclud­ ed. However, unfitness o f players was ranked second by 65% of the players. This contrasts sharply with our finding that 90% of injured players considered themselves fit. The role of the referee featured high among players but this was not confirmed by the study. The absence of shinguards and the calibre of the opposing team were found to be important in this study, and were considered so by players. Level of divi­ sion, although featuring prominently in our study was not considered to be im­ portant by most players. Recommendations A fundamental problem associated with an epidemiological assessment of data concerning sports related injuries is that of defining criteria and compar­ ing data.1 Although this study could not prove decisively what the main causative factors are the authors would like to suggest that the follow­ ing factors would improve the preven­ tion of injury: 1. improved field conditions. 2 Good discipline and refereeing apply­ ing especially to the more competitive divisions (including stringent applica­ tion of the rules protecting goalkeep­ ers from injury). 3. Consistent use of shock absorbing shin guards. 4. The use of ankle taping. 5. Adequate training and warm-up programmes. Finally, it is recommended that a more intensive study, possibly including the value of prophylactic measures, be done to determine the importance of such measures in injury prevention. Acknowledgements This study was undertaken as a stu­ dent project for the Community Health (4th year) course under the su­ pervision of Dr A. Kettles (registrar) as co-author. The statistical advice from Mr R. Sayed and help from Ms N. Ka- mies, Occupational Therapist, is grate­ fully acknowledged. The study would not have been possible without the co­ operation of the Cape District Football Association, players and first aiders We are also grateful to Dr T.D. Noakes for his assistance in editing our project report and to Dr J. T. Mets for finalis­ ing the manuscript. References 1 Ekstrand J, Gillquist J-. Soccer injuries and Their Mechanisms, a Prospective Study. Medicine and Science in Sport and Exercise 1983 15 267-270 2 Machlum S, Daljord 0 A - Football Injuries in Oslo A one-year study. British Journal o f Sports Medi­ cine 1984,; 18 186-190. 3. Sandelin J.. Santavista S., Kiviluoto 0: Acute Soc­ cer Injuries in Finland in 1980. British Journal o f Sports Medicine 1985; 19 30-33. 4 Wilkinson, W.H.C A Practical V i e w o f Soccer inju ries. British Journal o f Sports Medicine 1978, 12 : 43-45. . . 5. Ekstrand J. et al: Incidence of Soccer injuries and their relation to training and team success. Am eri­ can jou rn a l o f Sports Medicine 1983:11 : 63-67. 6 Human Science Research Council IHSR.C.) Sports Report on South African Sports. 1984-1985. 7. Bass Al-. Injuries of Leg in Football and Ballet Proceedings o f the Royal Society o f Medicine 1967, 60 . 527-530. 8.Muckle DS- injuries in Professional Footballers British jo u rn a l o f Sports Medicine 77-78 1981 Vol 15 . . . , „ 9. weightm an D, Browne R.O Injuries in association and rugby football. British jo u rn a l o f Sports Medi­ cine 1974; 8 183-187. 10. Renstrom P., Peterson L. Fotbollskadot Fotboii- splan med konstgras Valhalla idrottsplots i Gote- borg Rapport Naturvardsverkte SNVPM 846. 11. Roaas A., Nilsson S.: Major injuries in Norwegian Football. British Journal o f Sports Medicine 1979, 13 : 3-5 12. Ekstrand J, Cillauist J- The frequency of mus­ cle tightness and injuries in soccer players. The American Journal o f Sports Medicine 1982, 10I 7578 DECEMBER 1987 VOL2, NO 4 ,1 # R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) PH O TO G R AP H -S AS PO R TS IL LU ST R AT ED r ULTRA MANir ULTRA MEN FACE INTENSE COMPETITION. lain B a n n e r— Sports International ental toughness will be just as important as phy- |J H * I sical strength and endur- I I / I ance when Ultra Man en L H L j I trants tackle the two months of intense com- ^ petition, starting with the Duzi canoe marathon from January 28-30. They have already completed the 50km JSE Marathon, an optional event, and the first of the compulsory events is the 165km Vasbyt Cycle Challenge on November 28. But the Hansa Duzi, also compulsory, heralds the most gruelling phase of the endurance series backed by the pharmaceutical division of Ciba-Geigy. After the canoe marathon comes the optional Midmar Mile swim on Febru­ ary 14 — points for all events are worked out according to a special for­ mula, with the first Ultra Man finisher being awarded 100 and the tough 160km Sunday Times/Leppin Iron Man triathlon is on February 27. That's another of the four compulso­ ry events, along with the Comrades Marathon on May 31, but the athlete who wins the Ultra Man will probably have completed all eight events be­ cause the bonus points available in the optional events are too valuable to pass up. And if that's the case, many of the top Ultra Man contenders will be riding the Argus cycle tour on March 5 — just seven days after the Iron Man. The optional Two Oceans marathon on April 2 is next, with the Comrades Marathon the final, punishing test in the most difficult test of endurance yet devised in South Africa. While su­ perb physical condition will be essen­ tial, top triathlete George Janos be­ lieves the correct mental approach is just as important. "With so much hard racing in such a short period, one of the most difficult things will be to keep replenishing men­ tal energy;' says Janos, who was fourth behind Henk Watermeyer, Richard Hol­ liday and Nigel Reynolds in the 1987 Iron Man triathlon. "Anyone going seri­ ously for a top 10 overall placing will have to avoid a mental blow-out' Janos will do all eight events and thinks many of the top contenders will do the same "I want to win Ultra Man and that me­ ans I need all the points I can get," he says. An industrial engineer, Janos had to go back to the drawing board to re-think his training and racing schedule when he realised just how much racing was crammed into such a short period. "I've got to establish a training base this year because there will not be time to train in February and March," he says. “There's no time then to build a base. Instead, it will be a case o f sharpening up for each event." Doing most of his hard work this year means Janos will miss most of the 1987 triathlons They do not fit into his training schedule and he does not be­ lieve he can "do everything". "You have to be realistic," he says. "It's essential to build a solid base from which to compete next year and l,m hoping to do enough to enable me to take a bit of a break in December. Like many of the Ultra Man contenders, Janos is hoping for a full river in the Hansa Duzi. "The more paddling the better" he says "Less portage means we can save our legs for the Iron Man." Entries for the Ultra Man closed on Oc­ tober 31 and organisers Sports Interna­ tional expect a final field of more than 400. Top of the Ultra Man table after one optional event is Comrades specialist Nick Bester, who takes 100 bonus points into the Vasbyt challenge after finishing ninth in the JSE Marathon, lain Banner. R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) c IBA-GEIGY SPONSOR FIRST BLACK ULTRA MAN ENTRANTThe Ultraman, sponsored ___________by Ciba-Geigy's pharma­ ceutical division, has received its first black entrant, Robert Lambetha. Robert, a plumber from Grey's Hospi­ tal in Pietermaritzburg is an ex­ perienced Duzi canoeist, having com­ pleted the event four times, as well as being a strong Comrades runner Today, Ciba-Geigy's Ken Richards con­ tinued his company's sponsorship of Lambetha by handing over a new ca­ noe, paddle and bicycle to him in Pinetown. In attendance was Graeme Pope-Ellis who believes Lambetha has the ability to be most competitive in the Ultra Man. "With his new equipment, Robert will be in a position to prepare fully for the various events forming part of the Ultra Man" said Pope-Ellis. lain Banner, director of event organiser Sports International, believes Lam- betha's entry will pave the way for an awakening of latent triathlon- talent that must currently exist amongst black athletes. "Although the logistics attached to pad­ dling pose a problem to competitors who are without transport, Ciba-Geigy are making an effort to promote the sport by supporting the likes of Lam­ betha" said Banner Ken Richards of Ciba-Geigy believes that guidelines for training in cycling, run­ ning, swimming and canoeing, which his company will prepare over the next few months, will assist all interested sportsmen and women with training techniques and preparation for parti­ cipation in those various sports disci­ plines The Ultra Man which is made up of four compulsory events, (The Vasbyt Ultra Man Cycle Challenge, Hanza Duzi, Sunday Times/Leppin Iron Man and Comrades, and four optional events, JS.E„ Midmar Mile, Argus Cycle Tour and Two Oceans) is based on an accumula­ tive point ranking system with over R30 000 in prize money on offer to competitors. Close on 400 competitors have entered the competition, including the likes of Graeme Pope-Ellis, Eddie King, Danny Biggs, Henk Watermeyer and Piet Mare. For fu rth e r inform ation contact Michelle or Tracey at Sport Internation­ al on (011) 883-3333. Vasbyt 165 km Cycle Race Comrades Marathon gold medallist Nic Bester maintains a narrow lead in the Ultra Man stakes, despite finishing two minutes down on the leading bunch in the Vasbyt 165 km tour in the Northern Transvaal last week. Bester, by virtue of his ninth position in the JSE 50 km road race in August, went into the first compulsory Ultra Man event last Saturday with a lead of 100% in the Ultra Man ratings. But he almost saw his lead in the competition dwindle away on the wind­ swept country road outside Pretoria when fellow-Pretoria tri-athlete Piet Mare and Natal's Keith Elleker got away in an 18 man break after 120 km of hard riding. The pair managed to stay with the leading bunch and Mare managed to edge ahead of Elleker at the line to close the gap on Bester in the Ultra Man ratings. Mare held 2nd place to Bester going into the Vasbyt Tour with 92,38% after finishing 2nd Ultra Man in the JSE and the win last weekend means that he has closed to within 5% of Besters lead going into the next compulsory event, the Hansa Duzi Canoe Marathon towards the end of January. The race was won by Natal Springbok Cyclist Peter Tomkins in 4 hrs 14 mins. Unfortunately not all the results of the Vasbyt 165 km Cycle Race were available at time of going to press hence the omission of an updated Ultra Man listing. Looking Down the Track As Ultra-athletes look ahead the adrenalin will start pumping as they contemplate the jam-packed schedule which awaits them from the end of January. The compulsory Duzi from January 28-30 will take its toll, but to build points, competitors will be diving into the Midmar Mile only fourteen days later Just two more weeks to the toughest trial of all — the iron Man Tri­ athlon on February 27th. Director of Sports International, lain! Banner, believes that competition w ill be such, that leading athletes will not! pass up any chance of building points,! This means that just seven days after! Iron Man, contenders will be riding the! optional Argus Cycle Tour on March| 5th. Phew! What a punishing schedule, but! the R30 000 in prizes, the prestige and! the Ultra man medals will make it al| worthwhile, ^ DECEMBER 1987 VO L 2, NO 4,1987 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) DIE PLEK VAN OEFENING IN GESONDHEIDSBEVORDERING F. P. RETIEF M.B. Ch.B., M.R.C.P., M.D., D. Phil. Oxford. Direkteur-generaal, Departement van Nasionale Gesondheid en Bevoikingsontwikkeling he Role o f Exercise in the Promotion o f Health The im portant m otto mens sana in corpore sano reminds us that a healthy mind and body is the ideal ar­ mour with which to tackle life Too many South Africans, however believe that a healthy mind can be cultivated through mere passive recreation Com­ petitive participation is not a prereq­ uisite for the cultivation o f a healthy mind. A cheerful mind and healthy lifestyle have become an urgent neces­ sity, given the significant percentage o f our total disease load ascribable to a disease promoting lifestyle Given an ever ageing popula­ tion, exercise should be in­ creasingly emphasised as a brake to the physio­ logical processes o f ageing. South Africans from all parts o f the population spectrum seem unable to revert to a lifestyle o f in­ creased activity — be it due to work pressure o r life stressors such as ur­ banisation and poverty. Concerted community e ffo rt can play an important role to help involve more People in physical activity programmes m significant example is the North S !E [a-PSoject' 5tarted in 1972 in Fin- I E L key elements o f a National wealth Programme are: 1) greater cla- r ^ L reaardin9 psycho-social factors curving physical activity, 2) the applica­ tion o f the behavioural sciences in reaching particular communities, 3) the planning o f fitness awareness pro­ grammes in co-operation with the me­ dia. In South Africa the National Health Plan was announced in 1986. However, it is imperative for each community to work o ut its own health plan. Commu­ nity health centres, provided for in the National Health Plan can act as living laboratories from which to co-ordinate health promoting, activities. Health promotion amongst the dit ook so dat die gejaag na prestasie wat so 'n kenmerk van ons alle- daagse enjoys special attention with the Department, in order to be o f value, youth programmes must, however, be continued into the adult years. Mens sana in corpore sano word van een geslag na 'n ander ges- lag oorgedra om ons daaraan te bly herinner dat 'n gesonde gees en 'n ge- sonde liggaam die ideale wapen- toerusting is om die lewe mee aan te durf Die lewe se gewone, maar ook meer bedreigende lewensituasies en selfs krisisse, kan daarmee die hoof ge- bied word — binne in die lewensterrein van die individu, die geografiese en sosiologiese begrensinge van gemeen- skappe en in die besonder ons baie in- teressante Suid-Afrikaanse samelewing. Ongelukkig is te veel Suid-Afrikaners die gedagte toegedaan dat 'n gesonde gees bloot met die hulp van passiewe reaksie gekweek kan word. Ons is, toegegee, toeskouers op wie daar staatgemaak kan word! Ongelukkig is M e m b e r 1987 v o l 2, n o 4,1987 bestaan is, wel n kenmerk van ons toeskouer deelname is. Dan wonder die mens ook nog hoekom hy so moeg en vaal voel na n hele middag se opwinding voor die kassie! Verniel ons nie dalk ons koronere vate meer deur so te kyk as deur self te doen en mee te ding nie? Is so 'n Sater- dag dan nie meer stres-belaai as die meeste ander dae van ons lewens nie7 Mededingende deelname is natuurlik nie 'n voorvereiste vir die kweek van 'n gesonde gees nie en daarvan getuig dan ook aktiwiteite soos stap, voetslaan, draf en swem — alles dinge wat jy op jou eie kan doen. 'n Gesonde gees is in baie opsigte sinoniem met 'n blymoedige gees en is dit nie iets wat ons Suid-Afrikaners meer naarstigtelik moet nastref nie7 Wat het van lag en blote goedigheid geword? Idealerwys behoort daar eintlik nie 'n verskil tussen 'n gesonde gees en 'n gesonde leefwyse te wees nie. Laasge- noemde het 'n dringende noodsaaklik- heid geword, gesien die stewige persen- tasie van ons totale siektelas wat direk en indirek aan 'n siektebevorderende lewenstyl gewyt moet word. Weliswaar toon epidemiologiese studies dat min- stens 50% van die mortaliteit van die tien leidende doodsoorsake, na gesond- heidsbedreigende gedrag gevoer kan R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) word. Weerstand teen oefening en onaktiwiteit is maar te dikwels belan- grike elemente van hierdie soort gedrag. Lui om te rek, te trek, te werk en te lui om flink te dink! 'n STEEDS OUERWORDENDE MENSDOM Voorts het ons ook te make met 'n mensdom wat al ouer word en vandag word al hoe meer waarde geheg aan oefening om die prosesse van veroudering te rem. Die bekende fisioloog, a J. Meyer, het baie indrin- gend na hierdie aangeleentheid gekyk. Hy stel dit dat die klok van biologiese veroudering nie noodwendig met die biologiese ouderdom van die individu gesinchroniseer is nie Hy stem saam met ander kenners dat die groot water- skeiding in n mens se lewenspan op die ouderdom 30 jaar plaasvind. Weliswaar bereik die mens reeds maksimale gesig- en gehoorskerpte op 10 jaar, maksimale weerstand teen infeksies op 15 jaar, maksimale intellektuele vermoe op 21 jaar en maksimale spierkrag op 25 jaar. NS die ouderdom van 30 jaar verwelk die fisiologiese reserwes van die ver- skillende organe en stelsels baie lang- saam, maar onafwendbaar. Fisiologies word veral groot waarde geheg aan veranderinge in die bindweefsel en in die besonder word gewys op die toe- name in getal en deursnit van kol- lageenvesels wat tot gevolg het dat meer meganiese krag nodig word om hulle te rek of om hulle vorm te her- win. Met veroudering is daar verlies van spiermassa weens 'n afname in die ge­ tal en grootte van die spierweefsels, te- same met 'n verlies van sarkomere en 'n absolute daling in die ATP-inhoud van die spiervesels Op ouderdom 80-jaar is die spiermassa 30% minder as op 30 jaar. Finaliteit oor die oorsake van bover- melde verouderingsprosesse ontbreek nog grotendeels, maar metaboliese prosesse gepaard met ophoping van afvalstowwe figureer hier sterk. En daarmee saam gaan vermeerderde kol- lageenproduksie vanwee fisiese en moontlik selfs psigiese spanning. Dit al- les lei tot slytasie en die vraag onstaan dus, hoekom daar nie meer staat ge- maak word op vermeerderde fisiese ak- tiwiteit, om deur middel van n gesonde leefwyse hierdie prosesse van verou­ dering te rem nie. SUID-AFRIKANERS SE ONMAG OM 'n GESONDER LEWENSTYL TE BEOEFEN Ongelukkig bemerk ons daagliks in welke onmag Suid-Afrikaners verkeer om gehoor te gee aan die oproep om 'n meer gesonde lewens-styl te be- oefen, en om in die besonder, groter fisiese aktiwiteit na te streef. In ons samelewing tre f ons by die een pool aan diegene wat welvarend en ontwik- keld is maar wat in 'n drukwerkte vas- gevang is wat net nie tyd laat vir ont- spanning en oefening nie So oorweldig is hierdie persone dat hulle maar later net moet beken: “Ek het daar geen be- hae meer in nie." Dan weer aan die an- derkant van die spektrum, hulle wat blootgestel is aan ander soort lewe- stressors wat veroorsaak of vererger word deur toenemende verstedeliking of migrasie, industrialisasie, werkloos- heid en armoede. DIE ROL VAN GEORGANISEERDE GEMEEN- SKAPSOPTREDE Begryplik kan wetgewing, kommissies van ondersoek, spesiale owerheidsin- stellings en dergelike masjienerie aan hierdie situasie weinig doen. Gemeen- skappe kan egter verbasend suksesvol optree deur sterk en eendragtig 'n al- gemene probleem te identifiseer en dit dan gemeenskaplik aan te pak. Daar bestaan natuurlik talle voorbeelde hi- ervan. Een van die treffendste is waar- skynlik die Noord Karelia-projek wat in 1972 in Finland begin is nadat 'n gemeenskap by wyse van 'n massapeti- sie vir optrede n aksie, teen hartvaat- siektes geloods het. 'n Program wat wereldaandag getrek het, is van stapel gestuur, veral gerig op uitskakeling van lewenstyl foute, (onder andere onfiks- heid) wat as risiko-faktore vir miokard- infarksie geidentifiseer is. Hierdie pro- jek het veral ook getoon hoe belangrik dit is om kinders vroeg te betrek. Hon- derde spesiaal-gekeurde werkers is uit- gestuur om 'n bepaalde gesondheids- boodskap te verkondig en sigbare resul- tate het nie lank uitgebly nie. Die ou stelling is waar bewys.- "The people stand up, the doctor steps down". Die betrokkenheid van gemeenskappe in bevorderingsprogramme is nie iets nuut nie Winslow, 'n grondlegger van gemeenskapsgesondheid, se oor- spronklike definisie (soos mettertyd aangepas), verwys na hierdie omvat- tende aksie wat onder andere ten doel het "promoting mental and physical health and efficiency through or­ ganised community efforts..." DECEMBER 1987 VO L 2, 10 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) DIE SLEUTELELEMENTE VAN 'n n a s io n a l e p r o g r a m ■n Nasionale program ter bevordering van fisiese aktiwiteit sal na sekere sleu- telelemente moet omsien,- ♦ groter duidelikheid oor die psigo- sosiale faktore wat verhinder dat ak­ tiwiteit 'n groter deel van die mens se gesondheidsgedrag uitmaak. - W W V U L Z , IN U • hoe die gedragswetenskappe meer doelgerig ingespan kan word om bepaalde gegewe gemeenskappe te be- reik. • hoe om saam met die media strate- gee te beplan ten einde gemeenskappe meer fiksheidsbewus te maak. Tereg het Dr Robert Butler, 'n voor- malige Direkteur van die United States National Institute on Ageing, by geleentheid gese dat "if exercise could be packed into a pill, it would be the single most widely prescribed, and beneficial, medicine in the Nation." DIE NASIONALE GESONDHEIDSPLAN Cedurende 1986 is die Nasionale Gesondheidsplan afgekondig en nou wag ons vir gemeenskappe om gebruik te maak van aanbevelinge in hierdie Plan ten opsigte van plaaslike betrok- kenheid en deelname Dit is goed om te beplan vir dit wat op nasionale vlak moet gebeur, maar sekerlik van baie groter belang om te verseker dat elke gemeenskap in Suid-Afrika sy e/e gesondheidsplan uitwerk en deurvoer. Teen relatief lae koste versprei die gedagte van buurtwagte om mense en hul eiendom te beskerm, tans soos 'n veldbrand. Kan ons nie op dergelike wyse ook begin dink aan "buur- toefeninggroepe" om ons mense se gesondheid te help beskerm en te bevorder nie? Gemeenskapgesondheidsentra waar- voor daar in die Nasionale Gesondheids­ plan spesifiek voorsiening gemaak word, is nie net bedoel as plekke vir die behandeling of nabehandeling van pa- siente wat nie hospitalisasie benodig nie. Dit is inderdaad die ideale plek om baie van 'n gemeenskap se gesond- heidsbevorderende aktiwiteite te sen- treer — en dit dan ook te doen deur dit tot diep in die gemeenskap uit te dra. Dit behoort sentra van omvat- tende gesondheidsorg te word en te dien as lewende taboratoria waar programme vir die gemeenskap uit- getoets kan word. 'n Paar jaar gelede was daar reeds in 'n land soos Swede honderde gesondheid- sentra in werking, en is liggaamlike opleiding" dan ook as een van die be- langrikste aktiwiteite gesien waardeur vervroegde veroudering teengewerk kon word. Vanselfsprekend is oefenkun- diges en ontspanningbeamptes lede van die multidissiplinere spanne wat by sulke sentra optree. GESONDHEIDSBEVORDERING ONDER DIE JEUG My departement sowel as ander gesondheidsowerhede bestee reeds op verskeie vlakke tyd en aandag aan gesondheidsbevordering onder die jeug van ons land. Die Advieskomitee in­ sake Gesondheidsopvoeding beywer horn vir gekoordineerde gesondheids- voorligting in skole deur die onderskeie onderwysowerhede. Vanuit hierdie komitee het 'n paaronderwysgidse vir die gebruik van onderwysers in skole reeds die lig gesien, waaronder byvoor- beeld: "Noodbehandeling van Sport- bese rings". Die Bevolkingsontwikkelingsprogram het intussen ook goed op dreef gekom en onderwys- en jeugorganisasies tel onder hierdie program se telkengroepe Die mikpunt van die program is verhoogde lewenskwaliteit en veral by die jeug moet fisiese aktiwiteit gesien word as een van die steunpilare om juis dit te bereik. Vanselfsprekend moet so 'n doelgerigte program natuurlik tot in die volwasse jare deurgetrek word. Dit word gese "My departement sowelasander gesondheids­ owerhede bestee reeds op verskeie vlakke tyd en aandag aan gesondheids­ bevordering onder die jeug van ons land:' 1987 dat die fisiese aktiwiteite van mans af- neem namate hulle verantwoordelik- hede in die aktiewe lewe toeneem. Na die huwelik word dit minder, na die eerste kind nog minder — en prof. Brink het geoordeel dat nie meer as 10% van ons Suid-Afrikaanse mans tyd vir fisiese ontspanningsaktiwiteite in- ruim nie Die gevolgtrekking moet dus gemaak woord dat ons baie indringend sal moet kyk na hoe ontspanningstyd in Suid-Afrika tot die grootste voordeel en heil van ons mense se gesondheid aangewend behoort te word. Mag die dag aanbreek dat ons in hier­ die land ook sal praat van 'n oefenmalle bevolking, benewens ons sportmalle mense. Bronne 1. Hamburg, D. A. Habits for health. World Health Forum, 1987, Vol. 8, 9-12. 2. Meyer, B J. Veroudering van mens Feite en Fabels. Festschrift H. w. Snyman, 1985 7-10. 3. World Health Org. tech. Rep. Ser, 1961 215, 5. 4. Brink, A J. Jou hart en lewe, 1982, 217, Femina Uitgewers. 11R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) KONSENTRASIES VAN KAFFBEN IN URINE: RIGLYNE VIR ME ATLEET DEPARTEMENTE VAN FARMAKOLOGIE EN HUISARTSKUNDE, FakUlteitvan Geneeskunde, u n ive rsiteit van Stellenbosch, Posbus 63, Tygerberg 7505 HI Seifart Dr rer nat., D.P. van Velden, M.B., Ch. B„ M. Prax. Med., M. Esterhuizen, M.B. Ch.B., D.P Parkin, M.B., Ch. B, BSc. Hons., PR van Jaarsveld, Ph.D. BSTRACT A The International Olympic Committee (IOC) Medical Commission has placed limits on the use o f caffeine in athletes fol­ lowing evidence that it has ergogenic properties and can be abused in gaining unfair advantage in athletic events requiring stamina. The IOC allows a maximum urine level o f 15ug/mf for this drug and evidence o f higher levels is considered due cause for disdualification. Caffeine urinary elimination studies were undertaken in 5 healthy young adult athletes, 2 males and 5 females We conclude from our data that IOC limits will not be exceeded in healthy individuals who ingest diet caffeine and that side effects are likely to limit ingestion o f caffeine concentrate, by casual abusers, to amounts which will not exceed the regulatory norms. INLEIDING Die Internasionale Olimpiese Komitee se mediese afdeling het besluit dat die gebruik van kaffeien deur atlete be- perk moet word omdat die middel er- gogeniese eienskappe openbaar wan- neer dit in hoe dosisse geneem word.1'2'n Maksimum vlak van 15ug/mf in urine is vasgestel.5 Aangesien kaffeien 'n bestanddeel van 'n verskeidenheid dranke, tonikums en medikamente is wat vry algemeen in- geneem word, is daar 'n behoefte onder atlete aan duidelike riglyne oor die hoeveelheid wat ingeneem kan word sonder om die wettige perk te oorskrei. Met hierdie doel voor oe het atlete vn/willig verskeie dosisse van 'n kommersiele kaffeien bevattende toni- kum (Bioplus) en koffie ingeneem en die konsentrasie kaffeien is in hul urine met verloop van tyd gemonitor. METODES Bepaling van kaffeien Hoedruk vloeistof chromatografie is gebruik vir die kwantitering van kaffeien in urine Detail van die metode is soos volg: 'n Hewlett Packard 1090 apparaat toe- gerus met 'n outomatiese monster- voerder is gebruik. Skeiding is met 'n Whatmann Partesil C-18 kolom by 35°C bewerkstellig. Eluering was isokraties met 4:6 m etanol: water teen 'n vloeis- nelheid van 1,5mfVmin. Die konsentrasie kaffeien in die eluaat is spektrofotom- etries by 254 nm gemeet en met 'n HP 3392 integreerder geregistreer. Die minimum bepaalbare konsentrasie was "Die internasionale Olimpiese Komitee se mediese afdeling het besluit dat die gebruik van kaffeien deur atlete beperk moet word omdat die middel ergogeniese eienskappe openbaar wanneerditinhoe dosisse geneem word." 5ng/mf terwyl die standaardkurwe linier was tot 'n konsentrasie van 40ug/mf (r=0,99927). Ekstraksie van kaffeien uit urine is direk in die inspuitflessies van die monster- voerder gedoen. Die pH van 'n 1m£ urine monster is eerstens na 7,4 verhoog deur byvoeging van paar u? (3-5) 3M NaOH. Dit het veroorsaak dat 100% ekstraksie deur die byvoeging van 200uf mengsel chloroform : isopropanol (98:2) gekry kon word. Die urine plus ekstraksie vloeistof is vir 30 min geossileer en daarna gesen- trifugeer. Die aspirasienaald van die monstervoerder is so gestel dat 10uf van die organiese fase in die skeiding- sisteem ingespuit is. VRYWILLIGERS Vyf blanke atlete het aan die studie deelgeneem. Hul ouderdomme was tussen 20 en 25 jaar. Verdere beson- derhede word in Tabel I opgesom Toedlening van kaffeien Bioplus bevat 9mg kaffeien per me. Dit is in dosisse van 100mC, 50mf en 25mf deur die twee manlike atlete geneem wat 'n gemiddelde gewig van 78kg ge- had het. Die drie vroulike atlete het 50mf, 25mf en 12,5ml' geneem. Hul gemiddelde gewig was 58kg. Die doser- ings is op 'n gerandomiseerde wyse deur die atlete geneem en 'n uit- wasperiode van 10 dae is tussen dosisse gebruik. Urine monsters is aan- vanklik halfuurliks; later uurliks en twee- uurliks oor 'n 12 uur periode versamel (vide infra, Figure 1 en 2). Na elke mon- sterneming is die blaas volledig geledig en I50m f water geneem. Ten einde met 'n zero waarde te kon begin is kaffeien bevattende vloeistowwe 48 uur voor die begin van die eksperiment uitgesluit. Koffie wat 51,8mg kaffeien per 180mf koppie bevat is in hoeveelhede wat wis- sel vanaf 4 koppies tot 12 koppies binne een uur na 'n ligte ontbyt geneem. Na verloop van die een uur in­ name periode is urine versameling be­ gin soos hierbo met Bioplus beskryf. Elk van die v yf atlete het slegs een keer op 'n gerandomiseerde wyse een van die DECEMBER 1987 VOL 2, NO 4 ,11 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) BESPREKING Indien dit wettig sou wees om die kon- sentrasie kaffeien in die bloed van at- lefie tydens kompetisie te bepaai, sal dit moontlik wees om akkurate bereke- nings van die ingeneemde dosis te maak aangesien farmakokinetiese para­ meters soos die volume van distribu- sie en opruiming van die middel be- kend is (4-6). Dit is standaard praktyk om hierdie berekenings vir 'n ander xantienderivaat, teofillien te doen wan- neer laasgenoemde vir behandeling van asma gebruik word (sien byvoor- beeld 7). Die monitor van urine konsen- trasies van kaffeien om te bepaai of dit vir sy ergogeniese eienskappe deur 'n atleet misbruik is, is egter nie so een- voudig as die monitor daarvan in bloed nie Eerstens word slegs 1% van die ingeneemde kaffeien ongemetaboli- seerd in die urine uitgeskei.8 Dit is ook goed bekend dat die metabolisme van xantiene beinvloed word deur ouder- aom, lewerensiemstatus, swangerskap en rook. Tweedens varieer urinevloei peweldig met die graad van oefening wat gedoen word. Dit is dus moontlik oat n oefening wat na voltooiing ver- oorsaak dat 'n klein volume urine in die c io if ^ enwoordig is 'n hoe konsentra­ sie kaffeien tot gevolg mag he. ne«Tc!?e^r ^ffei'en in enkele doserings geneem word, is dit duidelik uit Figuur en 2 dat maksimum vlakke na 1 tot f j i Ur ln die urine verskyn. Daar moet inname skedules gevolg. resultate Figuur 1 en 2 toon die urine kaffelen- vlakke van die manlike en vroulike at- jete onderskeidelik. Die hoogste vlakke word in albei gevalle in die urine mon­ sters gevind wat 1 tot 2 uur na inname versamel is. Hierna neem die maksi­ mum waarde egter nie vinnig af nie Dit bly relatief konstant tot ongeveer 4 uur na inname waarna die konsentrasie vin- niger begin daal. Die gemiddelde maksimum urine vlakke het by die hoogste doserings kafeien (900mg vir mans en 450mg vir dames) nie hoer as I5ug/mf in die eerste 4 uur na inname gestyg nie. Duidelike tekens van ongemak (naar- heid en bewerigheid) het by hierdie doserings te voorskyn gekom. Tabel II toon die maksimum urine kaffei'envlakke nadat verskillende hoev- eelhede koffie ingeneem is. In hierdie eksperiment is die maksimum vlakke na 1 tot V I 2 uur verkry. Dit is duidelik van Tabel II dat die inname van koffie teen ‘n maksimum tempo van 12 kop- pies per uur (62lmg kaffeien) die uri- nevlak tot hoogstens 5,9ug/mf laat styg het. word dit aanvaar dat I5mg/kg die grens is waarby en waarbo newe- effekte soos naarheid en bewerigheid ontstaan.8 In die huidige eksperimente was die hoogste doserings slegs 11,5 en 7,8mg/kg vir mans en dames onderskei­ delik. Beide groepe atlete het egter by hierdie doserings alreeds ongemak er- vaar. 'n Selfbeperkende grens op die doelgerigte oormatige gebruik van kaf­ feien bestaan dus indien die gebruiker nie daarvoor gekondisioneer is nie. Uit Tabel ll is dit duidelik dat inname van koffie teen 'n buitensporige tem­ po van 12 koppies per uur nie die mak­ simale kaffeien konsentrasie in urine verby die vlak van I5ug/mf laat styg het nie Hierdie studie bevestig dus dat 'n vlak hoer as 15ug/mf kaffeien in urine slegs te wyte kan wees aan doelbewuste misbruik. R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) T Y D N A FIGUUR I Urinekaffeienkonsentrasie van twee manli­ ke atlete nadat verskillende volumes Bioplus geneem is (900,450 en 225mg kaffeien on- derskeidelik). Tydens elke urine versameling is die blaas volledig geledig en 150m? water Tabel I Besonderhede van vrywilligers wat aan die proef deelgeneem het. IN N A M E ( u r e ) Ceslag Gewig (kg) Aktiwiteit Manlik 77 Naelloper Manlik 79 Naelloper Vroulik 60 Veldatleet Vroulik 57 Middelafstand Vroulik 57 Naelloper FIGUUR 2 Urine kaffeienkonsentrasie van drie vrouli- ke atlete nadat verskillende volumes Bioplus geneem is (450,225 en 125,5mg kaffeien on- derskeidelik). Die gemiddelde gewig van die atlete was 58kg. Ander besonderhede is soos in Figuur 1. ingeneem. Die gemiddelde waardes is ver- bind terwyl die vertikale strepe by elke waar- de die standaard afwyking toon. Die gemid­ delde gewig van die atlete was 78kg. la b e l il Maksimale urine kaffeienkonsentrasie na inname van koffie oor een uur Aantai Koppies Kaffeien- inhoud (mg) Konsen­ trasie (ug/mf) 4 207 1,70 6 310 2,84 8 414 2,74 10 518 3,11 12 621 5,96 Urine versameling is halfuurliks gedoen na verstryking van een uur inname pe­ riode Dis maksimale konsentrasies is op 1 tot V h uur gevind. T Y D N A IN N A M E ( u r e ) Literatuurverwysings 1. Costill DL, Dalsky CP, Fink w j (1978). Effects of caffeine ingestion on metabolism and exercise per­ formance Med. Sci. Sports, 10, 155-158. 2 Ivy JL, Costill DL, Fink WJ., Lower R.w. (1979). in. fiuence o f caffeine and carbohydrate feedings on endurance performance. Med. Sci. Sports, 1 1 ,6-11 3. Delbeke FT. en Debackere M (1984). Caffeine- Use and abuse in sports, int. J. Sports. Med. 5 , 179-182 4. Lelo A , Miners JO. Robson, R. en Birkett D i (1986). Assessment o f caffeine exposure: Caffeine content o f beverages, caffeine intake and plasma concentrations o f methyl xanthines. Clin. Pharma­ col. Ther. 39, 54-59. 5. Lelo A, Birkett QJ., Robson R.A. en Miners j q (1986). Comparative pharmacokinetics o f caffeine and its prim a ry demethyiated metabolites pa. raxanthine, theobromine and theophylline in man Br J. Clin. Pharmac. 22, 177-182. 6. Gilman AG. Goodman LS, Rail TW. en Murad f. (1985) The Pharmacological Basis o f Therapeutics p 1673 Seventh Edition MacMillan Publishing Com­ pany, New Yprk 7. GibaldiM en Prescott L. (eds) (1983). Handbook o f Clinical Pharmacokinetics. ADIS Health Science Press, New York 8. Rail TW. (1985). The methylxantines. Chapter 25 in The Pharmacological Basis o f Therapeutics. Se­ venth Edition, pp 589-603 (eds., A.G Gilman, LS Goodman; TW. Rail, F Murad) MacMillan Publishing Company New York. PHOTOGRAPH - SA SPORTS ILLUSTRA TED DECEMBER 1987 VOL 2, NO 4,1987 14R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 'GLANSARTIKEL,r RASIONEEL-EMOTIEWE TERAPIE VIR SPORTLUI Professor Justus Potgieter Departement van Liggaamlike Opvoeding, Universiteit van Stellenbosch O ATI0NAL EMOTIVE THERAPY FOR SPORTSPEOPLE The psychological prob­ lems experienced by sports people are often at­ tributed to irrational thinking. The sportman's cognitions f greatly influence his emotions: as cognitions, emotions and be­ haviour are interdependent RET is based on the fact that the human being is a thinking, judging creature capable o f both rational and irrational thought. Irrational thinking leads to dysfunctional be­ haviour Thus two people can act differently in a similar ob­ jective situation as a result o f differing interpretations. Irrational thinking is often un­ compromising, marked by in­ tense, irrelevant emotions and unrealistic self-demands. Un­ reasonable demands o f perfec­ tion can lead to anxiety, frustra­ tion and aggression. Such irra­ tional thinking restricts the I .sportsman's capacity to partic­ ipate with spontaneity and to take risks, which leads to a dis­ ruption o f attention focus. 'Catastrophing' a second error in thinking, is the tendency to overemphasise the seriousness and trauma o f a situation. Together with uncompromising thinking this leads to negative performance, depression and self pity. Negative self ju d g ­ m ent in turn can lead to a vi­ cious cycle o f poor m otivation 3nd Performance. Appropriate Outdance can help to redefine distinction between the sportman's view o f his value as a person and his performance on the field. Overgeneralisation is often TBBfceab/e in the sportman wno is psychologically poorly UPPed. A belief that he can­ not win on a certain field or under cer­ tain conditions is irrational selfdeter­ mination that can be rectified through RET. The sport psychologist can edu­ cate the sportsman through cognitive restructuring to grasp that the chief influence is not the objective situation, but his perception thereof. RET is self therapy and the focus o f control lies PHOTOGRAPH - SA SPORTS ILLUSTRA TED H p R 1987 VOL 2, NO 4,1987 with the sportsman. RET provides a structure within which the sportsman can tackle his problems. It also contains a facet o f goalsetting, and employs imagination techniques in order to alter irrational thinking. Because RET aims chiefly at restructur­ ing the thinking processes o f the sportsman, no serious resistance to the therapist should come from the coach. The sports­ man's co-responsibility for his progress should avert the nor­ mal stigma attached to ther­ apy Algemene sielkundige proble- me van sportlui kan dikwels toe- geskryf word aan irrasionele denke. Omdat die mens se kog- nisies, emosies en gedrag inter- afhanklik is en mekaar dus wederkerig beinvloed, is dit lo- gies om te verwag dat die sportman se kognisies 'n groot invloed op beide sy emosies en sy gedrag sal uitoefen. Die ver- naamste beginpunt van rasio- neel-emotiewe terapie (RET) is dat die mens 'n denkende en oordelende wese is en oor die vermoe beskik om rasioneel sowel as op 'n irrasionele wyse te dink, Dit is die mens se irra­ sionele denke wat tot disfunk- sionele gedrag lei (Moller, 1985) Dit gebeur dikwels dat twee persone in soortgelyke situasies verskillend optree. Die werklike objektiewe situasie, soos byvoorbeeld 'n kritieke tydstip in n belangrike kompetisie, is vir albei persone dieselfde, maar omdat daar verskillende inter- pretasies daaraan geheg word, is die effek daarvan vir die twee persone nie eenders nie. Die een deelnemer sal byvoorbeeld onder druk swig, terwyl dit die prestasie van die ander bevord- er. Die verskil tussen hierdie twee persone se interpretasie van 'n gebeurlikheid is hoof- saaklik gelee in die bemiddeling- sproses wat jul kognisies speel. R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) Irrasionele denke en dinkfoute kan die basis van sielkundige swakhede in 'n sportman se mondering vorm. irra­ sionele denke is nie gebaseer op die werklikheid of op feite nie. Dit is dikwels absolutisties, gaan gepaard met in­ tense o f irrelevante emosies en verhoed dat die sportman sy doelstel- lings bereik. Absolutistiese Denke Een van die mees algemene dinkfoute is absolutistiese denke waarmee die sportman onrealistiese eise aan hom- self en die situasie stel. Dit kom gewoonlik in sy selfspraak tot uiting in sulke gedagtes soos "moet", “moenie" en “behoort" Onredelike eise van per- feksie kan lei tot angs, frustrasie en soms tot onvanpaste aggressie. Hierdie aggressie word dikwels na binne gerig en dit kom tot uiting in 'n onverdraag- same gesindheid van die sportman teenoor homself en sy feilbaarheid. As gevolg van hierdie irrasionele denkwyse laat hy homself me genoeg ruimte om spontaan mee te ding of risiko's te neem nie. Hy plaas onnodige druk op homself wat tot angs, woede en ag­ gressie kan lei. Verder vind daar ook 'n ontwrigting van aandagsfokus plaas, omdat die sportman selfgerig raak. Daar word nie voorgegee dat die sport­ man emosieloos moet wees of homself moet vereenselwig met gemiddeldheid nie, maar absolutistiese, perfek- tionistiese, onredelike of onrealistiese denke wat prestasie inhibeer, is gewoonlik die basis van probleme in die sportman se ego-kompetisie. Katastrofering Katastrofering is 'n tweede tipe dink- fout. Dit is die neiging om situasies as veel ernstiger of meer traumaties te sien as wat dit in werklikheid is. Dit sluit aan by absolutistiese denke in die sin dat die sportman se vorige swak ver- tonings of kleiner foute, selfs binne dieselfde kompetisie, op so n wyse geinterpreteer word dat dit sy huidige en toekom stige w e rk ve rrig tin g negatief beinvloed. Dit kan ook tot uit­ ing kom in depressie en 'n verlengde periode van swak vertonings wat in werklikheid niks met tegniek, vaardig- heid of fisieke vermoens te doen het me. 'n verdere gevolg van hierdie tipe denke is 'n lae frustrasiedrempel met gepaardgaande selfblaam, selfbejam- mering en depressie. Die neiging tot negatiewe selfbeoordel- ing wat op irrasionele denke berus kan ook aanleiding gee tot swak vertonings Dit kan ook 'n bose kringloop ontket- en wanneer die sportman begin twyfel oor sy eie vermoens en dit gevolglik sy m otive rin g en gepaardgaande prestasie negatief beinvloed. Baie sportlui ervaar periodes van vertwyfel- ing en kan deur middel van gepaste voorligting deur hierdie krisisperiodes gehelp word. Die sportman wat nie rasioneel kan on- derskei tussen sy waarde as persoon en sy prestasie op sportgebied nie, deur- dat hy sy eiewaarde aan sy fisieke prestasies koppel, gaan gewis in een of ander stadium probleme in hierdie ver- band ondervind Dit lei me net tot die gebruiklike "gebrek aan selfvertroue" nie, maar kan die sportman se selfkon- sep en selfwaarde negatief affekteer Oorveralgemenings Oorveralgememngs is baie dikwels ken- merklik van die sportman wat sielkun- dig swak toegerus is vir kompetisie. Hy bou 'n sielkundige blokkering op teen sekere spelers en glo dat hy hulle nooit sal kan klop me. Ander voorbeelde is spelers wat daarvan oortuig is dat hulle onder sekere omstandighede, soos byvoorbeeld op spesifieke bane of velde, nooit suksesvol is of sal wees nie Hierdie irrasionele selfindoktrinasie of selfsuggestie kan deur herindoktrinasie deur middel van RET reggestel word. Ongeldige afleidings uit bepaalde ge- beurtenisse wat nie deur feite onder- steun word nie, soos byvoorbeeld die sportman se persepsie dat hy nikswerd is omdat hy op 'n sekere wyse opgetree het of 'n punt afgestaan of 'n kom­ petisie verloor het, kan 'n ontwrigtende invloed op sy sielkundige benadering he. Die sportsielkundige kan n belangrike voorligtingsrol vervul deur saam met die sportman bogenoemde en ander irrasionele denke en dinkfoute te iden- tifiseer, te betwis en te wysig en te ver- "Oorveralgemenings is baie dikwels kenmerklik van die sportman wat sielkundigswak toegerus is vir kompetisie:' vang met rasionele denke. Deur middel van kognitiewe herstrukturering word die sportman opgevoed om te besef dat dit nie die objektiewe situasie is wat hom soseer beinvloed nie, maar sy per­ sepsie van die situasie. Die doel van rasioneel-emotiewe terapie is dus om die sportman te help om insig in die in- houd van sy denke, denkprosesse, en selfkommunikasie te verkry en sy gesindhede, oortuigings en filosofie te wysig om sodoende sy doelstellings op n rasionele wyse te bereik. RET is Selfterapie Daar word voorgestel dat hierdie tipe terapie geskik vir sportlui sal wees om­ dat dit in groot mate selfterapie is. Die fokus van kontrole berus dus by die sportman self. Die keuse tussen ra­ sionele en disfunksionele denke is sy eie. Hy dra dus medeverantwoordelik- heid vir sy terapie. Hierdie benadering behoort by die persoonlikheid van die meeste sportlui te pas. Sportlui be­ hoort ook me probleme met die didak- I tiese inslag te ondervind nie, omdat hulle uiteraard ontvanklik vir onderrig en afrigting is. Verder skep die werkswyse van RET heelwat struktuur en 'n raamwerk waa- rin die deelnemer sy probleme kan aan- I pak. Dit bevat ook 'n faset van doelwit- stelling... lets waarmee die ernstige deelnemer vertroud behoort te wees. I RET maak ook gebruik van verbeeld- ingstegnieke om irrasionele denke te identifiseer en te wysig. Omdat die meeste sportlui van een of ander vorm van beeldingstegniek gebruik maak as deel van hul sielkundige voorbereiding, behoort dit goed in te pas by die sport­ man se normale program, n Verdere voordeel van RET vir die sportman is dat dit vereis dat die klient goed vertroud moet wees met die ra- sionaal en die werkswyse van die ter­ apie voordat daar met werklike terapie begin kan word. Dit behoort die sport­ man se motivering asook die geloof- waardigheid van die terapeut te bevorder Omdat sportlui sielkundig redelik taai is, behoort hierdie terapie, wat in teen- stelling met byvoorbeeld die Rogeri- aanse benadering redelik aktief- I direktief en soms bedreigend of uit- dagend mag voorkom, nie ernstige verhoudingsproblem e tussen die sielkundige en die sportman te veroor- saak nie. Die moontlikheid van weer- stand deur die afrigter omdat hy mag voel dat die voortigter op sy terrein oor- tree, word in groot mate verminder deurdat die onmiddellike doel van RET is nie om die sportman se gedrag as sodanig te wysig nie, maar om die in- houd van sy denke asook die wyse waarop hy dink te rekonstrueer Die feit dat die sportman self verant- woordelik gemaak word vir sy vorder- ing en dat hy insig in die werkswyse en doelstellings van RET moet he, behoort die stigma wat daar moontlik aan sielkundige hulp kleef en die gevolglike traagheid van die sportlui om hulself aan te meld vir terapie, uit die weg ruim. verwyslng Moller, Andr6 T. (1985), Rasioneel-emotiewe terapie in die praktyk Stellenbosch: Universiteit-uitgewers _____________________ DECEMBER 1987 VO L 2, NO 4 ,19< R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) f SASMA NUUS SASGV NEWS Dr D. van Velden Head: Department of Family Practice. n die Suid-Afrikaanse Sportgeneeskunde Ver- emging se pogings om 'n nasionale bewuswording te kweek van die belang van fiksheid as gesond- heidsbevorderende maat- reel, is ons besonder bevoorreg om in hierdie uitgawe 'n artikel te publiseer van Dr F. R Retief, Direkteur-Generaal, Departement van Nasionale Gesond­ heid en Bevolkingsontwikkeling, insake die plek van oefening in gesondheids­ bevordering. Dit is bemoedigend om te weet dat die Departement van Nasion­ ale Gesondheid en Bevolkingsontwikkel ing, so 'n hoe premie plaas op gesond­ heidsbevordering in die Nasionale Gesondheidsplan wat in 1986 afgekon- dig is Die SASGV sal alles binne sy ver­ moe doen om by wyse van weten- skaplike artikels, simposia en kongresse, 'n motiveringsaksie te loods ter bevor- dering van 'n gesonder leefwyse sodat gesondheidsbedreigende gedrag grootliks uitgeskakel kan word. Dit is al- gemeen bekend dat die Suid-Afrikaanse leefwyse aanleiding kan gee tot 'n vlaag van sogenaamde "hipokinetiese siektes” wat nie geneesbaar is met die tradi- sionele allopatiese geneeskunde nie, maar eerder met 'n gestruktureerde oefenprogram wat op 'n nasionale ba­ sis georganiseer word. Aangesien so 'n poging op 'n multidissiplinere benader- ing rus, is die SASGV verheug dat die aanverwante mediese dissiplines soos dv, fisioterapie, biokinetika, maat- skaplike werk, ensl, nou ook lid kan word van ons vereniging om ons hande te sterk in hierdie taak. The Editorial Board of the Sports Medi­ cine Journal had a very successful meeting recently where the format of tne Journal was discussed in depth. In­ ternational recognition is to be persued some opposition to become af­ filiated with the international Sports Medicine Association (F.l.MS.) and to comply with their motto for 1987: "Lets trv? examPle to the world. Lets work « w t n e r for Sports Medicine, Exercise, a * ; ancl a better understanding ong our Nations'! A concentrated ef­ Margaret Simpson, Continuing Medical Education University of Natal PO Box 17039, Congella 4013. Tel no: (031) 25-4211. Provisional programme Wedsnesday. 6th A p ril 1988 Registrations Welcoming Drink Thursday: 7th A p ril 1988 Welcome by President Motivation / Perspiration / Inspiration Biomechanics of Running Drugs in Sport Fluid balance Morphalegic Considerations Diet — Fads & Fancies Liniments, strapping and bandaging Endotoxaemia in long-distance runners Advice for the beginner Running equipment Footwear Friday: 8th A p r il 1988 Foot Anatomy & Biomechanics Skin problems in the runner Physical examination of the ankle and foot Stress fractures Compartment syndromes Foot soft tissue problems: Tendonitis/Fascitis Physical examination of the knee Internal Derangement of the knee joint Tendon problems around the knee joint Anterior knee pain in runners Muscle tear treatment in runners Medical Aspects of the Iron Man Triathlon The assessment of Fitness of Middle- aged persons to participate in strenuous sporting activities Banquet Saturday: 9th A p ril 1988 Fun Run Open Session Key Address & Panel Discussion Speakers will include Prof T Noakes Dr E P Hugo Mr S N du Toit Dr DP Van Velden DrRRathgeber Dr C Noble Mr G Lindenberg Dr J Skwono DECEMBER 1987 VOL 2, NO 4,1987 fort should be made to increase our membership and to disseminate our Journal as widely as possible to all ap­ propriate Health Professionals. The South African Sports Medicine As­ sociation is deeply in debt to the spon­ sor of our Journal and would like to ex­ press our sincere appreciation for their concentrated efforts to enhance the teaching and practice of Sports Medi­ cine in South Africa. Dr. van Velden SASMA update 88 Course The CME course, concentrating on var­ ious medical and physiological aspects of running, scheduled for 6-9 April 1988, is another venture of the SASMA to dissem inate Sports Medicine knowledge to everybody involved in sport and exercise For further information please contact: Dr R Rathgeber, 112 Hillcon Towers, Umhlanga Rocks 4320 Chairman: Tel: 031 561-1777 or- R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) PREVENTION OF RUGBY INJURIES SHOULD MORE BE DONE? ETIENNE P. HUGO, Chairman: SA Rugby Board Medical Advisory Committee S A has reached the end of the 1987 Rugby Season. There has again been a justifiable concern from many interested groups for the safety of the play­ ers during this year. Some sections of the Medical Profes­ sion on Media are always ready to cre­ ate sensation or denigrate rugby or preferably both by headlining any seri­ ous injury whilst ignoring similar inju­ ries occuring in activities like motor cy­ cling and other sports. It will be proclaimed on each occasion that the controlling body of the game has done nothing and that the "laws must be changed" or "new laws must be introduced". Those with genuine concerns for the game will want evi­ dence of what might lead to justifia­ ble changes Some perspective is need­ ed by looking at what has been done and what has happened in recent years. The game of rugby is under control of the International Rugby Football Board. The board is composed of 2 represen­ tatives from each of the unions in membership including South Africa. The laws of the game or any alterations therein or interpretations thereof are promulgated by the board. The board's concern about safety and health matters related to rugby led to the establishment of a Medical Adviso­ ry Committee and South Africa was represented on this committee since the beginning. This immediately led to medical advi­ sors or Advisory Committees to the various unions, Medical doctors accom­ panying touring teams, doctors at representative touring matches as well as the stimulation of interest and research into injuries, commonly as­ sociated with rugby. The board has introduced various changes, intended to improve the game for the players and spectators and the safety of the players has be­ come a major consideration during the last 10 years. Law amendments were introduced in an endeavour to minimise unintention­ al injuries. Various facets of the game came un­ der scrutiny e.g., the tackle and lying on the ground, scrums, rucks, mauls and foul play where deliberate injuries can occur. The Medical Advisory Committee was responsible for very important recom­ mendations which have been accept­ ed regarding: • the use of drugs in rugby • dangers of footwear and damage from studs • use of mouth guards • training and fitness • replacement of injured players • dangers of concussion • the need of injured players to leave the field The board conducted a special study into the frequency and type of rugby injuries and it is involved in an analysis of all severe spinal injuries due to rug­ by as well as the assessment of the value o f mouth guards. The S.A.R.B. Medical Committee is ac­ tively involved and committed towards these programmes. The I.R.F.B. has been responsible for more than 30 law amendments, 14 notes or instructions to referees, and more than 20 directives to improve the position of the player. It is unacceptable to state that the board has been unresponsive to change and to make the game a safer one The referee plays a vital role in the im­ plementation of the rules but the failure of referees to apply the laws of the game is not in itself an adequate reason for altering the laws. Officials, selectors, managers and even team doctors, develop tunnel vision in relation to their own team. Players are allowed to play after receiving injec­ tions into painful areas or joints or they are allowed to play one week after be­ ing carried o ff the field with concus­ sion. The S.A.R.B. has recommended mini­ mum medical and first aid require­ ments at all rugby playing fields. The effective implementation of these requirements and essential profession­ al care at playing fields have become a pre-requisite for playing the game Players and parents at schools have the right to demand certain basic precau­ tions and available facilities. The establishment of these facilities re­ mains the responsibility of the school, club or union. If these demands are not met, the ef­ fective protection by the laws of the game or the suggested minimum first aid requirements will have little effect. Closer co-operation between players, parents, administrators and doctors is needed to improve the standard of care further, DECEMBER 1987 VOL 2, NO 4,1? R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) BASIC CONDITIONING FOR RUGBY DR KEITH CORDON — Team Physiotherapist O ugby being an amateur game largely precludes any o ff season training program, and the best that can be hoped for is that 6 weeks before the new season begins, the players will put in some form of aero­ bic training, the activity of choice be­ ing running. For maximal aerobic ef­ fect, between 20-45 minutes should be run on alternate days. A basic weight training program emphasising hyper­ trophy is strongly recommended for between 6 - 12 weeks during the off-season. Once the players return to organised practices (usually towards the end of January), training emphasises the build­ ing of stamina and this was effective­ ly achieved by hill climbing. A t Eben Cuyler where the team practises, there is a fairly steep incline (35 degrees) of approximately 40 metres and the team builds up to 20 hills. One of the problems experienced here was the development of inflamed achilles tendons, and it would be advis­ able to start with only 2-4 hills and add 1-2 a week as the season progresses. During the season hill climbing is phased out due to the demands of the game and the need for more specific fitness to be developed. A t this stage more intense, shorter and faster activi­ ties replace hill climbing. It must be remembered that rugby is not an en­ durance event, and a number of in­ teresting statistical factors which should have an important influence on the specificity of training have been demonstrated. For example during an eighty minute game, there are on aver­ age 140 seouences of action lasting 27 minutes of actual playing time As it has also been obsetved that 56% of the ac­ tivity lasts less than 20 seconds and 85% of the activity lasts less than 20 seconds, it means that the energy source is predominantly ATP-CP plus the anaerobic lactic acid system. We see therefore that at all standards of competition high levels of anaerobic Power and capacity are required, and "it must be remembered that rugbylsnotan endurance event" their development must receive more attention than is currently the case. To achieve this the players must be put through a series of tests to measure: 2. 6. muscular strength, muscular endurance, cardiovascular endurance, flexibility, leg explosiveness, quickness, agility, percentage body fat. The question most often asked is: what is the role of testing if the tests do not measure playing ability? The answer is that the tests measure potential abili­ ty which could mean that the player who achieves high scores has the tools to become a great player. Strength training (weight training) should be encouraged and if it could form a part of the conditioning pro­ gram would contribute significantly to the players realising their individual potential. There is no American or East European athlete today who is not on an intensive weight training program. The benefits in terms of developing the players physical capacity factors that will enable them to fulfill their potential and minimise tim e o ff through injury have been proven con­ clusively by our American, Eastern Eu­ ropean and Russian counterparts, warm-up: Before every practice and game the team was warmed up very systemati­ cally as follows: Five minutes of run­ ning, hopping, jumping to get the cir­ culation going, followed by slow stretches to every joint and muscle act­ ing over that joint. Before a game, a few plyometric (rebound jumping) ex­ ercises are included to stimulate the "reactive neuro-muscular apparatus". This is brought about by loading the elastic and contractile components of the muscle The actual warm-up should take between 10 and 20 minutes, de­ pending on the fitness level, tempera­ ture and nature of activity it precedes conclusion: In addition to improving performance, one of the primary benefits of ade­ quate physical conditioning is to minimise the occurence and severity of injuries. The incorporation of proper testing to provide information as to the players physical capability, super­ vised strength training, adequate rest and nutrition will ensure the rugby players spend less time in the treat­ ment rooms and more time on the playing field. rtQ and trauma. diclophenac sodium 50 mg (entericcoated tablets) Reg.no,m.1/253 (weMctioi/1965) ej C ib a - G e ig y (Pty) Ltd P.O. B o x 9 2 Is a n d o 1 6 0 0 F o r fu ll p re s c rib in g in fo r m a tio n p le o se re fe r to th e M .D.R. M e m b e r 1987 v o l 2, n o 4,1987 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) NEWS The Ponky Firer sports Medicine Aw ard South African medical authors with an interest in the growing gfield of Sports Medicine will be pleased to learn of the establishment of a new writing award. The Firer Sports Medicine Award will take the form of an annual cash prize of R500 presented in recognition of an important written contribution in sports medicine by Johannesburg Or­ thopaedic Surgeon, Dr 'Ponky' Firer Certain principles are laid down for the guidance of contributors.- <1 • The objective is to encourage good, well presented and concise contribu­ tions to the growing literature on sports medicine. • Open to South African authors, criter­ ia for evaluation will include good research and sound methodology. Written contributions not exceeding 1500 -1800 words and dealing with any sports medicine-related topic are invi­ ted. Ideally, the work should represent per­ sonal experience and should provide concise/practical help to GPs and others periodically involved in the management o f injuries, training schedules or the physiology of sport. Articles must be available for publica­ tion in "Sports Medicine" prior to, or fol­ lowing judging. The editorial board of the publication will nominate three ar­ ticles from which one winner will be chosen by an appropriate academic authority. Drugs and Sport Congress The National Symposium on Drugs and Sport Participation to be held at the Sports Centre, University o f Pretoria, is scheduled for 26 February 1988. An In­ ternational speaker will participate and the SASMA is officially involved in the programme This promises to be very informative and further information can be obtained from Gert Potgieter or Petra Taljaard at Tel. No (012) 542-2150. Drug abuse in sport and in the commu­ nity is becoming a major problem and needs to be addressed from many different angles. The 7th international Biochem istry o f Exercise Conference, London, Ontario, Canada June 1-4 1988. Tentative Programme The Role of Functional Demand in Regulating Gene Expression. Determinants of Muscular Growth — A Biochemical Perspective. Muscle Energetics — Phosphorylation of the Contactile Protein. Metabolic Disorders of the Muscle — Exercise Implications. Fluid, Electrolyte, and Acid-Base Homeostasis in the Working Muscle. Extramuscular Substrate Deliver/ and Control with Exercise. The Biochemistry of Muscular Fatigue. Poster Sessions Adaptation and Muscle Transformation. Skeletal Muscle Growth. Metabolic Disorders of the Body. Fluid and Electrolyte Balance. Substrate Utilization and Exercise Skeletal Muscle Fatigue. Suid-Afrikaanse Sport geneeskunde Vereniging APPLICATION FORM AANSOEKVORM South African Sports Medicine A ssociation Full Member/VoHe lid R25 Student Member/Studente-lid R5 Tel No/Tel N r . ................ M A S A No/MVSA Nr . F u ll M e m b e r M e d ic a l p /a c tin o n e r rs w h o a re m e m b e rs o f M A S A V o ile L id : M e d ie s e p ra k tis y n s w a t le d e v a n d ie M.V.S. A. is . S tu d e n t M e m b e r . M e d ic a l s iu d e m s in c lin ic a l y e a rs S tu d e n t e - le d e :M e d ie s e s t u d e n ie m h u lk lin ie s e ja re. A p p lic a tio n s to r m e m b e rs h ip o f S. A .S .M A s h o u ld b e s e n t to. The S e c re ta ry . S A S M .A H a tfie ld F o ru m W e s t. 1067 A rc a d ia S tre e t. H a tfie ld . P re to ria 0 0 8 3 . C h e q u e s to a c c o m p a n y m e m b e r s h ip fo rm DECEMBER 1987 VOL 2, NO 4,11 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. )