pg78.indd I have just finished reading a book titled Samaritan of South African Rugby, written by Pat Tebbutt. It is an historical ac- count of the Chris Burger/Petro Jackson Players’ Fund which was established to support rug- by players who have sustained serious injuries. The story starts in August 1980, the day Western Province played the Free State in Bloemfontein. Following a ro- bust loose scrum, all the players involved got to their feet except Chris Burger of Western Province, who lay motionless on the ground with a broken neck. By 4 am the following morning he had died. This tragic event inspired his col- leagues, led by the Western Province captain Morné du Plessis, to create the Chris Burger Players’ Fund to raise money to support in- jured players. Thirty years later over 400 seriously injured players have been assisted by the fund at a cost of more than 30 million rand. As the fund evolved, and the ethos for making rugby safer grew, there was need to actively promote an injury prevention programme designed to lower the risk of injury. Rather than re-invent the wheel, the leaders of the successful Rugbysmart programme in New Zealand and Smartrugby programme in Australia were consulted. Both these programmes were designed to achieve the goals of making rugby safer. As a result BokSmart was launched. BokSmart adopted the principles of these two existing programmes and then customised the content to serve the needs of South African rugby. The programme has grown exponentially. Since the inception of BokSmart in mid- 2009, over 10 000 coaches have been trained in principles of safe rugby. In addition, BokSmart has established a website rich with evidence-based information on matters pertaining to rugby (www. boksmart.com). Topics range from physical preparation for rugby to the on-field management of serious injuries. All articles are freely available and are designed to serve and educate anyone involved in rugby. This preamble brings me to the link to this edition of the journal. BokSmart commissioned the review paper on concussion, written by Dr Jon Patricios – this review provides the most current best practice principles for managing concussion. The paper explains how a series of international consensus statements, which started in 2001, accelerated the understanding of the management of this injury. While there is still much to learn, the field has progressed significantly in the last decade. The remainder of the journal has an assortment of interesting papers. For example, a study on scuba diving describes how divers neglect their auditory systems. The study shows that there needs to be more education on ear problems following a dive, as divers do not generally have sufficient knowledge to manage the conditions properly. Then there is a case study on the Paget-Schroetter syndrome, followed by a short review of the topic. Although not a common condition it has the potential to be serious and if detected early and managed properly can reduce the recovery time significantly. Next there is an interesting paper on the most common physical therapy modalities for the treatment of whiplash. The paper shows that there is no standard treatment and recommends the establishment of a best practice protocol. The ‘Editor’s choice’ paper, published with permission from the British Journal of Sports Medicine, describes a novel test which has the potential to detect symptoms of overreaching and overtraining. Although further research needs to be done, this test is innovative and has the potential to be practical in managing high-performance athletes. As this is the last edition of the South African Journal of Sports Medicine for 2010 it is appropriate to thank all the people that make this journal possible. Firstly, the reviewers should get applauded. They generally do an excellent job, with no recognition or reward. It is a time-consuming and difficult task. I know some of the authors get frustrated at the detailed reviews, but the quality of paper that finally gets accepted for publication is always much better than the original form of the paper. Next, the staff of the Health and Medical Publishing Group are thanked. Their efficient, friendly service makes the job of this editor much easier to manage! Mike Lambert Editor-in-Chief Turning tragedy into triumph A topic which is receiving much publicity as I write is the banning of 5 skinny models from participating in the Madrid fashion week. Madrid’s regional govern- ment imposed the rules ‘to protect the models as well as teenagers who may develop anorexia as they try to copy underweight catwalk stars’. 1 They used a body mass index of 18 as their cut- off value. The ‘anti-thin’ move has been criticised in Paris and New York, two of the world’s leading fashion centres. However, in Italy the move was supported by the mayor who intimated that she would like to apply the same rulings when the fashion show moves to Milan. The motive for imposing the ban is noble, as the ‘skinny trend’ is not showing signs of abating. A recent report by the British Medical Association identifies a link between the images of ‘abnormally thin’ models that dominate television and magazines, and the increase in cases of anorexia nervosa and bulimia. 2 The incidence of anorexia is at an all-time high with predictions of 0 - 5% of all females having eating disorders. While eating disorders were previously usually regarded as a female syndrome, the situation is changing with a steady increase in the number of men being diagnosed with eating disorders. A recent estimate predicts that of the 60 000 people with eating disorders in the UK, 10% are male. 2 This trend can most likely be explained by the contemporary lean, hungry look of male stars. To get a snapshot view of changing body beautiful images of different eras one only has to compare the ‘hunks’ of the 1960’s movies (i.e. Sean Connery as James Bond) to modern day hunks to see how the masculine image has changed. Marilyn Monroe, with her curvy body shape in the 1950s would probably be regarded as too fat for a leading role 50 years later. While the organisers of the fashion shows should be complimented for taking a bold stand against their skinny, unhealthy-looking models, they can be criticised for the way in which they have gone about it. Using a body mass index of 18 as a cut-off value is inappropriate and may penalise some models who live normal healthy lives. Instead of this approach the organisers should establish a structure that evaluates the health status of the models including their eating, sleeping and substance abuse habits and make decisions accordingly. The information on how to do this is available; it just needs to be applied. This third issue of the journal for 2006 has 4 interesting papers. The first paper by Professor Mars and colleagues examines the cooling of skin, subcutaneous fat and muscle with an icepack, at rest and after short-duration exhaustive exercise. This study produced some interesting results with important clinical applications. The next paper by Ian Cook examines the accuracy of different types of pedometers. It is well known that people who use pedometers are encouraged to be more physically active, so therefore there is great value in making pedometers available to the general public. However, the enthusiasm to make and distribute pedometers has exceeded the concern about their accuracy. This study addresses this point with a comprehensive research design. The results make a valuable contribution to the literature. The third paper, by Dr McHardy and colleagues from Macquarie Injury Management Group, Macquarie University, Sydney, Australia, is a clinician’s perspective of the modern and classic golf swing. This paper is relevant to sports physicians, biokineticists and physiotherapists and provides a clear analysis of the different types of golf swing and their possible link to injury, particularly lower back pain. Finally the paper by Dr Draper and her colleagues describes the state of the fitness industry in South Africa. This comprehensive study gathered data from 442 facilities around the country. The data provide an important benchmark for the state of the industry and will make a significant contribution to the development of perceived weaknesses in the industry. Mike Lambert Editor-in-Chief 1. Milan fashionistas fear Spanish skinny model ban. news.yahoo.com/s/ nm/20060914/od_nm/italy_models_dc (accessed 18 September 2006) 2. The changing shape of the model. news.bbc.co.uk/1/hi/uk/769460.stm (ac- cessed 18 September 2006) Skinny fashion – a role for sports medicine? SAJSM VOL 18 NO. 3 2006 57 EDITORIAL pg57.indd 57 9/21/06 12:15:22 PM ediToriaL 78 SaJSM voL 22 No. 4 2010