The discipline of sports 
medicine has developed ex-
ponentially in South Africa in 
the last 25 years. The first 
major scientific publications 
were on orthopaedic injuries, 
dehydration or heat stress. 
Reflecting on how the pro-
fession has evolved in con-
tent and depth of knowledge 
is remarkable. In this rela-
tively short time period an 
enormous amount has been 

learnt about the aetiology of injury, the accelerated treatment 
of injury, and the prophylactic role that physical activity plays 
in reducing the risk of certain diseases. Injuries that may 
once have ended the career of a player can now be surgically 
repaired, with the player resuming his/her place in the team 
within the same season. The science of fitness is sufficiently 
advanced to ensure that, for example,  a professional rugby 
player weighing 100 kg can sprint and tackle almost tirelessly 
for 80 minutes, an elite ultra-distance runner can run 90 km 
averaging 3 minutes and 36 seconds a kilometre, and an 
elite powerlifter can bench press over 400 kg. These are just 
some examples representing extreme fitness that have been 
achieved, in part, by the application of science. 

Recovery after competition or a hard training session used 
to take place in the pub over a couple of beers. Nowadays, 
enhancing recovery after exercise has become a specialist 
field, with some professional teams employing support staff 
trained in ‘recovery’. These practitioners have a repertoire 
of evidence-based protocols that include compression 
garments, ice-water therapy, massage, and protein drinks. 
Accelerated recovery after matches and training is probably 
as important to a team as the ability to acquire skills and 
develop new game plans. Failure in any of these facets 
will lead to a team underperforming. An outsider looking in 
might form the impression that the application of science and 
sports medicine to sports performance and injury reduction 
is ‘all wrapped up, signed and sealed’. What more is there to 
learn? However, anyone in the business of exercise science 
or sports medicine will know that the fun and games are just 
beginning. 

Take for example the recent predicament that Jake White, 
coach of the national rugby team, finds himself in (as we 
go to press). Conventional wisdom has guided the coach in 
deciding to let his top players miss the overseas leg of the 
Tri-Nations tour so that they can recuperate and rejuvenate 
as they prepare for the remaining 12 weeks before the World 
Cup. Science has shown that after a rugby season 96% of 
the players have at the very least a niggling injury, 50% of 
the players have more serious injuries, and 1% will require 
surgery to repair an ongoing injury. The decision of the coach 
to rest the players can be supported by strong evidence, 
and therefore surely he cannot be faulted? However, based 
on the reaction from certain quarters it seems that these 
‘evidence-based decisions’ are not universally supported. 
The sponsors are annoyed because of the perceived lack 
of publicity, and the fans feel that they are being betrayed 
because their stars are not playing, and ‘how can they support 
a team that is not the best?’. Added to the antagonistic forces 
are the mumblings from Australia about South Africa being 
in breach of contract because of the ‘under-strength’ team. 
From the ruckus that the coach’s well-intentioned decision 
has caused, it is clear that other strategies will have to be 
adopted in the future to ensure that the high-profile players 
are always visible,  while at the same time being free from 
injuries and fatigue. This scenario of sports medicine being 
at odds with popular opinion is just one example suggesting 
that the field of sports medicine is still facing new challenges 
which will have to be met with as much vigour and innovation 
as the challenges that scientists and doctors were faced with 
25 years ago.   

On the topic of innovation, this issue of the Journal is filled 
with a range of studies that reflect the creative work of South 
African scientists and show how local research contributes to 
the development of sports science and sports medicine. May 
you enjoy the read! 

Mike Lambert
Editor-in-Chief

Sports medicine – still evolving?

editoriaL

SaJSM  voL 19  No. 2  2007                                                                                                                    29

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