SPORTS MEDICINE
SPORTGENEESKUNDE

JO U R N A L O F TH E S.A. SPORTS M EDICINE ASSOCIATION 
TYDSKR1F VAN  DIE S.A. SPORTGENEESKUNDE-VEREN1GINC.

SEPTEMBER 1989 VOLUME 4/NUMBER 1

Injuries in First-class C ricket- an Analysis 
C atastrophic Rugby Injuries 
Psychological Factors in Sports Injuries

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C O N T E N T S

T Y D S K R IF  V A N  D IE S.A.JO U R N A L  O F TH E S.A.

SPORTS MEDICIN E / SPORTGENEESKUNDE
A S S O C IA T IO N V E R E N IG IN G

V O L U M E  4 N U M B E R  1 S E P T E M B E R  1989

E d ito r in C h ie f: D r C N o b le  A/I 8  B C Ii, F C S (S A ) 
A s s o c ia te  E d ito rs:
P r o f T  N on kes. M B  C liB .M D
D r D mi'ie van V eh len  M B  CUB (S lc ll) M  Prnx
M ed  (P re to ria )
A d v is o r y  B o a rd :
M edicine:
D r I Cohen M B ChB D.Obst RCOG 
O r th o p a e d ic  tra u m a to lo g y :
D r P F irer B S e (E n g )M B  B C h ( W i ls )
M  M e d (O r th o ) < W its)
B rig E H u g o  M B  C h B , M M e d  (C h ir ) ■ 
O rth o p a e d ics:
D r 1C Lifttin M B  B c h , F R C S  (E d in ) 
C a rd io lo g y :
C ol D P  M y b u r g h  S M  M b  C liB F A C C  
P h ysical E d u ca tio n :
P r o f H a n n es B o th a  D  Phil (P ln/s Ed) 
G y n a e co lo g y :
D r la c k  A d n o  M B  BCIi ( W its) M D  (M ed )
D ip  O & G  (W its)

C O N T EN T S

E d itorial co m m e n t
N e c k  Injuries in R u g b y ................................................. 2

S A S M A  N ew s
N e w  S A S M A  L o g o ......................................................... 3

C rick e t In ju ries
Injuries to Sou th Afr ic an C ricke ter s 
P laying at Firs t-C lass  L e v e l ....................................... 4

F isio lo g ie
Die Fisi ologi es e V o o r d e le  van
O p w a r m i n g  en A f k o e l i n g ........................................... 6

F a rm a k o lo g ie
M id d e l s  in S p o r t .............................................................. 9

N ew  P ro d u ct
V o lt a r en  Su p p o s it o r ie s  1 2 , 5 m g ................................ 10

R u g b y  In ju ries
C a ta s tr o p h ic  Injuries o f  the
Sp in al C o r d ......................................................................... 11

P sy ch o lo g y
P sy ch olo gica l Fa ctors  and Sp ort s I n j u r i e s ........... 13

Letters to the E d ito r........................................................ ...........16

D iet
T h e  Ath le te  and his Diet in G e n e r a l ................... ...........17

U ltram an  R o u n d u p  1 9 8 9 .............................................. 18

m  a f r i c a n  s p o r t s  m e d i c i n e  P ictu re s  C o u rte s y  of P h oto file/Im age B ank

SASGV

SASMA

P U B L IS H E D  B Y  T l IE SO U  
A SS O C IA T IO N  
H A I'F I EL D  KO R U M W  E ST 
HV>7 A R C A D IA  ST R E F T  
H A T F IE L D  
P R E T O R IA , 0 0 8 3

T h e  jo u rn a l oi t h e S A  S p o r ts  M e d ic in e  A s s o c ia tio n  »s e x c lu s iv e ly  Sp o n s o re d  b y C ib a - G e ig y  (P ly ) L td. T h e  
Jo u r n a l )> p ro d u c e d  b v  C o m m e d ic n , P O  Box 3 9 0 9 , R a n d b u rg , 2 1 2 5 .T h e  vie w s  e x p re s s e d  in th is  p u b lica tio n  
a re  th o s e  o t  the a u th o rs  an d  not n e c e s sa rily  th os e  o f  th e  s p o n s o r s  o r p u b lish ers

CtSA m  •

<r
S P O R T G E N E E S K U N D E  V O L 4. N R  1

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SPORTS MEDICINE

EDITORIAL

N ECK  IN JURIES IN RUG BY

R u g b y  has b ee n  des cribed as a co llis ion sport, and 
as su ch inju rie s ar e inevitable.

W h e n  se r io us injuries o cc u r  fre qu en tly  th e n  o n e has 
to look to ch a n g in g  the rules to d im in is h  the incidence  
o f  these injuries. N e ck  inju ries b e c a u s e  of their p o ­
tentially ca ta s tr o p h ic co n s e q u e n c e s  h a v e been 
featured p ro m in en tl y  in the m edica l an d lay litera­
ture. T h e In te rn at iona l R u g b y  B o a rd , th r ou gh  their 
m edica l c o m m i tt e e  h a v e been act iv e in this regard. 
T h e y  ha ve  penalis ed  the high tackle and ha ve  tried to 
tight en up on the s c r u m m i n g  rules. U n fo rt u n a te ly  
this so far has not resulted in a re du ct io n  in ser ious  
nec k injuries. Prof.A.T. S c h e r 's  statistics fro m  the 
C a p e  area h a v e revealed an inc re as ed  in cid e n ce  of 
neck injuries largely in sc ho ol boys.

T h is  m e a n s  that at sc h o o lb o y  level the n ew  laws are 
not a d e q u a te  or ar e not b ei n g en fo rc ed properly. In 
the s c ru m  the forc es on the a d o le s ce n t n ec k  are too 
gre at es p ec ia ll y  w h e n  the s c r u m  co llaps es.  It is 
therefo re im p era tiv e to re d u ce the forc es in the sc ru m  
and the d a n g e r  of the s c r u m  c ollap si ng . A n u m b e r  of 
so lu ti o n s h a v e bee n su gg es ted  b ut m a n y  o f  these are

h ig h ly  technical such as the re lationsh ip of the hips to 
the s h o u ld e r s  an d the d e g r e e  of w h e e li n g  of the scrum.

Su re ly  a r e du ct ion in th e n u m b e r  o f  playe rs s c r u m m i n g  
at sc ho ol level is the an sw er .

R e d u c in g  the p u sh in g  for w a rd s  to three or m a x im u m  
five, will a ch iev e both  be tter stability in the s c r u m  and 
r e d u ce the forces in the scrum.

If 5 m en  ar e used , the se co n d  row of for w a rd s  sho uld 
be in the flan k and not the lock p ositio n w h ic h  will fu r­
ther add to the stability. O n c e  m a turi ty  is reached the 
eigh t m a n  s c ru m  can ag ain  be used.

As re ga rd s the high tackle, the law s sh oul d be better 
en fo rc e d  and bet te r tackl ing te ch n iq ue s sh oul d be 
taught . N e c k  s tre n g th e n i n g  exe rc is es  sh oul d be c o m ­
pu lso ry  at all s c ho o ls w h e r e  ru gb y is played.

F in ally  a re gis ter of neck inju rie s sh oul d be kept in Sou th 
Afr ic a and the statistics m a d e  pu blic at the end o f  each 
se as on .

L e t 's  m a k e  r u g b y  s a f e r  —  P le a s e !

Dr. C liv e N o b le M B  B C h , F C S  (SA)
E d it o r -in -C h ie f

SAM SA NEW S / SASG V NUUS

It is w ith  g re a t p le a su re  that w e can a n n o u n ce  that w e are 
n ow  in a p osition  w h ere w e can  co n tin u e  to p u b lish  o u r 
Jo u rn a l, b rin g in g  you m an y in te re stin g  and in fo rm a tiv e 
a rticles. H o w e v e r, due to the h e a v y  fin a n cia l co m m it­
m en t to p u b lish  a Jo u rn a l of this fo rm a t, w e w ill in the 
fu tu re h ave to sen d  the Jo u rn a l o n ly  to su b scrib e rs and 
m e m b e rs of the S A M S A  at a sm all fee. D e ta ils w ill be 
an n o u n ce d  sh o rtly .

D ie SA S p o rtg e n e e sk u n d ig e  V e re n ig in g  h et h om  o ok  
b e y w e ro m  'n o o rs p ro n k lik e  w ap en  te o n tw e rp  en u sien  
die resu lta te  van die g o e d g e k e u rd e  em b le e m  reed s in 
h ie rd ie  u itg aw e. H ierd ie em b leem  is h e ra ld ie s b eter 
o n tw e rp  as die v o rig e  een en lui sp re e k w o o rd e lik  'n  
n u w e era in v ir o n s V e re n ig in g . O n s h oop  om  ons 
d ie n ste  aan ons led e nog v e rd e r u it te b rei en o n tv a n g

g ra a g  v o o rste lle  of k ritie k  in h ie rd ie  v e rb a n d . D a a r w ord 
re e d s b ep lan  v ir 'n S p o rtg e n e e s k u n d ig e  O p le id in g sk u r- 
su s ty d en s 27-29 Ju n ie  1 9 9 0  in P ort E lizab eth .

N e w  S A M S A  l o g o  

T h e h a n d so m e  n ew  S A M S A  logo a p ­
p ears fo r the first tim e in this issue of 
S p o rts M e d icin e . M e m b e rs w ill su rely  
a g ree that it m eets all the crite ria  of a 
w e ll-d e sig n e d  logo: It is a d y n a m ic 
g ra p h ic, w ith  a high  level of e n erg y  as 
b efits the top ic it is to co n v ey . The 
m e d ica l a sp e ct in te g ra te s co m fo rta b ly  
in the d e sig n  so that all in all w e h ave 
a m o d e rn  d esig n  that w e can  live and 

g ro w  w ith  in the years to co m e.

D r. D a w ie  van  V eld en  M B , C h B , M .P rax.

S A S G V
S A S M A

S P O R T S  M E D IC IN E . V O L  4. N O  1

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CRICKET INJURIES

INJURIES TO SOUTH AFRICAN CRICKETERS 
PLAYING AT FIRST-CLASS LEVEL

R IC H A R D  A S T R E T C H :
D E P A R T M E N T  O F  H U M A N  M O V E M E N T  ST U D IE S ,

U N I V E R S I T Y  O F  F O R T  H A R E

A B S T R A C T  Kei/worils: In ju rie s , cricket

T h e p u rp ose o f this in v e stig a tio n  w as to d e te rm in e  the m ost co m m o n  crick e t in ju ries and to m ak e re c o m m e n d a tio n s 
in an a tte m p t to red u ce the n u m b e r of in ju ries. T h e su rv ey  p o p u la tio n  co n sisted  of 92 p lay ers w ho had p lay ed  first- 
class crick et d u rin g  the 1 9 8 7 /8 8  seaso n . O ne h u n d re d  and n in e ty -th re e  se rio u s and 73 less se rio u s crick et in ju ries, 
w hich  had o ccu rred  th ro u g h o u t these p lay ers' ca re e rs, w ere re co rd e d . T w e n ty  p ercen t o f the se rio u s in ju ries w ere 
to the h ead , n eck  and face, 32%  to the u p p e r lim b s, 18% to the b ack  and tru n k , and 30% to the lo w er lim b s. T h e in ju ries 
w ere p rim arily  im p act in ju rie s as a resu lt of b ein g  h it by the ball e ith e r w h ile b attin g  o r fie ld in g , stress in ju ries as 
a resu lt of rep e titiv e  m o v e m e n ts fo r a p ro lo n g e d  len g th  of tim e, and m u scle and lig a m e n t in ju rie s n o rm ally  asso ciated  
w ith field sp o rts. R e co m m e n d a tio n s re g a rd in g  the use of e q u ip m e n t, tra in in g  and p ra ctisin g  for crick e t w ere m ade 
in an a tte m p t to red u ce the risk of in ju ries.

IN T R O D U C T IO N

ese ar ch  into cricket, a c o n ­
s e r v a t i v e  a n d  t r a d i t i o n a l  
sport, has been neglected. 
H o w ev e r, the S o u th  African 
C r ic ke t Un ion and the Form- 
ScaffC rick et C oach in g  Acad ­

emy have recently established a Cricket 
Research Centre. This Resea rch Cen tr e 
will no d o ub t co n tri b u te  to the e v o l u ­
tion of cricket from a traditional art to 
a blend of art and science.

Th e introduction of vast s u m s  of money, 
m o re  fixtures, esp ec ially lim it ed -over s 
m atches, and the in creas e in the n u m ­
ber of fast b o w le r s  on pi tches pre ­
pared for them, has placed ad ditional 
stresse s and strains on the m o d ern  
cricketer. Besides sound technical skills, 
these cric ke ters  need to po ss ess  a high

A u t h o r ' s  a d d r e s s :  R . A .  S t r e t c h  
1 0 3  Q u e e n s  R o a d  
K i n g  W i l l i a m ' s  T o w n  
5 6 0 0

A ck n o w l e d g e m e n t s :  T he a u t h o r  w o u l d  like 
to a c k n o w le d g e  the as si st a nc e received from 
the R E S E A R C H  D E P A R T M E N T  o f  the 
F O R M  - S C A F F  C R I C K E T  C O A C H I N G  
A C A D E M Y  f o r  this project.

level of fitness thus m a k in g  them  s u s ­
cept ible  to the traditional direct inj u­
ries of being st ruck  by the ball, indirect 
in ju ri es su ch  as 
m u s cle tears and 
r u p t u r e s ,  a n d  
o v er -u se  injuries 
as a result of re­
p e titiv e  t r a in in g  
for a sp o rt  that is 
bec om ing more ex­
plosive in nature.

injuries to first class cric ke ters in A u s ­
tralia w as found to b e 1 per 30 ma n- 
ho urs  played. ’ A si gn ifi ca nt increase

Th e  British Sport 
C o u n c i l  12 s u r ­
veyed 213  te am s 
in N o r th er n  E n g ­
land an d recorded 
251 in ju riesd uri n g  
a season.

Th e y  estimated the 
risk of injuries to 
the cr ic ke t pl ayers 
to be 2,6 per 10 000 
m an hours played. 
H o w e v e r ,  th e s e  
fig ures exc lu ded 
injuries th ough t to 
be trivial, as well 
as m a n y  ch ron ic  
ov er- u s e injuries. 
T h e  rate of all

S P O R T C E N E E S K U N D E  V O L  4. N R 1

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CRICKET INJURIES

in o v er -u s e injuries in y o u n g  children, 
esp ec ially in the ar eas o f  stress  frac­
tures and g ro w th  car tilage injuries was 
found. A c c o r d in g  to these a u th o rs  the 
p ri m a ry  areas of co n c ern , particularly 
to the y ou n g  fast b o w le rs , is d a m a g e 
to the g ro w th  car tilage o f  the k ne e and 
traction ap o p h y s is , as well as c o m ­
p re ss iv e stress to the artic ul ar su rface 
cartilag e of the f e m u r  a n d  talus.

T w e n t y - f iv e  pe rce nt of injuries o ccur 
to the head , face and nec k with c o n t u ­
sions, lacerations and nose bleeds being 
the m o st  co m m o n . : Se v en  cases of 
c o n c us s io n  w er e repo rte d in players 
w h o  were st ruck by the ball. Eye 
injuries in cr ic ke t w ere reported 
as long  a g o  as the b e g in n in g  of the 
c e n tu r y .4 T w o , out of a total o f  fifteen, 
cas es  o f  ocu lar injuries were reported 
to h a v e been cau se d  by cricket balls. 
D A m b r a i n  5 repo rte d two cases of 
c h r o n i c g la u c o m a  seco n d ar y  to trauma, 
out of a total of 18 as so ciate d with 
cricket, w hile  4% o f  184 cases and sev en  
p erc en t of 65 cas es o f  o cu la r c o n c u s ­
sion injuries in s p o r t s m e n  w e re  re ­
po rted O f  five cas es of eye injuries 
repo rte d, four resulted w hile  batting. 
O f  these b atting injuries, three w er e as 
a result of the ball def le ct in g  off the top 
ed g e o f  the bat w hile hoo kin g  and 
strik ing the ey e on the side of the 
d o m in a n t hand. Fin g er s w er e found 
to be the most v u ln er a b le  site for inju­
ries Th e s e inju rie s consi sted pri­
m a ri ly  o f  fractures , dislo ca tions  and 
con tusi on s su stai ne d whil e batting and 
fielding. T h e d a n g e r  of a fracture, as a 
r e s u l t o f  being struc k by the ball, to the 
distal third of  the uln a r of the top hand 
w h e n  batting w as  also indicat ed,  but 
no cases of this inju ry w er e reported 
" T h r o w e r 's  s h o u l d e r "  w h ic h  is caused 
by d eg en e r a ti o n  and in fla m m a to ry  
ch a n g es  or partial an d c o m p le te ru p­
tures of the rotator cuff, usually m uscl e 
of the bi ce p s ten don, is rega rd ed as a 
c o m m o n  cricket in ju ry .11’

T h e  case  of a y ou n g  fast b o w le r w ho 
dev e lo pe d  acu te p n e u m o m e d i a s ti n u m  
and bilateral p n e u m o th o r a c e s  whil e 
practising  fast b o w li n g  was r e p o r t e d 1', 
w h il e sp o n d y lo ly s is  w as found to be

co m m o n  in A u stra lia n fast b o w le r s  
p l a y i n g  first class c r i c k e t T h i s  injury 
is d u e  to a stress fracture that occ ur s to 
the parts inter ar ti cu la n s on the side 
o pp o si te the bo w li n g  a rm  as a re sult of 
the ro tat ion an d ex te nsi on  of the back 
w h e n  b o w li n g  fast. Pain occ ur s in the 
lo w er  lu m b a r  region or is localized in 
o n e side of the spine, s o m e t im e s  r a d i­
ating to the b u tt o c ks or leg after c o n ­
tinuo us stress to the back. Se riou s 
injuries, m a inly  to the lo w er  b ack of a 
n u m b e r  of elite and ju n io r fast b o w le rs  
w e re  found l2. C or r ig a n  c' reported 
that m u s cle tears of the a b d o m e n  o c ­
cu rr ed  in fast bow lers,  w hile  b a ts m en  
suffered rib fractures and soft tissue 
injuries, esp ec ially  to the u p p e r  leg, 
a b d o m e n  and testicles.

M a n y  injuries o cc ur in the low er  limbs 
d u e to im p ac t from the ball, stress 
inju rie s a s s o cia te d  w it h  re p et it iv e 
m o v em e n ts  and other injuries normally 
asso ciate d with field sports. T w en ty - 
five percent of injuries o cc u r  to the 
lo w er  limbs with the m ajo rity  being 
s trains and sprains. Fast b o w le rs  are 
particularly likely to suffer from muscle 
tears, especiall y o f  the hip flexor, the 
a d d u c to r  lo n g us o f  the leg and the 
re ctus fem ori s m u s cles  C' UI. C o r r ig a n  C| 
is of the con ten ti o n  that stress fr ac ­
tures are  c o m m o n  in fast b o w le r s  and 
occ ur primarily in the metatar sal bones, 
the fibula and  tibia. F u rth erm o r e 
talotibial ex osto ses, p at el la r te n d o n i­
tis, bruised heels and 'shin splints' 
o cc u r  as a result o f  o v er- u s e an d  are 
m o r e c o m m o n  to w a r d s  the en d  of the 
s ea s on  l).

T h e  pu rp ose  of this in v estig at ion was 
to d e t e rm in e  the m ost c o m m o n  cr ic ke t 
injuries and to m a k e r e co m m e n d a t io n s  
in an a tt em p t to r e d u ce the risk of 
injury.

M E T H O D S

Postal qu es tio n n a ir e s  w er e se n t to 
154 cric ke ters  w h o  had played in the 
198 7 / 8 8  C u r r ie C u p  an d Cas tle Bowl 
co m p et it io n s.  N i n ety -tw o  q u e s t io n ­
n a ir e s  (6 0 % ) w e r e  r e tu r n e d . T h e  
injuries re co rd ed  w er e not restricted

to th ose  received d ur ing that season, 
but w e r e  all the injuries r ece iv ed  while 
p la yin g  cl ub  an d pr o v in ci al cricket. 
F or the p u rp o se  of  this su rv ey  injuries 
w ere  g ro upe d  a cc o rd in g  to two c lassi­
fications. T h e  less ser ious  inju rie s were 
those that did not p re v en t the player 
from practising or training for the game,
w hile the ser io us inju rie s w er e those 
that pr event ed the p la ye r from pra c­
tising or training for a d ay or more. 
T h e  injuries w er e furth er d iv id ed  into 
injuries in four regions of the body: 
the head, neck and face; the u p p er  
limbs; the ba ck and trunk; and the 
lo w e r  limbs. T h e  Sa m p l e  Statistical 
A n a l y s i s  Sy s te m  (SAS) w as  used to 
co m p u  te the data and to p e rfo r m  cross 
tabulat ion s. T h e sm al l s a m p le  size 
did not a llo w  for furt her statistical 
an alysis.

R E S U L T S

N i n e t e e n  of the cric ke ters  in this in v es­
tigation had pl ayed  cricket at in tern a ­
tional level, w hile the highest level the 
o ther 73 pl ay ers  had p la ye d  at was 
provi nci al level. T h e y  had a m e a n  age 
o f  27,0 years, a n d  a m e a n  bo d y  m as s of 
82 kg and a m e a n  statur e of 1,82 
meters. T h e s e  val ues w ere si m ila r to 
tho se m e a s u re d  in an  a n th r o p o m e tr ic 
st u d y  on South Af ric an first-class cr ic k ­
eters l3.

T h e r e s p o n d e n ts  co nsiste d of 31 b a ts ­
m e n , 36 a ll -r oun der s,  16 b o w le r s  and 
nine w ic ke t- ke ep ers . D u ri n g  the off­
s ea s on  30% o f  the re s p o n d e n ts  spent 
no ti m ep ra ct isin g or training forcricket, 
w hile 47%  s pe nt b etw ee n  o n e and four 
hours  per w ee k  training and p ra ctis­
ing for the va ri ou s a spects of the gam e. 
D uri n g the p re -s easo n  period, 70% of 
the r e s p o n d e n ts  s pe nt b e t w e e n  three 
a n d  eight hours a w ee k  pra cti si n g  and 
training specifi cal ly for cricket. D ur­
ing the s ea s on , 50 % of the re sp o n de n ts  
sp en t b etw ee n  se v en  and ten hours 
per w ee k  prac tising and training for 
cric ket, w hile a furt her 27% sp e n t more 
than ten hours  per w ee k  practising 
and training.

S P O R T S  M E D IC IN E . V O L 4. N O  1

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CRICKET INJURIES

O n e hundre d an d nin ety -t h re e serious  
a n d  73 less ser ious  cricket inju rie s w ere 
recorded. O f  the se r ious  inju rie s 20% 
were to the head, 32%  to the u pp er  
limbs, 18%  to the b a c k  an d tr un k and 
30% to the low er limbs. S e v en ty -fo u r  
percent of these injuries occurred during 
matches, 21 % d urin g  practices and 5% 
occ urred d ur ing b o th  m a t ch e s  and 
practices. F o r ty -tw o  perc en t of the 
ser ious injuries o ccurred w h il e b a t­
ting, 33% whil e b o w li n g, 19%. while 
fielding and 5% w h il e either w a r m in g  
up or training. O f  the less serious 
injuries 16% w ere to the head , 43%  to 
the u p p er  limbs, 14% to the b a c k  and 
trunk and 27% to the low er limbs.

H EA D  N E C K  A N D  F A C IA L  
IN JU R IE S

O f  the 38 head injuries s u s ­
tained, 66% occ urred while 
the b a ts m en  w ere w e a r ­
ing no h el m et  and 24% 
while the b a ts m en  were 
w ea ri n g hel mets with

V'

su st ainin g  24 injuries. N i n e t e e n  in ju ­
ries w er e su stai ne d w hile  c a tch in g  or 
fielding the ball and one w hile  w a r m ­
ing up for a match.
T h e s e results su p p o rt the fin dings of 
o ther re s ea rc h ers  w h o  found that fin­
g er injuries were the m ost c o m m o n  
cr ic ke t in ju r ie s .IZV)

B A C K  A N D  T R U N K  IN ­
JU R IE S

T w e n t y - f i v e
(7 1 % )

e a r  p i e c e s  o n l y .
T h ir ty -o n e (81%) of 
the hea d  in ju ries 
were as a result of 
either being struck
by the ball w hile  a tt e m p tin g  to hook, 
by the ball deflecting off the top edge 
of the bat on to the head w hile  pl ayi ng 
a horizontal bat stroke, or as a result of 
being struc k by the ball rearing  off the 
pitch. Th e s e head injuries su staine d 
while batting inclu ded  tw o c o n c u s ­
sions, eight
br o k en  nose an d ch eek  bo ne s,  and 21 
lacerations, re qui ring stitches, ar oun d  
the eyes, m o u t h  an d chin. T h e  top and 
m iddle  o rd er b a ts m en  su st ai ned  m o re  
im p ac t injuries to the he ad  (24) than 
the low er ord er b a ts m e n  (11).

U P P E R  LIM B IN JU R IE S

O f  the 62 u pp er  li m b  injuries nine cases 
of sh o uld er  injuries w ere recorded w'ith 
four of these su staine d w h il e b o w li n g  
and five w h il efie ld in g . T h e  pha la nge s, 
metacarpal and lower arm  injuries made 
up 50 (81%) of the u p per  li m b  injuries. 
T hir ty  of these w ere ca u s ed  while 
ba tting with the top and m id d le ord er

o f

V t h e  3 5  b ac k an d  trunk 
injuries w ere  to the 

lo w e r  and m i d d l e  back. 
T h e s e  w er e m a inly  m usc le , li ga­

m e nt and te n d on  injuries. T w e n t y -  
three of these were su st ain ed  whil e 
b o w li n g  or as a result of the repetitive 
m o v e m e n t s  of bo w li n g  m a n y  overs.

L O W E R  L IM B  IN JU R IE S

T h e  5 8  lo w er lim b injuries c o n si st e d  of 
injuries to the b ones  of the foot (11), 
a n kl e lig a m en t (11), m u s cles  of the 
lo w er  leg ( 5 ) ,  knee car tilage (6), q u a d ­
riceps an d  h a m s tr in g  m u s cles  (10) and 
the groin (13). T w e n t y - tw o  (38%) low er 
lim b injuries w ere  either as a result of 
c o n tin u a l b o w li n g  or ca u s ed  by b o w l ­
ers tr a m p in g  in the ro ugh  foot m a rk s 
on the pitch in their deliv e ry  stride 
and fol low  through. T en (17%) lo w er  
limb inju rie s su sta ined w er e m u sc le  
and li gam en t injuries ca u se d  whil e 
b a ts m e n  w ere  r u nning b etw ee n  the 
wickets.

L ESS S E R IO U S  IN JU R IE S

T h e less se rio us injuries co n si st ed  of

30 (41 %) im pact injuries, 21 (29)% stress 
injuries from re peated actions and 22 
(30%) injuries norm ally associated with 
field sports. T h e  im p ac t injuries were 
as a result of b ein g  st ruck by the ball on 
the hand and for ea rm  ( 1 9 ) ,  head (10) 
and foot (1) T h e  o ther injuries were 
m a inly  m u sc le  and  li gam en t strains to 

the neck, bac k and trunk 
( 1 3 ) ,  s h o u l d e r  and elbow, 

(11) gro in (4) and ham st rin g  
(8) and three m ino r cases of 

shin splints.

D IS C U S S IO N

T h e top o rd er b a ts m en  face the 
fast b o w le rs  at the b eg in n in g  of 

the innin gs  w hen  the b o w le rs  are 
rested. D u rin g  the early part o f the 

inni ngs the ball an d w icket possess 
m o r e b o u n c e and tend to fa v ou r the 

bo w le rs  m a k in g  the b a ts m e n  m ore 
su sc ep ti b le  to im pa ct injuries, e s p e ­
cially to the head , h a n d s and forearms. 
Specialist b o w le r s  w er e found to s u s ­
tain m o r e hand injuries w hile batting, 
than the specialist ba tsmen even though 
the y spent less time batting \ Th ey 
co n ten d ed  that the b o w le rs  w er e not 
as skilled at b atting and did not p o s ­
sess the reactions and te ch n iq ue re­
qu ired to deal with fast b ow lin g.  O n e 
factor that m ay  ha ve  resulted in the 
d if fer ence in these fin dings is that the 
A u stra lian  pi tches are traditio nally 
faster and m o r e b o u n c y  than those in 
S o u th  Africa thus m a k in g  it m o r e d if ­
ficult for the less skilled b a ts m en  to 
play fast b ow lin g.

T h e  ability to ru n with the pads on and 
the skill o f  r u n n in g  b etw ee n  the w ic k ­
ets is not oft en  practised by cr icketers. 
M o r e  atten tion sh oul d be placed on 
this as pe ct, by inc lu ding it as part of 
the fitness train ing , in an a tt em p t to 
el im in a te  a n y  u nn e ce ss a ry  injuries 
su stai ne d w hile r u n n in g  betw ee n  the 
w ickets.

At front-foot im pa ct , the fast b o w le r 's

(C on tin u ed  on p ag e 19 . . . )

S P O R T C E N E E S K U N D E  V O L  4. N R  7

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FISIOLOGIE

DIE FISIOLOGIESE VOORDELE VERBONDE 
AAN OPWARMING EN AFKOELING

Dr P E K ruger

IN L E ID IN G

Indien ons v a n d a g  'n g es p re k  sal voer 
o o r  d ie  b e g i n s e l s  v an  o e f e n p r o -  
g ra m v o ors kri ft e, sal alle afrigters met 
g esag d a a r o o r  kan praat en kan getuig 
dat hulle o e f e n p r o g r a m m e  een of meer 
van hierdie b eg in se ls insluit. Wa n- 
n eer ons eg te r o o r  o p w a r m in g  en 
fle ksitei tso efe ning praat, d an  sal die 
m e es te  van ons er ken  dat hierdie 
ged ee lte van ons v o o r b ere id in g  nie sy 
r e gm a tig ep lek  in ons o efen p r og ra m m e 
en v o o rb er e id in g s fa s es  in n e em  nie. 
Da ar word slegs 'n pa a r m in n te vo or 
en mi skein na die oef en in g, d us die 
a fsk eep tyd jie s,aa n  hierdie gedeelte van 
o n s in oefe ning b estee terwyl dit in 
werklikh eid 'n integrate dee l van ons 
v o o rb ere id in g  m o et u itm aa k.  Laat ons 
dan nou baie v lu gtig  kyk na wat die 
v o o r d e l e  v a n  o p w a r m i n g  en 
fle ksi te it so efe n in g e is en ho e dit kan 
bydr a tot v er b eterd e prestasie.

F U N K S IE S  V A N  O P W A R M IN G  

1 V E R B E T E R D E  P R E S T A S IE

In d ie rustende liggaam is die blo ed  vloei 
na die spiere relatief laag as g ev olg  
van die va so ko nstrik tiew e toestand van 
die klein bloedva te . So o s wat die in- 
tensiteitvan 'n a k ti w it e it v er h o o g  word,

P E K ruger 
D ep artem ent M enslike 

B ew eg in g sk u n d e, 
U n iversiteit van Pretoria

so v a so d il a te er die b lo e d v a te  en m e er 
bloe d vloei na die spiere. T y d e n s  rus 
vloei 15-20% van die k ard iale uitset 
(Q) na die spiere. T y d e n s  oef en in g  van 
10-12 m in u te  v e r h oo g  die bloed vloei 
na 70-90% van die Q. 'n Sp ier  kan dan 
o o k s l e g s  sy m a k s im a l e  p resta sie le w er 
w a n n e e r  al sy b lo e d v a te  o o p is (P e te r­
so n en R en st rom  1986 p 87; Sh ar key , 
1985 p 21).

D ieb ela ngrikste fis iologieseaanpassing 
in die liggaam a s gev olg  van op w arm ing 
is eg ter 'n v erhog ing in lig g a a m s tem - 
peratuur. Die vo o rd ee l van 'n hoe 
li g g a a m s t e m p e r a tu u r  en veral spier- 
t e m p e r a t u u r ,  le d a a r i n  d a t  d ie  
m e t a b o l i e s e  p r o s e s s e  t e m p e r a -  
tu ur a fh a n k li kis.  V i r e l k e g r a a d s t y g i n g  
in lig g a a m s tem p e r a tu u r , styg die en- 
s i e m a t i e s e  a k tiw i te it , en d us die 
m e ta b o li es e reaksies in die sel geas- 
s o s ie er me t die en e rg ie si st e m e, die 
s o g e n a a m d e  Q |() o f t e  w el d ie  
m e t a b o l i e s e r e a k s i e t y d ,m e t  13%. Daar 
vind dus 'n v in n ige r  en m e e r volle- 
dig e d is so si as ie van O ,  plaas va nuit 
die h em o g lo b ien  en m io g lo b ien  na die 
weefsel w a a rd e u r  die s u urs to fv o o r-  
s ien ing ty den s die o efen in g  ve rbet er  
word - die o k s ih em o g lo b ie n -d is s o s ia - 
s ie k u rw e  v er sk u if  d us na regs. O p  
hierd ie m a n ie r  v er h o o g  die sp o rt m an  
se fisieke w e r k s v e r m o e  (prestasie) 
o m d a t  m e er O , b e s k ik b a a r  is en daa r 
'n a f n a m e  is in die w ee rs ta n d  van die 
p u lm o n e r e  bloedvloei . So  vr oeg  as in 
1947 het H o  en Ljimggren  b ew y s  dat 
na 'n b eh o o rl ik e o p w a r m in g  w as die 
ver b et er in g  in die 100m tyd 3 - 4 % (0,5-
0,6 sek), die 40 0  m tyd 3-6% (1,5-3,0 
sek) en d i e 8 0 0 m  tyd 2,5-5,0% (4-6 sek). 
So o r tg e l y k e  resultate is by s w e m  ge- 
vind (Astrand en R od ah l,  1977, p 562; 
Roy en Irvin, 1983, p 39; Fox en Mathews,

1981, p 271; Bro oks  en Fahe y, 1985, 
p 22; Klafs en A rn h e im , 1981, p 98).

U i t b o g e n o e m d e  figure kan b a i e d u i d e -  
lik w a a r g e n e e m  word hoe die mak si- 
m ale, su urs to fv e r b r u ik  ( V O , . ), die 
h a rt fre k w e n s ie  (HF), die la k taatk on- 
s e n t r a s i e  en Q |{l ty d en s  m a k s im a l e  
o efen in g  direk  ve rb and hou met 
die sp iert em p e ra tu u r. H o e  h oer  die 
s p i e r t e m p e r a tu u r  was, ho e h oer  w as 
die V O ,  en HF. D aar  is eg te r ook 
b e w y s  dat by  'n re k ta a lt em p e r a tu u r 
van m e e r  as 40"C was d a a r 'n a fn a m e 
in die V O ,  A lh o e w el die arb eidstv d 
bv die h oogs te  s p i e r t e m p e r a tu u r  nie 
to e ge n eem  het nie, was die lak taat ko n- 
s en tr a s ie aa n s ie n li k  laer. V er d e r  blyk 
dit dat 'n to e n a m e van 1 0 ° C  in 
s p i e r t e m p e r a t u u r  d ie  m e t a b o l i e s e  
reaksiety d ( Q l0)v er dubb el en dat die 
k u r w e in die fisiologiese o m v a n g  baie 
sk erp  stvg (Broo ks en Fahe y, 1985, 
p21; Fox en M a th e w s , 1981, p p2 71-
272).

Daar is v er der a a n ge to o n  d a t d e u r  die 
s p ie r g r o e p e  v o o r  'n k r a ga ktiwiteit te 
oorlaai, dit tot 'n ver b et er in g  in p r e s ta ­
sie lei. Daar word v er m oed  dat daa r 
'n v e r h o o g d e  vlak van p ri kk el in g  van 
die m o to r e e n h e d e  is wat o p g e ro e p  
word o m  die v e r h o o g d e  ar b e id sl a s te 
hanteer. Hie r die m o to r e e n h e d e  word 
dan oorg ed ra  na die w erk li kh e id sp re s-  
tasie me t 'n g e v o lg li ke to e n a m e  in die 
s p o r t m a n  se fisieke w erk sv er m oe . 
(Kl afs en A rn h e im , 1981, p98).

2 K O O R D IN A S IE

O p w a r m i n g  v er oo r s a a k  'n to e n a m e in 
s p i e r t e m p e r a tu u r  met 'n gev o lg li ke 
v er b et er in g  in k oordinasie.  Die re de is 
d at die s e n u w e e -i m p u l s e  vi nn iger

O '
S P O R T S  M E D IC IN E . V O L 4. N O  1

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FISIOLOGIE

b e w e e g b y h o e r t e m p e r a t u u r e n d a a r o m  
m oet die s p o r t m a n  sy sp iert em p e ra - 
tuur gee le veer  hou om  s o d o e n d e  sy 
kon tra ksi es p oed  en k oo rd in a si e te ver- 
hoog  ( Astran d en R od ah l,  1977, p 562; 
Pet erson en R en st r om  1986, p 87). Met 
a n d er  w o o r d e ,d a a r  is 'n to e n a m e in 
die te m po  van die n e u r o m u s k u le r e  
tr a n s m is s i e s  ( o o r s e n d in g s )  en die 
o p r o ep  van spierv ate, s o w el as die 
a k t i v e r i n g  v a n  d i e  " n e u ­
ro m u s k u le re g e h e u e "  vir die 
spe sif ie ke  b e w e g i n g s  wat nodig  
is vir die item (R oy en Irvin,
1983, p 39).

V er d e r ve r be ter  o p w a n n i n g  die 
sp o rtm a n  se k oo rd in a s ie  d eu r 
die o n tw ik k eli n g  van die s p o r t­
man s e k in e s te tie s e  g ew a a rw o r - 
din g en vestig so 'n n e u r o ­
m u sk u le re  pa tro on  van presta- 
sie. Dit help d a n  die s p o rt m a n  
om te bep aa l w a n n e e r  hy 'n 
toestand van g er eed h ei d  bereik 
het - hy se g e w o o n lik  " e k  voel 
nou r e g "  (Klafs en A r n h e im ,
1981, p 98.

3 V O O R K O M IN G  V A N  
B E S E R IN G S

P r o g r e s s ie w e o p w a r m in g  lei tot 
'n m erk b are  a fnam e in d i e  risiko 
vir bes eri ngs. Dit v o o r k o m  e n / o f  ver- 
m ind e r die s p a n n in g  in, en die sk eu r 
van die sp ie rv ese ls  v a n a f hulle tendi- 
neuse  aa n h eg ti n gs.  Dit vind g e w o o n ­
lik in die an ta g o n is  plaas. Die on ve r-  
m o e van die an ta g o n is  o m  vinnig 
te verslap, plus die g ro ot kontrak-  
tiele krag  van die agonis, plaas die 
a n ta g o n is  o n d e r  g e w e ld ig e  sp an n in g  
wat kan ve r oo rs a a k  dat die spi er ve se ls  
s owel as die te n d o n - a a n h e g tin g s  kan 
skeur. D eu r m iddel van o p w a r m in g  
w o r d  d i e  l i g a m e n t e  e n  a n d e r  
k olla g en e u s e w eefse l g es tr ek  o m  so 'n 
g ro ter m ate van tleksiteit te v er se k er  
(Pe terso n en R en st r om , 1986, 87; Klafs 
en A rn h e im , 1981, p 98).

Barnard  et al. het a b n o r m a l e  EKG  
p at ro ne gevin d in 70%  va n 44 nor- 
m a a l w e g  a s i m p t o m a t i e s e  pr o b a n te

tydens u it p u tte n d e o efen in g  toe ge en  
v o o r a f o p w a r m in g  g ed o en  w as  nie. 
T o e  'n 2 m in u u t o p w a r m in g  (dr af op 
die plek) die o efen in g  v o o r a fg eg a a n  
het, w a s  al die p r o b a n t e  se E K G  
pat rone n o rm a a l (A stran d en Rodah l,  
1977, p 5 6 3 ) .  H ie r die v er sk ynse l word 
t o e g e s k r y f  a a n  'n  o n v o l d o e n d e  
b l o e d to e v o e r  na die hart.
(Fox en M a th e w s , 1981, p 272).

4 P S IG O L O G IE S E  
V O O R B E R E ID IN G

O p w a r m i n g  dra by tot die v er w y d er - 
ing van li gg aa m lik e s p a n n in g  voor 
w e d y w e rin g . S p a n n in g  is m e er op- 
m e r k s a a m  v oor w e d y w e r in g  wat deu r 
o p w a r m in g  v er m in d er  word en tot 'n 
g ro te r m at e van o n ts p a n n in g  lei.

M E T O D E  V A N  O P W A R M IN G
( o p w a r m in g s p r o g r a m )

O p w arm in g  kan in tw ee ka teg oriee in- 
g ed eel w ord , nan in Iik:

(i) A lg cm en e o f  n ie-v erw an te op w a n n in g  
- dit b eh e ls  die a lg e m e n e  o p w a r m in g  
va n die ligg aam  en sluit in ak tiw iteite

soos liggies d r a f  en fle ksiteitsoefen- 
inge;

(ii) sp esifiek e o f  v erw an te op w arm in g  - 
sluit in a ktiw iteite w a t so o rtg ely k  is 
aan die wat in die v aa rd ig hei d van die 
item g eb ru ik  word (Klafs en A rn h e im , 
1981, p98).
'n G e k o m b in e e r d e  o p w a r m i n g s p r o ­

g ra m  wat s a a m g es tel is uit ver ske ie 
n av o r s in g s tu k k e sal as volg daaruit 
sien:
(i) fleksiteitso efen in g e - m a t ig e e n b e p -  
er kt e st re k kin g  van spiere en spier- 
g r o ep e van die hele ligg aa m  en die 
w at g eb r u ik  gaan word in die 
ak tiw iteit:

(ii) stad ig e d ra foefen in g e - beg in sta- 
dig  en v e r m e e r d e r  g ele idelik die 
intensiteit, die o efen in g  m o et aan- 
sw et in g  v er o o r s a a k  en die liggaam - 
s t em p e ra tu u r la a ts ty g ,b y v o o r b ee ld  
te m p o lo p e ;

(iii) fle k siteitso efen in g s - s ta dige  en 
volle dig e st re k kin g  van d ie  spiere, 
s p ie r g ro e p e  en g ew ri g te  wat spesi- 
fiek vir die va a rd igh eid / a ktiw it eit 
b en o d ig  word;

(iv) s p o r t s p e s i f i e k e  o p w a r m in g s -  
a k t iw it e it e  - b e s t a a n  u it  v a a r -  
d i g h e i d s d r i l o e f e n i n g e  w a t  d ie  
ak tiw it eit e van die sp ort it em  ins- 
luit, bv hek kied ri lo efe n in ge. B e­
gin w ee r een s teen 'n m a tig e in ten ­

siteit en v e r m e e r d e r  die intensiteit soos 
wa t hy voel sy li g g a a m s t e m p e r a tu u r  
styg  en sy k a rd io v a s ku le re  stelsels 
versnel. V oor beeld: bofbal - d oen  goeie, 
v e ld w e r k , k o l fw e r k  en v a n g w e r k . 
H ierd ie tipe van oefen in g e het 'n tw eele- 
d ig e doel:

a) so rg  d a t die s p i e r t e m p e r a tu u r en 
b loe d v lo ei o p ti m aal is in die s p i­
er e wat direk d e u r  die s p o rtm a n  
g eb r u ik  g a a n  w ord , en

b) vo o rs ie n  'n o p w a r m in g  vir die 
h a n d -t o t- oo g  k oo rd in a si e en a n ­
d e r  n e u ro m u s k u le r e  m e g a n is m e  
wat d ir e k  b etr o k k e is by die item 
(Fox en M a th e w s , 1981, p 272; 
Roy en Irvin, 1983, pp 39-40; 
Klafs en A r n h e im , pp 98-99).

Na die o p w a r m in g  m o et 'n d ro e 
T - h e m p a a n g e t r e k  word om te voorkom

S P O R T G E N E E S K U N D E  V O L  4. N R  7

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F © L C M l O l

d at die spiere te g ou  afkoel as gevolg 
v an  sw eetverd am p in g. Die positiew e 
voo rd ele v a n  o p w a rm in g  begin  gou 
om  te v erm in d er en die ideale tyd sver- 
loop tussen die o p w arm in g  en die 
a a n v a n g  van  die item  m oet nie langer 
as 10-15 m in ute w ees nie (Peterson  en 
R en strom , 1986, p 88).

TYDSDUUR VAN OPWARMING

Die intensitiet en d u u r v an  op w arm in g  
w ord  bepaal d e u r die item  en die fiks- 
heidstatus van die sp o rtm an . 'n Op- 
w a rm in g sp ro g ra m  w a t geskik is vir 'n 
g oed  gekon d ision eerd e sp o rtm an  sal 
versek er 'n sw ak  gekondisioneerde 
sp o rtm an  uitput.

sp o rtm an  aan tree vir sy  item  m o et hy 
sy sw eetp ak  uittrek. By veld item s in 
atletiek m o e t die atleet w e e r sy sw eet­
pak aan trek  na voltooiing v a n  sy 
p oging, en indien hy te lank m o et w ag  
vir sy volgen d e p oging m o et h y  ligte 
op w arm in gsoefen in ge tussen sy 
pogings u itv oer (Klafs en A rm h eim , 
1981 p 99).

Die ru sp erio d e tussen die opw arm in g  
en die item  m oet h oo gsten s 15 m inute 
w ees, w an t na 45 m in ute is die v oo rd e- 
lige invloed van die o p w arm in g  
gekan seleer en het die sp iertem p era­
tu u r teru ggek eer, na die pre- 
op w arm in gsvlak k e (A stran d  en Ro- 
dahl, 1977, p 563).

tyd en s die item . Baie atlete vind die 
u itv oerin g  v an  veral die strekoefen- 
inge b aie ontsp an n en d  (R oy en Irvin, 
1983, ; p 4 0 ; P eterson  en R enstrom , 
1986, p 88).

V olgens Fox en M athew s (1 981, p 273) 
is afkoeling absoluut noodsaaklik w eens 
die volgen d e tw ee fisiologiese redes:

(i) Die bloed - en spierlaktaatvlakke 
d aal vin n iger tyd en s 'n arbeidsherstel 
as tyd en s 'n ru sh erstel; en

(ii) m atig e oefening hou die sp ierp om p  
aan die g an g , dit voo rk om  o p d am - 
m in g van  bloed in die ekstrem iteite en 
v erm in d er so die g e v a a r v a n  floutes 
e n / o f  duiseligheid n a oefening.

SOURCE OF GRAPHS: 
Brooks en Fahey, 1985 
Fox en Mathews, 1981

V E R W Y S IN G S

A S T R A N D , P .O ., R O D A H L , K. T e x tb o o k  o f  w o rk  P h y s io lo g y , 
(2 e  u itg a w e ), N e w  Y o rk : M c G ra w -H ill B o o k  C o., 1987.

B R O O K S , G .A ., F A H E Y , T .D . E x e rc is e  P h y s io lo g y : H u m a n  Bio- 
e n e rg e tic s  an d  its A p p lic a tio n s, L o n d o n : M a c M illa n  P u b lis h in g  
C o ., 1985.

F O X ,E .L . M A T F IE W S , D .K . T h e  P h y s io lo g ic a l b a s is  o f  P h ysical 
E d u c a tio n  an d  A th le tic s. (3 e  u itg a w e ), N ew  Y o rk : S a u n d e rs  
C o lle g e  P u b lis h in g , 1981.

K L A F S , C .E ., A R N H E IM , D .D . M o d e rn  P rin c ip le s o f  A th le tic s 
T r a in in g , (5 c  u itg a w e ), S t L o u is: C V  M o s b y  C o ., 1981.

P E l E R S O N ,L ., R E N ST R d M , P. S p o r ts  In ju rie s, Jo h a n n e s b u rg : 
J u ta  an d  C o. L td ., 1986.

R O Y ,S .A .,lR V l N ,R . S p o rts  M e d ic in e , N e w  J e r s e y : P re n tice -F la l) 
In c., 1983.

S H A R K E Y , B .J. P h y s io lo g y  o f  F itn es s, (2 e  u itw a g e ), Illin o is: 
H u m a n  K in e tic s P u b]., 1984.

Die m eeste n av o rsers beveel 'n op- 
w arm ingsperiode v an  15-30 m inute aan 
teen 'n relatiew e h oe tem p o v an  ener- 
gieverbruik (3,0 tot 3 ,4 liter 0 2/m i n  of 
teen 'n h ard lo o p sp oed  v a n  12-14 
k m /h ).

Die d u u r en intensiteit van  die o p ­
w a rm in g  m oet ook aan g ep as w ord  by 
die o m g e w in g ste m p e ra tu u r en klere- 
drag. H oe h oer die o m g ew in g s­
te m p eratu u r is en hoe g roter die hoe- 
veelheid klere w a t ged ra w o rd , hoe 
g o u er w ord  die v erlan g d e lig gaam s­
tem p eratu u r v an  38,5°C  bereik (spi­
ertem p eratu u r 39°C  of h oer). Dus 'n 
stygin g v a n  o n g e v e e r 2°C w o rd  v er- 
lang (A stran d  en R odahl, 1977, p 563; 
R oy en Irvin, 1983, p 39; Kalfs en 
A rnheim , 1981, p98). O p koel dae 
m oet die opw arm in gstyd  v erlen g w o rd  
en m oet die o p w arm in g  in 'n sw eet­
pak ged o en  w ord . E ers w an n eer die

H uidiglik glo baie sp ortlu i n og dat 
op w a rm in g  hulle sal u itp u t, m a a r uit 
die v o o rafg aan d e bespreking is dit 
duidelik d at die sp o rtm an  sy prestasie 
kan verb eter indien by korrek en 
o o r d e e l k u n d i g  o p w a r m . 'n O p - 
w arm in g sp erio d e van  15 m in ute w ord  
aan b eveel vir hoerskoolatlete.

AFKOELING

Die sportaktiw iteit m o et gevo lg  w ord  
d e u r 'n afkoelperiode v an  3-5 m inute 
w a a r t y d e n s  l a k t a a t ' en a n d e r  
m etaboliese p rodu k te uit die spiere en 
weefsel v e rw y d e r w ord  o m  spier- 
styfheid en sp ierp yn  te v erm in d er. 
Strekoefeninge en liggies d raf m aak 
deel u it van  h ierdie p ro g ra m . V erd er 
gee dit die sp o rtm an  geleentheid om  
kalm  en ru stig  te w o rd  (fisies en psi- 
gologies na die afskeiding van groo t 
hoeveelhed e epinefrien (adrenalien)

Q -
^  S P 0 R T S M E D I C I N E . V 0 L 4 . N 0 1

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MIDDELS IN SPORT:
RESULTATE V ER K R Y TYD EN S DIE 

SA SEN IO R  A TLETIEK K A M PIO N SK A PPE VAN 1988 en 1989

P J v a n  d e r M erw e 
P h .D ., N at. Sci.

O P S O M M IN G

Siftingsm etodes w aarin  g asch ro m a- 
tografie en g a sch ro m a to g ra fie / m assa 
sp ek trom etrie gebruik i s , is u itg evo er 
op 124 u rienm on sters w at tyd en s die 
SA Senior A tletiekbyeenkom ste van
1988 en 1989 v ersam el is in 'n poging 
o m  die gebruik v an  v erb od e m iddels 
aan  te toon. M iddels w a t d e u r die 
Internasionale O lim p iese-K om itee as 
v erb od e verk laar is, is in 4% v an  die 
u rienm on sters aan getoon . Die resul- 
tate toon duidelik d at atlete onw etend 
m ed isyne gebruik w at v erb od e m id- 
dels b evat of m iddels b evat w a t hulle 
prestasie nadelig kan beinvloed.

IN L E ID IN G

Die eerste toetse vir die gebruik van  
verb od e m iddels d eu r atlete in Suid- 
A frik a  is ty d e n s d ie SA  S e n io r 
A tletiekbyeenkom s v an  1983 gedoen 
toe 10 0  u rien m on sters v e rsa m e l en 
g eanaliseer is.1 Sedertdien w as die 
gebruik van  v erb od e m id d els in sp ort 
in 'n poging o m  p restasie te verb eter 
verskeie kere die o n d e rw e rp  v an  w ye 
nuusdekking gew ees.

H ierdie verslag handel o o r die resul- 
tate w a t v erk ry  is d e u r die analise 
v an  124 u rienm on sters w a t tydens 
d ie S A  Senior Atletiekkam pioenskappe
van  1988 en 1989 v ersam el is.

M A T E R IA A L  E N  M E T O D E

In die tw ee jaar is 124 u rienm on sters 
v ersam el - al die m ed aljew en n ers van 
1988, 'n totaal v a n  95, en al die atlete 
w at eersteplekke behaal het in 1989, 'n 
totaal van  29.

H ierd ie u rienm on sters is geanaliseer

d e u r tw ee siftin gp rosed u res: m etod e 
A  vir die teenw oord igh eid  van  stim u- 
lasie en a n d e r b asiese verbindings m et 
behulp v a n  g asch ro m atro g rafie (GC) 
en m etod e B vir die teenw oord igh eid 
v a n  anaboliese steroiede m et behulp 
v a n  g a s c h r o m a t o g r a f i e / m a s s a -  
sp ek trom etrie (G C /M S ). Alle ver- 
bindings w a t d eu r m etod e A  aangetoon 
is, is bevestig m et G C /M S .

R E S U L T A T E  E N  B E S P R E K IN G

In 1988 w as d a a r 29 (30,5% ) u rien m on ­
sters w a t v reem d e verbindings b evat 
het teen o o r die 8 (27,6% ) in 1989. 
Tabel I toon  die verbindings w a tg e -  
iden tifseer is m et GC en G C /M S  vol- 
g ens m eto d e  A. M etod e B het geen 
anaboliese ste ro ie d a a n g e to o n  nie. Die 
39 v erbindings w a t in
1988 geidentifiseer is 
het in slegs 29 uri­
e n m o n s te r s  v o o r - 
gekom  en die 11 
verbindings w a t in
1989 geidentifiseer is 
het in 8 u rienm on sters 
v o o rg e k o m  w a t aan- 
dui d at so m m ige uri­
en m onsters m eer as 
een verb in d in g b evat 
het. Die v erb od e 
m id dels w a t in 7 u ri­
e n m o n s te r s  v o o r ­
gekom  het w as 
f e n k a m f a m i e n  en 
m e t a b o l i e t ( l ) ,  
f e n ie lp ro p a n o la m ie n  
(3),k od eien (2)en  efed- 
rien  (3). Die konsen- 
tra sie sv a n e fe d rie n  in 
die 2 u rienm on sters 
w as eg ter te laag om  
as 'n positiew e resul- 
taat b eskou te w o rd

(volgens intern asion ale bepaling). 
A n tih istam iene, w at som s saam  m et 
ander verbindings soos efedrien, kafeien 
en antibiotika in dieselfde u rienm on ­
sters v o o rg ek o m  het, w as in 11 
m o n sters teen w o ord in g. H oew el 
antihistam iene nie v erb od e m iddels 
is nie gee dit o n gew enste new e-ef- 
fekte so o sslap erigh eid , duiseligheid, 
sp iersw ak h eid , v erlaag d e konsen- 
tr a s ie v e r m o e  en g e b re k  aan  
koordinasie, alm al w a t die prestasie 
v a n  atlete n ad elig kan beinvloed. 
Kafeien w o rd  as 'n v erb od e stim ulant 
beskou as dit in konsentrasies h oer as 
12 n g / m l  in die urien voorkom . 
D aar w as 10 u rienm on sters w at 'n 
kafeienkonsentrasie tussen 5 en 12 
(J.g/m l (hoogste 10,5 (J.g/ml) gehad  
het. H ierd ie vlak kan nie maklik

V e rb in d in g s G e id e n tifise e r d eu r 
G a sc h ro m a to g ra fie  en 

G a sc h ro m a to g ra fie /m a s sa s p e k tro m e tr ie

VERBINDING FREKWENSIE

1988 1989
O ksatom ied
Flu o xatien  en m etaboliet 
O rfen ad rien  
D oksilam ien 
P irim etam ien 
Fenielprop an olam ien 
Fenfram ien  en m etaboliet 
K odeien
F enk am fam ien  en m etaboliet 
D iklofenac 2 
T rim etop rim  2 
E fed rien  2 
C hlorokien en m etaboliet 3 
C hlof enir arm en en m etab oliet 7 
N ikotien 7 
Kafeien (hoer as u g / m l )  7 
V erap am il en m etaboliete_______ 0 1

TO TA L 39 11

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FARMAKOLOGIE

V s *
/

# >
&

* ^ '  - v
/

v

< / .

y*

b er eik  w o rd  d e u r  die n o r m a le  in ­
n a m e  van a ll ed a a g s e kaf eien -b ev at-  
tende d ra n ke s o o s  koffie, tee en  Coc a-  
Cola nie2-3 en dit w ee r s p ie el die ge- 
w il d h e id  van k a fe ie n -b e v a tt e n d e ton- 
ik u m s o n d er o n s  atlete.

Na d ee glik e b e s tu d e r in g  van al die 
g e g e w e n s  is sleg s 3 u r ie n m o n s ters  
(3,2%) in 1988 en 2 ur ie nm on st er s (6,9%) 
in 1989 as po si ti e w e resul tat e gerap-  
porteer ; 'n g e m i d d e ld  va n 4%.

S A M E V A T T IN G

H o e w e l slegs 4%  van  die v er s a m eld e 
u r ie n m o n s t e r s  v er b o d e m id d e ls  bev at 
h et w a t as po si ti ef g er a p p o r tee r  is, 
w a s  d a a r  'n g r o o t aan ta l m onsters  
w a t a n d er v er b in d in g s  be v a t het w a t 
hoofs a a k li k  a f k o m s t ig  is v a n a f m e d i -  
s y n es  w a t vir g riep  en v er k o u e ge- 
b ru ik  wor d. H ier d ie si tuas ie is nie 
t y d e n s  a n d e r  S A  S e n i o r  
A t le ti e k b y e e n k m o m s t e  w a a r b y  se d ert 
1983 getoets is, o p g e m e r k  nie. Veral 
d ie g eb r u ik  v an a n ti h is ta m ie n e w ek  
k o m m e r .

D ie op lossm g  van d ie p robleem  le veral in 
d ie volg en d e:

1. G e n e e s h e r e  m o et b e w u s  w ee s 
d a a r v a n  d a t s o m m ig e  griep-, 
v e r k o u e - e n  h o e s p r e p a r a t e  v er b o d e 
m id d e ls  be v a t en d us nie deu r 
s p o r t m a n n e  g eb r u ik  m a g  word  
k or t v oor o f  ty d en s b y e e n s k o m -  
s te nie. D ok te r s  m o e t nie su lke 

m e d i s y n e  a a n d e e l n e m e r s  v o o rs kryf 
n ie o m d a t  die ve rto o n  v an  'n 
v o o r s k r if  nie die s k uldigh e id  van 'n 
atlee t o p h ef nie.

2. D ie o n us rus in die  finale instans ie 
no g b y  die s p o r t m a n  o m  se ker  te 
m a a k  dat hy nie o n w e te n d  enige 
m e d i s y n e  g eb r u ik  wat v er b od e 
m id d e ls  of a n d e r  m id d e ls  w a t sy 
pre stas ie s k an  b en a d e el, b e v a t nie.

D A N K B E T U IG IN G S
Die skryw er w il graag sy opregte dank betuig 
aan m ej H SL K ruger vir haar bydrae tot die 
analise van die urienm onsters asook aan die 
Suid-Afrikaanse A m ateur A tletiekunie vir hulle 
sam ew erkin g.

F O R  T H E  V E R Y  O L D  A N D  T H E  V E R Y  Y O U N G : 
N E W  V O L T A R E N  1 2 ,5 m g  S U P P O S IT O R IE S .

C ib a - G e ig y  ar e pleased to a n n o u n c e  
the in tro d uc ti on  of V o lt a ren  S u p p o s i­
tories 1 2 ,5 m g  a n d  25mg .

In te nd ed  pr im ari ly  for y o u n g  chi ldren 
and the elderly  the n ew  d o s a g e for m 
will c o m p le m e n t  the lOOmg s tre ngth 
o f V o lt a r en  Supp osit orie s.
T h e s u p p o s it o r y  d o s a g e for m  offers 

pro v en  a n ti -i n fla m m a to r y , an alges ic  
an d  an ti p y re tic prope rtie s w ith s e v ­
eral benefits:
G u a ra n te e d  d osage. C o m p li a n c e  is 
en s u re d  an d  the co rrec t d o s e is 
a d m in is te red .
R a p id  se ru m  levels. W h e n  g iven  rec- 
tally, p e a k  levels are ac h iev e d  wit hin 
o n e hour.
S h o rt h a lf-life . A llo w s  d o s a g e  fle xi­
bility.
T h e  s u p p o s it o ry  is ide all y su ited for 
p o st -o pe ra ti v e p a in  a n d  in fla m m ation.

Detai ls from C IB A  G E I G Y  
(O il)  9 2 9 -2 2 3 7

LITERATUUR VER WYSIN GS

1. H u n d t  H K L ,  V a n  d e r  M e r w e  P] e n  
V a n  V e l d e n  D P  ( 1 9 8 4 )

D r u g s  i n  s p o r t :  A  r e p o r t  o f  l a b o r a t o r y  
i n v e s t i g a t i o n  i n t o  t h e  p r e v a l e n c e  o f  t h e i r  
u s e  i n  S o u t h  A f r i c a .
S . A f r . M e d . J . ,  6 6 , 8 7 8 - 8 8 .

2 .  V a n  d e r  M e r w e  P J ,  M u l l e r  F O  e n  M u l l e r  F . 
( 1 9 8 8 )

C a f f e i n e  i n  s p o r t :  A n  i n v e s t i g a t i o n  i n t o  
t h e  u r i n a r y  e x c r e t i o n  o f  c a f f e i n e  in 
h e a l t h y  v o l u n t e e r s  a f t e r  i n t a k e  o f  c o m ­
m o n  c a f f e i n e - c o n t a i n i n g  b e v e r a g e s .  
S . A f r . M e d . J . ,  7 4 , 1 6 3 - 1 6 4 .

3 .  S e i f a r t  H F ,  V a n  V e l d e n  D P ,  E s t e r h u i z e n  M ,
P a r k i n  D P ,  V a n  J a a r s v e l d  P P .  ( 1 9 8 7 )  
K o n s e n t r a s i e s  v a n  k a f f e i e n  i n  u r i e n :  
R i g l y n e  v i r  d i e  a t l e e t .  
S A S p o r t g e n e e s k u n d e T y d s k r i f ,  2 , 1 2 - 1 4 .

C)
S P O R T S  M E D I C I N E . V O L  4. N O  1

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RUGBY-SERIOUS INJURIES

CATASTROPHIC RUGBY INJURIES OF THE 
SPINAL CORD: 

AN INCREASING PROBLEM
A lan  T. S ch er, M .B ., C h .B ., D .M .R .D .

IN T R O D U C T IO N

In 2 pr ev io u s p a p e r s  1:2 , I have 
rep orte d on 50 pa tients a d m it te d  to 
the Spin al C o rd  Inj ur y C en tr e at 
C o n r a d i e  H o sp ita l in C a p e  T o w n  from 
1964 to 1980, with para lysi s d u e to 
r u g b y  injuries to the ce rv ica l spinal 
cord. Since  the first pa pe r,  p u blish ed  
in 1976 1 there has b ee n  co n si d er ab le 
d isc uss io n  as re ga rd s r e d u cin g  the 
in cid e n ce  of these ser ious  injuries and 
va ri ou s ch a n g es to the rule s ha ve  
been int roduc ed. In an at tem p t to 
ascert ain w h e t h e r fo llo w in g  on these 
rule ch a n g es , there h as bee n any 
d ec r ea s e in the in cid e n ce  of, or ch an g e 
in the m e c h a n is m  of, these injuries, 
an a naly sis of the case histories and 
the r a d io g ra p h s  of all r u g b y  players 
a d m it te d  to the S pin al C ord Injury 
C en tr e d ur in g  the 7 y e a r  p erio d  1981 
to 198 7 has b ee n  m ad e.

F IN D IN G S

A total of 38 pl ay ers w ith cervical 
spinal cord injury ei ther p e r m a n e n t 
or te m p o ra ry , w er e identified. Nine 
(24%)  o f  the pl aye rs w e r e  17 years of 
ag e or u n d e r  at the time o f injury. T h e 
dis tr ibution o f  the levels o f  inj ury are 
s h o w n  in T ab le  I. N o t a b le  is the high 
p e rce n ta g e (32%) of pl a ye rs  w h o  
su stai ne d inju ry at the C 4 / C 5  level.

A lan T. Scher, M .B ., C h.B ., D .M .R .D .

D ep artm en t o f  R ad iolog y
T y g erb erg  H osp ital an d  U n iversity o f
S tellen bosch
P .O .B ox  63
T Y G E R B E R G  7505

T w o  pl ay ers w e re  inju red at the C2 
level a n d  10 players  s h o w e d  no ev i­
d en c e of or th o p a e d ic  inju ry on x-ray 
ex a m in a ti on . T h e  m a jo ri ty  of injuries 
w e re  su s ta ine d  eithe r in the s c ru m  
(39%) or d urin g  tackles (42%) as s h o w n  
in T a b le II. Th is is in k eep in g  with the 
f in d in g s in p re v io u s  an aly ses. u  A 
w id e  s p e c t ru m  of o r th o p a e d ic  injuries 
w er e su st ain ed , b u t the m a jo r it y  of 
p lay ers  (66%) su st ain ed  their injuries 
as a resul t o f p u re  flexion violen ce or a 
c o m b in a tio n  of flexion an d  rotation. 
N o t a b le  w a s  the high n u m b e r  of fle x­
ion d is clo ca ti o n s su sta ined co n se quen t

u p o n  co lla pse  of the scrum.

Fifteen (39%) of the pl ay ers  w er e in ­
jure d in scrum s. Th is  figu re co rrelates 
w'ell with the 40%  in cidence  of sc ru m  
inju ries n ote d  in m y  pre v io u s a n a ly ­
ses 1,2 an d  also w ith in te rn ational 
ex p e r ie n ce .3-4 T h ir te en  of the 15 p l a y ­
ers w ere  in ju re d  as a re sul t o f  co llaps e 
o f  the s c r u m , the m a jo ri ty  o f  these 
b ei n g pl aye rs in the front ro w , either 
p ro p s or h ooke rs . O n e  p la ye r w as  
injured by  c r a sh in g  of the tw o p acks  
of f o r w a r d s  w ith the injured 
p la ye r b e i n g  ca u g h t u np re p a r ed .

P ic C o u rte sy  o f SA  Sp o rts Illu strated

S P O R T G E N E E S K U N D E  V O L  4 . N R  1

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Six p layers su stain ed  com plete, 
p erm an en t q u ad rep leg ia. The m ajor­
ity of o rth o p aed ic injuries sustained 
(Table III) w e re  a n terio r d isloca­
tions, either bilateral o r unilateral.

T a c k le  in ju ries.

Sixteen (42% ) of p layers w ere injured 
d u rin g  a tackle (Table II). The n eu ro ­
logical deficit w as less severe and 
only 4 p layers sustained co m p lete p a ­
ralysis. The sp e ctru m  of orth o p aed ic 
injury (Table III) v aried  con sid erab ly 
from  the injuries sustained d u e to 
scru m m in g. This w id er variation  of 
o rth o p aed ic injury and lesser degree 
of n eu rological deficit is in keeping 
w ith the m o re v aried  m echanism .

O ne p lay er w as injured as a result of a 
double tackle. O f p articu lar note and 
cau se for co n cern , is the observation  
that 6 p lay ers w ere injured as a result 
of a high tackle aro u n d  the neck. The 
overall p ercen tage of injuries sustained 
in tackles has increased  w hich is in 
keeping w ith the findings of Silver 5

In ju rie s su stain ed  in ru ck s an d  m au ls.

O nly 4 (10% ) of the p lay ers w ere 
injured in these ph ases of the gam e. 
This low  p e rce n ta g e  is som ew h at 
su rp risin g, as in a p rev io u s an aly ­
sis2- a 20%  incidence w as record ed . 
Silver, rep o rtin g  on 63 p layers in­

S P O R T S  M E D I C I N E . V O L  4. N O  1

jured in E n glan d , co m m en ts on an  
increase in the p e rce n ta g e  of p layers 
injured in ru ck s an d  m au ls.5

The reason  for this significant d ecrease 
in the p ercen tage of p lay ers injured in

ru ck s and m auls is n o t clear. 

C O N C L U S IO N

D uring the p eriod  1 964 to 1980, 50 
ru g b y  p lay ers w ith  cervical spinal 
cord  injury w ere ad m itted  to the Spi-

"... the in cid en ce o f ru g b y  
spinal cord in ju ries in the 
C a p e P ro v in ce has not 
decreased "

nal C ord  Injury C en tre a t C on rad ie 
H osp ital,2 an a v e ra g e  of 3 p lay ers a 
year. D uring the p eriod  u n d er rev iew  
in the p resen t p ap er (1981 to 1987) 38 
p lay ers w ere ad m itted , an a v e ra g e  of 
5 ,4  p lay ers a year. This ind icates that 
d espite increased  public a w aren ess of 
serious ru gby spinal injuries and 
considerable am en d m en ts to the rules, 
the incidence of ru g b y  spinal cord  
injuries in the C ap e P ro vin ce has not 
d ecreased . Silver an d  G ill6 co m m en t 
on the gratifyin g d ecrease of serious 
cervical spinal cord injuries in ru g b y

p lay ers in the U n ited  K in gd om , W ales 
an d  N e w  Z ealan d , but n ote that the 
only co u n try  w h ere there h as n ot been 
a d e crease in the incidence is South 
A frica.

A s co m m e n te d  on 
in p r e v i o u s  p a ­
p e rs,1,2 an d  also in 
re p o rts from  o v e r­
seas 4, flexion re ­
m ains the m o st im ­
p ortan t m echan ism  
of injury. The tw o 
p h ases of the g am e 
w h ere m ost serious 
injuries o ccu r are 
a gain  identified to 
be the scru m  and 
the tackle.

Fou l p lay  w as re ­
sponsible for a sig­
nificant n u m b er of 
injuries. A p art from  
the single instance, 

w h e re  a p la y e r w a s injured b y cra sh ­
ing of the scru m , a disturbin g n u m ­
ber of p lay ers w ere injured by the 
high tackle. D espite p rev io u s co m ­
m en t on the d a n g e r of this illegal 
play-7 no d ecrease in these avoid able 
injuries has taken place.

R E F E R E N C E S

1. S c h e r A T . R u g b y  in ju ries to th e c e rv ic a l spin al
c o r d . S A fr M ed  J 1 9 7 7 ; 5 1 : 4 7 3 -4 7 5

2. S ch e r A T . R u g b y  in juries of th e  sp in e  a n d
sp in a l c o rd . C lin S p o rts M ed  1 9 8 7 ; 6 (1 ): 8 7 - 
9 9 .1 2 .

3. B u r ry  H C , G o w la n d  H . C e rv ic a l in ju ry in 
fo o tb a ll - a N e w  Z e a la n d  s u r v e y . Br.J S p o rts  
M e d  1 9 8 1 ; 15: 5 6 -6 0 .

4. W illia m s  P  a n d  M cK ib bin B. U n sta b le  c e r v i­
ca l sp in e  in juries in ru g b y  a 2 0 -y e a r  re v ie w . 
In ju ry  1 9 8 7 ; 1 8 (5 ): 3 2 9 -3 3 2 .

5. S ilv e r JR , Injuries of th e sp in e  s u s ta in e d  in 
r u g b y . B r.M e d  J 1 9 8 4 ; 2 8 8 : 3 7 -4 3 .

6. S ilver JR, Gill S. Inju ries of th e s p in e  su sta in e d
d u rin g  ru g b y . S p o rts M ed . 1 9 8 8 ; 5: 3 2 8 -3 3 4 .

7. S c h e r A T . T h e  h igh  r u g b y  tack le - a  c o n tin u in g
m e n a c e . S A fr S p o rts  M ed  1 9 8 1 ; 1 1 : 3.

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PSYCHOSOCIAL FACTORS AND 
SPORTS INJURIES

ANDRE MOLLER 
DEPARTMENT OF PSYCHOLOGY, 
UNIVERSITY OF STELLENBOSCH

D uring the p ast tw o d e ca d e s there has 
been a g row in g  a w aren ess of the asso ­
ciation betw een  p sy ch o lo gical factors 
and sp o rts p erform an ce. In p articu lar 
the effectiveness of v a rio u s p sy ch o ­
logical techniques and p ro ce d u re s in 
im p rov in g  p erfo rm an ce w a s exten ­
sively research ed . H o w e v e r, a rev iew  
of the literature rev ealed  that v e ry  little 
system atic research  has been d on e on 
the possible relationship betw een  p sy ­
ch ological factors and sp o rts injuries.

The genesis of injury is con sid ered  a 
co m p lex, m ultifactorial p ro cess. The 
only p sy ch o lo gical v ariab le studied in 
this regard  is stress. Findings by Holmes 
& R ahe (1967) that the o nset of illness 
is significantly associated  w ith  an in­
creased  p ercep tion  of stressful life 
events, w as exp an d ed  into the field of 
life stresses and athletic injuries by 
B ram w ell, M asu d a, W a g n e r & H olm es 
(1975). Their stu d y  sh o w ed  that an 
injured g ro u p  of football p lay ers had a 
significant h igher life stress level than 
the non-injured g rou p . T h ey divided 
p lay ers into low -risk, m od erate-risk  
and high-risk g rou p s on the basis of 
low , m o d e ra te  and high Life C h ange 
Units. In the low -risk g ro u p  30 p e r­
cen t of the p lay ers suffered injuries. In 
the m o d erate-risk  g ro u p  5 0  p ercen t of 
the p lay ers suffered injuries, w hile in 
the high-risk g ro u p  73 p e rce n t of the 
p layers suffered m ajor tim e loss in­
juries.

Sim ilar results w ere rep o rted  by Sara- 
son, Joh nson  & Siegel (1978). C od - 
din gton  & Troxell (1980) co n d u cted  a 
sim ilar stu d y  on high school football 
p layers. They found significant differ­
ences b etw een the injured an d  n on ­
injured athletes for the facto rs of fam ­
ily events an d  object loss. Six p layers

re p o rte d  d iv o rce of their p aren ts, and 
four p lay ers re p o rte d  d eath  of a p a r­
ent. The research ers co n clu d ed  that 
the risk of injuries for these p layers 
w as five tim es g re a te r than for those 
rep o rtin g  no su ch  loss.

In a recent study, M ay, Veach, Southard 
& H e rrin g  (1985) studied n in ety-seven 
elite m ale and fem ale athletes (biath­
lon, ra c e  w alk in g, figu re skating, 
gym nastics and basketball). Their study 
again  d em o n strated  that "th e a m o u n t 
of life ch an ge is an im p ortan t force in 
an  in d ivid u al's life w hich m a y  influ­
ence the onset of injury" (p.177). 
A th letes, especially those e xp eri­
encing high life ch an g es w hich  can  
lead to considerable an xiety  reg ard in g  
p erfo rm an ce, ended u p  actu ally  e x p e ­
riencing problem s. A s w ou ld  be 
exp e cte d , these individuals had se v ­
eral health problem s w hich are co m ­
m o n ly  related  to stress, su ch  as h ead ­
aches, d igestive tract d isturban ces, 
an xiety  an d  substance use. The 
a u th o rs con sid ered  the u se  of n on ­
p rescrib ed  m ed icatio n  by these 
athletes as of p articu lar interest. They 
arg u e d  that these individuals w ho 
exp erien ced  high d egrees of ch an ge 
w ere so anxious that they avoided going 
to the a p p rop riate health ca re  p ra cti­
tioner. This self-m edication leads to 
m o re  p roblem s, and therefore, their 
health an d  p erfo rm an ce d eterio rated  
even m o re. A n o th er interesting find­
ing of this stu d y is that the you n ger, 
d evelo p m en tal athlete tend ed  to be 
m o re  v ulnerable to life stresses. It m ay  
w ell be that the y o u n g e r, d ev elo p m en ­
tal athlete h as n ot yet learn ed  the p sy ­
ch ological cop in g skills o r the p sy ch o ­
logical p rep aratio n  skills to be as effi­
cient o r con sisten t as the elite athlete.

A ccord in g to these researchers the effect 
of life ch an g e and the ensuing stress 
m a y  be to h in d er co n cen tration  on 
en viro n m en tal cu es that a re  crucial 
a n d /o r  to block p reviou sly learned 
ad ap tiv e resp o n ses w hen  difficult and  
potentially d am ag in g  situations are 
recog n ized .

A cco rd in g  to N iedeffer (1981) this also 
explains w h y  som e athletes n ever seem  
to re co v e r co m p letely  from  an injury. 
This failure is often seen in the case of 
knee injury. W h at h as h ap p en ed  for 
the injured athlete is that the pain and 
a n xiety  g en erated  by the injury (fears 
of future injuries) result in his being 
m o re  atten tiv e an d  sensitive to this 
area. A tten tion  is d istracted  from  the 
u su al cu es to w hich the athlete a t­
tends. H e begins to look for som eon e 
com in g  from  the side instead of ru n ­
ning w ith the sam e relaxed  feelings he 
had p rior to the injury. P erfo rm an ce is 
inhibited by the attentional d istrac­
tions. In ad d ition , m u scle tension 
increases th ro u g h  bracing an d  a desire 
to p ro te ct the knee. A s a result, flexi­
bility on the playing field is red u ced  
ev en  th ou gh  it isn 't red u ced  in the lab 
or test situation. G iven these ch an ges 
the athlete d oesn 't p erfo rm  as well 
and increases the likelihood of fu ture 
injuries b ecau se of the re d u ction  in 
flexibility (p l4 8 ).

T hese results on stress an d  injury 
co n trad ict the co m m o n  m y th  that a c­
cidents o ccu r as a n atu ral p ro cess of a 
sp o rt o r are the p hysical h a z a rd s of a 
p articu lar activity. These stu d ies su g ­
gest that one co m p o n en t of injury and 
illness is an en viron m en tal or p sy ch o ­
logical factor. The con seq u en ce of this 
finding is that the b ehavioral co m p o ­
nent is poten tially preventab le (M ay et 
al., 1985, p. 178).

S P O R T G E N E E S K U N D E  V O L  4. N R  1

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PSYCHOLOGY

W h a t are the p sy ch ologic al c o n s e ­
q u en c es  or c o n c o m it a n t s  of injury and 
how is future p e r fo r m a n c e  influenced 
by pr ev io u s inj ury? Ag ain , very little 
r esearch has been d on e on this issue.

Acco rd ing to Rotella (1985) the research 
by Kiib ler- R os s (1969) on the stages of 
death and d yin g  offers the best c o n ­
ceptual fr a m ew o r k  within which to 
un d ers ta n d  the p sy ch ologic al c o n s e ­
q u en c es  of ath letic injury. Acco rd in g  
to this model , a loss (e.g. death of a 
loved one, d iv o rc e,  a m p u ta tio n  , etc.) 
is an ex tre m e ly  stres sful expe rience  
w h ic h  will trig ger typical p h y s io lo g i­
cal and psy chological responses. Sports 
injuries, a cc o rd in g  to this theory, also 
co n st it ute a loss, i.e. loss of the ability 
to prac tise and perfo rm . Injured 
a th letes  w oul d th e r ef o r e p ro g r es s  
throu gh  sim ilar and p re d ic ta bl es ta ges . 
Th is re sp onse  pattern is typified by 
the fol low ing  em otio n a l co m p on e n ts :

a pro tection a gain st the negativ e e m o ­
tions a c c o m p a n y i n g  injury and  may 
h a m p e r  the pro ce ss of a c c ep ta n ce and 
reco very. Sho ul d the inju ry persist, 
m o m e n t a r y  isolation and lone liness 
m ay  follow. As they b e c o m e  a w are of 
the ex ten t of the injury they a d v a n c e  
thr ou gh  the fol low ing stag e which is 
typified by an ge r and ag gressio n 
(p. 276).

A N G E R  A N D  A G G R E S S IO N

T h e  a th le te  b ec o m es  irritated with 
h im s elf and directs his irritability 
a gain st family, friends or p eop le who 
w a n t to help. He m a y  protest ag ain st 
o r resist treatment. H e  m a y  b la m e an 
o p p o n e n t for a g gr e s s iv e play or h im ­
self for insufficient p re pa ra tion. Often 
it is expressed in m o re su btle ways  
an d thus is less o b v io u s,  e.g. th ou gh ts  
like " w h y  did this h a p p e n  to m e ? "  
occur.

D E N IA L  B A R G A IN IN G

A c co r d in g  to Rotella (1985) it is n o r ­
mal for a th ­
letes, imrne- ■ 
d i a t e l y  f o l ­
lo w ing  an in­
ju r y , to re ­
spond by stat­
ing that there 
is no dam ag e, 
it is less e x ­
tensive than 
o r i g i n a l l y  
thou ght , or it 
will pro ba bly  
be bette r to­
m o rr o w . It 
m a y  be m a n i­
f e s t e d  in 
k e e p i n g  an 
in ju r y  fro m  
t h e  c o a c h ,  
m i n i m i s i n g  
the severity of 
an injury or 
r e f u s i n g  to 
see a p h y s i­
cian. Denial 
also serv es as

T h e  next stage  is hera lded w he n the

a th le te  b eg ins to bargain, e.g. " O k , I'm 
injured but 1 m u st be able to play in 
time for the pl ayo ffs ".  A c co r d in g  to 
Rotella (1985) this stage is typified by a 
true se ns e of loss. Th e a th le te  o bse rv es  
a leg in a cas t o r  an arm  in a sling and 
he is well a w a r e  that the injured lim b is 
the d if fer ence betw ee n  obs er v ing 
action from the sidelin es and p e r fo r m ­
ing in the com p etitio n. Id ent ity has 
been lost and a perception is formed 
that the loss m a y  also be the te a m 's  
loss (p. 276).

D E P R E S S IO N  A N D  G U IL T

T h e athlete m ay  ex p e r ie n ce a d ee p  
em p ty  feeling, ev en  with o ut bu rs ts 
o f crying. Fe el ings o f  d e s p a ir  ma y 
su rf ac e (e.g. "I will nev er be ab le to 
p e r fo r m  eff ec tiv ely a g a i n " ,  or " 1 m ay 
n e v e r c o m e  back to full strength ag ain"), 
a c c o m p a n ie d  by neg ative  self esteem  
and phy sical s y m p to m s  su ch as re st­
lessness, n au s ea , loss of ap pe tite, poor 
sleep, etc. Fee lin g s of guilt are c o m ­
mo n (e.g. "1 ha ve  let my  coac he s,  t e a m ­
m ate s, friend d o w n  by gett ing

S P O R T S  M E D IC IN E . V O L 4. N O  1

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PSYCHOLOGY

N EXT UP IN 
SPORTS M ED ICIN E

in ju re d ")  and m a y  even aris e from his 
a g gre s s iv e feelings or feeling s of jea l­
ousy (envies o ther heal thy athletes).

a n x i e t y

It m a y  arise from th ou gh ts  like " W h a t 
is g oin g  to h a pp en to me n o w ? "  "How' 
am 1 goin g to c o p e ? "  " W h a t  ar e my 
ch a n c e s ? "  or m a y  be d ue to a feeling of 
loss of control ove r his em otions. 
A n x ie ty  is co nsi der ed a c o m m o n  c o n ­
s e q u e n ce of injury. A c c o r d in g  to Ro- 
tella (1985) an xie ty  related to an injury 
ma y lead to reinjury, injury to an other 
part of the b o d y  due to forcing the 
recently injured limb, a te m po ra ry  
p e r fo r m a n c e d ec r e m e n t d u e  to lo w ­
ered co n fid e n ce and p e r m a n e n t loss of 
c o n fid e n ce and ab ility to p e r fo rm  (p.
273). It is also often hyp oth es iz ed  that 
" i n ju r y - p ro n e "  athletics m ay  be a m o n g  
the m o r e an x io us and in s e cu re  c o m ­
petitors, but ex cep t for a few studies 
there is little corr ob o ra tio n  of this re la­
tionsh ip (Cratty, 1983). M o re  research 
needs to be d o n e  d ea lin g with this 
int ric ate int eraction  betw een injury and 
anxiety.

Th e s e  em o tio n a l c o m p o n e n ts  are not 
co n st a n t and a lw a y s present: it can 
a p p e a r  in any  order, with v a ry in g  in­
tensity and im p o rt a n c e for different 
persons. H o w ev e r , a k n o w l e d g e  of 
these factors is im po rta nt,  b ec a use  it 
will en a b le the coach or trainer, the 
ph ysician a nd o th e r  p ers ons atten d in g  
to the injured athlete to bette r u n d e r ­
stand his re actions and im p r o v e the 
qu ality of their care.

In co n c lu si o n , injuries in all sp ort s are 
inc reasing d es p ite te ch no logic al a d ­
va nce s in safety e q u i p m e n t (B r a m w ell  
et al., 1975). H o w ev e r,  a revie w  of the 
li terature reveal s that the re lationsh ip 
be tw ee n  ps ych ologic al factors and 
spo rts inju ries as well as the p s y c h o ­
logical rehabilitation of the injured 
athlete are rather neg lected areas in 
research.

I m p or ta n t qu es tio n s  re m ain u n a n ­
sw er ed , e.g.: Ap ar t from stress, do 
o ther p sy ch olog ic al va riable s such as 
self es te em , co n cen tr a ti on , att ent ion,

co pin g  skills, etc. con trib u te  to injury? 
W h y  d o  ce rtain athle te s see m  to be 
m o re  pr o n e to injury than others?  W h y  
do so m e in d iv id u als nev er see m  to 
reco ve r co m p le tely  from an injury? 
W h a t are  the p sy ch olog ic al c o n s e ­
q u en c es  of injury and ho w  can they be 
dealt wit h?

It is ev id en t that in future, cl ose r re­
search atte ntion will have to be given 
to the role of p sy ch olog ic al factors in 
sports injuries. Existing findings, 
h ow ev er , su gg es t that those involved 
in the training and care of athletes 
must be a w a r e  of em o tio n a l c o n d i ­
tions that m a y  con trib u te  to injury, 
and thereby assist in re du ci n g  the 
p sy ch o lo g ic a l risk c o m p o n e n t and in ­
jury rate. T e a m  ph ysicians, trainers 
and c o a c h es  m u st  also pay clo se a tt e n ­
tion to the p sy ch o lo g ic al re habil itation 
of the injured athlete. T h a t the b o d y  is 
re ady to return to co m p eti ti o n  d oes  
not im p ly  that the mind is also p re ­
pared. Failu re to attend to the p s y c h o ­
logical co n s e q u e n c e s  of inju ry m ay 
increas e the risk of rein jury  and a d e t e ­
rioration of pe rfo rm ance.

REFERENCES

B r a m w e l l , S . ,  M a s u d a ,  M . ,  W a g n e r ,  N . &  H o l m e s ,  
T  ( 1 9 7 5 ) .  P s y c h o s o c i a l  ( a c t o r s  i n  a t h l e t i c  
i n j u r i e s ,  l o n r n a l  o f  H u m a n  S t r e s s , 1, 6-211. 
C o d d i n g t o n ,  R . & T r o x e l l , J  ( 1 9 8 0 ) .  T h e e t t e c t s o f  
e m o t i o n a l  f a c t o r s  o n  f o o t b a l l  i n j u r y  r a t e s ,  lo u r -  
n a l  o l  H u m a n S t r e s s ,  4 ,  2 - 5 .
C r a t t v ,  B.|. ( 1 9 8 3 ) .  P s y c h o l o g y  i n C o n t e m p o r a r y  
S p o r t  ( 2 n d  e d . ) .  N e w  J e r s e y :  P r e n t i c e  H a l l .  
H o l m e s ,  T  &  R a h e , T .  ( 1 9 7 6 ) .  T h e  s o c i a l  r e a d j u s t ­
m e n t  r a t i n g  s c a l e .  J o u r n a l  o f  P s y c h o s o m a t i c  
R e s e a r c h .  H ,  2 1 3 - 2 1 8 .
K u b l e r  - R o s s ,  E. ( 1 9 6 9 ) .  O n  d e a t h  a n d  d y i n g .  
N e w  Y o r k :  M a c m i l l a n .
M a y J . R . ,  V e a c h , T . L . , S o u t h a r d , S . W . &  H e r r i n g ,  
V I . W .  ( 1 9 8 5 ) .  In N . K .  B u t t s ,  T . T .  G u s h i k e n  &  B. 
Z a r i n  ( E d s . )  J h e  E l i t e  A t h l e t e .  N e w  Y o r k :  S p e c ­
t r u m  P u b l i s h e r s .
N i d e f f e r ,  R . M .  ( 1 9 8 1 ) .  T h e  e t h i c s  a n d p r a c t i c e  o f  
a p p l i e d  s p o r t  p s y c h o l o g y  N e w  Y o r k :  M o n v e -  
m e n t  P u b l i c a t i o n s .
R o t e l l a ,  R. J.  ( 1 9 8 5 ) .  T h e  p s y c h o l o g i c a l  c a r e  o f  t h e  
i n j u r e d  a t h l e t e .  In L . K .  B u n k e r ,  R. J . R o t e l l a  &  A . S .  
R e i l l y  ( E d s . )  S p o r t  P s y c h o l o g y . C h a r l o t t e s v i l l e :  

D e p t ,  o f  H e a l t h  a n d  P h y s i c a l  E d u c a t i o n .  

S a r a s o n ,  J . G . ,  J o h n s o n ,  J . H .  &  S i e g e l ,  J . VI . ( 1 9 7 8 ) .  
A s s e s s i n g  t h e  i m p a c t  o f  l i f e  c h a n g e s :  D e v e l o p -

T h e next issu e of S p orts M ed icin e 
w ill co n tain , am o n g st o th ers, the 
fo llo w in g  a rticles:

S p orts in ju ries:
Su rvey  at Bureau f or Studen ts 
Healt h -U n iv er sity  of the OFS.
E P rinsloo.

S w im m in g :
E p i d e m i o l o g i c a l  s t u d y  of 
failure to co m p le t e  a long 
d is ta n ce  swim.
D erek Yach.

S tren g th  F itn ess:
A b iom e ch a n ica l a pp r oa ch  
M el Siff.

P h y s io th e ra p y :
S o c c e r :  W a r m i n g - u p  and 
St retc hin g.
G ary Jacobsen .

N u tritio n :
E ner gy v al ue of food 
M ie k e  Faber.

G en eral:
A cut e ca u li flo w er  ear.
jD A  B ekker.

C o n g re sse s:

R ep o rt -b a c k  on Sp orts M e d i ­
cine Con gre ss .

P L U S :
D e ta ils o f "B e st A rticle " 
C o m p e titio n .

S P O R T G E N E E S K U N D E  V O L 4. N R 1

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Letters to the Editor

Injury Rehabilitation with 
Machines.
D ear Sir,

I w ou ld  like to co m m en t on the article 
by M .C. Siff "In ju ry rehabilitation w ith 
m ach in es" in the V olu m e 3 N o. 2 1988 
issue in w hich  he d iscu sses the u se of 
m achin es in rehabilitation. T h ere is 
definitely no one typ e of exercise 
m achin e that can  offer all the best 
available form s of m u scle w ork. A s 
w e know , all m u scle w ork  is highly 
specific to the sp ortin g activity  of that 
p articu lar athlete. W h e n  discussing 
rehabilitation the isokinetic ap p aratu s 
offers y ou  a g re a t sp ectru m  of reh a­
bilitation variables ab ove pulleys, p ro ­
p riocep tive n e u ro m u scu la r facilita­
tion (P .N .F.) an d  n o rm al strength 
m achines. I h av e w ork ed  w ith this 
equipm ent and h ave found it to be 
excep tion ally helpful in the acu te 
rehabilitation p h ase of the p o st­
o p erative patient. P .N .F . is v e ry  effec­
tive bu t in m a n y  cases the patients are 
far too stron g for the p h ysiotherapist. 
U su ally  the p h ysio th erap ist is too 
fatigued to be of a n y  effect, an d  there­
fore can n o t g iv e the patien t a reason ­
able exercise session, unless the 
patien t is excep tion ally  w eak. This 
equ ip m en t also offers the athlete 
d irect v isu al feedback w hich  helps to 
m otivate the patient. A n  im p ortan t 
asp ect of early isokinetic rehabilita­
tion in certain  p o st operative co n d i­
tions e.g. K en n ed y L.A .D . re co n stru c­
tion of the an terio r cru ciate ligam ent. 
In su ch  cases the knee joint m u st not be 
load ed  in full extension for a p p ro x i­
m ately  6 m onths. This can  be co n ­
trolled e xtrem ely  safely for the full 
rehabilitation p eriod  allow in g the 
p atien t to load the relevan t thigh m u s­

cu latu re w ith ou t d a n g e r of o v e rlo a d ­
ing the reconstruction. A n  acu te m edial 
collateral ligam ent m u st n ot be loaded 
in full extension either, these athletes 
can  u n d e rg o  extensive q u ad ricep s a t­
rop hy. W ith  early con trolled  stren g th ­
ening y ou  can lim it load ing of the 
involved ligam en t w hile v e ry  effec­
tively m aintaining an d  even im p rov ­
ing the q u ad ricep s stren g th  for early 
retu rn  to play. A n o th er good  exam p le 
is an a cu te  ankle sp rain  w hich  can  be 
actively rehabilitated in n on -w eight- 
b earing doin g inversion  and eversion 
ran ges of m o vem en t, strictly co n trol­
ling the inversion so as n ot to o v erlo ad  
the healing lateral stru ctu res.

In m an y  soft tissue injuries it is u nw ise 
to initially load d am ag ed  stru ctu res 
eccentrically. This can  a g g ra v a te  the 
healing p ro cess e.g. m u scle tissue. 
C o n ce n trics/iso k in e tic loading is p re ­
ferred before p ro gressin g  onto eccen ­
tric load ing, w hich 1 a g ree is extrem ely  
im p ortan t. O nce the athlete is reh a­
bilitated to a painfree full ra n g e  of 
m o v e m e n t he is able to be tested . This 
helps to m otivate the p atien t into c o ­
op eratin g w ith fu rth er rehabilitation 
w hich is norm ally a big problem . M any 
a p atien t is extrem ely  cau tiou s and 
an xio u s in the early stag es of rehabili­
tation. Isokinetic ap p a ra tu s helps them  
to build u p  this confidence initially. 
C onfidence is not easily gained w hen  a 
p atien t is handling a pulley w h ich  he 
d oes n ot control. If he exp eriences 
p a in h e c a n d ro p th e  w eight and dam age 
him self further.

The isokinetic ap p a ra tu s offers a w ell- 
con trolled  en viro n m en t for rehabilita­
tion and this can  be u sed  as a fo u n d a­
tion for stren gth en ing before p ro g re ss­
ing the patien t onto oth er exercise

m achin es and m uscle w ork  m odali­
ties.

The best rehabilitation environm ent 
for an y  athlete is one w hich  offers 
isokinetic, eccen trics, v ariab le isoton­
ics an d  pulleys. D iagonal p attern s are 
also im p ortan t. M ost im p ortan t o f all 
is th a t the patien t should be intro­
d u ce d  back to extensive functional 
activities, before retu rn in g to his sp ort­
ing activities.
Y o u rs Faithfully,

Iv a n  L evm ran d
(B.Sc (P h ysioth erap y) (W its)
B.Sc (M ed. H ons) in Sport Science 
(U .C .T )

D ear Sir,
The n eed in the p rivate 

secto r to establish a South African 
R esu scitation  C en tre h as been evident 
for so m e time.
Initiated by the Red C ross (East C ape 

R egion) and w ith the assistance of Dr 
M ark H arries w ho w as instrum ental 
in establishing the U K  C ouncil, the 
Sou th  A frican  C en tre has n o w  been es­
tablished.
The C ou n cil w ou ld  like to invite other 

interested p erson s to join an d  becom e 
involved in the w ork  of RESCO.

The C ouncil will p ro m o te  uniform ­
ity an d  stan d ard isation  in C P R  tech­
n iq u e s /m e th o d s  in all areas ranging 
from  basic to a d v a n ce d  Life Support. 

A p p lication  form s are available from 
the S ecretary, R esu scitation  Council 
of South A frica, P .O .B ox 4 9 2 , P ort Eliza­
beth, 6 0 0 0  .

Y o u rs faithfully,
C .A .S cales (M rs.)
p p  J.A .S trom b eck  M B.Ch.B.
C h airm an .

^  S P O R T S  M E D I C I N E . V O L  4. N O  1

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THE ATHLETE AND HIS DIET 
IN GENERAL

Mieke Faber, RIND, 
SA Medical Research Council.

here are m an y  superstitions 
about the v ario u s foods ath ­
letes should eat ( an d  avoid ) 
to im p rove their perform ance. 

H ow ever, it is know n that the 
nutritional req u irem en ts of 
athletes are based on the sam e 
fundam ental principles that 
govern the nutrition of h u ­
m an beings in general. It 
should be kept in m ind that a 
nutritionally well b alanced 
diet could aid the athletes p e r­
form ance and m an ipu lation  
of the diet m ay  even im p rove 
his p erform an ce. G ood  e a t­
ing habits entail know ing h ow  
to com pile the diet from  the 
various foods available. The 
following guidelines should 
be kept in m ind:

* In a w eight stable p erso n  of ideal 
w eight the en erg y  intake should equal 
the en ergy exp en d itu re. This will re­
sult in the bod y w eight rem aining m ore 
or less stable.

* Less than  30% of the en erg y  intake 
should be supplied by fat. S atu rated 
fat (m ainly anim al fat) should n ot 
su p p ly m o re than  10% of the total

en erg y  intake.

* Betw een  10-15 % of the en erg y  should 
be sup p lied  by protein, 1-1,5g  p ro ­
te in /k g  b od y  w eigh t should be suffi­
cient for m o st athletes.

* A p p ro x im a te ly  55-58%  of the en ergy

sh ou ld  be su p p lied  by carb o h yd rates, 
m ainly in the form  of co m p lex carb o ­
h yd rates. It should be kept in m ind 
that alth o u g h  su g ar is a con cen trated  

form  of en erg y, it 
d oes not su p p ly  any 
nutrients oth er than 
en ergy. If m o st of 
the carb o h yd rates in 
the diet are supplied 
b y  su g ar, the athlete 
is a t risk of d evelo p ­
ing vitam in and m in­
eral deficiencies.

* Provided that a well 
b a la n c e d  d ie t  is 
c o n s u m e d , u n d e r 
m o st circu m stan ces 
there is no need for 

additional v itam in  an d  m ineral su p ­
plem entation .

W hen selecting the food intake, it should 
be kept in m in d  that none of the ord i­
n a ry  foods are of special v alu e or 
con train d icated  in athletic p erfo rm - 
an ce. ( f )

Letters to the Editor
(Continued from  p l6 )

Dear Sir,
APPLIED KINESIOLOGY

W ith reference to Dr. K ro m h ou t's let­
ter in the June 1988 issue elaborating 
on the m erits of A p p lied  K inesiology,
I wish to co m m en t as follow s:

1- A pplied K inesiology can n o t be re­
ferred to as 'h ig h ly  accu ra te '. The 
basis of this sy stem  is the d iagn osis of 
p hysiological im balance by m anual 
estim ation of the stren g th  of certain 
indicator m uscles. T h ou gh  this m ay 
suggest som e im balance, a cc u ra cy  can 
be achieved only by m ean s of suitable

in stru m en tatio n  such as a d y n a m o m e ­
ter, force plate or strain guage. M o re­
o ver, m an u al isom etric testing can 
p ro d u ce  m easurable fatigue in the 
m u scles of the p atien t and the p ra cti­
tioner, so the test p ro to co l itself can  
in tro d u ce im balance!
2. The basis of the system  need s to be 

carefully evaluated, since perfect m uscle 
b alan ce is u n p hysiological. The h u ­
m an  b od y  is asy m m etric in stru ctu re 
and function, even in elite athletes. In 
b iom echan ical research  I h ave p e r­
form ed  on w eightlifters, not a single 
subject has d isp layed  sy m m e try  of 
m u scle stren gth , y et each  one has been 
th o ro u gh ly  healthy.

3. D r.K rom h ou t points o ut co rrectly  
that an th ro p om etric or radiological

techniques m easu re stru ctu ral differ­
ences u n related  to functional im bal­
ance. Both ch iro p ra cto rs and o rth o ­
p aed ic specialists should m ake use of 
ap p a ra tu s w hich  can  assess the func­
tional ch aracteristics of the sp o rtsm an  
d u rin g actual sp o rtin g  m ovem en ts.

4. M uscle b alan ce is altered  both  after 
stren u ou s exercise o r p rolon ged  in ac­
tivity, a situ ation  w hich can introd uce 
seriou s u n certain ty  into applied kine- 
siological testing.

A pplied K inesiology requires m ore 
extensive stu d y and better ap p lica­
tion.

Y o u rs faithfully,
M.C.Siff. Ph.D.

C om m u n ication  Studies Division, 
U n iversity  of the W itw atersran d .

S P O R T G E N E E S K U N D E  V O L  4. N R  /

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ULTRAMAN 

VOLTAREN ULTRAMAN 1989 
EMULGEL ROUND-UP 

For the second year in succession, Nic 
Bester walked away with the top lau-
rels in the 1 9 8 8 / 8 9 Voltaren Emulgel 
Ultraman Competition. 

Bester's winnings totalled R16 000 
and other medalists shared R14 000. 
There were cash prizes of R2 000 for 
the first Ultraman to finish each event. 
For a time it looked as though Danny 

Biggs might maintain his early lead as 
he was still well ahead after the Μ id mar 
Mile and the Two Oceans. 

An exciting contest was settled on 
the last event of the Ultraman Calen-
dar — The Comrades Marathon. Be-
ster's fourth place enabled him to wipe 
out Biggs' 6 point lead and win by a 
further 8 points. 

A P P L I C A T I O N F O R 
RESEARCH GRANT 
To promote knowledge about the role of sugar in 
health and nutrition, the South African Sugar 
Association looks to the scientific community for 
reliable and up-to-date information. As part of this 
process, it supports scientific research projects 
designed to clarify issues which arise in this public 
terrain The Sugar Association acts on the 
recommendations of a Research Adviser and 
Advisory Panel. 

Priorities for research funding by the Association are: 
1. Physical work, exercise or sport in relation to diet. 
2. Obesity and the comparative role of different 

dietary factors and forms of exercise. 
3. Hyperlipidaemias in relation to diet. 
4. Causes of dental caries and periodontal disease. 
5. Causes of diabetes mellitus and its management. 
6. Dietary influences on brain function. 

Proposals in any one of these priority fields will be 
given consideration. The research grants are 
awarded on a 2 yearly basis. Continuation of the 
grant for the second year of study is dependent on 
progress made, as assessed by the Advisory Panel 
from a report submitted for this purpose. 

INSTRUCTIONS OR PROPOSAL PREPARATIONS: 
In order to allow for a proper evaluation of proposals 
by reviewers, the following items should be included: 

1. One page abstract of the proposed project 
(200-word maximum). 

2. Short description of background for proposed 
research. 

3. Succinct statement of project objectives. 
4. Short description of methods to be used in 

pursuing objectives. 
5. Human subject assurance, if applicable. 
6. Curriculum vitae and list of full-length 

publications over last six years. 
7. Detailed budget (to include the proposed 

budget for the first and second years of study). 
NOTE: No funds are provided for major equipment 

(unit cost greater than R2 000) or travel costs. 
The deadline for proposals to be submitted is 
15 November 1989. Application forms are available 
from and, when completed, should be returned to: 
The Nutritionist, The South African Sugar Association 

PO Box 374 DURBAN 4000 
Tel. (031)3056161 

SUGAR ASSOCIATION 

SPORTS MEDICINE. VOL 4. NO 1 

The women's race was 
totally dominated by Sally 
Bantock. T h i s former 
Provincial Hockey player 
scored 375 points, no less 
than 200 points ahead of 
the second lady, Sandra 
Eardley. Sally was placed 
14th o v e r a l l in the 
Voltaren Emulgel Ul-
traman Competition. 
The Veterans was a close 

run thing with Wilmot 
finishing on 442, less than 
20 points ahead Winners  all! Pictured  above are the overall 
of Max Botha ivinners in the three  Ultraman  categories.  Nic 

Bester  (Men),  Sally Bantock (Women)  and Wilmot 
(jf  (Veterans) 

Picture Courtesy of Sports International 



CRICKET INJURIES 

(. . . Continued from  page 5) (Text continues on 
following page) 

ACUTE AND CHRONIC 
INJURIES SUSTAINED IN 
FIRST-CLASS CRICKET 

DURING BATTING (n=81) 

Phalyngeal Fractures (25) 
Muscle Tears (1) — 

Rib Fractures/Contusions (Z 
Lower Arm Contusion (4) 

Back Strains (3) 
Groin Strains (2) 
Quadriceps Tears (2) 
Hamstring Tears (2) 
Knee Ligament Tears (2) 
Calf Strains (2) ~~~ 
Ankle Ligament Tears (2) 
Foot Fractures/Contusions (4) 

DURING 
BOWLING (N=64) 

Elbow Strains (1) 

Shoulder Strains (4) 
Pinched Nerve (6) 

Back Strains (22) 

Abdominal Muscle Strains (3) 

Groin Strains (8) 
Quadriceps Tears (2) 
Hamstring Tears (3, 

Knee Ligament Tears (2) 

Ankle Ligament Tears (6) 
Foot Stress Fractures/ 
Contusions (4) 

DURING 
TRAINING AND 
WARMING UP (N=ll) 

Facial Lacerations (3) 

Back Strains (2) 

Phalangeal Fractures (1) 

Groin Strains (1) 
Hamstring Tears (1) 

Ankle Ligament Tears (1 

Foot Contusions (2) 

Facial Laceration (1) 
Elbow Strains (2) 
Shoulder Strains (5! 

Phalangeal Fractures (19! 
Groin Strains (2) 
Hamstring Tears (Z 

Knee Li-
ment Tears 

A n k l e ^ L i g 
ment Tea: 
Foot Contu" 
sions (1) 

f r 

DURING 
FIELDING (N=37) 

TOTAL INJURIES SUSTAINED 
N=193 

SPORTGENEESKUNDE  VOL  4. NR 1 
φ 



CRICKET INJURIES

T a b l e  I: S e r i o u s  a n d  l e s s  s e r i o u s  i n j u r i e s  s u s t a i n e d  w h i l e  p l a y i n g  c r i c k e t

S E R IO U S  IN JU R IE S LESS
SE R IO U S

Bat B o w l Field O t h e r  T o t a l 7< T o ta l

( lead , N eck and
Facial in juries 31 3 1 3 38 20 12 10

U p p er Limb 
injuries 30 5 2 6 1 b2 32 31 43

Back and Trunk
injuries 5 28 2 3 5 18 10 14

L o w er Lim b
injuries 15 28 10 5 58 30 20 27

T otal Injuries 8J 64 37 11 193 73

7, 42 33 19 b 100 100

b o d y  has to a b s o r b  a vertical force 4,1 
ti m es gre ate r tha n the bo d y  w ei gh t 
and a ho rizontal d ec el er a tio n  force 1,6 
times his b o d y  weight. ,4J5 
T h e s e  authors  found that these im p act 
forces, in a s so ci ation w ith the lateral 
flexion, ex ten si on , ro tat ion  and c o m ­
p re ssion of the vertebral c o lu m n  d u r ­
ing delivery,  to be the re aso n  for the 
increas e in ba ck injuries in fast b o w l ­
ers. A front-on a ct ion woul d m a k e the 
b o w le r  m o re  su sc ep ti b le to injuries 
than o n e w h o  b o w ls  with a side-on  
act ion  all o w in g  him to s u m m a te  his 
b o d y  forces m o r e  efficiently thus p r o ­
ducin g  m a x im a l ball veloci ty with 
m in im a l strain to his b o d y  s t r u c ­
tures l6.
In a st ud y on  the fitness of cric ke ter s 17 
it was found that cric ke ters  had an 
a b o v e  a v er a ge level of fitness, with the 
ex c ep tio n  of b a c k  and h a m stri n g  flexi­
bility. No si gn if ic an t dif fer ences  in the 
v a ri ou s c o m p o n e n t s  of fitness w ere 
found w hen  b a ts m en , b ow le rs , all- 
r o un d e rs  and w ic ke t- ke ep e rs  were 
co m p a r ed . T h e  b ow le rs , w h o  need to 
po ss ess  stren gth in the hips, ba ck and 
s h o uld er s,  sh o w ed  the lowest score 
for s tre ngth and m u s cu la r  e n d u r a n ce 
o f the a rm s  and s h o u l d e r s . 15 Th is  lack 
o f s tre ngth and flexibility in the back  
and h am st ri n g s,  co u ld  be o n e of the 
m ai n ca u se s of bac k injuries in b o w l ­
ers. By follo w ing a s pe ci alized  train­
ing p r o g r a m m e  aim ed at d ev e lo p in g  
an a p p r o p r ia te level of fitness specific

to the task to be p e r fo rm e d  in a match, 
unnecessary injuries could b e a v o i d e d . lv

C O N C L U S IO N S

T h e  f ollow in g r e c o m m e n d a t io n s  are 
m a d e  in an  a tt em p t to p re ve n t serious 
injuries taking place, as well as to try 
to redu ce  the n o r m a l injuries a s s o ci­
ated with field sports:

* c o n s id era tio n  m a y  h a v e to be m a d e 
to m a k e  the w ea ri n g  of helmets, 
pa rt ic ul ar ly  those with a full visor, 
c o m p u l s o r y ,

* b a ts m en  need to practise on pitches 
that ar e si m ilar to those they
are likely to e n c o u n t e r in a match,

* b o w le rs  need to d e v e lo p  leg, back 
and tr unk  s tre ngth and flexibility,

* b o w le rs  should e n su re  that the boots 
worn are ab le  to a b s o r b  the tr e m e n ­
d o us forces g en er a te d  at front-foot 
im p ac t in the d el ivery  stride,

* cap tain s and c o a c h es  sh o uld  avoid 
o v e r - b o w l i n g  their fast bow le rs,  
pa rt ic ula rl y  at the b eg in n in g  of the 
s ea s on ,

* b o w le r s  and c o a c h e s  need to place 
special em p h a s is  on te ch n iqu e in an 
a tt e m p t to d e v e lo p  a s ide-on b o w l ­
ing action,

* all cr ic kete r s need to fol low  p er­
so nalized  training p r o g ra m m e s  
ca ter in g  for their sp ecific nee d s and 
their s p eci alis ati on  in the team.

T h e g am e o f crick e t is d e m a n d in g  
m o re p h y sica l o u tp u t from  the p la y ­
ers w ho ca n n o t affo rd  to su ffe r u n ­
n ecessary  inju ries, p articu larly  at vital 
sta g e s of the seaso n . A t all levels the 
a stu te  coach  and p lay er m u st e n su re 
th at u n n e ce ssa ry  in ju rie s are n ot a 
c o n trib u tin g  facto r in a te a m 's failu re 
to reach  its p o ten tial.

REI-ERLNCES
I W e ig h tm a n , D  an d  B ro w n e , R.C. In ju rie s in e le v e n  '•elected 

spor(>. B ritish  Jo u rn a l o f S p o r ts  M e d ic in e , 1971, 2 , 27.

2. T e m p le , R. C ric k et In ju rie s: Fast P itc h e s  c h a n g e  th e G e n lle -  
m a n 's S p o r t , T h e  P h v s ic ia n a m .1 S p o rts m e d ic in e , 1 9 8 2 .1 0 (6 ) 
ISM 92.

3 P a y n e , W .R ., I lo v , G ., L a u s se n , S.P . an d  C a rls o n  J.S. W h a t 
res e a rc h  te lls th e  C ric k e t C o a c h . S p o r ts  C o a c h , 1487, 10(4) 
17-22.

4. O g ilv ie , F M . O n  o n e  ol th e  res u lts ol’ c o n c u s s io n  in ju rie s  o f 
th e e v e  ( " h o l e s "  <il th e m a c u la ) T r a n s  A p lith a lm o l S o c  
U .K . f a l l ) ,2 0 ,2 0 2 -2  29

3 D 'A m b ro in , A. T ra u m a tic  m o n o c u la r  - c h ro n ic  g la u c o m a , 
T r a n s  O p h th a lm o l So e. A u st., 194 5 , 5 ,1 1 6 - 1 2 0 .

6 . L ille w o o d , K .R. Blu n t o c u la r  tra u m a  a n d  h v p h a e m a , 
A u s tra lia n  Jo u r n a l o l O p h th a lm o l, 1982, 10, 2b3-2hh.

7 Jo n e s , N .P . a n d  T u lin , A B S e v e re  e v e  in ju rie s  in c r ic k e t, 
B ritish  jo u r n a l ot S p o r ts  M ed ic in e , 1986. 2 0 ,(4 ), 178-174

8. W illia m s . I.G .P . Jo in t In ju rie s, In-1 C o h e n , C .K  B eaten  and 
D M itc h e ll (E d ito rs ). T h e  S o u th  A frican  T e x tb o o k  o l Sp orl>  
M e d ic in e , U n iv e r s ity  o f W it u a t e r s r a n d , lo h a n n e s b u r g  
1979.

9. C o r r i g a n , A .B . C ric k e t In ju rie s, A u s tr a lia n  F am ilv  I Mu sic ia n  
1984, !> (8 ), 53S-5t>2.

It' C o K o n , J.H .C . an d  A rm o u r, W .J. S p o r ts  In ju rie s an d  th eir 
tre a tm e n t, S ta n  lev Paul a n d  C o, L o n d o n , 197^.

1 I. C le m e n ts , M .R . an d  H a m ilto n  D .V . P n e u m o m e d ia s tin u m  as 
a  c o m p lic a tio n  o t fast b o w l in i; in c r ic k e t. P o s tg ra d u a te  
M ed ic a l Jo u r n a l, 1982, 5 8 , 4 35.

12. F o s te r, D ., E llio tt, B. G ra v , S ., an d  H er/ b erg , L. G u id e lin e s  
fo r th e  Fast B o w le r, S p o r ts  C o a c h . 1984. 7(4> 4 7 -4 8

13 . S tr e tc h . R. A. A n th ro p o m e tr ic  p r o file  o l lir s l-c la s s C r ic k e te r s , 
S .A . Jo u rn a l lor R e s e a rc h  in S p o r t, P h v sica ) E d u c a tio n  a n d  
R e c r e a t io n , 1987, 1 0 (1 ), 6 3 -7 6 .

14. E llio tt, B .C . a n d  F o s te r, D .H . A B io m e c h a m c a l A n a ly s is  ol 
th e  Iro n l-o n  an d  s id e - o n  fa st b o w lin g  te c h n iq u e s . Jo u rn a l ol 
H u m a n  M o v e m e n t S tu d ie s , 1984, 10, 83 -9 4

15. E llio tt, B .C . F o s te r, D .H . an d  G r a v , S  B io m e c lia n ic a l an d  
P h y s ica l F a c t o r s - in f lu e n c in g  Fast B o w lin g , A u s tr a lia n  J o u r ­
nal o f  S c ie n c e  a n d  M ed ic in e  in S p o rt. 1986, 1 8 ( 1 )  16-21.

16. F o s te r, D. In ju ry  a n d  its P re v e n tio n  in Fast B o w lin g , 
P ro c e e d  m g s o f  A .S .M .F . A n n u a l Sc ie n ti tic  C o n fe re n c e , P erth 
A u s tr a lia , 1984.

(7 . S tr e tc h , R.A . an d  B u y s, F.|. P h v sica l F itn es s P ro file  o t  So u th  
A frica n  U n iv e rs itie s  C ric k e te rs , U n p u b lish ed  p a p e r, 1987.

R e d d ic k , T  Plav C ric k et th e right w a y . S e v e n  S e a s 
p u b lic a tio n s  C a p e  T o w n , 1979.

D a v is, K. T ra in in g  p rin cip le s r ela te d  to C ric k e t, 
C o a c h , 1984, 8 (3 ), 2 3 -2 5

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