Good sports

Neil Bramwell speaks to the GPs behind our Olympic and Paralympic stars.

AS THE cream of Australia’s sporting talent prepares to head for the Olympic and Paralympic Games in London, behind them is a medical support team just as diligent and dedicated.

“If something is going to go wrong, it will go wrong at the Olympic Games when athletes are pushing for that extra 0.2%,” says Dr Peter Baquie, medical director of the Australian Olympic team. So his 70-strong team of doctors, physios, psychologists, nutritionists and masseurs will be focusing on preventing injury rather than providing miracle cures.

“This isn’t about sexy, whizz-bang medicine. I will be asking our team to be putting 110% energy into the things that make 1% difference, such as compressing a sprained ankle and icing it well. It’s more of a marriage with the basics rather than a fling with new techniques,” he says.

Dr Baquie spent 15 years as a GP in South Gippsland before retraining in sports medicine and becoming involved with the Australian hockey team, with whom he worked at the Sydney and Athens Olympics. He combined this with work at Melbourne Storm rugby league team before filling the vacant post of AOC medical director in 2007.

He is now based at the Olympic Park Sports Medicine Centre, at Melbourne AAMI Park, where he combines a sports medicine practice with his work with the AOC and a role as club doctor for Hawthorn Football Club.

He says London does not pose as many environmental and climatic challenges as did Beijing, where he was also team medical director. This time around, seemingly routine issues, which ultimately can mean the difference between gold and silver, become the focus.

For instance, athletes who will be participating in the first few days of competition are given practical advice about whether to take part in the Opening Ceremony, when four hours of marching and standing around in alien and uncomfortable shoes often result in blisters and drained energy reserves.

Many swimmers are unlikely to participate in the showpiece event, the pinnacle of many athletes’ careers, for this reason.

Jetlag and sleep deprivation are also obstacles, especially in a buzzing Olympic Village. Athletes are being encouraged to start their days early before they leave for the UK, and sleeping pills are only to be used as a last resort – and then only if the athlete has trialled them previously.

The medical team is paying particular attention to sports with a potential for rain interruption, such as archery. It has sought the advice of Tennis Australia’s performance manager, who has vast experience of frequent rain breaks at Wimbledon, on keeping athletes warm and ready for action.

The probable London temperature fluctuations have also been a factor to consider. The triathletes might be swimming in Hyde Park in temperatures of 14°C while a long-distance walker could face temperatures approaching 32°C.

Athletes’ core temperatures are monitored via a swallowed Core Body Temperature Ingested Sensor, which passes through the GI tract in 24 hours and emits a low-frequency signal through the body from a sensor, which vibrates at a frequency relative to the body’s temperature.

One of the most important tasks of the medical team is infection control. A sniffle in one athlete can wipe out a whole team and isolation is a tricky logistical exercise in the limited facilities of an Olympic Village.

A recent paper in the British Journal of Sports Medicine suggested the rigorous preventative measures exercised by the Norwegian Winter Olympics team at Vancouver 2010 resulted in a much greater medal haul than at the previous Games in Turin, something Dr Baquie is hoping to replicate.

“We will be telling our athletes not to use hankies and to use tissues instead, to wash their hands regularly, and there will be plenty of honey and lemon, syrups and soothers to protect their airways.

“A slight cough two days before the marathon can be critical, so we are hyper-acutely aware of infection control. Aggressive management of people’s sub-par well-being is the key,” he says.

Add to this the co-ordination of recovery programs for all the sports, the maintenance of psychological well-being of athletes who may have under-performed, and the application of rigorous anti-doping regulations, and there should perhaps be a medal awarded to the medical teams themselves.

Dr Don McIntosh specialises in the care of young gymnasts.

Many of the headline sports have their own medical staff, including Dr Don McIntosh, whose speciality is gymnastics but who will also be involved with other sports at the AOC’s medical headquarters at a London school.

He combines sports medicine with his GP work in Dandenong and also worked with Fitzroy Football Club and the Australian Ballet before becoming chief medical officer for Gymnastics Australia 10 years ago.

An accomplished footy and hockey player, Dr McIntosh’s competitive streak was on display at the Delhi Commonwealth Games.

“If something impresses me I will be up there yelling and screaming and clapping. I’m not a small person and I had a few comments when I returned from India that the cameras picked up on this excitable bloke in a big green and gold shirt,” he says.

His preparations start even earlier than most, with potential star gymnasts being identified and nurtured from an early age to peak in Olympics years.

Dr McIntosh’s involvement in their care and conditioning typically begins at 12, with specific selection processes for the different disciplines. For instance, the team looks at parents and grandparents when selecting thinner and hyper-flexible athletes for Rhythmic Gymnastics.

“We want healthy people competing at the Olympic Games and with younger athletes there is potential for different things to go wrong such as injury to bony growth plates. We see problems with soft tissue injuries through overload and repetition during their training programs,” he says.

“One of the great things about Australian sports science is that we always get good information from sources such as the Australian Institute of Sport on the best ways to go.”

Dr Geoff Thompson will cater to the health needs of Paralympians.

The real unsung heroes of the sports medicine field, as with their athletic counterparts, are the 30 healthcare professionals who will accompany the Paralympic team. They are headed by Dr Geoff Thompson who, in 1989, after 15 years in general practice, became one of the founding sports and exercise physicians in Australia (there are now around 150).

He now runs a specialist practice in Darwin, was involved with the men’s hockey team for the Sydney Olympics, and had a general role in Beijing before taking over as chief medical officer of the Australian Paralympic Committee.

He says Paralympians’ medical needs far outweigh those of the athletes at the Olympics.

“Athletes with spinal cord lesions are prone to urinary tract infections and pressure sores, often without knowing they have them, so we now have a screening program to help prevent infections.”

Deep vein thromboses can be a problem on long flights: “One athlete who knew she had a predisposition gave herself an injection, overdosed and we had to deal with the tummy full of blood as a result of haemorrhage.”

Athletes with cerebral palsy might need medication for convulsions or epilepsy, and acupuncture and Botox will be used to try to control unwanted muscle spasm in London.

Wheelchair athletes rely on their upper body for their independence and so are very reluctant for the medical team to perform any definitive surgery.

“But they are a very happy bunch,” he says. “Their disability is their challenge and so sport is an absolute bonus.”