While most members of the health care community are able to offer some benefit to athletes engaged in active competition, there are some that are internationally recognized to offer predictable and reliable benefit. It will be of great benefit to our athletes if meaningful study is conducted by our Jamaican athletic administrators in this regard. For a country that is on the top of the world in sprinting, we lag considerably behind current international standards and practices for medical personnel appointment. According to international practices, the medical personnel ought to be comprised of Medical Physicians, Chiropractors, Sports Psychologists, Athletic Trainers, Physical Therapists/Physiotherapists and Massage Therapists. While there is an overlap in some responsibilities, there are unique and essential skillsets that each possess.
The ideal Medical Physician is typically a medical doctor trained in or has experience in sports medicine. The greatest need for a medical physician is for orthopaedic-type injuries, medical emergencies, general illnesses or other medical needs that may arise, especially those outside of competition. Other needs may include preparing medical exemptions/certificates and liaising with local medical personnel in the event of a medical emergency. It is important to note that all internationally sanctioned competitions, have a local medical team that is responsible for medical emergencies that may arise during competition.
A Chiropractor is the authority on non-surgical neuromusculoskeletal conditions of the spine (neck and back) and extremities (arms and legs). They not only help when there is an injury, but also where there are structural imbalances which may impair athletic performance. Many athletic injuries can be traced back to a misalignment or injury in the spine, imbalances in the pelvis and/or leg length inequalities. Chiropractors are the experts in handling these types of problems. This professional ideally should also have specific training in or experience in Sports Chiropractic.
Athletic success requires more than just physical preparedness, it also requires a calm and focused mind. Many athletes, especially the younger, more inexperienced athletes, have a difficult time navigating the stresses of competition. It is difficult to expect a coach to have to meet this need as they are often ill-equipped and too busy coaching, to be able to adequately cater for the psychological wellbeing of the athletes. The trained Sports Psychologist is the professional responsible to perform this role.
Ideally the Physiotherapist should possess specific training in not only modalities like ultrasound, hot pack application or icing, but also soft tissue manipulation, stretching, taping and bracing. There are some physiotherapists who have specific training in the treatment of sports injuries and they should be given preference in team selection.
Not all massages are the same. Massage for athletic performance is a very specialized area and requires specific training. Currently, G.C. Foster College of Physical Education & Sport provides diplomas in Sports Massage Therapy, where the masseuse or masseur will understand the various components of massage for athletic performance including pre-competition and post-competition. Every effort should be made to select persons with the appropriate designation and experience. Massage is only one of many forms of soft tissue (muscle, ligament and fascia) manipulation. It is important to note that Chiropractors, Physiotherapists and Athletic Trainers are also trained in various forms of soft tissue manipulation.
Based on the volume of work needed and the importance of these roles, a 60 member team should have the following 10 member medical and allied medical personnel. The following table contrasts the ideal with what obtained for the team sent to London 2017:
As I close, it is important to note that the Final make up of our teams is at the sole discretion of the recognised selection committee responsible for the respective Games/Championship. They are tasked to work within the constraints of available personnel, quota restrictions imposed by the IOC/IAAF and the established preferences of the athletes and coaches themselves. I hope you find this report enlightening and it is my hope that it will be used to guide future decision making as it relates to the selection of accompanying medical and allied medical personnel.
Neil Gardner, DC, DACNB
Diplomate, American Chiropractic Neurology Board
Chiropractic Neurologist ,Gardner Chiropractic & Neurology Ltd.