April 1, 2018 This week we hear from our Sports Medicine Doctor Peter Nathan.
Dr Peter Nathan is Sportreat’s resident Sports Medicine Doctor. He has been working at Sportreat since it opened in August 2008.
Peter graduated from the University of Auckland and since then has had further experience working in the UK and USA. He initially came to WA to complete a sports medicine qualification and since then he has undertaken further studies in sports medicine and has completed a Masters Degree in Sports Medicine at the University of NSW.
He is a fellow of Sports Doctors Australia and is also a fellow of the Royal Australian College of General Practitioners having completed full specialist GP training in addition to his sports medicine qualifications.
As well as work in sports medicine and general practice he also works part time at Murdoch Hospital Emergency Department and acts as the Match Day Doctor for Super Rugby WA.
He is currently the President of Sports Medicine Australia’s WA branch and is a National Board Member and Executive director of Sports Medicine Australia. Peter is also a member of a number of medical advisory committees.
Sports medicine specialises in preventing, diagnosing and treating injuries related to participation in sports and/or exercise. Because of the competitive nature of sports, a primary aim of sports medicine is to return the patient to their former level of function as soon as practically possible.
While there are undoubtedly many health benefits from regular exercise unfortunately every year hundreds of people also suffer sporting injuries – sprains, strains, fractures and broken bones.
The economic cost of this is significant and the perception of injury risk may discourage many people from regular exercise potentially causing an increase in preventable health problems such as Diabetes, Obesity, Hypertension and Heart Disease.
More often than not most of these injuries could have been prevented had the correct preparation been undertaken.
Avoid Doing Too Much Exercise Too Soon
Make sure you prepare for activity by starting at a level and pace you’re comfortable with. Gradually increase your workload over a series of sessions. Without undertaking the proper preparation for your activity, your risk of injury increases by 35%.
If you’re unsure of how to increase your fitness level see a qualified fitness professional for advice. Your Family Doctor (GP) is well qualified to advise you about safe activity or they may refer you to either an Exercise Physiologist or Physiotherapist for further advice. People with more complex medical problems may benefit from the advice of a Musculo-Skeletal Physician, Sports Physician, or Sports Doctor.
These medical specialists often work in multi-disciplinary clinics where they can liaise with other sports medicine professionals to construct a personalised program.
Many local council provide supervised exercise classes at their Gymnasiums.
Always Warm Up, Stretch and Cool Down
Always remember to warm up and cool down when undertaking activity. Warming up prepares you both mentally and physically for performance and decreases your risk of being injured. To warm up, simply start your chosen activity at a slower pace. Also remember to cool down after activity sessions to help reduce muscle soreness and stiffness.
Research shows that cooling down after activity may reduce injuries by almost 10%. Stretching after exercise is often beneficial as well. Although some studies have cast doubt on the benefits of stretching most health professionals feel these studies were not adequately designed.
If you are still sceptical observe the pre and post game procedures of your favourite sports teams! Some people may need a personalised warm up and stretching programme to compensate for medical problems or chronic injuries.
Drink the Right Amount of Fluids
Thirst is a poor indicator of fluid needs, so don’t wait to feel thirsty before having a drink. If you are exercising at high intensity in hot conditions always drink fluids (water or a sports drink) before, during and after activity.
In extreme conditions if you are sweating heavily you may need to drink at least 2 cups (500ml) an hour before exercise, 150ml every 15 minutes during exercise and enough to fully re-hydrate yourself after exercise.
However at lower intensities of exercise fluid requirements are much less and studies have shown some people develop dangerously low salt levels due to excessive fluid intake. This is more likely during longer events. If in doubt get professional advice particularly if you are on diuretic medicine often used to treat Blood Pressure.
Wear the Right Gear
Everyone needs to prepare for the activity ahead. Wear protective equipment such as helmets, padding, and mouthguards, where required.
Whilst wearing of Cycle Helmets is now taken for granted, many of us will remember the controversy surrounding the implementation of this measure.
Similar debate preceded the introduction of compulsory seatbelts in cars. Today many doctors are advocating the use of helmets for Alpine Skiing and Snowboarding.
Some Resorts are making Helmets compulsory for their own Staff and for children who hire equipment. There is good evidence that wrist guards can prevent wrist fractures in Snowboarders.
Good quality shoes specifically designed for your chosen activities are also a must as a number of studies have found a relationship between the type of footwear worn and the incidence of injuries to the lower limb. Podiatrists can offer professional advice about footwear.
Avoid Exercising in Hot Conditions
Exercising in hot conditions can cause heat injury with symptoms of fatigue, nausea, headache, confusion and light-headedness. Avoid exercising in very hot conditions, particularly in the middle of the day. During activity, try to rest in the shade whenever possible and protect yourself by wearing light clothing, sunscreen, sunglasses and a hat.
Know How to Treat Injuries
When undertaking activity, you should know what to do if an injury occurs, especially if you have suffered an injury in the last 12 months. Injury statistics have found previous injury increases the risk of further injury by 57%. Those who suffer a soft tissue injury should treat it with RICER – Rest, Ice, Compression, Elevation and Referral.
Commence RICER immediately after injury occurs and continue for 48-72 hours. You should also avoid HARM factors – no heat, no alcohol, no running and no massage and see a sports medicine professional to help you get back to your activity as quickly as possible.
Dr Peter Nathan consults at Sportreat on Wednesday and Thursday mornings, as well as Friday afternoons.
