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ACL injuries, lower limb injuries, neck pain, tendons and ultrasound in sports medicine practice were the chart busters in the 2nd half of 2011. Over 4000 listeners monthly enjoy the 35 BJSM podcasts available now. And we continue to add to the list.
We are very open to your suggestions as to whom to interview – feel free to email, post a message on twitter (include @BJSM_BMJ of course) or call 1 800 BJSM.
That’s all for this blog – take the time to listen to a BJSM podcast and provide feedback via ‘email or your favourite social media site
Three exciting updates from the frontlines of health promotion through physical activity.
Illustration by Liisa Sorsa, 23.5 hours video
First, congratulations to Professor Steven Blair for winning the Bloomberg Manulife Prize for the Promotion of Active Health. This international competition celebrates a researcher whose work promises to broaden understanding of how physical activity, nutrition or psychosocial factors influence personal health and well-being.
Professor Blair has tirelessly raised awareness of the burden of low fitness. His dedicated data gathering and adroit analysis has allowed him to deduce that physical inactivity is the biggest public health problem of the 21st century. His 2009 editorial in BJSM shares this title and has been downloaded more than 20,000 times (available free online).
Secondly, after garnering global attention, Mike Evan’s videos 23.1/2 hours is being translated into multiple languages. Sports Medicine colleagues will ensure the video can be enjoyed by speakers of Arabic, Spanish, Chinese, and Italian. And there will likely be more offers to come.
This will further enable the first physical activity ‘YouTube sensation’ – 23 1/2 - to promote behaviour change, while recognizing the physical activity challenges in a wide range of countries.
While 1.6 million hits demonstrates 23.1/2’s current success, translation into multiple languages may take this video to the ‘next level’ with a goal of 10 million views!
The video has already gained international traction as shown by the breakdown of views per country: US 844, 664, Canada 320, 000, UK 61, 345, Australia 49, 100, India 32,000, Netherlands 14, 977, Singapore 13,761, Germany 13, 345, Malaysia 11, 986, Sweden 11,589, Israel 11, 387, Saudi Arabia 10, 786, Mexico 10, 607…and the list goes on.
If you haven’t watched the video yet, check it out here (and note Steve Blair’s fun cameo at around 2 minutes 50).
And a third exciting sign of progess was Scotland appointing a physician to head their campaign against physical inactivity.
Doctor Andrew Murray (@docAndrewMurray) – who clearly has to differentiate himself from his colleague “Andy Murray” (@andy_murray).
The more important of the two, although seemingly not by # of Twitter followers, Doctor Murray, makes the point that “having a low level of fitness is equivalent in risk to having diabetes, smoking, and being obese combined”. BJSM likes that emphasis – amazing but true. All the best in the job DocAndy – we look forward to interviewing you for a BJSM podcast (with subtitles).
So – things are moving in the right direction – let’s all take up the cudgels and promote, promote, promote. Remember that Kotter said transformational changes takes 10 times as much communication as you expect it will need (plus 7 other things: see BJSM article on Kotter’s eight-step programme for transformational change).
Define ECG interpretation standards in athletes and;
Develop a comprehensive, freely-available online training module for physicians to gain a common foundation in ECG interpretation in athletes.
This educational resource will help physicians distinguish normal ECG variants in athletes from ECG patterns that suggest an underlying cardiac disorder.
This state of the art E-learning program will be hosted by BMJ Learning and will be accessible to any physician in the world with the aim of improving the cardiovascular care of athletes.
Participants include:
AMMSM:
Jonathan Drezner, MD (Chair)
Jeff Anderson, MD
Chad Asplund, MD
John DiFiori, MD
Kim Harmon, MD
Stephen Paul, MD
ESC Sports Cardiology Section:
Mats Borjesson, MD
Domenico Corrado, MD, PhD
Hein Heidbuchel, MD
Antonio Pelliccia, MD
Sanjay Sharma, MD
PACES
Michael Ackerman, MD, PhD
Bryan Cannon, MD
Peter Fischbach, MD
Jack Salerno, MD
Other U.S. Cardiologists
Euan Ashley, MD
Aaron Baggish, MD
Vic Froelicher, MD
Joseph Marek, MD
David Owens, MD
Jordan Prutkin, MD
Victoria Vetter, MD
F-MARC (FIFA Medical Assessment and Research Centre)
Professor Timothy Noakes (and @GaryTaubes) add these insights to the discussion in this guest blog:
Photo courtesy of Gavin Clarke, Flickr cc
What astonishes me is the continuing failure of so many people, my medical colleagues included, to realize that the solution to personal obesity is so simple. The cause for most people is exactly as Gary Taubes described it – a diet too low in fat and protein and too high in carbohydrate especially sugar. If you are over forty, overweight, personally motivated, and not eating a high fat/high protein/low carbohydrate diet, then you are missing out – your life is passing you by.
The second key is also as Taubes describes it – obesity begets inactivity whereas leanness promotes activity. Trying to get lean by exercising whilst continuing to eat the “healthy” high carbohydrate diet will be unhelpful for most with an elevated BMI (and who are are therefore by definition, carbohydrate intolerant/resistant). You need first to lose the weight by changing to a high fat/high protein/low carbohydrate diet. As the weight falls of (as it does very dramatically at rates that most will not believe), the desire to exercise becomes increasingly overwhelming. In time the desire to exercise becomes addictive.
Trying to encourage overweight people to exercise without first changing their habitual eating patterns (not diet, please note) will never produce the same outcome as will one in which the initial focus is on changing to a high fat/high protein/low carbohydrate diet.
As Gary Taubes describes, this has been known since 1861 but was written out of the medical and popular literature after 1970 when Dr Ancel Keys essentially single handedly developed the global fear of fatty foods that mislead the world and led directly to the epidemic of obesity and diabetes that began to engulf especially people in the developed world especially after about 1977.
Until we rid ourselves of the ridiculous idea that carbohydrate foods are somehow “healthy” (for all) and fatty foods are unhealthy, and as long as we allow our eating patterns to be dictated by industries that aim remorselessly to increase global consumption of sugar and refined carbohydrates, then we cannot solve the global problem of obesity and diabetes.
But at an individual level we can take control by realizing that obesity is a genetic/nutritional disorder caused by excessive carbohydrate consumption in those who are carbohydrate-resistant (and who are therefore unable to metabolize carbohydrates especially fructose, appropriately but who will store the excess calories in fat, rather than expend them in physical endeavor).
Dr. Timothy Noakes is a Sports Physician, Exercise Physiologist and Discovery Health Professor of Exercise and Sports Science at the University of Cape Town and Sports Science Institute of South Africa.
My feeling is that although some doctors diagnose by MR instead of via cognitive processes, that is NOT the problem in sports and exercise medicine. See Chris Milne’s recent lucid description of what happens in the sports medicine setting. However, we are in a phase where PATIENTS are DEMANDING MRs — as this article highlights toward the end.
So the next implementation/knowledge translation challenge is to education patients to value a careful history and physical exam. That won’t be easy in a time where technology is valued – at times to excess.
BJSM priortizes ‘hot topics’ such as sports imaging, US in imaging. You can sign up for free Table of Contents (TOC) via email and over 2000 folks follow us on Twitter (@BJSM_BMJ) where we post alerts to this blog and other useful sport and exercise medicine links.
The topic of a new BJSM podcast is Ankle sprains and rehabilitation, with human movement specialist Evert Verhagen.
He addresses accurate diagnosis, whether to tape or brace (and when), principles of return to sport, and issues of cost-effectiveness. This podcast is geared to clinicians treating patients after ankle sprain — and preventing these injuries in the first place. See Evert’s e-learning module at the BMJ [link http://learning.bmj.com.] and his editorial on injury prevention with Professor van Mechelen.
If you haven’t checked out our podcasts, go there now. Feel free to post your comments below.
