ACSM Olympic Games Expert Commentary

Beijing Games: Make a Post, Win a Prize!

Now that the Games have ended, we'd like to hear your comments and reflections on the performances, records, and athletes in Beijing. Please submit your thoughts on the questions below, using the "Comments" feature, by Friday, Sept. 5; one ACSM student member, one ACSM Alliance member and one ACSM professional member will receive a FREE registration to the 2009 ACSM meeting of their choice, as determined by a random drawing.

1. What was the most significant sports performance by an individual and why?

2. What was the most significant sports performance by a team and why?

3. What country was most successful and why?

4. What was the most relevant sports medicine/exercise science issue at the Games and why? Was it the environment, injuries, older athletes, extraordinary new Olympic record...or something else?

5. What is the top challenge for the athletes, organizers, or officials that needs to be improved or resolved before the 2012 Olympic Games in London?

6. What did you enjoy most and least about the Beijing Games, and why?

Please reference which question you're responding to in your comment. And don't forget to leave your full name so we can contact you!

The Young Gymnast

At these games there have been concerns raised that some of the female Chinese gymnasts do not appear to meet the minimum age requirement of 16 years old. This raises the question - is competitive gymnastics safe for girls under 16 years of age? Historically there have been two areas of concern: growth and development in young gymnasts and risk of injuries. Many people have looked at these issues to determine if indeed young gymnasts are at risk.

It is clear that over time gymnasts are getting smaller but it is not clear whether this is a result of selection or participation in gymnastics. Researchers have found that elite level gymnasts may experience diminished growth during their years of training and competition and then catch-up growth during time off or after stopping the sport. No one is sure whether the catch-up is complete however.

The second concern has to do with young gymnasts and risk of injury. Advanced levels of training and competition do appear to correlate with increased risk of injury. These can be acute injuries like ankle sprain or overuse injuries like wrist pain. Studies also show that elite gymnasts have a high re-injury rate after injury, suggesting rapid return to activity with inadequate rehabilitation.

You may have noticed a lot of the young gymnasts wearing wrist braces. There is a specific injury unique to gymnasts that is an injury to the growth plate of the forearm bone called the radius. As they spend a lot of time walking, jumping and landing on their arms, the growth plate can be injured and actually stop growing. Not only does this cause the arm to be short but also results in long term wrist pain and inability to do gymnastics. The growth plate normally closes around age 14 in girls so is not a problem for older gymnasts.

Andrew JM Gregory, MD, FAAP, FACSM
Pediatric Sports Medicine Specialist
Vanderbilt University; Nashville, TN

Ankle Sprains in Gymnastics

Each year, more than 86,000 gymnastics-related injuries are treated in hospitals, doctors' offices and hospital emergency rooms. Gymnasts run, jump and tumble on soft surfaces and compete on narrow equipment, which makes them prone to ankle sprains. Considered a ligament injury, 75 percent of sprains are classified as lateral ankle sprains.

Here are a few things gymnasts should consider:

There are three grades of ankle sprains. A grade one means that the ligament is not completely torn it’s just injured but stable. Grade two and three lateral ankle sprain involve a complete tear of one or two ligaments.

The problem with a lateral ankle sprain in sports is typically the pain and instability.  Long term, most ankle sprains respond well to resting, icing, and compression to get the swelling down and a period of immobilization. If the ankle is stable, taping it can help support it during a competition – this form of treatment is commonly used during major competitions like the Olympics.

For those athletes with a more severe ligament tear, taping the ankle typically will not provide the kind of support needed to compete at a more advanced level. Definitive treatment will require some form of support, bracing or immobilization. If a gymnast with a lateral ankle sprain decides to compete they may be forced to make small adjustments to their routine due to pain or fear of re-injury. Ultimately this will significantly affect their performance.

If a gymnast is faced with a severe ankle injury, rest and medical attention is always the best course of action.

David A. Porter, MD, PhD, FACSM

Methodist Sports Medicine Center

Clarian Human Motion, Indianapolis

Ice Vest Precooling

The idea that some mild degree of pre-cooling (a slight reduction in body core temperature of 0.5-1.0 °C prior to exercise) might reduce thermal stress during exercise in the heat has been around for over 20 years. Many studies have demonstrated that pre-cooling results in less thermal strain during exercise, i.e. a lower body core temperature during exercise of similar intensity.  While pre-cooling has been shown to modify (improve) the thermoregulatory responses to exercise not all studies have demonstrated a clear improvement in performance. Lately, using an ice vest has been shown to provide adequate pre-cooling to lower body core temperature prior to exercise and appears almost as effective as more sophisticated pre-cooling procedures (i.e. water immersion, whole body cooling garments) in lowering body temperature.  Use of such ice-vests has allowed researchers to get out of the laboratory and evaluate pre-cooling in the field.  Recent fieldwork has verified that pre-cooling with an ice-vest can reduce body temperature and reduce thermoregulatory strain during most, but not all real or simulated athletic competitions. Overall, endurance athletic events seem to respond best to ice-vest pre-cooling.  Fieldwork has verified the ability to reduce the rise in core temperature under actual 4-5 km race conditions.  In addition, pre-cooling with an ice vest prior to an interval workout (8 x 1000 m) is able to keep body core temperature lower during the first 5-6 repeats. In addition, peak power output during a high intensity cycling exercise (Wingate test) is higher in athletes who undergo ice vest pre-cooling. In contrast, no real advantage has been ascribed to pre-cooling individuals performing high intensity-intermittent exercise (simulated soccer match).  Laboratory tests have provided good evidence that pre-cooling with an ice vest can reduce thermal strain and improved performance.  However, improved athletic performance from ice vest pre-cooling in competitive events has not been verified. Overall, ice vest pre-cooling does not impair performance but does reduce thermal strain in competitive athletes. Regardless of its impact on performance ice-vest pre-cooling should be beneficial to the health and safety of endurance athletes.

Gary W. Mack, PhD, FACSM

Department of Exercise Sciences, Brigham Young University

Ready, set, go! Getting primed for prime time

After Michael Phelps tied Mark Spitz's record of seven gold medals in one Olympics, Phelps stated that his hard work, imagination, confidence, and coach, in addition to his competitors' comments, get him fired up to compete.

Observers of the Olympics are often amazed at how some athletes are able to handle the pressures of their sport while performing on a world stage. Successful athletes, such as Michael Phelps, often have an uncanny ability to manage their thoughts and emotions, even when all eyes are upon them. This ability to be focused and in control of their emotions under pressure is a result of the many training hours and competitive experiences they have endured.

Training involves learning, not only the physical and technical skills of their sport, but also the mental skills and strategies associated with their sport. The mental skills that are frequently associated with success are resiliency, motivation, arousal and emotional management, confidence, and attentional focus control. Coaches of successful athletes often incorporate mental training into daily practices. Through mental training, athletes often identify their present needs, beliefs, worries, behaviors, and emotional responses to their performances. They also learn to examine the consequences of certain feelings and thoughts and learn how to generate alternative causal explanation to negative events.

Mental skills such as positive self-talk and positive imagery can help them challenge and modify their negative responses to poor performances. Practice and rehearsal of these mental skills serve to make thought processing more efficient and emotionally beneficial. Regular use of these skills can help develop mental toughness or calmness under pressure, which will greatly improve the odds that they will be successful in the future.

Scott B. Martin, Ph.D., ACSM Member

Department of Kinesiology, Health Promotion, and Recreation

University of North Texas, Denton

More from ACSM's Staff Roving Reporter...

Sold Out...But Plenty of Empty Seats

So far, we've been to three of our four events. We saw men's gymnastics (including Team USA), women's gymnastics (France, Brazil and some mixed groups), and two men's basketball games (Iran/Russia and Germany/Angola). It's my understanding that everything is sold out; however, there have been plenty of seats where we've been. It's kind of sad that there are so many people who want tickets and so many empty seats, but no way to get them. I'm sure a fair number of them are reserved for athletes, sponsors, media, family, etc. – but there are still plenty more. I wasn't sure what to expect as far as ticket scalpers. I've seen a few folks with signs that say "I need tickets," usually in multiple languages, but none with signs to sell tickets. There were a couple of people on our Great Wall tour the other day who came here with no tickets, expecting they would be available. We are definitely glad we planned ahead and got ours!

We've got spirit, yes we do...

One of my favorite parts about being at the Olympics was seeing people get excited and cheer for their country. The Brazilians seemed to be especially good at this. One of the beach volleyball matches we saw was Brazil against Georgia. The Brazilian men's team won the gold at the last Olympics, and this was Georgia's first time at the Olympics for beach volleyball. The Brazilian fans were loud and crazy - and having a great time. But there were plenty of people cheering for the underdogs, too. Though Georgia was playing a tough team, they held their own. I think everyone NOT from Brazil was cheering for Georgia. The same principle rang true at the basketball games we saw. Though Russia and Germany were no match for Iran and Angola, respectively, all the teams seemed to have plenty of fans and people to cheer for them. I guess that's part of the Olympic spirit.

Stephanie Garwood
ACSM Staff

Michael Phelps' Nutrition Regimen

Rumor has it that swimmer extraordinaire Michael Phelps eats 12,000 calories a day. As my client, a petite figure skater, commented, "That's what I eat in five days. Do some athletes really eat that much?"

Whether or not 10,000 calories a day is accurate is beyond my knowledge base, but for someone who swims five hours a day and also does dry-land training, Michael could indeed require close to that many calories. (So do some triathletes and others who do exorbitant amounts of exercise.) And it looks like he does a good job of choosing an effective sports diet. He enjoys carbs as the foundation of each meal (grits, pancakes, bread, pasta) with protein as the accompaniment (eggs, cheese, meat, along with a little bit of fat for flavor, calories and satiety – as well as endurance performance).

It also looks like Michael believes in the 90-10 rule: 90 percent quality foods and 10 percent treats (as in the chocolate chips in his pancakes). For a hungry athlete to eat 100-percent "clean foods" would be too time consuming and needless. No one needs to eat a "perfect diet" to have a good diet.

How does a hungry athlete find time to eat 10,000 calories? One trick is to eat compact foods, like a bowl of granola instead of a bowl of Cheerios, or a milk shake instead of a glass of milk.  The other trick is to drink beverages with calories in place of calorie-free plain water. That is, quenching your thirst a quart of Gatorade instead of a quart of water adds 200 calories. A quart of orange juice would offer 400 calories. Replace the Gatorade or OJ with a recovery shake made with milk, powered milk, peanut butter, banana, and some honey, and you can guzzle 800 to 1,000 calories down the hatch.

An important key to consuming high amounts of calories is to have the foods readily available, so when you stop training, you can start fueling. At the Olympics and Olympic training center, food is abundant 24/7. At other times, a personal chef (a.k.a. a mom) could be very handy!

Whatever Michael is eating, it's working for him. Good genetics + hard training + a strong mind + good nutrition is indeed a winning combination. Go for it, Michael. We're proud of you!

Nancy Clark, R.D., FACSM

Gene Doping in Olympic Sports

Much has been written about the emerging threat of "gene doping" in elite-level sport. Gene doping refers to the idea that athletes will literally modify their DNA in an effort to enhance their performance. Gene doping is simply an extension of the medical treatment of “gene therapy”, where DNA is modified in patients seeking treatment or cures for debilitating genetic disease. Despite the hype, no evidence exists showing that an athlete has ever attempted gene doping (though testing for it is basically impossible). Moreover, the likelihood of successful gene doping in Beijing or other near-future sporting events is remote; very significant technical hurdles remain before gene doping would ever be put to successful practice. Gene therapy trials for various medical conditions have been fraught with setbacks (including patient deaths) and progress has been slow. And because gene therapy trials are not being conducted to study sport performance but rather specific medical conditions, successful gene therapy interventions are not likely to have easy cross-over to performance enhancement, which is necessarily a different “condition” than the genetic diseases under investigation. 

Despite these limitations, the history of sport provides ample evidence that a few athletes (and/or their coaches) are not likely to concern themselves with the technical intricacies and dangers posed by gene therapy, especially with the potential for remarkable (in fact, super-human) performance enhancement. In fact, the World Anti-Doping Agency (WADA) has already established several recommendations and policies warning athletes against gene doping, though with no way to test for its use. Will an athlete someday attempt gene therapy for performance enhancement? Most certainly, though the outcome is likely to be poor (or lethal), given the significant technical hurdles. Will it happen anytime soon?  Unlikely. Perhaps the best outcome of the media coverage of gene doping will be a broader conversation of the role of performance enhancement techniques in sport. Much has been written about the potential regulation (rather than complete restriction) of drug doping for performance enhancement, and similar arguments have recently been made for gene doping. Expanding this conversation to the broader public will give important direction to improving the health and safety of our athletes.

Stephen M. Roth, Ph.D., FACSM

Department of Kinesiology

University of Maryland

More from ACSM's Staff Roving Reporter...

The sky is not blue. Before I came to China, I heard a lot of talk about the environment and air quality here. There is definitely a noticeable difference between Beijing and Indianapolis. When we were flying into the city, we could distinctly see a layer of smog. First we were above... then flying through it. When we arrived, it was pretty gray and dreary-looking. But that afternoon, things cleared up a little, and there was a hint of blue in the sky. That must have been a rarity – because there has been no blue in the sky the last two days. The smog, coupled with the humidity, makes it pretty uncomfortable outside. And of course, the big tourist attractions are outdoors, so that's where we've been spending a lot of our time.

Before I left the States, several people asked me if I was bringing a mask. I did not, but I have seen some residents wearing masks. They are few and far between, but it seems like mostly older folks. As far as Olympic personnel, athletes and volunteers, we haven't seen any of them wearing masks.

Olympic Venue Security

Everything I'd heard said to arrive at the Olympic venues early. So we took that to heart. I think we were the only ones. There is a special subway line that goes to the Olympic Green, National Stadium, Indoor Stadium, and Water Cube. Everyone must have a ticket to an event at one of those venues and go through security before they can get on this subway line. It's kind of nice to have security more centralized so you can get it over with and not worry about it once you get to the Olympic Green area. On Saturday, we arrived at security around 9:30 – our event started at noon. There was no security line and we breezed right though with no problems. We were in our seats for men's gymnastics by 10:30. We were practically the only people in the area. It didn't start filling up until about 11:30. On Sunday, security was a little different. We went to men's basketball, so we headed to a different venue in a different area of the city. This time, after our bags went through the machine, they wanted to look inside. I had Advil, cough drops, and Dayquil (I'm a bit ill). They tried to throw them away – I think because they looked like candy. I tried to explain that it was medicine, but they didn't really speak English. I must have finally been convincing, or else they just gave up – because they let me take my meds with me.

Stephanie Garwood
ACSM Staff

Competing with Cancer

US Olympic swimmer, Eric Shanteau, has an outstanding chance of living a long life, despite his recent diagnosis with testicular cancer.  Without knowing the specifics of his case, it can be said that 96% of testicular cancer patients survive 5+ years beyond their diagnosis, up from 83% in the 1970’s due to improvements in curative treatment.  These improvements are due to the introduction of platinum based chemotherapy agents such as cisplatin and carboplatin and the curative removal of lymph nodes in the pelvis.  These treatments, while vastly improving survival from multiple cancers, including testicular and ovarian, are no free lunch.  Their use is definitely warranted, given the large improvement in cancer survival.  However, adverse long term and late effects of these treatments include second primary cancers, lymphedema,  cardiovascular sequelae, the metabolic syndrome, neurotoxicity, and pulmonary problems.  The good news is that exercise training has been shown to improve many of these conditions in cancer survivors.  The American Cancer Society has published guidance for exercise and health eating to minimize, prevent, and rehabilitate long term and late effects of cancer treatment, based on a growing body of evidence published in the scientific peer-reviewed literature.  Mr. Shanteau may wish to make up his mind now to maintain his exercise habits and healthy diet for the remainder of his life.

Like Lance Armstrong before him, Mr. Shanteau has an opportunity to be a role model.  However, in 2008, we know more about the long term effects of cancer treatment and the potential role exercise may play in maintaining health during and after cancer treatment than we did at the time of Mr. Armstrong’s diagnosis.  Perhaps, in the long run, the role Mr. Shanteau can play could include promotion of healthy lifestyles among the 12 million cancer survivors alive in the U.S. today.  In the short run, we’ll all cross our fingers for him that his weekly CT scans and blood work allow him to complete his Olympic dream, with his father (a lung cancer survivor) watching from the stands. Good luck and God speed, Eric.

Kathryn H. Schmitz, PhD, MPH, FACSM

Assistant Professor, University of Pennsylvania School of Medicine

Center for Clinical Epidemiology and Biostatistics, Abramson Cancer Center