The recent drugs scandal in Indian Athletics reignites the debate surrounding good sports medicine practice. Few would argue that guilty athletes should be punished however it is imperative that India figures out why this has occurred.
It is my firm belief that the net of blame be extended beyond the obvious athletes and coaches and include what is clearly a lacking system. A good system would include a coach, a sports physician, a nutritionist and a physiotherapist. Sadly, I feel that this is not the case for the majority of athletes in the elite national programmes. I believe that if the athletes felt confident in their management team of experienced experts, they would be far less likely to resort to the extreme measures of drug abuse.
Athletes must consume good quality protein, carbohydrates and other sources of nutrition to meet the high demands that top-level sport places on their bodies. Supplements are often used because they are a more convenient form of obtaining the nutrients needed for recovery. The supplementation industry is not well regulated and a number of studies have found that sports supplements have been contaminated with banned substances.By building a good nutrition programme for India's elite athletes we negate the need for them to take risks. This starts with simple measures such as having qualified sports nutritionists and sports medicine physicians working with the athletes and coaches on a full time basis. They would be charged with constantly monitoring the food served in canteens to ensure it provide the nutritional requirements for athletes to consistently train at their best. In addition they should be conducting regular consultations with athletes to develop a nutritional profile specific to the athlete as no two athletes are the same and small differences in their nutritional needs may exist.
Once the athletes are on good nutritional programmes but are still not meeting the demands of the training load that the coach needs them to perform, additional members to the medical team must be included.
This is where the sports physiotherapist is called in. A detailed musculoskeletal profile is conducted and the athlete is subjected to a number of physical fitness tests.
If weakness and sub-optimal conditioning are present, an individualised strength and conditioning programme as well as a recovery programme are implemented to aid the athlete in managing the training load.
Should there be a performance issue or lack of recovery after these measures then the medical team would look at supplementation. Safe and effective supplements would be used and the athlete would be subjected to regular testing to ensure that the supplements and other intervention programmes were aiding their performance.
Considering that the London Olympics is less than a year away, India needs to address the shortcomings in its system as a matter of urgency.
(Mathews is head physio therapist at Kokilaben Dhirubhai Ambani Hospital, Mumbai. As part of the Mittal Champions Trust, he was key to the success of Abhinav Bindra, Vijender Singh and Saina Nehwal)