Non-steroidal anti-inflammatory drugs in sports medicine: guidelines for practical but sensible use

British Journal of Sports Medicine 2009;43:863-865
The authors recommend an approach to NSAID use in sports medicine whereby simple analgesia is preferentially used when analgesia is the primary desired outcome. However, based both on the current pathophysiological understanding of most injury presentations and the frequency that inflammation may actually be a component of the injury complex, it is premature to suppose that NSAID are not useful to the physician managing sports injuries. The prescribing of NSAID should be cautious and both situation and pathology specific. Both dose and duration minimisation should be prioritised and combined with simple principles of protection, rest, ice, compression, elevation (PRICE), which should allow NSAID-sparing. NSAID use should always be coupled with appropriate physical rehabilitation.  NSAID are probably most useful for treating nerve and soft-tissue impingements, inflammatory arthropathies and tenosynovitis. They are not generally indicated for isolated chronic tendinopathy, or for fractures. The use of NSAID in treating muscle injury is controversial. Conditions in which NSAID use requires more careful assessment include ligament injury, joint injury, osteoarthritis, haematoma and postoperatively.

BJSM reviews: A–Z of nutritional supplements: dietary supplements, sports nutrition foods and Ergogenic aids for health and performance Part 3

British Journal of Sports Medicine 2009;43:890-892

Until recently we have considered free oxygen radical production in the body to be a solely "negative" occurrence that might be countered by supplementation with antioxidant nutrients. The supposed benefits included improved health and mortality, and for athletes, the extra advantages of enhanced performance through a reduction in exercise-induced damage. In fact, as discussed below, The Cochrane Review¹ found little or no difference in the normal population between antioxidant administration and those taking a placebo. Mortality was, in fact, slightly higher in the antioxidant group. The review focuses on antioxidant supplementation in athletes and includes the possibility that some oxidative species play a positive role in the adaptation to exercis

Setting Standards For The Prevention And Management Of Travellers’ Diarrhoea In Elite Athletes: An Audit Of One Team During The Youth Commonwealth Games In India

Br J Sports Med. Published Online First: 25 October 2009
Hygiene guidelines included only drinking bottled water, eating hot food and regular hand washing with alcohol gel. Ciprofloxacin was offered to non athlete team members as prophylaxis but not to athletes due to its possible association with tendon disease. Rifaximin may be an alternative for this group.

A–Z of supplements: dietary supplements, sports nutrition foods and ergogenic aids for health and performance Part 2

British Journal of Sports Medicine 2009;43:807-810
The subject of supplements is of crucial importance and there is a vital need for reliable, balanced and unbiased information for athletes and their support staff. The use and potential for abuse of supplements by athletes have been of concern to all those involved in supporting athletes for many years. Of primary concern is the health of the athlete. Performance issues are secondary and performance will only be helped if optimum health is  maintained. The ergogenic effects of many supplements are controversial and good evidence for efficacy is rare.
This 2. part covers:
AMINO ACIDS, ANDROSTENEDIONE, ARGININE,ASPARAGINE AND ASPARTATE

A–Z of supplements: dietary supplements, sports nutrition foods and ergogenic aids for health and performance Part 1

British Journal of Sports Medicine 2009;43:728-729

All the above terms (and more) have been used to entice the unwary (and wary!) athlete to spend money on dietary products that claim to enhance their health and sports performance.

The Oxford English Dictionary definition of suppplement is: "Something added to supply a deficiency". Yet many supplements, or their individual ingredients, are nutrients or food chemicals for which the body does not have an estimated or theoretical requirement. Thus there are clearly other factors that underpin their use by athletes.

There are many reviews on supplementation in athletes, some of which are very good. Our aim is not to replicate these, but to give a series of very brief overviews, some of which will be by experts in the field. Our main aim is simply to demystify some of the many supplements on the market in order to provide a useful
resource for athletes, sport and exercise enthusiasts, along with allied professionals such as nutritionists, coaches, physiotherapists and doctors.