INTRODUCTION TO SPORTS MEDICINE By Prof. Dr. Salahuddin Khan Ph.D (Sports Sciences) drsalahuddinkhan@yahoo.com

DEFINITION OF SPORTS MEDICINE Sports medicine is the branch of medicine and related techniques that deals with the prevention, diagnosis, treatment, and rehabilitation of sports injuries or illness resulting from participation in sports activities. (Prof. Dr. Salahuddin Khan)

A BRIEF HISTORY OF ANTI-DOPING The word doping is probably derived from the Dutch word dop, the name of an alcoholic beverage made of grape skins used by Zulu warriors (South Africans Warriors that defeat the British Army) in order to enhance their prowess in battle. At the turn of 20th century, the term became familiar in the world. Originally, the word dop, referring to illegal drugging of race horses. Hence, the word refers to the practices of enhancing performance through foreign substances or other artificial means.

EARLY YEARS OF DOPING The use of ergogenic drugs (Performance Enhancing) by the athletes is not new. There have been reports of athletes ingesting substances in attempts to improve performance, since the Greeks started the Olympics in 776 B.C. Ancient Greek athletes are known to have used special diets and stimulating mixtures to strengthen their selves. 300 BC three competitors were disqualified from competing in the Olympics for ingesting mushrooms and animals’ protein.

The first reported drug-induced death in a sporting event was British cyclist using ephedrine in 1890s. Cyclists and other endurance athletes usually used strychnine, caffeine, cocaine, and alcohol in the 19th century. Thomas Hicks ran to victory in the marathon at the 1904 Olympic Games, in Saint Louis, with the help of raw egg, injections of strychnine and doses of brandy administered to him during the race. .

Continue By the 1920s, it had become evident that restrictions regarding drug use in sports were necessary. Drugs abuse in the modern era of athletes become a recognizable problem in 1935 and since then the drugs problem in amateur athletes has continued to grow.

USE OF DRUGS (DOPING) IN THE 20th CENTURY In 1952 stimulants use were reported during winter Olympic Games in Oslo, Norway. Russian athlete began using anabolic steroids. In 1958 American physicians recognized the ergogenic potential of anabolic steroids and began testing them in American athletes.

In early 1960s amphetamines were implicated in the death Continue--- In early 1960s amphetamines were implicated in the death of several cyclists. In 1968 anabolic steroids abuse become severe enough to cause the international Olympic Committee to institute drug testing.

In 1976 anabolic steroids were first banned from use by athletes Continue--- In 1976 anabolic steroids were first banned from use by athletes by the International Olympic Committee during the summer Olympic Games in Montreal Canada. In 1983 nineteen competitors in the pan American games in Caracas were disqualified for drug use, many other athletes voluntarily withdrew from the games rather than risk being tested.

Ben Johnson a Canadian sprinter and 100 M world record holder with Continue--- Ben Johnson a Canadian sprinter and 100 M world record holder with a record time of 9.83 Sec: at Rome in 1987 and 9.79 sec: at Seoul Olympic Games in 1988 was stripped of his world record and Olympic Gold medal title when he returned a positive drugs test, and was suspended for two years and earned a life time ban in 1993, when he was tested positive again on his return from suspension.

THE ANTI-DRUG-ABUSE ACTS In 1970 the Comprehensive Drug Abuse Prevention and Control Act established rules for manufacturing and prescribing habit-forming drugs. It stipulated that physicians can prescribe all drugs, but a special license is required to prescribe drugs with a high abuse potential.

This license is issued by the Drug Enforcement Administration. Continue---- This license is issued by the Drug Enforcement Administration. The Anti-Drug Abuse Acts, signed into law in 1986 and 1988, set up funding for the treatment of drug abuse and for the creation of law-enforcement programs to fight the illegal sale of drugs. These acts also detailed severe punishments for individuals selling and possessing drugs illegally.

First Attempts In 1928, the IAAF (athletics) became the first International Sport Federation (IF) to ban doping. Many other IFs followed the same, but restrictions remained ineffective as no tests were performed. Meanwhile the problem was made worse by synthetic hormones, invented in the 1930s and in growing use for doping purposes since the 1950s.

The death of Danish cyclist Knud Enemark Jensen during Continue----- The death of Danish cyclist Knud Enemark Jensen during competition at the Olympic Games in Rome 1960 (the postmortem discovered traces of amphetamine) increased the pressure for sports authorities to introduce drug testing.

Continue----- In 1966, UCI (cycling) and FIFA (football) were among the first IFs to introduce doping tests in their respective World Championships. In the next year, the International Olympic Committee (IOC) instituted its Medical Commission and set up its first list of prohibited substances. Drug tests were first introduced at the Olympic Winter Games in Grenoble and at the Olympic Games in Mexico in 1968.

Tests Begin to Work Most IFs introduced drug testing by the 1970s, however, the use of anabolic steroids was becoming widespread, especially in strength events, as there was no way of detecting them yet. A reliable testing method was finally introduced in 1974 and the IOC added anabolic steroids to its list of prohibited substances in 1976. This resulted in a marked increase in the number of doping-related disqualifications in the late 1970s, notably in strength-related sports such as throwing events and weightlifting.

Continue---- Anti-doping work was complicated in the 1970s and 1980s by suspicions of state-sponsored doping practices in some countries, which were confirmed by the former German Democratic Republic. The most famous doping case of the 1980s concerned Ben Johnson, the 100-metre champion who tested positive for stanozolol (anabolic steroid) at the 1988 Olympic Games in Seoul. Johnson's case focused the world's attention to the problem of doping to an unprecedented degree. In the 1990s, there was an evident connection between more effective test methods and a remarkable drop in the level of top results in some sports

New Challenges While the fight against stimulants and steroids was producing results, the main front in the anti-doping war was rapidly shifting to blood doping. "Blood boosting," removal and subsequent re-infusion of the athlete's blood in order to increase the level of oxygen-carrying hemoglobin, has been practiced since the 1970s. The IOC banned blood doping as a method in 1986.

One of these was erythropoietin (EPO). Continue--- Other ways of increasing the level of hemoglobin were being tried, however. One of these was erythropoietin (EPO). EPO was included in the IOC's list of prohibited substances in 1990; however, the fight against EPO was long hampered by the lack of a reliable testing method. An EPO detection test (approved by WADA) was first implemented at the Sydney Olympic Games in 2000

WORLD ANTI DOPING AGENCY (WADA) The need for an independent international agency, which would set unified standards for anti-doping work and coordinate the efforts of sports organizations and public authorities. The IOC took the initiative and convened the First World Conference on Doping in Sport in Lausanne in February 1999. The proposal of the Conference, the World Anti-Doping Agency (WADA) was established on November 10, 1999.

WADA Code The purposes of the World Anti-Doping Code and the World Anti-Doping Program which supports it are: To protect the Athletes' fundamental right to participate in doping-free sport and thus promote health, fairness and equality for Athletes worldwide, and To ensure harmonized, coordinated and effective anti-doping programs at the International and National level with regard to detection, deterrence and prevention of doping

Continue---- The Code is the fundamental and universal document upon which the World Anti-Doping Program in sport is based. The purpose of the Code is to advance the anti-doping effort through universal harmonization of core anti-doping elements. It is intended to be specific enough to achieve complete harmonization on issues where uniformity is required,

Fundamental Rationale for the World Anti-Doping Code Anti-doping programs seek to preserve what is intrinsically valuable about sport. This intrinsic value is often referred to as "the spirit of sport", it is the essence of Olympism; it is how we play true. The spirit of sport is the celebration of the human spirit, body and mind,

It is characterized by the following values: Continue---- It is characterized by the following values: • Ethics, fair play and honesty • Health • Excellence in performance • Character and educations • Fun and joy • Teamwork • Dedication and commitment • Respect for rules and laws • Respect for self and other Participants • Courage • Community and solidarity

Doping is fundamentally contrary to the spirit of sport. Continue---- Doping is fundamentally contrary to the spirit of sport. To fight doping by promoting the spirit of sport, The Code requires each Anti-Doping Organization to develop and implement educational programs for Athletes, including youth, and Athlete Support Personnel.

Prohibited Drugs List The Prohibited List shall identify those Prohibited Substances and Prohibited Methods which are prohibited as doping at all times (both In-Competition and Out-of-Competition) because of their potential to enhance performance in future Competitions or their masking potential and those substances and methods which are prohibited In-Competition only. The Prohibited List may be expanded by WADA for a particular sport. Prohibited Substances and Prohibited Methods may be included in the Prohibited List by general category (e.g., anabolic agents) or by specific reference to a particular substance or method.

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