Edition 05/2002

Identifying Health Risks Prior To Participation

Particularly in view of recent tragic deaths of young Australians whilst participating in sport an article caught my attention when reading the March 2002 edition of the US published magazine "Athletic Business."   The article, written by Michael Popke, was titled "Doctors On Duty," and explains how more US state associations were turning to medical professionals for guidance.

In November 2001, mere weeks after Texas became the most recent US state to create a committee of medical professionals to oversee sports medicine issues in high school sport, John Alexander, a junior basketball player at Houstons Pasadena Dobie High, collapsed and died on the court during a game.  The tragedy, which was eventually attributed to Alexander's enlarged heart, marked the fourth time a Texas high school athlete died of that condition in 2001.

It became a rallying point for the University Inter-scholastic Leagues Medical Advisory Committee, which was formed after two high school footballers died from enlarged hearts one day apart at a practice in the scorching August heat.  These deaths were a little more than two weeks after a Minnesota Viking's offensive tackle died from heatstroke.  A third Texas football player died of an enlarged heart in September.

"We felt it was time to take some serious action and look into our policies.  These deaths raised the awareness that perhaps there's more that we can do", stated UIL Athletic Director Charles Breithaupt, referring to the 11 member group comprised of doctors and certified athletic trainers.

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An enlarged heart - also known as left ventricular hypertrophy, which is caused by a thickening of the heart muscle because of an increased workload - has become an all-too-common health problem in young athletes.  In addition to the four deaths in Texas several high school athletes around the US have also died of complications associated with an enlarged heart during the past year. 

When UIL's Medical Advisory Committee (which consists of two orthopaedic surgeons, a cardiologist, a sports medicine specialist, a paediatrician, a neurosurgeon, two certified athletic trainers, a team physician, an emergency medical technician and a member of the Texas High School Coaching Association) first met in late September 2001, members divided into subcommittees, to evaluate the four areas vital to student-athletes' health: heart conditions, head injuries, heat-related issues and the use and effectiveness of pre participation physical examinations and medical history forms.

Already the committee has spurred changes the way the state administers physicals to all student-athletes.  Previously, examinations were only required of seventh and ninth graders.  Beginning in August however, high school juniors must also take pre-season examinations if they want to play sports.  The forms doctors use to administer  the examination have also been changed to reflect new heart-check parameters defined by the UIL.  The extent of some physicians' previous heart examinations went little beyond checking for a pulse, UIL athletic Director Charles Breithaupt says.

Another result of the Medical Advisory Committees' work is a strategy to provide echocardiogram screenings for Texas' one million or so high school student-athletes to detect any heart abnormalities or diseases that may exist.

  Continued ....