Take A Pill

>I have arthritis – mostly caused by attempting to be an athlete. Was I good as an athlete? Not especially, though I got to do my sport until my thirties. I got to travel a little and enjoyed it a lot. But because I loved it so much, I worked and played hard and with the work and play I over used the majority of my joints and muscles. The end result was injury induced arthritis in my back, my feet, my knees, my hips, my shoulders, my elbows, and my wrists. Doesn't sound like too much fun!

Early on in this journey, the aches and pains drove me to find ways to control the aches and pain. I asked my peers; I asked my coaches; I asked my family; I asked strangers on the street: what do you do about arthritis. Most everyone had a cure and most of the cures had to do with "taking a pill" or "getting a shot". No one seemed to worry about the quality of "the pill" or the quality of "the shot". I found out that there was good stuff that could be shot into my aching joints that helped a lot! In fact, most physicians were very helpful about giving me "a cortisone shot", and if I went to enough different physicians I could keep most of the pain under control. I had these shots off and on for my major joints over the course of about 20 years. I finally found out that this probably wasn't good practice and that it was actually pretty stupid. But, the price was worth it, I got to play longer! Much later in my journey through life after the big time playing was done and the pain was worse, I learned that ingesting supplements could help joint repair. Thus, the last 20 years has been a long journey of stopping and reading at the drug store or health store to find the right supplement to help the problem.

I was busily doing my thing until an experience with the United States Anti-Doping Agency (USADA) educated me, in a way that I didn't want to be educated. To be clear, I never at any time chose to use a drug that was a performance enhancer – rather I chose supplements to help improve joint function and reduce the arthritic pain of my joints. Then a few years ago, while attending an educational meeting of USADA, I learned about the contamination of supplements in this country. I always knew that health food stores are not monitored by the United States Department of Agriculture (USDA) or the Food and Drug Administration (FDA), but for some reason I never made the jump from the fact that supplements are not monitored to the knowledge that these products have no oversight, AT ALL.. Neither did I know that the majority of these supplements are now made in Mexico, China, or in the basement lab of an amateur chemist/entrepreneur. I wasn't a top level athlete who had the luxury of "performance enhancing drug education" from USADA or WADA, or the NFL, NBA, MLB, or the NCAA, I was just a better than average athlete who loved and wanted to play and perform. I was the average ignorant "joe some" on the street. I was just a person with a lot of arthritis that HURTS!!! It was through the USADA experience that I learned supplementation is fraught with potholes. And, I learned that I really didn't know what I was ingesting – it could have been cat pee for all I knew, and maybe it was.

And there is the rub. Supplementation in this country is out of whack. Whenever there is something wrong or when we want to improve and get something right, we "take a pill". We have pills for any problem and I do mean any problem! We have memory pills to improve cognitive functioning – which students and children take to improve on examinations or doing school work. We are all whacked! Every night and it doesn't matter the station on television, there is an advertisement for "male enhancement". I wonder where that blue pill is manufactured and what the level of cat pee is in that pill.

When I discuss this with my college freshman, I am surprised that many of them supplement and buy at the local GNC store, which was originally started by Victor Comte of BALCO fame. All my students seem to know is: "take a pill" and all will be well.

All my pill popping and injections haven't warded off arthritis. I probably would have been better off with less exercise, less competition, and less masking of all of the injuries. My coaches NEVER told me to slow down and do less. Rather, the expectation was that I would perform – which I did.

Overuse injuries occur because we players don't know when to quit and we need better and wiser minds to get us to rest and train correctly. Athletes are seldom able to view their physical performance in an objective light and seldom can they make the hard decisions about overuse.

Overuse injuries occur over time and are the result of repetitive micro-trauma to the tendons, bones and joints. Overuse injuries are the most challenging to diagnose and treat and treatment varies and as does recovery. The best advice is not go there to begin with. Train in a responsible manner. A good web site on overuse is : http://www.sportsmed.org/secure/reveal/admin/uploads/documents/ST%20Overuse%20Injuries%2008.pdf

Supplementation should be avoided and athletes should be educated against supplementation. Both of these problems exist because athletes and sometimes coaches lose sight of the true value of sport.

Coaches should realize that "…manufacturers of dietary supplements are not required to provide evidence of efficacy or safety prior to marketing the product. Moreover, except for a supplement that contains a "new dietary ingredient," dietary supplements are not required to have FDA approval or to be registered with the FDA before they are produced and marketed. Manufacturers are responsible for establishing their own manufacturing practice guidelines, because there are no FDA regulations to ensure the identity, purity, quality, composition, or strength of dietary supplements. Once a dietary supplement is marketed, the FDA must demonstrate that the product is unsafe before it can take regulatory action against the dietary supplement, essentially amounting to a "postmarketing" regulatory framework…." http://jama.ama-assn.org/cgi/content/full/289.12.1568v1

Wiser and better advocates of play for children should be our mantra not playing until we can't move and not playing with the use of supplementation from "taking a pill"

I wish I had been coached and informed about both problems of overuse and supplementation. I wish my coaches were wiser and better advocates of safe and healthful play. My days of playing are limited because of my overuse injuries; I hope your athletes won't be saying the same thing 20 years from now – or in my case 40 years from now.

S. Stoll, Director

Center for ETHICS*

University of Idaho

http://www.educ.uidaho.edu/center_for_ethics