American College of Sports' Medicine Evolving Position Stands

Great to hear that that august body of sport in North America, the ACSM, views ongoing discussion and the production of evidence in the field establishing itself as an authoritative reference body for contemporary knowledge.


The ACSM has now suggested that it is serious about retaining a leadership position in evidence-based sports' medicine by recruiting an 'evidence-methods' specialist by the name of Lynette Craft PhD of Northwestern University. The hope is therefore that ACSM becomes a contemporary resource for media & clinicians as well as researchers through their evolving Position Stands and Joint Position Statements which are free to the public online (ACSM Position Stands link).

The Position Stand on Exercise and Fluid Replacement is under discussion since the  publication of Tim Noakes' new book on hydration ('Waterlogged: The Serious Problem of Overhydration in Endurance Sports') raised fresh concerns on hyponatremia & excessive fluid intake and there looks to be promise that reviews of this Position Stand will be considered as a result.


We can all look forward to the future and the prospects of this form of evolution and reflective practice affecting everyone involved in sports' medicine.

As Victorinox adapts the Swiss Army Knife post 9/11 is the brain just like the flagship product?

Victorinox, the makers of the famous 'Swiss Army Knife' have adapted to life since increasing aircraft security. This got me thinking about a piece on BBC earlier in the year on how the brain could be seen possibly like a Swiss Army Knife too!

It is certainly adaptable, but there were other aspects to the interview with Nancy Kanwisher of the Institute for Brain Research examining the different activities of the brain in different compartment-a little like the commonly seen multipurpose knife.


Is the brain like a Swiss Army Knife? audio


The pocket knife with multifarious uses was actually patented back in the 19th Century by Karl Elsener when he and his mother had to start a cutlery company to handle an order from the Swiss Army (which from memories of a visit to the Military Tattoo a few years back was not an extensive army at all, and consisted of an entertainment troupe of drumming jugglers s far as could be seen from their appearance in Edinburgh). The company actually still counts the Swiss amongst a dozen armies as clients.


The name Victorinox was also an adaptation of his mother's name, and the French term for 'Stainless Steel'. Remarkably they still manufacture 35000 knives PER DAY, despite the crackdown on security following terrorist activities in 2001 which had an immediate effect of a 30% drop in sales.


The company has had to adapt by creating versions within its brand, including items such as MP3players & a 1TB flash drive within its standard red clasp & a 'Flight' production of their classic design.


So is the brain just like one of the Victorinox classics, with different parts available for different tasks in quite separate compartments, or is it a single purpose tool as suggested in the interview piece? Certainly the brain is adaptable-less of a surprise than hearing that the a company starting out as a cutlery company then received iconic name for a multi-purpose tool based around a knife should now hail sales of around 50% of its total worth as coming from new product categories!

Pressures of Fame can leave effects long after the lights go down PART TWO

This is the second part of this blog further examining the turn of events that can lead performers into a cycle of decline after their careers have finished or situations changed.


The sudden loss of Junior Seau to suicide within three years of his retirement from playing American Football at the highest level has also led others whom have experience of adrenalin rushes and all that accompanies fame to question themselves and examine their own lives after a 'bout of stardom' (ESPN Playbook Sounds article).

Slash & McKagan notoriously were drunk
receiving award at 1990 American Music Awards

Musican Michael Andrew 'Duff' McKagan was a founding member and bass player with the legendary Guns' n Roses, and is now actively involved in other bands such as Loaded & Velvet Revolver. 

He writes several weekly columns now, including a fascinating blog this week being devoted to the adrenalin kick of playing music, particularly in live events, and comparing some similarities of sport and rock music following Seau's death-but marking out the differences too. 

He makes the point, however, that musicians rarely have to be in pristine physical condition to perform (and some of his personal experiences would suggest he certainly was a distance from prime physical states when at the height of his career: he is notorious for being one of the last people to see Kurt Cobain alive and suffered pancreatitis as a result of his alcoholism). Even a career on the wane appears to be able to provide an adrenalin shot when playing live, even in smaller venues than the heyday.

Although born in Christchurch in New Zealand, Riki Ellison went on to represent the  San Francisco 49ers as a linebacker.  He discussed in a recent interview with the LA Times that Junior Seau's position (also as a linebacker) contributed to his death, and concluded: "We often associate cowardice with the choice that Junior made. But I believe his fateful decision was highly influenced by brain damage, inducing states of depression that he absorbed from his life as a middle linebacker — by the self-isolation it caused, and how it clouded his clarity and judgement". 

The Seau suicide follows the high profile death this year of Dave Duerson formerly of the Chicago Bears Defence, who killed himself leaving a note asking that his brain be studied too. The San Diego County medical examiner's office has stated that "At this time the medical examiner's office is awaiting the family's decision regarding study of the brain for repetitive injury by researchers outside of the office".

SPACE blogs & comments on Robert Cantu's work

This brings to mind a statement made at the World Federation of Athletic Trainers & Therapy Congress last year in Calgary, when Dr Robert Cantu from the Boston University Center for the Study of Traumatic Encephalopathy (also referred to as the Boston/NFL Brain Bank) intimated that there was a reluctance on their part to encourage any further brain donations from athletes, as it may be a contributing factor in suicides providing a 'justification' to shooting oneself in the chest should that athlete reconcile that action as having a perceived benefit to others.

Pressures of Fame can leave effects long after the lights go down PART ONE

Another high profile casualty of post stardom angst?

A spiral of depression clouding judgement or the influence of brain damage inflicted during a career in sport - 

sometimes perhaps due additionally to something such as substance abuse? 

Is there something similar for other performers whom have tasted fame?

A verdict of suicide has been delivered by the Coroner's Office in San Diego in the case of Junior Seau, who died on May 2nd: this again has exploded the possible effects of playing National Football League (NFL) American Football, and a colleague of Polynesian Seau's has intimated that his position made him at risk from collision injury and repeated concussion. 

Ex-San Francisco 49er Riki Ellison was, like Seau, a Middle Linebacker, enduring the most violent contacts involving the head and helmet with what he claims as a 'head-first' approach as being a fundamental of the position.  He feels that the tragic events occurred as a result of sustained concussions to the brain, along with an inability to control depression that follows the end of a career of extraordinary accomplishment over 20 seasons. 

Regular readers of this blog would recognise this mix of depression and post-career disappointments with a background of actual brain changes (see SPACE blogs on concussion) can lead to suicidal self-fulfilling prophecies with the ultimate results being tragic family circumstances, divorce, and death.

Achievements of extraordinary accomplishment have often been hand in hand with adrenaline rushes only rarely experienced unless competing at world-class levels.


It has been experienced enough for Jacob Bell, an offensive lineman whom has recently signed with the Cincinatti Begals after a four year period at the St Louis Rams. He has quit the sport at the age of 31 actually citing the Seau suicide as the 'cherry on the top' in a list of factors.  This week Bell also claimed in an interview with the St Louis Post-Dispatch that there was another factor to his decision: 
“I've had a lot of fun playing. I've seen a lot of things. I've played in a lot of games. The reality is that for me it came down to risk and reward. I think you've always got to weigh that out. At some point, you've got to kind of figure out what you're in the game for. 


One of my biggest concerns when it comes to the game in general is my personal health. One thing that's obviously on the minds of a lot of people lately is brain research and all the stuff that's going on with that." He has also suggested he suffered from about 30 concussions in a season (Washington Post article on Jacob Bell)!


As a further 100 or so ex-players have added their names to lawsuits against the NFL in addition to the 1500 former NFL athletes already suing regarding head injuries sustained in their careers, we can expect more of the type of stories exploding over the media this month since Junior Seau's tragic passing-another athlete seeking to leave his head to medical science, another self-fulfilling prophecy leaving more than just a scarred brain behind him-which is a real tragedy.

Can Exercise Prevent Dementia? New Research suggests memory & cognitive improvements!

Exercise has been championed for many reasons, and a recently published paper from Canada has shown promising improvements in memory & other cognitive measures in elderly populations.

When compared to aerobic exercise (AT)-namely walking, resistance training (RT) showed enhanced cognitive performance and functional plasticity in both healthy and those already demonstrating mild cognitive impairment. The programmes were carried out twice in a week for six months.


The team from the Centre for Hip Health & Mobility at Vancouver Coastal Health and the University of British Columbia have importantly shown selective attention and conflict resolution functions improved with weight training, a well as associative memory: these are deemed as robust predictors for conversion from mild cognitive impairment to dementia.


Nagamatsu et al (Arch Intern Med. 2012;172(8):666-668 Arch Intern Med Nagamatsu et al Study) have raised the bar in terms of combating what is a global problem with dementia now being detected at one new case every 7 seconds: Mild Cognitive Impairment is a well established risk factor for dementia.


"We can't say resistance training exercise eradicates Alzheimer's disease but it does show promise in delaying the onset. It improves brain function in the processes that are associated with aging and the early stages of Alzheimer's disease," said one of the authors, Teresa Liu-Ambrose, a researcher with the Centre for Hip Health and Mobility at Vancouver General Hospital, Vancouver Coastal Health and the University of B.C. Brain Research Centre who is also an assistant professor in the Department of Physical Therapy at UBC and a Michael Smith Foundation for Health Research and CIHR New Investigator scholar.


"I am already convinced of the positive effects of exercise on ageing but we need to refine the prescription for exercise through evidence. We need to be able to say who will benefit from what specific forms of exercise," Liu-Ambrose added.


Interestingly the current study involved 86 female subjects, selected because of evidence in previous research showing women derive more brain benefits from exercise. It is unclear why that is, but it could be because exercise stimulates production of circulating estrogen, encourages socialization, or some combination of both.

This follows on to the work already completed by the same research team's Brain Power Study, published in the January 2010 issue of Archives of Internal Medicine and July 2011 issue of Neurobiology of Aging: these also demonstrated that 12 months of once-weekly or twice-weekly progressive strength training improved executive cognitive function and functional brain plasticity in healthy women aged 65- to 75-years-old and provided lasting benefits.

In the next phase of the study, researchers will analyze MRI scans of study participants who performed cognitive tasks while in the machine under-going a test called functional MRI. Previous research has shown brain volume changes with exercise in the elderly, possibly due to clearance of inflammation. Another study, for which participants are now being recruited, will look at the effects of exercise in those with vascular dementia or a history of small strokes.

The team developed and launched an informative  video of the resistance training exercises used in the study.

 "By developing this YouTube video we can help translate our findings directly to the senior population and fitness instructors who are working with them." says Liu-Ambrose. 

"Exercise is attractive as a prevention strategy for dementia as it is universally accessible and cost-effective." 

This paper could alter the way exercise is implemented to halt the decline opening the debate as to whether cognitive function can be altered through any means once there is impairment.

Chris 'Mossy' Paterson retires from rugby

He knew when his game was up.
Chris Paterson finally hung the boots up for good this weekend from all rugby.
A Scottish newspaper had an excellent opinion piece on when it the timing is right for sportsmen to retire. 
(Timing for Retirement in Sport article)

For Scotland's most capped male international rugby player, this weekend was the appropriate time to finish.


Scott Hastings, at the time Scotland's most capped player, can be remembered for hiding behind the rugby posts when being called off in his final professional game for the Edinburgh Reivers, but as this archive article (Curtain Call for Great Scott) shows there may be some disappointment, but then he has since also found a media profile since finishing.


So Chris Paterson, forever known as 'Mossy', managed to sign off as a professional player with a try & a smile as he left the field against Treviso in the RabodirectPro12 League. His contribution to international rugby was recognised in our personal blog that has been the most read article published.


Chris Paterson retires from internationals Blog

Chris Paterson directing from the back in his last match

The final words are fittingly his own: he was quoted in a newspaper article last week and concluded: 
“On the whole, I’ve had a fantastic career, and one I’m really proud of. And the further I get from retirement I’ll probably look back on it even more fondly. At the moment I’m still involved with it. I’ve got a week left and I’ll commit myself to it entirely until half-nine on Saturday, then hopefully walk off with a big smile on my face and look forward to things in the future.”


I can confirm he did walk from the adoring masses within the Supporters' Club with a broad grin amid the smart phones & cameras. And into the future whatever that holds. 
Here are a collection of images from his career that the BBC have placed on their website in recognition of his career: C D Paterson in pictures