The FINA Sports Medicine Web Pages are designed to provide team physicians and allied medical support staff with up to date medical and scientific information to guide their daily care of the aquatic athlete.
Coaches, athletes and parents can also use these pages to answer their questions regarding aquatic health issues.
The World came together in Shanghai for the 14th FINA World Championships in July of 2011. 178 of the 202 National Federations were represented making this the best attended FINA World Championship ever. 2165 athletes participated in the five aquatic disciplines of diving, water polo, synchronised swimming, open water swimming and swimming. Diving and Water Polo were held in separate pools, while synchronised swimming and swimming were held in the same pool, with synchronised swimming occurring in the first week of the Championships followed by the swimming events. Together this made for a spectacular three facility aquatic complex with an open air stadium for diving and indoor stadiums for water polo and a shared venue for synchronised swimming and swimming. Open water swimming was set at Jinshan City Beach which featured a 1.5 square kilometre man-made enclosed salt water basin.
The Opening Ceremony was spectacular bringing back memories of the Beijing Olympic Games with its coordination and complexity. These World Championships featured both a Theme Song – Dreams on Oriental Seas, as well as a Championships Song – Lin Bo Shui Dao (Riding the Waterways). Each of the four venues had medical support with seasoned Doping Control Officers, fluent in English, as well as a host of excited assistants. They worked tirelessly to see that the job of athlete care and doping control ran smoothly.
As it turns out the Beijing Olympic Games was an excellent training ground for Medical and Doping Control officers. There was no lack of experienced personnel. Each training and competition site had a medical facility well staffed with doctors, nurses and assistants. There was on site equipment ready for any heart problems that may have occurred in both athletes and spectators, which was in accordance with the medical rules, overseen by the FINA Sports Medicine Committee (SMC). Ambulance services were on site all the time. A medical clinic was also set up in each of the host hotels to provide 24 hour medical care. SMC Chairman, Dr. Cees-Rein Van Den Hoogenband, conducted an on-site visit several months prior to the start of the Championships to ensure all medical services were in place.
Several hospitals were on alert during the Championships for illness and injuries. The capacity of the hospitals had been reviewed during the on-site visit. Unfortunately, Emergency Room care and even hospitalisations are needed from time to time in Championships of this size.
Regardless of the setting, the FINA designated medical insurance company BJD Assistance, with offices in Gruyeres, Switzerland, covers all medical costs to all athletes, coaches, and officials, at any FINA sanctioned event. This insurance pays for all outpatient and inpatient services, medications, and even evacuation if necessary. It is important to note that activation of this medical insurance must occur within 24 hours of first contact with any medical services while participating at a FINA event abroad. The contact number is +41 26 921 80 01.
Recently, an issue regarding meat products containing clenbuterol in China needed the attention of the SMC and the Doping Control Review Board (DCRB). Since clenbuterol is on the WADA Prohibited Substance List, all National Federations were advised to eat only at FINA sanctioned hotels and competition venues, where strict measures were taken to prevent any difficulties. This also allowed for control of any foods that might have contained bacteria causing gastrointestinal problems at the Championships. Several outbreaks of diarrhea still occurred however, but responded quickly to antibiotic therapy. Investigation showed that in the great majority of the cases, the target individuals had gone outside the controlled diet provided by the hotels and training settings.
FINA SPORTS MEDICINE COMMITTEE, DOPING CONTROL REVIEW BOARD AND NATIONAL TEAM MEDICAL MEETING
At the half way mark of the Championships, July 23rd, a National Team Medical Meeting was held, facilitating all five aquatic discipline’s health care teams to be in attendance. The meeting had a large turnout, with approximately 120 health care workers present. All five continents were represented. The meeting included agenda items to help educate National Medical Teams as to the function of both the FINA SMC and the FINA DCRB. The meeting was chaired by Dr. Cees-Rein Van Den Hoogenband, and presentations were given by Dr. Saul Marks, Honorary Secretary of the FINA SMC, Dr. Andrew Pipe, Chairman of the FINA Doping Control Review Board (DCRB) and Dr. Margo Mountjoy, Bureau Liaison to the FINA SMC. Dr. Farhad Moradi, member of the FINA SMC, helped in the organisation of the meeting. The following FINA Health Care Educational Resources were discussed:
• The Medical Corner in the FINA Aquatic World Magazine
• The FINA Sports Medicine Newsletter
• The FINA Sports Medicine WebPages
• Upcoming FINA Clinics to include Sports Medicine Education
• An on-line Shoulder Project that has been approved for production, with an educational video, demonstrating shoulder exercises to prevent shoulder injuries, the most common injury in the aquatic sports
• The upcoming 17th FINA Sports Medicine Congress in Istanbul, Turkey, December 10-11, 2012.
FINA Aquatic Scientific Research was also discussed. There is to be a study over the next six months done at the University of Otago in New Zealand, to confirm a safe upper limit of water temperature in Open Water Swimming, since there is presently little scientific literature on the subject. The study is to be jointly funded by FINA, the International Triathlon Union (ITU) and the International Olympic Committee. It was also discussed that there will be another Injury and Illness Surveillance Project done at the 15th FINA World Championships in Barcelona, 2013, in follow up of the one done in Rome. Dr. Andrew Pipe then did a presentation on the doping control programme in Shanghai as well as the future of blood testing. It was very well received and there were many questions from members of the National Federation Heath Care Teams. Last, there was a short power point presentation on the upcoming London Olympics, 2012, provided by Dr. Kevin Boyd of the FINA SMC, with specific emphasis on the medical programme.
Chen Ruolin in a 10m Platform dive - credit: Giorgio Scala
The outdoor Diving Venue was spectacular. Despite the heat, there was some amazing diving and outstanding contests, with the Chinese Team sweeping the gold medals. There was an onsite medical facility right besides the diving facilities. There were several minor injuries and one more serious injury which required hospitalisation overnight.
Synchronised Swimming was held in the main swimming pool in the week prior to the start of the Swimming events. The venue was excellent and the medical facilities were also adjacent to the pool. There were no injuries reported during the Synchronised Swimming Events.
OPEN WATER SWIMMING
The man-made Open Water Swimming venue allowed the ocean water to be filtered, thus the water in the basin was much clearer than the water just on the other side of the retaining wall. This same wall allowed placement of ambulances along the course as well as a rescue helicopter, which was present whenever athletes were in competition. Rescue craft were on site and well manned throughout the competition all throughout the course. This allowed for a well coordinated evacuation plan, to ensure the health and safety of all Open Water Swimming competitors.
Open Water Swimming also has feeding stations for the events of 10km in distance and above. There were two of these placed on the course, allowing athletes to take in nutrition and hydration as well as allowing coaches to monitor the health of their athletes. For the 25 km event, to avoid increasing water temperatures, the FINA Technical Open Water Swimming Committee, in conjunction with the SMC, changed the start time of the race from 8 a.m. to 6 a.m. This was done to avoid the heat of the afternoon sun to ensure the safety of the athletes.
Open Water Swimmers were in absolute safe
The Water Polo event was conducted in a permanent and separate facility. The medical facility for first aid and transportation to hospital if necessary was located a short distance from the pool. Despite the fact that Water Polo is a contact sport, there were a lower number of injuries than expected, both during practice time and in the matches. There were only minor injuries reported, including mild head injuries, dental illnesses or injuries, and small cuts to the skin requiring stitches.
Medical services were very well organised for the Swimming event. The medical clinic was set up between the warm-up pool and the competition pool. The clinic was staffed by two physicians. Minor issues were treated on site whereas more major problems were sent to the hospital for further assessment and treatment. The ambulances were on the pool level, just 50 metres from the starting block.
The Chinese Health Care System uses Emergency Rooms liberally as an initial treatment site. The physicians at the clinic indicated that they had transported approximately 20 athletes, coaches or staff to the hospital over their week of training and competition.
INJURY & ILLNESS SURVEILLANCE
Dr. Shiyi Chen, Chief Medical Officer for the 14th FINA World Championships, was assisted by Dr. Ama Shurong Zhang and Dr. Annie Jiarui Chen. They met daily with the SMC chair to review participants requiring medical support. Over sixty minor medical injuries and illnesses were reported, several requiring a brief hospitalisation. Regarding hospital visits, it was interesting to note that dental illnesses and injuries were most common (nine cases), followed by muscular strains, respiratory infections and trauma. There was one car accident that occurred off site involving one participant who did not sustain life-threatening injuries. The SMC would like to acknowledge Dr. Chen and his staff for excellent organisation and for their collaboration with the FINA SMC.
Doping Control was coordinated by Dr. Andrew Pipe, Chairman of the FINA DCRB, with excellent collaboration by ChinADA, the Chinese Anti-Doping Organisation. Dr. Pipe and Dr. Van Den Hoogenband were both present at the pre-event on-site visit to organise the anti-doping programme. Both blood and urine testing were conducted on a random basis spread over all five FINA disciplines. In addition, urine erythropoietin (EPO) testing was randomly performed in selected events. Over three hundred urine tests were performed, some with added volume for EPO testing. Thirty blood samples were also taken randomly.
Doping control was the responsibility of the DCRB and performed by the following members: Dr. Pipe, Dr. Sando, Dr. Hawksworth, Dr. Mosterds, Dr. Segura and Dr. Wu. All members of the SMC assisted in the anti-doping programme. The coordination of efforts between the SMC and DCRB brings the world of science and medicine together to work towards doping free sport. Since 3-4 events were often occurring simultaneously, thus a cooperative effort was necessary.
All samples were sent to the WADA laboratory in Beijing, China for analysis.
The combination of the Medical and Anti-Doping aspects of the Aquatic Disciplines is complex, even when presented in summary. The end result is more than worth the efforts of all the staff and volunteers – a doping free environment where athletes can safely pursue their dreams and perform to the best of their abilities. The numbers of Chinese volunteers, doctors, anti-doping specialists and support personnel were numerous, and their work made an important contribution to the success of the 14th FINA World Championships.The elite champions of aquatic sport deserve nothing less than:
• coordination of FINA and the Shanghai Organising Committee to assure athlete safety – before, during and after competition
• an excellent Anti-Doping Programme
• top quality medical treatment and health insurance coverage
Sports Medicine Committee
*The Sports Medicine Committee is comprised of the following members:
• Dr. Cees Van Den Hoogenband (Chairman)
• Prof. David Gerrard (Vice-Chairman)
• Dr. Saul Marks (Honorary Secretary)
• Dr. Jim Miller
• Dr. Mohamed Diop
• Dr. Farhad Moradi
• Dr. Kyriakos Nanousis
• Dr. Kevin Boyd
The committee has global representation from all continents. The committee is responsible for the health and safety of athletes participating in FINA Aquatic Sports.