Medical Screening for Athletes

Medical Screening for Athletes

The recent sudden and unexpected death of Ironman legend Dean Mercer sent shock waves around the lifesaving community. Not just because he had remained so amazingly fit but was also so young, at only 47 years of age.

How does someone like this suffer a life ending heart attack?

I spent my childhood watching Dean race and was lucky enough to be able to race him a number of times in surf carnivals and the Coolangatta Gold. But more recently I had the privilege of coaching his young boys and having his wife Reen as my assistant coach. But this isn’t a blog about Dean or his family. It’s more about the risks involved in amateur sport and the reluctance to prioritise health over expensive untested and un-proven performance gimmicks.

Over the last 10 years I have presented to a number of surf clubs, the Queensland and the Australian teams about dealing with medical emergencies and taking more ownership of health. It’s more designed for those teams traveling and to highlight the need for athletes and individuals within a team to take ownership of their health, despite the outward appearance of being bullet proof. The presentation always begins with the footage of the tragic death of Piermario Morosini on the football pitch during a professional soccer game in Italy. The footage is traumatic and confronting to say the least. I use this footage to demonstrate the importance of medical teams and procedures within the team. Because from the footage and the chaos that ensued following Morosini collapsing it appears there was no protocol or procedure.

But the footage also looks to highlight the importance of pre-competition medical screening as the coroner determined Morosini had an underlying heart condition that led to his death.

Video footage of the incident.

But how could that be?

He was playing professional football at the highest level, played for his country and was seen as a sporting hero.

But sadly there was no team protocol for medical screening as there isn’t in so many different sports teams and squads. Fast forward in the presentation to footage of Anthony Van Loo in Belgium, collapsing in similar fashion to Morosini on the football pitch. Only this time following the collapse and the immediate medical staff response, Van Loo can be seen to twitch and sit straight up.

The difference here and the reason Van Loo went on to play for another 6 years is that the club and Van Loo in pre-season medical screening had determined that he had an underlying heart condition. A condition that caused his heart to stop beating. As a result Van Loo had a de-fribillator implanted in his chest that effectively was there to shock the heart should it happen to stop beating. As a result, as so visibly seen in the video, Van Loo lived.

Video Footage of Anthony Van Loo

So what does this mean for our sport and our competitors?

Lifesaving is amateur sport and to a greater extent an individual amateur sport. The risks this posses is that everybody is doing different things health wise. People constantly say to me that they can’t get a bone scan or MRI to determine the cause of their pain and injury but that they can continue to buy high priced drinks, gels, rubs and bath oils. They can’t afford to do medical screening because it would involve them not being available for their 4th session for the day or heaven for bid a trip to Brisbane.

These issues arise when clubs and coaches have no medical advisers, no rehab team and essentially no idea. It’s sadly a sport living in the dark ages.

The enormous improvements in speed, power and strength that so many professional or heavily government funded sports have had over the last 20 years has not been the result of gimmicky sports drinks and rubs. It comes from sports science and medical management. In a professional team the medical, sports science, rehab specialist make the calls about the appropriate course of action and the athlete follows that. That’s why those players recover faster, that’s why they are able to continually perform at their best without constant injuries.

In Lifesaving however, everyone from the person drinking at the bar to the coach standing on the beach has an opinion on how the athlete should train, recover and prepare. So it’s no wonder there’s enormous injury rates. But short of starting an enormous rant, what does this have to do with a heart attack.

What the death of Morosini and collapse of Van Loo showed was the need for the club to take ownership of their athletes/players health. The need to have procedures in place that aren’t always intended on improving performance but on improving the health and well being of their teams members.

Unfortunately when you leave it up to the individual, a person who is only concerned with the immediate future and their performance. A medical screening test every 12-18 months is the first thing to be neglected from their program.

Don’t believe me?

You would think that after the recent events with Dean Mercer and even the death of young Northcliffe competitor Gerry Dennis in the Gold Coast canals, believed to be related to an underlying heart condition, that the lifesaving world would be banging down the doors for medical screening prior to returning to pre-season training. But sadly no, in fact it’s almost the opposite with national team members baulking and questioning why there is now mandated medical screening for all Australian Team members.

But perhaps we shouldn’t be placing the blame and emphasis on the athlete, but more on the clubs to enforce this as a health and safety measure for their athletes and members.

After all, aren’t they responsible for the safety of their training squad?

Take another example I have come across in the last couple of years, concussion. Now while this is a massive issue in the contact football codes, it’s relatively un-spoken about in Lifesaving. However head clashes, head knocks and craft hitting athletes is a common enough occurrence that it should be spoken about. So what happens when a young competitor hits their head on their board or another board at training? Or has a head clash in flags? Or is struck by the oar in the boat?

Does the coach implement a HIA (Head Injury assessment) do they perform a SCAT test?

Have they done any pre-season cognitive testing to determine the baseline levels of cognition so they have a measure of when the athlete can return to sport?

So who then makes the call on when that athlete can return to training?

Who and how are you determining whether they should go to hospital?

Who has been documenting it?

Get your cheque books ready coaches and clubs because it’s  only a matter of time, in the litigious society we live in, that an athlete takes a club and its coach to court. When that athlete blacks out in the ocean, with a post concussion syndrome it won’t be a case of looking for the sideline medical team to get a stretcher like happens in football, it’s a case of finding the body on the bottom of the ocean and trust me that 1-2 million dollars you have on your coaching insurance will be lucky to cover your legal costs, let alone the impending compensation bill.

But back to heart attacks, in a sport that’s so heavily dominated by Masters athletes we have to start doing more. While these athletes are putting on the clubs cap and competing under the clubs banner it might be time for the clubs to spend a little less money on extraneous surf sport competition equipment and superstar athletes and more on the members health and safety.

There will be people out there rolling their eyes that the health of the clubs members should be left up to the members themselves, and that this is just another attempt at over regulation and the nanny state at work. But the work of the nanny state has saved thousands upon thousands of lives. The cessation of smoking in public, the wearing of helmets on motorbikes and seatbelts in cars are all examples of rules where humans need to be regulated to protect themselves against themselves and perhaps in a sport that calls it self “Life-Saving” we could implement a radical way to save the lives of our own.

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