Dr James Le Fanu: 31 January
The modern athlete aspiring to tness is vulnerable to a host of minor and major illnesses. Indeed, the Oxford Textbook Of Sports Medicine spends around 800 pages describing in detail – and without a hint of irony – the ways that exercise can be harmful to health: sudden death, debilitation due to overtraining, susceptibility to viral illnesses, and a variety of acute injuries to bone and muscle lie in store.
These hazards are inescapable given the driving dynamics of sport, the Olympic motto Citius, Altius, Fortius – Faster, Higher, Stronger – which, for the past 100 years, have resulted in the remorseless improvement in the world’s sporting records as modern training techniques have pushed the limits of human performance beyond their natural boundaries.
‘The magnitude of bodily changes involved in severe exercise is such that it is di cult to appreciate,’ observed the great British physiologist Professor Archibald Hill: ‘A man running 100 yards at top speed does enough mechanical work to lift his body 85 yards into the air – about one-third the height of the Woolworth building in New York City.’
Over the years, medical experts have identi ed hazards for virtually every sport – including, perhaps surprisingly, cycling. The initial reaction was hostile, the main concern being it would precipitate unnatural desires in women, or as the British Medical Journal put it, ‘In women of a certain temperament, the friction produced by the saddle may lead to effects on the sexual system which we need not particularise’.
Since then, more specific hazards of cycling have included ‘cyclist’s spine’, a condition in which side-to-side movement of the pelvis causes muscular strain at the base of the spine, resulting in chronic back pain. There’s also ‘bicyclist’s facies’, a distressed look in which the physical effect of cycling was said to lead to permanent facial contortion.
When these hazards failed to warn the public off the sport the British Medical Journal brought out its big guns – cycling was bad for the heart. ‘There must be few of us who have not seen the effects of over-exertion’ an editorial observed. ‘Cycling causes dilation of the heart from thickening of its walls, which a medical man will view with apprehension.’
In 1992, the British Medical Association conceded that cycling might be healthy, but since then, two more hazards have been reported: the skin cancer malignant melanoma, due to sun exposure when cycling in shorts, and the ‘numb penis syndrome’ in young men for whom long hours in the saddle traumatise the pudendal nerve.
This week’s medical query comes courtesy of a lady from Lincoln with severe arthritis of the right hip joint, confirmed by an X-ray. ‘I’m in pain day and night, and it makes walking a distance very difficult,’ she writes.
She expected her consultant to advise her to have a hip replacement, but instead he recommended a steroid injection into the joint. This sounds like severe arthritis, though the symptoms of pain, especially at night, can be exacerbated by the in ammation within the joint, known as trochanteric bursitis.
The way to find out whether this is so is to note whether symptoms improve after an injection, but there’s no doubt that eventually an operation will be necessary.
Email drjames@lady.co.uk
These hazards are inescapable given the driving dynamics of sport, the Olympic motto Citius, Altius, Fortius – Faster, Higher, Stronger – which, for the past 100 years, have resulted in the remorseless improvement in the world’s sporting records as modern training techniques have pushed the limits of human performance beyond their natural boundaries.
‘The magnitude of bodily changes involved in severe exercise is such that it is di cult to appreciate,’ observed the great British physiologist Professor Archibald Hill: ‘A man running 100 yards at top speed does enough mechanical work to lift his body 85 yards into the air – about one-third the height of the Woolworth building in New York City.’
Over the years, medical experts have identi ed hazards for virtually every sport – including, perhaps surprisingly, cycling. The initial reaction was hostile, the main concern being it would precipitate unnatural desires in women, or as the British Medical Journal put it, ‘In women of a certain temperament, the friction produced by the saddle may lead to effects on the sexual system which we need not particularise’.
Since then, more specific hazards of cycling have included ‘cyclist’s spine’, a condition in which side-to-side movement of the pelvis causes muscular strain at the base of the spine, resulting in chronic back pain. There’s also ‘bicyclist’s facies’, a distressed look in which the physical effect of cycling was said to lead to permanent facial contortion.
When these hazards failed to warn the public off the sport the British Medical Journal brought out its big guns – cycling was bad for the heart. ‘There must be few of us who have not seen the effects of over-exertion’ an editorial observed. ‘Cycling causes dilation of the heart from thickening of its walls, which a medical man will view with apprehension.’
In 1992, the British Medical Association conceded that cycling might be healthy, but since then, two more hazards have been reported: the skin cancer malignant melanoma, due to sun exposure when cycling in shorts, and the ‘numb penis syndrome’ in young men for whom long hours in the saddle traumatise the pudendal nerve.
This week’s medical query comes courtesy of a lady from Lincoln with severe arthritis of the right hip joint, confirmed by an X-ray. ‘I’m in pain day and night, and it makes walking a distance very difficult,’ she writes.
She expected her consultant to advise her to have a hip replacement, but instead he recommended a steroid injection into the joint. This sounds like severe arthritis, though the symptoms of pain, especially at night, can be exacerbated by the in ammation within the joint, known as trochanteric bursitis.
The way to find out whether this is so is to note whether symptoms improve after an injection, but there’s no doubt that eventually an operation will be necessary.
Email drjames@lady.co.uk