Sports and Science

gopi marathon

On November 26 Mr Gopi Thonakal from Wayanad won the gold in the Asian Marathon Championship. He is the first Indian male runner to achieve this feat, clocking a time of 2 hours fifteen minutes and forty-eight seconds. It was not his best effort. He has done it before in 2:15:25. This is the good news.

Mr Gopi is unlikely to ever become the world champion. In 2016 he competed with a world class field at the Mumbai marathon and came in eleventh at a time of 2:16:15. His personal record was at the Rio Olympics in 2016 where he finished twenty-fifth.

The world record time set in 2013 by Dennis Kimetto is 2:02:57. There are a few men who routinely run the distance in under two hours and five minutes. Between Gopi and these men stands a great wall which he is unlikely to surmount. This is the bad news.

But Mr Gopi is a remarkable man. To run forty two kilometers in under 2:15 is tough by any standards, an extraordinary feat of strength and endurance. Mr Gopi has, apart from his innate talent, great determination and incredible mental and physical fortitude. Most of us will never be able to grasp the level of application that is required for such an accomplishment.

Imagine any field of endeavor. Let it be your own work or hobby. Imagine working at it with such single minded dedication that you become measurably one of the world’s most accomplished hundred people in that field. You are now one among the best hundred of the planet’s teeming millions in your particular field of endeavor. Most of us will agree that the effort required is considerably more that what we are capable of, or willing to put in, even if we have the necessary talent.

It is also not a solitary effort. At the moment of achievement- the century, the marathon finish, the great goal- the performer at the centre grabs all attention. We do not see the host of other factors which have worked to make that moment happen. Luck, for one. But luck is capricious and comes and goes as it will. There are other factors over which we have more control. A great team for instance. Science. Modern day sporting excellence cannot stand apart from science. Science is at work in every aspect of the game, from the playing track to the players’ clothes.

Perhaps the union of sports with science began when the great Galen took up his first job as surgeon to gladiators at the coliseum in Pergamum around 100AD. The greatest athletes of the day fought for their lives against each other or crazed lions and tigers. Galen’s teaching held sway in the western world for over a thousand years. He and Hippocrates cast such long shadows that they are now held responsible for the stagnation of medicine in the west for a millennium and a half.

In the east, as in the west, sports and sports medicine evolved around martial arts, like war and surgery. Most martial schools had their own medical systems and doctors. Kerala’s kalaripayatt experts were not just martial arts exponents, they were also healers- of sprains and contusions and fractures. Like Galen’s teachings their’s too are frozen in time. Today many kalaris continue their healing services and maintain busy OP clinics. These are frequented by even the educated elite who commonly believe that anything short of a fracture, and sometimes also a fracture, is best treated by a kalari ashan. My neighbor the scientist takes his daughter to a kalari when she has a contusion of the wrist, and when I, a qualified orthopod, ask him what her bandage is for he changes the subject. Within such compartments do we live, science for work and belief for life.

Meanwhile sports medicine has developed in leaps and bounds. It is an umbrella term which brings together all of the science developed for a singular purpose- to make an athlete perform better- faster, stronger, higher. Citius, Altius, Fortius, as the Olympic motto goes. The kinesiologist stands here under this umbrella, so do the nutritionist, orthopod, dentist, physio, coach and psychologist, to name only a few.

The amount of knowledge too has grown enormously. To give one example, the anterior cruciate ligament (ACL) is a structure within the knee about an inch long and less than a little finger’s thickness. Weight for weight it would be the most studied bit of tissue in the human body. Volumes have been written about the ACL in sickness and in health, its anatomy, physiology, biomechanics, what happens when it doesn’t work and how it can be repaired or reconstructed. A man can spend his entire life studying the ACL without claiming to have known it fully. There are many men and women who do just this, and that is just one ligament in the human body.

I had the opportunity to speak in a seminar on sports medicine recently. It was attended mostly by athletes and their coaches. The athletes were teenagers from different parts of the state and were quartered in a nearby hostel attached to the Sports Council. After the session a few of them with injuries came to be examined. They were six girls, most of them around sixteen years of age, and one just thirteen. Two had minor contusions from injuries sustained a couple of days back while practicing. One with a knee injury had on a small bandage around her knee, almost as tight as a tourniquet. Clinical examination showed a medial meniscal tear, and a possible ACL injury. A medial meniscal tear in an athlete may be an indication for early surgical repair. This one was already three weeks old. The fourth athlete had a chronic lateral ligament injury in her left ankle. She said she couldn’t do speed work because her ankle kept giving way. She now worked out with a bandage which helped somewhat. The thirteen year old had injured her right shoulder a couple of days in a fall ago and was in intense pain. She had on a makeshift sling.

You may well ask what state of the art treatment these kids were getting, these promises for India’s future gold medals. All of them were taken to the district Ayurvedic hospital immediately after injury by their coach, as is the usual protocol. A couple were X-rayed. Most of them were bandaged after massage with oil. The thirteen year old was due to start her massage therapy the next day. The chronic ankle injury had failed Ayurvedic treatment and now was on homeopathic medicines for her condition.

The world has moved on. The occasional medals that we win at the Olympics are a tribute to our athletes’ innate talent. These victories are in spite of the support we give them, not due to it. Our sports administrators, coaches and athletes, barring in a few elite games like cricket, are mired in superstitions and follow centuries old regimes based on a frozen science. We could win a lot more medals with the present infrastructure but for that to happen the rest of the world would have to go back to Galen and Hippocrates.

Once every four years we send a contingent of athletes to participate in the Olympics. The athletes compete their heart out but without much success. This is the signal for the rest of us to begin our self flagellation- how can such a large country fail so miserably, we ask. At the end of the month the team comes back, at the bottom of the medal tally with a couple of bronze or silver medals. We now return to more important matters, like building ever taller statues for dead heroes or showing off our ancient heritage to each other.

You may recall how a state minister offered the Brazilian footballer Ayurvedic treatment for an injury he sustained during the last world cup. Our minister is a little behind the times, a couple of millennia or so. World class athletes and teams stand squarely on the foundations of modern science. Sustained sporting excellence today can be attained only with solid scientific support.

About a year ago a junior state level javelin thrower came to me with a one month old injury in her right upper limb. Her coach took her straight to a kalari asaan when she fell, who massaged the limb for a month. I took an X- ray and found a Galeazzi fracture dislocation, a common fracture pattern for which surgical treatment alone gives satisfactory results.The delay was not due to lack of expertise; it is a straightforward surgery done by most orthopedic surgeons. The irony is that if the child had not been the athlete she was, if she was not under the mercy of her coaches, she would have received better care earlier.

Such is the state of sports in our land- in one word, medieval. I see no reason for hope.

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