thumb_thumb_Goodman_Carmel_web.jpg WA Institute of Sport Medical Director Dr Carmel Goodman has been involved in elite athletics since 1970, both as athlete and physician. She recently travelled as Olympic doctor for the Hockeyroos to Athens, where heat was not the only thing she had to contend with. Despite over $1million spent on ice jackets and ice baths for athletes, the Hockeyroos lost to the Netherlands in the semi-final. This was a shattering experience for the more experienced team members who had enjoyed a winning streak under the previous coach Ric Charlesworth.?

 

“I tried to explain to the newer group how the older girls viewed winning as they had never lost before. There was no psychologist in Athens – in retrospect it may have helped but as the coach said, the girls used me for that. Whatever I had to say wouldn’t soften the blow, so it was difficult at the end. I could see that those who were devastated would be devastated anyway.”

Security was top priority during the Olympics, with US and Israeli athletes avoiding team colours or personalised quarters to minimise their profile.

“People thought things were over the top with the U.S. and the Israelis at first, but we soon realised it was necessary. I was not aware of any Australian security in that I didn’t see any around, but there were rumours of security guys in plain clothes.”

However, Carmel noted some remarkable gaps.

“Security was only at some places an hour or two before the event. For example, there was security on the main hockey pitch but the two smaller pitches that gave access to it were not as secured. One athlete mentioned he jumped over the fence and got into the closing ceremony. He was quite pleased with himself and it showed that security was quite lax in some places.”

The Sydney Olympics saw 40% of athletes on beta agonists for asthma. Questions were raised about performance enhancement, and from February 2004 athletes were required to provide documented proof of exercise asthma.

With 15-20000 applications for use of asthma medication sent prior to the Olympics, Aussie Olympians had to disrupt training for weeks at a time by withdrawing from their medication, undergoing exercise tests and, if necessary, bronchial provocation testing.

“The documentation was sent to the Olympic committee but 4 or 5 athletes got to Athens and found they weren’t approved. Luckily we kept copies.”

Topical or inhaled steroid use also required documenting as part of the drugs testing revisions, causing new issues for the athletes.

“From a hockey point of view, a lot of girls used cortisone cream for infected turf burns – so I had to be on top and notify the officials every time they were used. There was a huge amount of paperwork required and it was very stressful.”

Caffeine is no longer banned in elite sport due to the difficulty in controlling its use and defining a cut-off level. Australian athletes were amongst those to take advantage of the new ruling, with mixed results.

“We did a lot of research before we went and found a significant increase in endurance, reaction time and repeated sprint ability of approximately 10% across the board. On that basis I used it for the hockey girls. I offered them the research and let them know it was their choice. I gave them caffeine tabs before games with 14 of about 18 girls taking them.?

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Dr Carmel Goodman (second from left) with the Hockeyroos in Athens.

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“Some of the girls had difficulty sleeping especially if they took them in the afternoon, so I ended up giving them sleeping tablets. But based on the significant increase we had seen and the lack of negative effects on a two weeks basis I decided to give it to them.”

 

Another issue relevant to doctors is the potential liability in treating athletes who return to sport against medical advice. Knee injuries are a big problem in hockey. A premature return to sport after cruciate reconstruction inevitably results in an arthritic knee. Having dealt with this issue, Carmel advocates caution.

“All you can do is advise, lay out the risks and get them to sign a disclaimer. The other thing I do to cover myself is to tell the coaches. I don’t think as a medical person you can be in a position to actually forbid an athlete from competing. There may be legal issues later, but that’s a risk you run.”

As a mother of two, we asked Carmel how her experience in elite athletics affected the participation of her kids in sport.

“Of course, I have encouraged my daughters to engage in as much activity as they can. I’ve tried not to emphasise winning at all costs – I simply said it is more important to participate than to win. Having said that, they have seen how serious I am about sport.”

Since 1998 Carmel has been Medical Director of the WA Institute of Sport. What does she see as the high points of her tenure?

“Probably the major highlights would be seeing athletes come into the institute not at an Olympic level, but over the period develop into Olympic athletes. Also, looking after and screening injury prevention and management programs – hopefully those have gone some way to help make Olympic athletes.”

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