Brief Narrative: An Orthopedic Surgeon’s Experience as a Boxing Team Doctor
Corresponding Author: Aman Hooda, Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India, Phone: +91 9646003620, e-mail: email@example.com
How to cite this article Hooda A. Brief Narrative: An Orthopedic Surgeon’s Experience as a Boxing Team Doctor. J Postgrad Med Edu Res 2020;54(4):241–243.
Source of support: Nil
Conflict of interest: None
The experience of an orthopedic surgeon selected to be the doctor of the Indian boxing team is presented, right from the news of getting selected for the post till the arrival back to India with the championship trophy. The preparedness prior to joining was very different, due to limited exposure to sports medicine protocols, which are different from orthopedics. The team expectations were different, and the Doctors’ expectations were different, but as the days went by, bonds strengthened, and a mutual understanding developed, leading to the doctor becoming an integral part of the Indian boxing team. The coaches were receptive and open to my suggestions to improve the performance of the players. This was a learning experience for both the team players, management and coaches, and the orthopedic surgeon who accompanied them as a team doctor.
Keywords: Sports, Sports injuries, Sports medicine.
The Asian Boxing Confederation (ASBC) Asian Junior Championship was proposed to be held at Fujairah, United Arab Emirates (UAE), from October 11 to 17, 2019. On October 2, 2019, I received a mail from the Ministry of Youth Affairs and Sports, Govt. of India, regarding my nomination as the team doctor of the Junior Indian boxing team. I was excited but nervous too because it was an entirely different venture; after discussing the same with my Head of the Department (HOD), I accepted the proposal as it is always a privilege to wear the Indian jersey and represent one’s country on an international platform. My HOD, who had served as the team doctor to the Indian Hockey team in the year 2007, warned me that I should expect very different things than what I had imagined, as my speciality-related work would perhaps not be the main work I would be asked to do.
I had apprehensions before I joined the team as this new duty was way beyond my normal routine of examining patients and operating them and carried a great amount of responsibility. I did my homework and researched if there was any national or international agency enforcing some uniform medical standards applicable to boxers. Questions such as what are the common injuries expected to occur in the boxing sport and what should be the likely training schedule with the coaches and stretching routine of the players were on my mind. The dietary requirements and the importance of weight maintenance needed to be answered before I dived into this new job for the coming month. Hence, I prepared a proforma with the relevant parameters such as age, sex, weight, height, and body mass index. Obtaining the appropriate past history of use of any medications for chronic diseases and concussion injuries leading to loss of consciousness, shortness of breath, and chest pain was important.
I became well-acquainted with antidoping rules which were totally new to me and are based on WADA models of best practice for international federations and the world antidoping code (WADA). It includes—what is doping and the prohibited list, including analgesics and steroids, testing and investigations, proof of doping, result management, and consequences to the boxer and the team. Another aspect of elite sports is psychological preparedness and morale boosting. Orthosurgeons are not prepared for this, but I was guided to be ready and prepared for this. I personally believe that whether in an operation theater (OT) set-up with a scalpel in your hands or inside the ring, down on your feet, it is of paramount importance to manage the stress and performance anxiety adequately. Hence, the psychological assessment and counseling play a key role in enhancing the performance of an athlete.
With all this in mind, I reported at the Sai National Camp, Rohtak, Haryana, a day prior to the departure. I met all the coaches and the young members of the team on October 7, 2019, at Rajiv Gandhi Sports Stadium, Rohtak. At the camp, I met each of the team members in person and enquired about any active complaints which was a great way of maintaining continuation of medical support.
I left for Dubai along with the Indian team for Asian boxing championship via a flight on October 8. The team consisted of total 10 coaches: 5 each for the male and female teams; 26 boxers, 13 males and 13 females; 2 physiotherapists; a masseur; a team manager; and a team doctor (which was me). Boxers were categorized according to their weight into 13 groups starting from 44 kg to 80 kg and above. The most spectacular thing that I noticed about the team was their discipline and immense focus to bring home medals; the coaches were strict yet warm-hearted and caring, and the spirit of comradeship also enveloped me into its fold. All the boxers had gained entry into the national team by winning national championships of respective categories. But this tournament was a different kettle of fish! A total of 239 boxers from 26 countries across Asia were participating in the tournament, which increased the level of anxiety in all of us.
The team arrived at Dubai the same evening and we headed to Fujairah, which is a 3 hours bus drive from Dubai Airport. Fujairah is a beautiful city lying along the Gulf of Oman and is known for its beaches, the Hajar Mountains, and the Sheikh Zayed Mosque; the weather was pleasant during the evenings, but dry and hot in the morning. We reached Fujairah late at night and stayed at the Concorde Guest, a high-end hotel in the middle of the city.
On the next day, registration was done, the paper work was compiled, and the formalities were completed. I was required to submit the medical report of each boxer stating that they are fit to play. I was briefed regarding the antidoping rules in accordance with the policies of WADA, which I had also read. The boxers followed a strict routine, comprising vigorous training sessions for an hour, twice daily. The weight of the candidates was assessed twice in a day, and the meal and the physical activity were maintained accordingly. Due to the hot and arid conditions, the perspiration rates were high and the boxers were feeling low and weak. Keeping in mind the change in the climatic conditions, I have advised intake of oral rehydration solution instead of plain water to maintain the electrolyte balance and hydration status.
On the third day, that is, October 10, 2019, an inaugural ceremony was held which started at 5 p.m., at Sheikh Zayed Sports Complex (5 km from the hotel). The ceremony was headed by Prince of Fujairah; highlights were the sand art and the laser show.
The rules for the tournament were announced; boxing championship will have a total of 3 rounds; each of 2 minutes with a break for a minute. There will be a total of 5 judges, one in the ring and the rest four, around the ring. One physician, one technical committee person, and one time keeper will also be present.
The tournament started with a match between India and Iraq, where in the under-48 kg category, our boxer has won convincingly, with a clean sweep score of 5–0. It was a thrilling show to witness, and as someone in the crowd roared loudly “BHARAT MATA KI JAI” followed by slogans, “INDIA-INDIA,” I could feel a shiver running down my spine.
From October 11 to October 14, preliminary rounds for each category for both males and females were held. Each day started with a training session at 5.30 a.m. in the morning. Every boxer had to undergo weight assessment and a medical examination on the day of the match, between 7 a.m. and 10 a.m. in the morning. After the training session and medical assessment, the whole team had a meal together. Every day, around 11 a.m., I, accompanied by two physiotherapists, met each boxer in person. I had to be extremely careful in prescribing any medications keeping in mind the WADA, that is, World Antidoping Agency guidelines. Painkillers such as Aceclofenac or Diclofenac with or without muscle relaxant Thiocolchicoside was allowed. But androgenic agents, stimulants like amphetamines, beta blockers to stabilize the heart rate, narcotics, cannabinoids, and glucocorticoids were strictly prohibited.
The physiotherapists followed a mandatory routine of stretching and warming up before all the training sessions and matches. I assessed the injuries and problems faced by the players in each game and modified few exercise protocols to maximize their performance capacity. A masseur had also been appointed to give massage to the players at the end of each day and to aid relaxation. Body aches and sore throat were the most frequent complaints in all the boxers, because of a common practice of splashing cold water on their head immediately after training, which was stopped on my suggestion.
Every day, the team left for the tournament venue, around 12.30 p.m. post lunch; the first round of the match used to start at 3 p.m. and continued till 5.30 p.m., followed by a break of an hour. The second round commenced at 6.30 p.m. and continued till 9 p.m. Although all the coaches were champions of their era and elder to me, yet they were quite humble and receptive of new ideas and suggestions. During the training sessions and just before every match, they sought my opinion and the same would be implemented as much was possible. This ensured a very conducive and professional environment, which was highly uplifting. At the end of preliminary rounds on the evening of October 14, 21 players entered the semi-final league; 8 males and 13 females. For the first time in the history, all the female boxers had qualified for the semi-finals, which meant that at least 21 medals were confirmed, and this was a very great thing, leading to much rejoicing in our camp.
October 15, 2019, was a rest day before the semi-finals of the tournament begin, and the condition of two female boxers suddenly worsened due to the onset of the menstrual phase of their cycle. They complained of severe abdominal cramps and one of them fainted that morning. I evaluated and found that she was highly dehydrated due to the ongoing fifth day of heavy menstrual flow. I advised her to rest and do warm compresses over lower abdomen for symptomatic relief, prescribed her an antispasmodic analgesic, and intake of lots of fluids and ORS to regain her electrolyte balance and strength. Later, she went on to score a gold medal for the nation. I also attended the technical Olympic boxing rules seminar on the same day in the evening, and it was a wonderful experience to know more detailed rules about boxing.
On October 16, 2019, the team had reached the venue well before time and a training session to warm up the boxers was held. Observing the boxers closely that day, the realization dawned upon me that the game was not just about the physical strength and stamina and that the “real game” has begun a lot prior to entering the boxing arena. I found out that the mental stability of the players is very important, and immense focus and unwavering determination are imperative to win the game. I tried motivating the players positively in this regard, through small interactive sessions before they headed to bed each night. Three countries were giving a tough competition to India, that is, Uzbekistan, Tajikistan, and Kazakhstan. Their boxers had good stamina but used to beat opponent players in the last round, prolonging the fight. I brought this strategy to the notice of the coaches and boxers, which really helped them. By the end of October 16, in the night, 15 boxers representing India had entered the finals.
The final day, October 17, started on a heart-wrenching note with the aura of nervousness among all the boxers. After the routine training session in the morning, a boxer who had a past history of shoulder subluxation complained of pain in the left shoulder, and on examination, the apprehension test was positive. She had undergone left Bankart repair for unstable dislocating shoulder. After discussing with the coaches, I allowed the girl to play with certain precautions. She lost the final game and won a silver for the nation, but she gave a tough fight to the opponent. On the final day, the matches started at 12 p.m. in the noon. The finals were extremely enthralling as both the blue and red corner boxers were fighting the best.1
It was a proud moment for everyone representing the nation, when the Indian National Anthem was played six times in the stadium, and we stood at first rank in the medal tally, that is, 21 medals—6 Gold medals, 9 Silver medals, and 6 Bronze medals. The entire Indian team was jubilant and was highly applauded by the audience and other teams. This was followed by a Gala dinner, at night, where all the players let loose their inhibitions, and everyone enjoyed the scrumptious meals whole-heartedly, as the food restrictions were relaxed for a while (Fig. 1).
October 18, 2019, on the last day of stay, the entire team had been left for Dubai via bus, dressed in their red and black Indian track suits, which they had worn throughout the tournament. We were welcomed in India at the Delhi airport, with garlands and flowers at 2 a.m. in the early morning by the Boxing Federation of India, on a triumphant and elated note. With mixed feelings, we all dispersed and headed back to our lives.
As I carry on and resume my duties, I feel extremely obliged to my Mentor and Head Professor Mandeep Singh Dhillon and the Ministry of Youth Affairs and Sports, Govt of India, for bestowing upon me this opportunity to experience and closely observe this extravagant display of patriotism, channelled discipline, motivation and sportsman spirit, and the lessons learnt, which I will bear forever in my heart.
It was a great learning experience for me to rove into an unknown arena. I did feel there were a few lapses which should be taken care of in general in case of such international and national level tournaments. First, the provision of a SPORTS PSYCHOLOGIST to help the players to cope with the performance anxiety and stressful experiences which are common during such championships. The second thing that needs to be looked upon is adding a DIETICIAN to the team as the importance of weight maintenance cannot be overlooked. An ideal team doctor would be a SPORTS MEDICINE specialist which is an emerging speciality in India but this will be the future.
1. https://affairscloud.com/overview-of-asbc-asian-junior-boxing championships-2019-held-in-fujairah-uae/Retrieved on March 26, 2020.
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