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Avoid Sports Injuries: Tips From an Olympic Doctor

Medscape: Are there any vulnerabilities that might be specific to female athletes?

Beim: In my book, I always harp on the muscular imbalance in the lower extremities, which I see more in women than men (although I do see it in men), and it definitely increases the risk for overuse and traumatic injuries in the knee. No question. Women and some men tell me that their knee has been bothering them and that they have some patellar tendinopathy. But they also have very weak hips.

Many people do not think about working their hips. Many studies have proved that weak hips can lead to knee overuse injuries, and in my opinion that can also increase the risk for traumatic injury, particularly in skiing or basketball and other court sports.

So I am always harping on my patients to strengthen their hips. Hip abductors and adductor exercises are so important, but many people do not do them.

Respiratory Diseases

Medscape: I read that respiratory diseases are very common among Olympic athletes, particularly during the Winter Games. How do you deal with such illnesses, and where do you draw the line and tell them to withdraw?

Beim: A respiratory illness would have to be very severe for us to recommend that an athlete withdraw. Fortunately, I have not had to treat any serious cases at the Games. In fact, in all the Games I have been to, I cannot recall anybody who has been withdrawn because of a respiratory illness. We get colds or an occasional mild flu that someone may have gotten during their travels. We usually just treat these people symptomatically. Even with these illnesses, however, I have to follow theWorld Anti-Doping Agency (WADA) list of substances that we are allowed and not allowed to use.

Performance-Enhancing Drugs

Medscape: What about performance-enhancing drugs? Are you involved in checking for these?

Beim: Yes. Athletes can be tested anytime, anywhere. This is how it works: At the Olympic Games, athletes have to submit to the doping control agency -- usually by email -- a form that they fill out on where they are going to be training every day, where they live, and whether they are going to go somewhere else for a while. These are called "whereabouts."Athletes have to document where they are during the period of the Games, and the anti-doping agency can show up anywhere -- at the training facility, up at the village, at their housing, at the hotel. An athlete can be tested anywhere, anytime. Doping control is not going to do a drug test only on athletes who win gold medals.

I am involved, along with the medical director of the U.S. Olympic Committee, to make sure in advance that any medications that athletes are taking are allowed and are not prohibited (i.e. on the doping list). Right now we are reviewing all of the athlete history forms and are almost done. If an athlete is taking a banned substance for medical reasons, we have to make sure that they have the proper documentation, which is a therapeutic-use exemption that is filled out and must be approved by WADA.

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