South African Institute of Drug-Free Sport Position Statement on CBD (Cannabidiol) and THC (Tetrahydrocannabinol)

Cannabidiol (CBD) and Tetrahydrocannabinol (THC) have become easily available to athletes over the years. Using these substances may inadvertently expose an athlete to the possibility of an adverse analytical finding (a "positive" test) and a sanction. Athletes need to understand the risk of an anti-doping rule violation or adverse analytical finding should these products be used, especially if no therapeutic use exemption exists. This position statement attempts to clarify the use of CBD and THC and their associated risks with Anti-Doping Rule Violations (ADRV) in the athletic population. The South African Sports Medicine Association supports this position statement.

Acetabular fracture after cycling related falls: High index of suspicion is required to avoid missing the injury on plain radiographs

Cycling participation as a medium of transport and as a competitive sport has steadily increased in recent decades. Traumatic injuries secondary to falls and collisions occur relatively frequently. Fractures of the hip and pelvis are uncommon with no studies to date reporting their exact incidence in this sport. Injuries specific to the acetabulum are reported even less frequently. We present four cases that highlight the insidious nature of acetabular fractures in cyclists and document their management and recovery. The number of acetabular fractures following falls from bicycles directly onto the lateral hip result in a relatively high number of fractures. Many of these may be missed due to the absence of findings on plain x-ray imaging.It is therefore important to have a high index of suspicion for hip and pelvis fractures when treating cycling related traumatic injuries.

Corticosteroids in sports-related injuries: Friend or Foe

Corticosteroids act as potent anti-inflammatory drugs and have been used in various sport settings for the treatment of both acute and chronic injuries. Basic physiology and mechanisms of action for gluco- and mineralocorticoids are discussed. Methods of administration, the action on the inflammatory response, and potential short and long-term side effects of corticosteroid use are also deliberated. More specifically, corticosteroid use in the treatment and management of sport-related injuries are discussed, elucidating on the ethical boundaries and anti-doping regulations pertaining to corticosteroid use in sports, as well as putting forth suggestions for the use of local steroid injections and their contraindications. In conclusion, it was found that, despite some controversy in the use of corticosteroid treatment in the sports environment, little empirical evidence exists that could conclusively rule for or against its use. It is however clear that, if clinically justified, there is a significant role for corticosteroid treatment in the realm of sports injury and notably with a relatively low risk profile, if administered correctly.

Critical fusion frequency in MS during mild induced hyperthermia

By raising the body temperature of 0.5 degrees C the critical fusion frequency of a flickering light increases in normal subjects but decreases in multiple sclerosis (MS) patients. The change was present in 14 patients with definite MS and in 5 of 10 patients with probable MS. No clinical worsening was observed during the procedure or in the following hours.