So you’d think it would be warm & sunny here in Kenya. Wrong, yesterday’s afternoon session took place in rather heavy rain. The support staff (Barry, John & Mick) hopped on the mountain bikes to chaperone the athletes round the course that had been designated & what a mistake that proved to be.
As we turned off the road onto the first part of the track, the rutted track turned dangerously slippy & within less than 5 minutes I’d taken a tumble, closely followed by John. As we careered down a steep track past a few houses, we provided first class entertainment for the assembled locals who were in hysterics watching us slide sideways past them to the bottom of the hill. At the bottom, the clay mud had clogged the gears, the brakes & finally the wheels gave & stopped turning.
Once we managed to limp back to the Centre, we broke out the hosepipe & spent almost half an hour cleaning ourselves & the bikes from the sticky red glue that had engulfed all that had ventured out. Unfortunately I hadn’t my camera handy to record the hilarity.
Today, the morning session was conducted roadside as the rain had continued through the night & this evening, after a long day in clinic, John & I did a four mile run followed by a session in the gym, whilst many of the athletes completed an easy run. Barry opted for a snooze & Spencer was engaged by his emails.
For those of you interested in how a sports medic spends his time on camp, I sat down with John last night to ask him a few questions.
Please introduce yourself, what you do & give us a brief
background of your career to date
My name is John Rogers (see photo). I work as a doctor with UK Athletics (UKA) and recently qualified as a Consultant in the new NHS specialty of Sport and Exercise Medicine (SEM).
After medical school and house jobs in Belfast, I spent 4 years training in Manchester as a GP/family physician. During this time I trained as a middle distance runner and competed at national level over 800 and 1500m. My participation in athletics stimulated my interest in Sport and Exercise Medicine. I spent the next 2 years working as an Exercise Medicine Physician with a company called Wellness International who are based at the adidas UK headquarters. I then started a training programme in London as a registrar in SEM where I was privileged to have placements at the British Olympic Medical Institute and Chelsea Football Club. I returned to Manchester in 2009 to work as a GP partner for 2 years whilst completing my training as a consultant in SEM. I currently work for UK Athletics (UKA) as their Endurance Medical Officer. This role involves running a clinic 1 day a week seeing non-funded track/road/cross-country and mountain running endurance athletes who have competed for GB&NI over the past 12 months. It also involves covering altitude training camps in Iten, Kenya and Font Romeu, France several times a year, covering GB & NI teams at European and World Cross-country Championship and covering GB & NI teams at World and European Junior Championships. Most of my working week involves working as a Sports Physician in NHS hospitals in Manchester and Sheffield.
How long have you been involved with the UK Athletics/London
Marathon endurance programme?
3 ½ years
Please could you explain for those that might not have
experience of altitude training, what the benefits are that athletes would hope
to take advantage of in terms of performance & how these occur
physiologically.
Living and training at altitude(1800-2500m) has been used by athletes and coaches to enhance performance in endurance events for over 40 years. At altitude there is a relative lack of oxygen (hypoxia) in comparison to sea level. The body adapts to this relative hypoxia in several ways. One of the main performance enhancing adaptations that occurs in athletes is the production of more of the hormone erythropoetin which in turn stimulates the production of more red blood cells. More red blood cells means greater capacity to carry oxygen from the lungs to the exercising muscles. This results in improved performance in endurance events at altitude and when athletes return to sea level.
What is your role prior to departure for Iten or Font
Romeu?
Collecting up to date medical forms on all the athletes, making sure they are all aware of the travel medicine and vaccination/antimalarial guidelines, making sure they have an up to date ferritin(iron) level checked 3-4 weeks before departure, ordering pharmaceutical and medical supplies to bring out to the camp.
When you arrive, what baselines do you take, if any, what
parameters do you monitor & what other tasks occupy your time?
The main things I like to know are usually established prior to leaving. Namely - an athlete’s ferritin level, any existing injury or illnesses and when travelling to Iten, what they are doing with regard to malaria prophylaxis. When we get to altitude I have informal chats with all the athletes to make sure they are settling in OK and there are no particular problems. The physiologist monitors for baseline hydration status, sleep quality, weight and flags up any significant issues to me. Day to day tasks involve reviewing athletes with acute or chronic injuries or illnesses, supporting physiotherapy and soft tissue staff who are often much busier than me, supporting coaches and other staff members who may need help with day to day running of the camp eg. timing sessions.
What complications do you see most often in athletes adapting
to an altitude training environment & how can they reduce the risk of these
occurring.
Sleep disturbance on week 1 – usually settles quickly with acclimatisation but important to ensure comfortable warm bed, consider bringing own pillow if known sleeping difficulties, bring earplugs in case needed. Sometimes a short course of sleeping tablets for 3-4 days is necessary.
Dehydration – education prior to departure and monitoring from physiologist
Training too hard on week 1 – education of athlete and coach prior to departure
Iron deficiency – check your ferritin before departure to guide appropriate iron supplementation at altitude
Asthma and/or Hayfever exacerbations – report symptoms early. These are usually easily managed by increasing preventative corticosteroid inhaler/nasal spray and use of other medications.
What experiences have made the most impact on you personally
during your trips to Kenya?
Visiting the local Moi Teaching and Referral Hospital in Eldoret was an eye opening experience. This hospital serves a population of about 20 million including parts of Sudan and Uganda. The extent of poverty and deprivation in Kenya really hit me when I visited this hospital. There was a stark difference in terms of facilities and equipment in comparison to UK hospitals and it made me realise just how lucky we in the western world are. During busy periods in this hospital there can be up to 3 patients sharing 1 bed!
There are major problems with HIV in Kenya and this hospital has a dedicated unit which cares for HIV sufferers and also pioneers some of the world’s leading research in this area. The infant mortality rate in sub-Saharan Africa is high with 1 in 6 children dying before they get a chance to celebrate their 5th birthday.
Despite the disadvantages and difficulties with poverty in Kenya, the people I have met always seem very happy and are incredibly humble and welcoming. I can’t help comparing the Kenyan positive attitude towards life with the many patient’s I have seen in the UK who have so much more in terms of material goods and yet suffer terribly with depression and anxiety. The children are always smiling and when running though Iten the local kids are always shouting ‘How are you?’ with massive cheesy grins on their faces!
The local St Patrick’s secondary school has produced multiple World and Olympic champions and world record holders over distances from 800m to the marathon. They plant a tree for each world or Olympic champion who has attended the school and are already well on their way to a small forest! Their Irish coach and mentor Brother Colm is an inspirational character who has played a major role in the development of these athletes and confirms what a positive impact sport can have on a person’s life.
For more info on how you can make a difference see www.shoe4africa.org
What will your role be during the Olympics?
I will be based at the UKA pre-Olympic altitude training camp in Font Romeu for 1 month before the Olympic games working with British endurance athletes from 800m up to marathon distance in their final preparations.
During the games themselves I will be based at the athletics stadium providing medical cover for athletes from all countries throughout the track and field schedule.
What advice can you offer less experienced medics that are
looking to develop a career in sports medicine?
It is an exciting and rewarding specialty to be involved in! The workload can be high and involve antisocial hours but it allows opportunities to travel and meet and work with very interesting and highly motivated people.
- Speak to a doctor who is already involved in Sports Medicine
- Have a look through the BASEM, Faculty of SEM, ACSM and ACSP websites –
Get involved in a sport you’re interested in by volunteering to visit / help out a team doctor
That is some great information for anyone wanting to follow your career path. Thank you, John for taking the time to answer the questions, enjoy your time in Iten & best of luck for all your imminent adventures over the coming 12 months.
