The fastest, highest, strongest, the perfect rhythm or spectacular play-in essence, the beauty and thrill of sports. Yet, our vision of sports medicine is usually circumscribed–as on our cover-to the team doctor treating a player’s injury on the field. The inside pages of this issue take a deeper look and bring to mind that while sports themselves generate lessons for life and society, sports medicine can offer vital lessons for approaches to health care.

Sports push athletes to their limits and continually challenge them to go beyond. Through medical management of athletic training, sports medicine has the difficult challenge of balancing this drive with proper conditioning and prevention against overuse and injury (Ultrasound Diagnosis for Preventing Knee Injuries in Cuban High-Performance Athletes), providing important clues to improved prevention and treatment of trauma in the wider population.

Sports gives medicine the opportunity to study the body at its best, offering a glimpse into the potential of differing body types for different activities (Body Type and Performance of Elite Cuban Baseball Players).

Sports training pays attention to the whole athlete for optimum performance, recognizing that a batter’s slump may have as much to do with family troubles as with the angle of his swing. Sports medicine recognizes this essential link between mind and body, a relationship that long escaped the attention of many fields of Western medicine. Thus, in Cuba, each national team is assigned a medical triad consisting of a physician, physical therapist and psychologist (Health and High Performance: Interview with Carlos Jiménez). The maximum expression of this harmony is found in the aspects of Oriental medicine adopted at the Sports Medicine Institute’s unit dedicated to natural and traditional medicine (Scoring Points for Holistic Medicine: Interview with Anisio León and Pedro Carmona).

… while sports generate lessons for life and society, sports medicine can offer vital lessons for approaches to health care.

Clean sports perhaps have no rival in their ability to teach values to youngsters as they grow up: fair play, team spirit, perseverance, respect, hard work, the ever-present need to strive for excellence. Since the late 1960s, sports medicine has taken on the very tough job of combating doping at athletic events and training sites across the globe, up against powerful and moneyed interests that taint the spirit of sports and endanger athletes with performance-enhancing drugs and methods. Cuba’s Anti-Doping Laboratory is one of 34 worldwide accredited by the World Anti- Doping Agency (WADA) to test athletes’ blood and urine for doping agents, from the simplest compounds to the latest designer drugs (Cuba in the World’s Tough Battle for Drug-Free Sport). Cuba’s national Anti-Doping Program-aimed at young people, the general public, athletes, coaches and medical personnel- includes information, education, testing and athlete sanctions. Both the lab and the program are part of the global effort to keep the spirit of sports intact, a reminder that sports must be a contest of character, not chemistry-to paraphrase Dr. Gary Wadler of the World Anti-Doping Agency.[1]

We know that regular exercise can lead to a longer and better life. Evidence-based sports medicine offers a deep well of research that can and should be applied more broadly. Its experience with physical fitness for disease prevention and with therapies for addressing health concerns such as stress, psychological problems, substance abuse, and especially chronic diseases are invaluable for improving quality of life in the general population. Although apparently unrelated to the issue’s central theme, the article we carry on dementia and the elderly warns of clear risk factors, including hypertension, depression and history of stroke-all modifiable through regular exercise and other lessons learned from sports medicine (Prevalence of Dementia and Alzheimer’s Disease in a Havana Municipality: A Community-Based Study among Elderly Residents).

Two articles look ahead to forthcoming issues of MEDICC Review -the first, Taking to the Streets: The Terry Fox Run for Cuban Cancer Research, reports on this annual event across Cuba, organized in cooperation with the Canadian Embassy in Havana, leading into our July issue on cancer. The Viewpoint (Before the Bow Breaks: Tradition vs. Nutrition for Cuba’s Next Generation) offers a preview of some difficult questions we will be tackling in the October issue dedicated to nutrition.

Finally, this thought: the noncommunicable chronic conditions that are the number one causes of illness and death in Cuba are also becoming a pandemic threat to countries and populations across the globe. As we have seen above, sports medicine’s experience and research can be vital to sorting out solutions and adopting critical preventive strategies. Cuba has a head start because the national Institute of Sports Medicine and its provincial centers are located squarely within the public health system. Yet, the danger remains that sports medicine will be sidelined as “specialty medicine”. The challenge-for Cuba, medicine and population health-is to bring its lessons fully into play.

The Editors

1. Klein JZ. Dr. Gary Wadler of the World Anti-Doping Agency gives his answers to your questions (Part I). The New York Times. 2008 Jun 26 [cited 2009 Feb 20]. Available from: http://olympics.blogs.nytimes.com/2008/06/26/dr-garywadler- of-the-world-anti-doping-agency-gives-his-answers-to-your-questionspart- i/?scp=1&sq=Gary%20Wadler%20Anti-Doping&st=cse