Pakistan's Cricket's Medical Nightmares

As a physician, there have been multiple times that I have shaken my head whenever Pakistan's injury woes have cropped up. Over the past few years, it has been the same list of injuries: Shoaib Malik's ankle, Umar Gul's back, Shoaib Akhtar's foot or hamstring or knee, Inzamam's back and on and on and on. Either its the same injury recurring multiple ways, or it is injuries which can be clearly be blamed on poor preparation (hamstring's or groin strain's).

My intuitive feelings about the situation often lead me to conclude that perhaps it was just Compton the team physio, and Bob Woolmer who had to make the majority of these decisions, and that is what is the problem here. I must say, in my mind, Shoaib Akhtar's continuous solicitation of outside opinions did push me towards thinking that this was a ship with no captain.

Then, I read Kamran Abbasi's blog from the 24th, and then had to begin doing some research, because according to his estimation there must be atleast ten physicians involved with the whole PCB framework. Well, first of all, it took me forever to find out who is involved with this so - called medical board of inquiry. It took me even some time to find a picture of the chair of the medical board of inquiry, Dr. Sohail Saleem. And it was after Googling, Yahooing and MSN Search engining that I finally came across an article in The News from 2005, which listed the constituents of the Pakistan Cricket Board's medical inquiry committe, with its visiting consultants:

"The permanent faculty of the medical commission comprises Dr Sohail
Saleem (coordinator medical commission), Murray Stevenson (Biokineticist),
Darryn Lifson (physiotherapist) and Grant Compton (trainer).

The members of the Visiting Faculty of the medical commission are Dr Abdul
Wajid (consultant Orthopaedic Surgeon —Agha Khan Hospital Karachi),
Dr Waqar Farooqi (consultant Orthopaedic Surgeon —Shalimar Hospital,
Lahore), Dr Meesaq Rizvi (Sports Physician —Shapes Health Studio, Lahore)
and Dr Azhar Turab (consultant radiologist - Shaukat Khanum Hospital, Lahore)."

A fine collection of specialists by any definition, who appear to all have the proper credentials. Yet, given their performance over the past few years, specially with the drugs/doping fiasco just a few months ago, one would have thought that they would all have gotten thrown out on their proverbial and perhaps even literal tush! Yet, here they are are, making a complete mosh of teh Shoaib Akhtar situation and perhaps even now with Shabbir Ahmed, who in the space of four days went from fit to non-fit.

It is beyond preposterous that the sport which is earning millions for the board, and players who are major participants in that sport and are irreplaceable assets, are being treated in such a cavalier manner by a medical board. If this was happening in any professional sport in North America or Europe, someone would have lost their job by now. the health of the athletes is of paramount importance, and somehow ways have to figured out to maintain that fitness. Fitness and the medical board's inquiries must go beyond treating when there is a problem, and trying to ascertain whether a player is "really" injured or not.

The medical board, must truly show a commitment to player fitness, on and off the field, and the team must be made to adopt a true fitness regime. I found it interesting, that while I was searching for the members of the medical board, I came across this report in The News again, where two Pakistani trained physios were upset with Woolmer's fitness regime. This either speaks to a lack of perspective by these physios or a problem with Woolmer's regime. I think the issue here really is, is that fitness has not become part of the Pakistani sports psyche. The preponderance of foreigners, albeit highly trained and professional, in the training realm, fails to make a connection with the cricketers who are usually only a year or two removed from small towns around Pakistan. This is where the PCB, and its Pakistani consultants and the selectors must show their strength, and demand a higher commitment to fitness by the squad. The Medical Board must also be held to a higher standard, and where a player is injured within the same year after returning from an injury, they must be taken to task and they must undergo quality assurance based testing. And why isn't there a dietitian and perhaps even a sports pharmacologist on the squad to help assist the players?

A commitment to fitness, a local, Urdu speaking presence on the fitness and physio groups affiliated with the team, and greater quality assurance process may not fix all the problems, but it may be a start to improving the team's perennial injury problems.