The use of complementary and alternative medicines and therapies (CAM) in Australia and across the world is becoming increasingly prevalent. The most recent survey conducted by MacLennon et al. in 2004 [2] identified that more than half the general Australian population had used some form of CAM in the previous 12 months before the survey was conducted.[2-4] Up until now, the prevalence of CAM use among elite Australian athletes was unknown. As athletes are constantly looking to gain an advantage over their competitors through physical or psychological interventions or through the application of new technologies, it was hypothesised that the use of CAM in this group would be higher in athletes than in the general population. After surveying 497 elite Australian athletes we found that 93% of this specific population utilised at least one CAM within their lifetime. The 10 CAM (as defined by the Therapeutics Goods Administration) used most frequently were sports drinks, massage, sports bars, cereal bars, multivitamins, aloe vera, sports gels, Pilates, caffeine and yoga. There were no significant differences identified between specific sporting groups- football codes, court sports, field sports, water sports and others, with all groups reporting high usage. Sports physicians, family, coaches and friends were identified as the main sources for product information, with health food shops, sports dieticians and sports physicians being the predominant providers of the actual product. Four CAM sold on the Australian market which purported to decrease the symptoms of delayed onset muscle soreness (DOMS), or reported anti-inflammatory properties which could impact of the inflammatory response associated with DOMS were studied. Lyprinol® (an anti-inflammatory agent), topical Arnica (for symptomatic relief of soft tissue trauma), Tienchi Ginseng (proposed to relieve symptoms of DOMS) and Devil’s Claw (an analgesic and anti-inflammatory agent) were the chosen CAM. Four separate randomised, double blind placebo controlled studies comprising of 20 subjects per study were carried out with the same DOMS inducing methodology (downhill treadmill running) employed. All subjects in each of the four studies had their performance (counter movement and squat jump, maximal force), pain (visual analogue scale and muscle tenderness) and blood parameters (high sensitivity C-reactive protein, interleukin-1A, interleukin-6, tumour necrosis factor-K, creatine kinase and myoglobin) analysed seven times over five days. Lyprinol® did not affect performance, pain or blood markers of muscle damage and inflammation analysed in this study. Despite Lyprinol® being marketed as having “potent anti-inflammatory” properties, Lyprinol® did not demonstrate any antiinflammatory properties in our sample group at a dose of 200mg daily for two months, and did not alter any of the markers of inflammation after a downhill running protocol. A significant difference was identified in quadriceps muscle tenderness between the topical Arnica and placebo groups 72 hours after the downhill running protocol. This indicated that the topical Arnica group experienced less quadriceps pain at this time point, though this was not reflected in the quadriceps visual analogue scale results. There were significant differences identified between the topical Arnica and placebo groups for muscle tenderness in the gastrocnemius and tumour necrosis factor-K concentration at baseline. Further statistical analysis assessing relative changes from baseline did not demonstrate any statistically significant differences between the groups for either of these parameters. We therefore conclude that the symptomatic relief of soft tissue trauma claimed from a topical Arnica product sold in Australia was not conclusively demonstrated in this study. The single, isolated significant difference identified in quadriceps tenderness does not conclusively, from this study, indicate efficacy for the use of this topical Arnica for the relief of soft tissue trauma. Tienchi Ginseng demonstrated the most promising outcomes, with statistically significant differences identified in performance and inflammatory markers in favour of Tienchi Ginseng. Though it cannot be conclusively deemed beneficial for DOMS from this study alone, Tienchi Ginseng warrants further research with larger sample sizes and a similar muscle damage protocol. Finally, Devil’s Claw did not demonstrate beneficial outcomes in regards to DOMS within this study. It actually demonstrated some, perhaps detrimental effects, upon analysis of performance and inflammatory markers. We are unsure of the mechanisms behind these findings, particularly when considering the proposed anti-inflammatory effects of Devil’s Claw. From the literature, Devil’s Claw appears to be beneficial in chronic musculoskeletal conditions however it does not seem to impact on muscle damage and pain resulting from DOMS inducing exercise. The questionnaire study has demonstrated that there is a high usage of CAM among elite Australian athletes, an area up until now that has been unexplored. The onset of CAM use within the Australian athletic population, and the prevalence of CAM use by other professional Australian athletes would be an area to explore in the future. In regards to products which specifically claim to benefit athletes suffering soft tissue trauma such as DOMS, convincing evidence for specific product use was not demonstrated in these studies. Further research involving greater sample sizes may reveal more definitive outcomes, specifically in regards to the use of Tienchi Ginseng. / Doctor of Philosophy (PhD)
| Identifer | oai:union.ndltd.org:ADTP/201152 |
| Date | January 2007 |
| Creators | Pumpa, Kate Louise, University of Western Sydney, College of Health and Science, School of Biomedical and Health Sciences |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
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