Show of mental strength

It's rare for a world class sportsman to confess to being too mentally unfit to continue playing his game. Competitive sports, is after all a show of strength and any sign of weakness is bad for the image. A fractured wrist or torn meniscus may justify some time off, but it's harder to view an emotional problem as a cause of disability.

So the world was shocked when English batsman Jonathan Trott withdrew from the recent Ashes tour of Australia due to a "stress-related" illness. While English players and local media reactions were largely supportive, Trott's decision drew plenty of flak from other quarters. For some players and cricket fans, his departure was seen as an escapist "flight" reaction, and the common perception was that he wasn't strong enough to cope with the pressure of being a world-class athlete. The batsman's move was labelled "poor and weak" by Australia batsman David Warner, and India born South African cricketer Gulam Bodi tweeted: "Hahaha, joke of the day! Trott to go home frm the ashes due to stress illness! Bloody man up n take the heat! Stop running for cover." Here in India too, Trott's withdrawal was greeted with derision. One piece of advice offered was: Ask Sachin how he dealt with the stress of playing International cricket for 24 years.

Experts say this lack of understanding is associated with the stigma attached to mental illnesses. "In India, we just don't talk about depression and other stress-related mental illnesses in the way they do in Western countries," says Dr Samir Parikh, Director, Department of Mental Health and Behavioural Sciences, Fortis Healthcare. While anxiety and stress is common among Indian players too, they rarely let out since maintaining a "cool and in control" faade really counts for an athlete.

Psychological issues are considered personal and are largely ignored. But this has harmful long-term consequences, say experts, since sports performance depends upon honing both physical and mental skills. "There are many sportspersons in India who have been emotionally devastated by trivial incidents such as Vinod Kambli and Dingko Singh for example," says Dr (Col) Chengappa, consultant, sports medicine, Safdarjung Sports Injury Centre.

Trott's move is significant in more ways than one. His openness about his "anxiety-related" illness is refreshing and may pave the way for other athletes to come forward without fear of ridicule. "When celebrities share their fight with psychological problems, they raise awareness and help reduce the stigma about these issues, encouraging people to seek help," says Dr Parikh. Recognising an emotional problem and working to resolve it is important for an athlete. Recovery involves breaking the routine of rigorous competitive sports, spending time with family, and getting medical and psychological help. "Typically this is not a long process, and depending on the overall condition, a person should be able to get back to their life soon enough," says Dr Parikh.

The English cricketer's withdrawal from play also draws attention to the need for sports psychology, which is in its infancy in India. While sports psychologists are an integral part of teams the world over, traditional coaching methods don't lay enough emphasis on sport psychology and what is really needed is an integrated approach involving coaching with psychology and sports science. "The growing world of competitive sports calls for the involvement of sports psychologists and mental conditioners in a much bigger way," says Dr Parikh.

Sports medicine specialists say that various factors must be taken into account during mentoring. "We can't ignore the sociocultural and economic background of players," explains Dr Chengappa. For many young Indian athletes, travelling outside the country and interacting with western athletes is challenging in the most basic ways such as using restrooms and eating meals. "Building the self-esteem is the first step in mental conditioning, before you can take an athlete to the next level of preparing him for competitive stress. A coach must ensure that mental conditioning is not trivialised as something for the weak," says Dr Chengappa.

On the fast track

Fasting may actually have more health benefits than you imagine. A 2013 review of fasting diets in the British Journal of Diabetes and Vascular Disease suggests that apart from helping with weight loss, fasts can even reduce cardiovascular risk factors such as blood pressure, triglyceride levels and inflammation. But do get the advice of a nutritionist before you proceed on a fasting diet, to determine the one that's right for you.

Vibrations don't cut it

Anyone wanting to build muscle won't gain much from standing on a pulsating platform or using a vibration machine in the gym. Though vibration technology is supposed to help users tone muscles and boost the metabolism, it doesn't help in fat loss, says a study in the International Journal of Sports Medicine.

Cholesterol guidelines need to be rejigged for Indians

Much is being made of the new cholesterol guidelines issued by the American Medical Association, and those taking cholesterol lowering drugs called statins want to know whether they should change track or not.

"The new guidelines represent a paradigm shift in approach to treatment of heart disease, in that they don't recommend relying on the LDL cholesterol levels to calculate cardiac risk and determine the prescription of statins," says Dr Ashok Seth, Chairman, Fortis Heart Institute. Instead, the new approach relies on a calculation of overall cardiac risk that leaves LDL out of the mix altogether.

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The cholesterol-only criteria is no longer applicable and cardiac risk will be calculated taking into account blood pressure readings, diabetes, history of heart disease and so on. So even if your cholesterol level is normal, a family history of heart disease and a high figure for C-reactive protein (CRP) will put you in the 'high risk' category. But experts here aren't convinced about these recommendations."These are America centric guidelines, not applicable in the Indian context. These guidelines don't take into account the metabolic syndrome that Indians are at risk of developing, reflected in high triglycerides and low HDL cholesterol. Basically, we would require a different risk calculator for Indians," says Dr Seth.