|Friday, March 17
Creatine and other chemical or dietary supplements are used by athletes with the intention of improving performance and gaining a competitive edge.
However, use of performance-enhancing substances, whether proven or perceived, raises many questions for young athletes, parents, coaches and administrators:
The principle concern of supplement use is safety, but many athletes and coaches are more concerned with the potential for "bigger, stronger, and faster." Is it safe to take creatine, androstenedione, ephedrine or other sympathomimetic amines during or in preparation for competition?
Underlying the entire issue is the use of anabolic steroids. Systematic denials of steroid efficacy for performance enhancement by the medical community decreased the credibility of medical providers with regard to improving sports performance with ergogenic substances. As a result, athletes have turned to other providers and sources for answers which are not always based on science and safety.
The questions that should be answered before any drug or substance is recommended for adolescent athletes include:
Most of the drugs used in medicine are cleared by the Federal Drug Administration (FDA) for safety and efficacy. Substances like creatine are not under the jurisdiction of the FDA and are not subject to the rigorous pre- or post-release review of everyday medications.
For substances known to enhance performance, but considered unsafe or unethical, the international or national sport governing bodies conduct doping contol testing to discourage the use of "banned" drugs.
Substances like creatine cannot currently be detected by standard testing, but ephedrine and the symapthomimetic amines can be easily detected and are currently on the IOC banned list.
These questions must be posed with regard to the use of ergogenic substances in athletes:
There are no set answers to these questions. They address the very heart of youth athletic competition down to the basic questions of what is winning and at what price.
We teach our young athletes lessons they will carry throughout a life time. The value of hard work, setting and achieving of goals, good nutrition and hydration, teamwork and sportsmanship are the simple lessons of athletic participation.
We can inadvertently pass the wrong message to athletes who do not have the genetic gift of speed, endurance, motor skill or motor planning that doing your best is not enough.
Coaching decisions regarding the use of ergogenic aids like creatine will shape the future of individual programs and the future of young athletes. The issues extend well beyond improved performance and safety into the realm of ethics, informed consent, reliability and responsibility.
In general, a coach should not recommend a substance to a minor without consulting the parents and should never recommend using a substance above the package or industry dosage or amount. As in the practice of medicine, your credo should be "first do no harm."
Here is a checklist for nutrition and substance recommendations to youth athletes:
Dr. William O. Roberts is a clinical associate professor at the University of Minnesota and a charter member of the American Medical Society for Sports Medicine. He is a member of the Sports Medicine Advisory Board for Minnesota High Schools and the USA Soccer Cup. Roberts is also a senior editor of the Sports Medicine Journal and has worked with various other publications. He currently resides in Bear Lake, Minn., where he is the director of the Twin Cities Marathon.