TSA Medical Commission Proposal

Triathlon South Africa has established a medical commission to advise on team medical issues and other matters related to sports medicine and drugs in sport. The medical commission will have input into the safety and well being of the athletes, and be available to advise athletes and coaches should such assistance be requested.

Medical Commission Members:
Andrew Jansen Van Rensburg – Physiotherapist and ITU Certified Triathlon Coach.
Dr Demitri Constantinou– Sports Physician
Prof Yoga Coopoo – Biokinetist

The role of the Medical Commission is:

  • Counsel TSA on all medical issues pertaining to events.
  • Assess the sports medicine requirements and nominations received for various TSA sanctioned teams, and make recommendations to TSA.
  • Advise TSA on sports medicine and drugs in sport issues.
  • Advise TSA on changes in treatment of sports injuries, acclimatization programs and training problems as they relate to injuries.
  • Provide sports medicine and drugs in sport advice to athletes with medical problems, questions and concerns.
  • Keeping athletes in line with WADA requirements at all times.
  • Assist in setting up a medical team to assist the athletes at major events.
  • Program and conduct medical assessments of team members after selection should this be requested.
  • Provide other sports medicine advice and services as requested by TSA.
  • Interact at conferences with agendas containing issues relevant to the medical commission.

Resource for the athletes:

A direct link to the world anti doping web site, to ensure they receive up to date restrictions on medications etc they are permitted to take

What is WADA?The World Anti-Doping Agency is the international independent organization responsible for promoting, co-coordinating and monitoring the fight against doping in all its forms. WADA works towards a vision of the world that values and fosters doping free sport

For queries, concerns or ideas please email:

South Africa has a drug free sport resource on

Prevention of injury

New studies have shown that static stretching before exercise actually causes the stretched muscle to become 15% weaker for 10 minutes after stretching. Therefore, the best pre-exercise routine is to do a 5 to 10 minute warm up, then do DYNAMIC STRETCHING before exercise.

Dynamic stretching is the same positions as regular static stretching, but doing slow controlled movements increasing and decreasing the stretch. It is important not to bounce or rush. Take 20 to 30 seconds per muscle to dynamically stretch prior to exercise.

After exercise it has been proven that if you do not statically stretch, you are 50% more likely to pick up an injury. Therefore after exercise, you should cool down for 5 to 10 minutes and do STATIC STRETCHING on muscles for 30 seconds each side. This stretching should be felt in the muscle belly for optimum efficacy. If you do pick up an injury, ice the area as soon as possible and use a crepe bandage for moderate compression. Anti inflammatory tablets or rubs can be used dependant on the severity of the injury. Rest periods vary on the injury. If you are in doubt, get a full assessment by a physiotherapist. You can find a physiotherapist by location and speciality at no cost by logging on to

Stretching Guidelines

  • Use dynamic (slow moving and controlled stretches) before exercise and static stretching after exercise.
  • Hold stretches for 30 to 45 seconds.
  • Never feel pain during a stretch, the feeling of a strong stretch is adequate.


1. The Figure 4 Stretch
The stretch is performed by lying on the back, bending both knees along the floor, then crossing one leg over the other as shown. Lift the straight leg using your hands and hold the stretch.

2. Glute Medius Stretch
The stretch is performed by lying on the back, bending one leg to a 90 dergree position at the hip and knee. Pull the bent knee to the opposite shoulder and hold the stretch.

3. Hamstring Stretch.
Lying on the back, use a towel or a theraband under the foot and lift the leg. Ensure the knee remains straight and the pelvis stays on the floor. Hold the stretch.

4. ITB Stretch
From the hamstring stretch position, point the side of the foot upward (invert the foot) and pull the leg inward towards the opposite leg. Hold the stretch.

5. Shell Stretch
Starting position is on all 4s, stretch back so that your buttocks reach your heels. This is a gentle stretch for the back extensors. Hold the stretch.

6. Diagonal Shell Stretch
Starting from all 4s, place one hand on top of the other, and diagonally stretch your body toward the opposite side. Hold the stretch.

7. Diagonal Neck Stretch
Place one hand behind your back, using the opposite hand pull your nose into your armpit. Hold the stretch.

8. Sub Occipital Stretch
Sitting upright, tuck the chin in and extend the neck. The stretch should pull just below the skull. Hold the stretch.

Stretches compiled by Andrew Jansen Van Rensburg BSc (Physiotherapy) WITS and ITU Certified Triathlon Coach.

Doping in sport

The use of drugs and performance enhancing drugs in sport goes back to ancient times, when various concoctions were used by athletes. The word “doping” in fact comes from the Dutch / South African word “dop’ – the name of an alcoholic drink made of grape skins used by Zulu warriors in order to enhance their performance in battle.The International Olympic Committee in 1963 first published a list of prohibited drugs, and some were on the list even though they were not able to be detected; such as anabolic steroids. After the events that shook the world of cycling in the summer of 1998, the IOC decided to convene a World Conference on Doping, bringing together all parties involved in the fight against doping.

This conference in 1999 led to the Lausanne Declaration on Doping in Sport. This document provided for the creation of an independent international anti-doping agency to be fully operational for the Olympic Games in Sydney in 2000.

Thus the World Anti-Doping Agency was established on 10 November 1999 in Lausanne to promote and coordinate the fight against doping in sport internationally. WADA was therefore set up as a foundation under the initiative of the IOC with the support and participation of intergovernmental organizations, governments, public authorities, and other public and private bodies fighting against doping in sport. WADA is therefore the international independent organization created in 1999 to promote, coordinate, and monitor the fight against doping in sport in all its forms. WADA’s chief activities focus on seven areas reflecting the importance of a comprehensive approach to the fight against doping in sport:
Code Adoption, Implementation & Compliance:
Science & Medicine:
Anti-doping Coordination:
Anti-Doping Development:
Athlete Outreach:
Out-of-competition Testing:

One of the most important achievements to date in the fight against doping in sport has been the drafting, acceptance, and implementation of a uniform set of anti-doping rules, the World Anti-Doping Code (Code).

The Code is the core document that provides the framework for harmonized anti-doping policies, rules, and regulations within sport organizations and among public authorities.

Since 2004 WADA is responsible for the preparation and publication of a list of prohibited substances and methods (the List). An annual updated List is published by October 1 and it comes into effect on January 1 the following year.

It is an International Standard identifying Substances and Methods prohibited in-competition, out-of-competition, and in particular sports.

Substances and methods are classified by categories (e.g., steroids, stimulants, gene doping).

The use of any Prohibited Substance by an athlete for medical reasons is possible by virtue of a Therapeutic Use Exemption.

Athletes are strictly liable whenever a prohibited substance is found in their bodily specimen. This means that a violation occurs whether or not the athlete intentionally or unintentionally, knowingly or unknowingly, used a prohibited substance or was negligent or otherwise at fault. Ignorance is never an excuse.

Athletes should always be very cautious is recommended regarding supplement use.

A significant number of positive tests have been attributed to the misuse of supplements, and taking a poorly labelled dietary supplement is not an adequate defence in a doping hearing.

Athletes, like anybody else may suffer from medical conditions that need treatment. If the treatment is a prohibited substance, then he/she can apply to use that medication, without fear of testing positive. They will need to apply and obtain a therapeutic use exemption (TUE) in advance from the International Federation or National Anti-doping Organization (NADO) (South African Institute for Drug Free Sport – SAIDS).

The TUE will be taken into consideration if the substance is detected in the athlete’s sample and it will protect the athlete from sanctions if the medical justification is confirmed. A TUE Committee reviews all applications. The decisions are sent to WADA, who check these. If an athlete appeals a decision, they may do so with WADA. There are strict guidelines and criteria for granting TUE’s.

If an athlete is tested, the laboratory that has analysed the “A” sample will report the results to the NADO and WADA. The samples analysed by labs are identified by code numbers and not the athlete names, ensuring confidentiality and no bias in the outcomes. If there is an Adverse Analytical Finding (AAF) on the “A” sample, the organization responsible for results management will conduct an initial review to verify whether there is a valid TUE in place and to ensure that sample collection and analysis was conducted according to correct procedures.

If the initial review does not justify the AAF, the athlete is informed in writing of the results and the rights regarding the analysis of the “B” sample. At this point, the athlete will be provisionally suspended. If the athlete decides to have the “B” sample analysed, the athlete may attend or choose to send a representative on their behalf. Please note that the B sample is the same as the A, but is still sealed. It is not, as is often assumed, another test. Should the “B” sample analysis confirm the “A” sample analysis, the NADO will proceed with the results management process, which includes the right to a fair hearing. The hearing will determine whether an anti-doping rule violation has occurred as well as determine what sanctions will be imposed. The sanctions are standardized for the doping offence, and whether it is a first or subsequent violation. In the event that the “B” sample analysis does not confirm the “A” sample analysis the test result will be invalidated and no further action will be taken. This is extremely rare. An athlete has the right to appeal any decision regarding a positive test or a sanction imposed. This can in the first instance be filed with the SAIDS, and then to the IF and finally to the Court of Arbitration for Sport (CAS). If CAS or an appeal tribunal rules otherwise, the initial decision remains in effect while under appeal.

Demitri Constantinou

Articles of Interest

  • Acromioclavicular Joint Injuries – Dr. Ferguson
  • Exercise and Illness – Dr. Ilsley
  • Feet Issues and Alignment – Paolo Ghiselli
  • Hip Arthroscopy – Dr. Cakic
  • Hipand Knee Replacements – Dr. Barlin
  • Road Rash and Sun Protection – Dr Kelly
  • Triathlete Knee Problems – Dr Vardi
  • Result Management and Sanctions – Dr. Ismail Jakoet
Therapeutic Use Exemption

A TUE form are to be completed by your Health Care Professional and sent to SAIDS in the case of Therapeutic Use Exemption.

Click here for TUE form



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