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Yesterday's heroes
  1. Domhnall Macauley
  1. Editor, British Journal of Sports Medicine

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    Yesterday's heroes living on their memories. A great past to look forward to. It comes to us all. The day you realise that your past has arrived and that, inevitably, your future is downhill. When life is sweet, races run fast, there is no tomorrow. Success leads to success, every training session brings new challenges and every season new opportunities. Kick off the bend, the roar of the crowd. But that someday always comes. When athletes begin to choose their races, players worry about the coming season, and boxers believe in that last great fight. Maybe an injury, perhaps a missed tackle, a training session that hurts just a little too much, or a race that slips out of reach. The doubts begin. Anno Domini offers relentless opposition.

    Sport creates its own heroes. We worship our sporting idols, the Olympic champions, the international footballers, and the leading players in our chosen sport. We cherish them at their peak, but soon forget. A half time hotdog. Professional athletes may be well paid, but they are in the minority. The lucky ones have an income and sponsorship that gives them an independent livelihood. Others dedicate their lives to minority amateur sports for a brief moment of televised glory every four years. And then it ends.

    We know what it takes to make champions: the dedication, the determination, and the sacrifices. National figures become international celebrities. Anonymity becomes a household name. Even those who play on the village team are feted locally. For a while. Having dedicated their young life to sport, given up educational opportunities and potential employment, they are left to fend for themselves when their sporting career is over. No skills, no qualifications, just a handful of medals and a drawer full of tracksuits. But no job.

    The life change is enormous. Yesterday a hero, today discarded. Perhaps it is time to ask if those who dedicate their lives to sport know the price they pay. We know that some may suffer injury that haunts them for the rest of their lives. But, even those with a successful career may be psychologically scarred by the inevitable slide from hero to zero. Public opinion, sporting administration (and that includes you!) encourage young people to aim for sporting excellence, and we are not afraid to show them what is needed. But, the opportunity costs are huge. We read in the newspapers that young people are not interested in committing themselves to top level sport. If they know the price, it is little wonder.

    Perhaps we in sport and exercise medicine have a responsibility. If we are truly on the side of the athlete, our care should be focused not just on the moment and the next event but in the future. Our duty of care may extend to holistic care beyond their sporting career. We may have an administrative position on a national body, in an international committee, within a sporting institute and, with it, the opportunity to influence the long term of athletes. Athletes need to know to prepare for life after sport, to achieve the educational qualifications to enable them to make their way in the world after sport. They must be psychologically prepared for the ego crash on the way downhill. We have a duty to prepare the way, in detraining athletes, in cushioning their fall from stardom, and rehabilitating them into the real after life in the sporting incubator. A market economy leaves them on their own, the sporting machine spits them out after use, and when the new generation moves in yesterday's heroes get in the way. There is no one else to speak up for these former athletes. Those who cope survive, those who cannot cope are still our patients. As doctors, we are our patients' advocate.

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