National Collegiate Athletic Association |
CommentFebruary 23, 1998
Guest editorial -- Focus on facts needed in creatine discusion
BY STEVE PLISK In the opinions section of the February 9 issue of The NCAA News, Dr. Charles Yesalis comments that the dietary supplement creatine "occurs naturally in the body, but so does testosterone." I am reminded of another statement in an article by an NCAA News staff writer to the effect that creatine has been compared with androgenic-anabolic steroids. These types of unqualified comparisons -- where fundamentally important differences between creatine and steroids are not acknowledged -- place student-athletes and coaches in a very challenging position when looking for answers. Athletes know that creatine is legal and readily available, and that it works. They have experienced or seen these results first-hand, and many are aware of the research demonstrating its effect on metabolic power, capacity and recoverability as well as muscle mass and strength. But they have also heard the half-truths, "health risk" rumors, and "cramping" or "death" allegations. Simply put, there is so much contrasting and emotionally charged information being circulated about creatine right now that athletes and coaches don't know what to believe. Comments such as those cited above serve only to complicate the situation, and consequently it is important to get some useful information on the table. Pertinent facts Creatine is a small protein (consisting of three amino acids) which -- at the risk of dignifying the comparisons mentioned above -- is not related to steroid compounds in any way. However, creatine does what every so-called "sports supplement" claims to do: it up-regulates muscle function and builds work capacity, lean mass and strength (in turn contributing to the misperception of it as just another "crash weight gain" powder). In fact, creatine's ergogenic value is due to its role in the Creatine Kinase-Phosphocreatine pathway in muscle tissue. A growing body of evidence indicates that this pathway is in fact a conduit through which cellular energy flux is coordinated in muscle (in addition to being an energy "buffer" or "capacitor"). As such, it may be more appropriate to compare creatine supplementation with the practice of carbohydrate loading as a means of improving metabolic power and capacity than it is to compare it with "body-building" supplements. Professor Yesalis' other comment about creatine was this: "You'd have to eat 10 to 20 pounds of red meat a day for the loading dose of creatine. That's fine...if you're a tiger." It is true that a five-gram teaspoonful of creatine is equivalent to that contained in approximately one kilogram of lean, raw meat. Furthermore, a four- to five-day loading phase typically involves about 20 grams per day of creatine intake, which in turn raises questions about the effects on endogenous synthesis and excretion. Ongoing research has already begun to shed some light on these issues:
These issues may be far from settled, and in fact a manuscript addressing them in greater detail is currently in press in Strength and Conditioning (the professional journal of the National Strength and Conditioning Association). The NSCA will also be addressing them in a six-hour symposium at its upcoming 21st NSCA Conference and Exhibition in June. In any case, there is a growing body of evidence verifying creatine's ergogenic and clinical efficacy (to back up the empirical claims); and rumor notwithstanding, there are no factual indications that it is unsafe. Due to ionic properties which tend to stabilize cellular membranes and prevent ischemic/hypoxic damage -- as well as enzyme and nucleotide loss -- intravenous or intramuscular phosphocreatine (not creatine) administration is used medically:
Since creatine monohydrate supplementation increases tissue creatine and phosphocreatine pools -- and heavy (especially eccentric) training is notorious for causing muscle cell disruption, albeit through a different mechanism than that seen in cardiac pathology -- it is possible that some indirect benefit may be achieved by scheduling creatine intake during recovery periods involving the greatest adaptive tissue remodeling (in keeping with the "zig-zag" concept proposed above). Furthermore, there is tentative evidence that dietary creatine ingestion can improve lipid profiles, possibly reducing the risk of atherosclerosis [Kreider, R.B. et al. Med. Sci. Sports Exer. 30: 73-82, 1998]. While I do not mean to inflame an already volatile issue, I am struggling with the simplistic view that creatine is responsible for health problems which, in reality, are the result of ignorance or lack of common sense (case in point: the "hydration" and "cramping" issues arising in football). The scene is not ubiquitous, but is still too familiar: athletes who pay the price during the off-season in terms of training and nutrition report to preseason camp, where they encounter a coach determined to "run them into shape" for consecutive days -- or weeks -- in summer heat with pads on. Please don't misunderstand me. Athletes must practice the way they are going to play, and football is a tough sport. But let's step back and think about this for a moment: By virtue of creatine supplementation and sound training, an athlete is capable of generating greater intramuscular heat, acid-base disturbances, dehydration, electrolyte wash-out and substrate depletion problems; and it is a fact that excessive work demands can do more to wear athletes down than can be done to prevent or treat it. Even the most effective and aggressive means of recovery or restoration cannot replete fuels, fluids, electrolytes -- and overall homeostasis -- if unrealistic workloads are inflicted over successive days (or weeks) in extreme environmental conditions. It follows that significant metabolic problems should arise, and in my opinion such athletes are lucky if muscle cramps or strains are the only result. This is just a working hypothesis, but it may well account for the perceived relationship between muscle dysfunction and creatine intake. Regarding the recent deaths in college wrestling, there is some debate about whether any (or all) of these athletes were using creatine or had used it in the past. I believe these discussions deflect attention away from the central issue. Let's suppose that all three athletes did indeed use creatine to enhance their strength and endurance, each accepting the possibility of gaining body mass in the process. Wrestlers are a different breed of athlete who embody a gritty attitude and "do what it takes" mentality better than perhaps any other sport. It is quite possible that these young men believed the performance advantage of using creatine would be worth the extra time and effort required to "cut" additional weight before competition and that there would be no extraordinary health consequences for doing so. But once again, let's do a reality check here: Athletes who achieve greater lean mass via training and supplementation will require more extreme weight loss methods in order to stay in a given body weight class and the inherent danger grows accordingly. Having digressed from the original point, the questions remain: Does creatine cause or contribute to health problems (or even death) in athletes? Or is simple nescience to blame? There are no easy answers to such explosive issues, which is precisely why we must address them rationally. This also brings us to yet another sticky issue: the state (and direction) of coaching education in college athletics. While most sport coaches have an excellent grasp of what's happening on the field, there are relatively few who really understand and apply what's happening under the skin. Are coaches and administrators aware that the body synthesizes creatine in different tissues, utilizes it via different mechanisms, and clears it through different pathways than testosterone? In most cases, probably not, but incomplete information such as that cited above does not help them fulfill their responsibility to provide athletes with accurate information and guidance. The point is that prompt and proactive changes are triggered by scenarios where student-athletes' health and well-being is the central concern (as they should be). In our zeal to resolve such problems, we must keep in mind that it can only be achieved by focusing on the complete picture. Steven S. Plisk is director of sports conditioning at Yale University. The story noted in the first paragraph was published October 28, 1996. The phrase cited by the author did appear in that article, but the context was that casual comparisons have been made between creatine and steroids because both result in increased mass. The article contained cautionary comments about creatine from members of the sports-medicine community, but it also included information about research that had found no negative effects resulting from creatine use. At its most recent meeting, the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports recommended funding for three research projects on the physiological effects (other than performance) of the use of creatine by male and female collegiate student-athletes. Comment -- Convention should bond the membershipThis article first appeared in The Intercollegiate Athletic Forum:
BY WILLIAM A. MARSHALL After having been privileged to attend and participate in 27 annual NCAA Conventions, it was sad to see the three divisions of the Association go their separate ways in 1998. For years, there was a spirited exchange of ideas, philosophies and information among the institutions, conferences and individuals from all divisions that many members looked forward to as decisions concerning the place and value of intercollegiate sport in higher education were debated. The exchanges took place in committees, among the division steering committees, in the hallways and on the floor of the Convention. It was educational and enlightening to hear the various philosophical positions being espoused by the membership, which learned from each other in the process. The sharing and cross-pollination that resulted benefited higher education and ultimately the student-athlete. While the three divisions will continue to meet and debate about their own problems, the depth of the discussion will necessarily become more provincial. Gone are the days when the entire NCAA membership listened to an impassioned and eloquent speech from Father Edmund Joyce of Notre Dame or coach Joe Paterno making a case for a football-related piece of legislation or the Division III membership voting for women's championships in their division, of the "Three for Three" debate when changes in divisional membership criteria were being considered. While change may have been inevitable with many good things flowing from restructuring, in some global respects, we will also be poorer for it. An example: Donna E. Shalala, U.S. secretary of health and human services and formerly chancellor of the University of Wisconsin, Madison, was at the 1998 Convention and addressed the Division I membership. What a shame that Divisions II and III weren't invited or provided with an opportunity to hear and benefit from her message. With the technology available to the NCAA, her message could have been shared electronically in a number of locations if no room large enough to hold the total membership was available. In the future, the NCAA leadership should look for ways to bring the entire membership together for events other than the opening session and the honors dinner. Interdivisional interaction is needed. Extending an invitation to visit other division business meetings and debates, personally or electronically, would provide learning opportunities for individuals who are interested in broadening their experiences. William A. Marshall is director of athletics at Franklin and Marshall College. Opinions -- Football recruiting overhyped, overanalyzed, overdone
Paul Daugherty, columnist "I love college basketball. I'm not thrilled with how they play it now. It's aerobic gymnastics. It's nonstop auditions for Play of the Day. It could use a good chest pass. "The game isn't deteriorating, goes the other argument. It's evolving. If basketball used to be marching music, regimented, orderly and full of chest passes, now it's jazz, free-flowing, improvisational and full of fill-it-up. "That's great, if you like jazz.... "Teaching has been overrun by highlights. What kid shoots a squared-up 15-foot jumper now, when he can back up three feet and let fly a triple? Layups belong with Bob Cousy. In lots of places, so do boxing out, taking smart shots and working on free-throw shooting. Does anyone work on free-throw shooting?.... "College basketball is still the best game. It's more exciting than ever, even as its best players treat it as an errand on the way to the bank. But more exciting doesn't mean better. And college ball is not better."
Rob Daniels, sportswriter "(The February 3) Duke-North Carolina game won't decide the NCAA championship. It will be only the first of definitely two, probably three and possibly four meetings between the teams in the next eight weeks. "So hype may be a trifle silly. It is also undeniably good. "A basketball game can't restore your faith in a world where 8-year-old kids learn to ride bikes so they can ferry crack from one bad neighborhood to the next. It can't stop you from wondering why Ted Kaczynski lives and Arthur Ashe is dead. But taken on its own level, at least the magnitude of Duke-UNC and its return to national prominence make you believe college basketball can be relevant again."
Initial-eligibility standards
Emeral A. Crosby, principal "The problem isn't with the NCAA raising the bar, it's with how high and how fast it's raised."
Fighting in ice hockey
Larry Atkins, columnist "This is the biggest rationale for hockey fighting -- that it is part of the game because of the physical nature of the sport. Yet, you don't see fights in the NFL, even with big, fat, sloppy 325-pound linemen hammering the heck out of each other on every play. The NBA is strictly against fighting -- just look at the recent two-game suspension of the 76ers' Derrick Coleman for his altercation with Corliss Williamson of the Sacramento Kings. If fighting is an integral part of ice hockey, why is it not allowed in the Olympics or in high-school and college hockey? "Hockey fighting is not tolerated in the NCAA. If a player has a fight in a game, he is disqualified for that game as well as the next game. If the same player fights again later in the same season, he is disqualified for that game and the next two games. Likewise, fighting is not tolerated in the Olympics. If a player fights during an Olympic game, the International Ice Hockey Federation Rules mandate a minimum one-game suspension, with the possibility of a discipline committee imposing further penalties. "Sure, to many people, fighting makes hockey more entertaining. Then again, nude cheerleaders would spice up the NFL and giant windmills and other obstacles planted on the course would make golf more interesting. "If you want to see pro athletes slug it out, watch boxing in Las Vegas or Atlantic City. Buy Evander Holyfield's next fight on pay-per-view. Watch kick-boxing on ESPN. "I'm not saying that the NHL should become as dainty as the Ice Capades. You still can have exciting hockey with hard-hitting checks and digging for the puck in the corners. But the NHL has to ban fighting if it ever wants to be taken seriously as a major sport. Otherwise, it still will be perceived as the Three Stooges on ice. With twice as many eye pokes."
Recruiting
Roy Williams, men's basketball coach "Up until the last couple of years I have enjoyed recruiting. I don't enjoy it 99.9 percent of the cases now. It's always been hard and it's always been a little demeaning, but it's gotten to be very demeaning, distasteful. "If it wasn't for (recruiting), I'd work for the minimum wage and be the happiest guy in the world. But...because of that, there isn't enough money to pay you to make you feel like it's worth putting up with some of the stuff you put up with."
Women's ice hockey
Kerry Miller, ice hockey player "I feel like we get patronized a lot. People don't treat us as seriously as the boys, because they don't think it's going to go anywhere."
Sara Stern, ice hockey player "People come to our games and you're not just playing for your team, you're playing for all women. If a boy messes up, they'll say, 'Well, he's not that good.' But if we mess up, people think girls' hockey is not that good. It puts added pressure on us. We may not be as physical as the men, but we deserve respect. We work just as hard as they do."
Sponsorship by beer companies
Rick Taylor, athletics director "It's a dilemma a lot of s |