Should Nat Fyfe be earning frequent flyer points?

It has recently been reported that following a lower leg fracture, sustained playing Australian Rules Football, star Dockers’ player Nat Fyfe was to be flown across Australia for surgery to treat the fracture (AAP, 2016). On first reading this poses some interesting questions.

• Are the Orthopaedic Surgeons in Perth not suitable to treat a lower leg fracture?
• Do elite athletes require special treatment when it comes to looking after their injuries?
• Are there negative effects to changing time zones to treat a fractured leg?

Of course a couple of these questions are a little problematic and open a can of worms, not so much based in science but in politics. For this reason, it’s probably best to stay out of the argument of whose health service is better and are elite athletes treated differently and instead look at the ramifications of travelling across the country for what appears to be a relatively simple procedure.

Over the years it has been reported that regular air travel reduces the careers of athletes. Researchers have quoted anecdotally that travelling across time zones can reduce athletic performance (Leatherwood & Dragoo, 2013). Moreover, it has been noted in some studies that travelling from west to east has a more detrimental effect (Leatherwood & Dragoo, 2013). Interestingly jet lag can be suffered with as little as a 1 hour time zone shift and jet lag has also been associated with a reduction in performance (Fowler, Duffield, & Vaile, 2015).

Air travel places other significant loads on the body. Most notably when related to oxygen use. Ordinarily oxygen saturation in blood in a healthy individual is 97%. During air travel oxygen saturation can drop to 88% (Geertsema, Williams, Dzendrowskyj, & Hanna, 2008). This is a significant reduction and would certainly not enhance recovery from injury and cell repair.

The other significant risk of air travel is deep vein thrombosis (DVT) and possible subsequent pulmonary embolism (PE). Some might think that this is unlikely to happen to healthy athletes, however studies have shown that when athletes travel to and from competition via airplane they are at increased risk (Parker et al., 2011). Prolonged travel activates the coagulatory system or blood clotting and combining this with endurance activity can shift the haemostatic balance and therefore increase the risk of DVT. As Parker et al (2011, pg. 130) reported “individuals who travel substantial distances to compete in endurance events may be at an increased risk of DVT”.

The concept of flying athletes across the country for surgery and interventions that can be conducted in the city in which they live is questionable. It raises serious questions regarding an athlete’s health and adding risk factors to their successful recovery. As I’ve outlined these can certainly be serious in nature and could curtail a career. Let’s hope those who make these decisions take all of the above evidence into account and aren’t making a decision based on friendships or alliances. We don’t need to see our young successful athletes being put at unnecessary risk.

AAP. (2016). Fremantle’s Nat Fyfe has broken leg, set for surgery as Dockers’ awful AFL season worsens. Retrieved April 25, 2016, from http://www.abc.net.au/news/2016-04-25/nat-fyfe-has-broken-leg-fremantle-dockers-afl/7355760?section=sport

Fowler, P., Duffield, R., & Vaile, J. (2015). Effects of simulated domestic and international air travel on sleep, performance, and recovery for team sports. Scandinavian Journal of Medicine and Science in Sports, 25(3), 441–451. doi:10.1111/sms.12227

Geertsema, C., Williams, A. B., Dzendrowskyj, P., & Hanna, C. (2008). Effect of commercial airline travel on oxygen saturation in athletes. British Journal of Sports Medicine, 42(11), 877–81. doi:10.1136/bjsm.2007.042960

Leatherwood, W. E., & Dragoo, J. L. (2013). Effect of airline travel on performance: a review of the literature. British Journal of Sports Medicine, 47(9), 561–7. doi:10.1136/bjsports-2012-091449

Parker, B., Augeri, A., Capizzi, J., Troyanos, C., Kriz, P., D’Hemecourt, P., & Thompson, P. (2011). Effect of air travel on exercise-induced coagulatory and fibrinolytic activation in marathon runners. Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine, 21(2), 126–130. doi:10.1097/JSM.0b013e31820edfa6