To me, the 4th of August 2012 feels like yesterday. It quickly became known as ‘Super Saturday’ – or in Sebastian Coe’s words, the “greatest day of sport I have ever witnessed.” And as the chief medical officer for the British track and field team at the time, it is difficult to disagree. Team Great Britain won three gold medals in one ‘golden hour’ at the London Olympics in the Games’ premier sport, athletics. I remember the ecstatic scenes, the tears, the celebrations, and my own thoughts about the difficult road to glory for our team’s three champions: Jessica Ennis (heptathlon), Greg Rutherford (long jump) and Mo Farah (10 000m). Together they had suffered illnesses, countless injuries, setbacks and ‘failures’. Mo and Greg failed to qualify for their respective finals at the Beijing Olympics in 2008 while a navicular stress fracture kept Jessica at home, immobilised in a walker boot.   

Reflecting on many challenging elite athlete health care and performance decisions, I have learnt five key lessons: (1) the athlete’s goal must be the common goal – they must be empowered to actively participate in careful and key shared decisions; (2) performance nearly always trumps prevention, prediction, protection (and all the other ‘fancy’ health box gift wraps); (3) high performance teamwork is always about respectful relationships; (4) practice ethical and evidence-based medicine – no exceptions, and (5) evidence is never only ‘medical’ or ‘scientific’ – it is also the evidence brought to the table by the expert athlete and the expert coach.

Although science must never be the only evidence, we cannot practice evidence-based health care without knowing current best evidence (the 5 A’s: ask a relevant question, acquire, appraise, apply and act on the best evidence). In this Post-Truth era of fakery, snake-oil salesmen and pseudo-science (also in sports medicine!) we unashamedly bring science to the table. I want to thank co-editor, Dr Milena Tomovic and all the authors who contributed to this target topic on athletics. We cover the latest evidence on managing tendinopathies, including challenging high-hamstring tendinopathies, stress fractures, groin injuries, injuries in youth athletics and hamstring muscle injuries. You can also read an excellent scientific analysis of what it will take to break the triple jump world record and the latest evidence on young talent development in athletics. We discuss the clinical approach to spondylolysis and an update on iron is to the point with many management pearls. Experienced sports physicians from South Africa provides travelling athletes and their support staff with invaluable practical advice to prevent illness and jet lag, while senior athletics clinicians and researchers in the field reflect on the urgent need to improve epidemiological research in athletics. Finally, reigning Olympic Heptathlon champion, Nafi Thiam provides wonderful perspectives on what it takes to be a young elite athlete – a true role model for many in the sport. 

The scientific evidence and its skilful real-world application presented here by experts from all over the world will inspire athletes, coaches, clinicians, and sport scientists to make better quality decisions. More importantly, I hope that this edition will empower the next generation ‘Super Saturday’ athletes to actively participate as equal partners concerning their health and performance.

Paul Dijkstra MD

Director of Medical Education

Consultant Sport & Exercise Medicine Physician

Milena Tomovic MD

Sport & Exercise Medicine Physician