The era that John Betjeman referred to when nostalgically writing about Joan Hunter Dunn playing tennis at Aldershot, or even John Major’s more recent memories of the sound of a cricket bat hitting a ball before it whistles off to the boundary, are very different from today’s “barmy army” cricket. The days are past when a county cricket side could find themselves one man short, as Sussex did in 1919, and call upon one of their spectators, Harold Heygate, to fill the gap in the team.

Heygate hadn’t played first-class cricket in 14 years but, even so, he strapped pads over his suit and headed to the wicket. Unfortunately his war wounds and arthritis were such that he couldn’t hobble to the crease in time and was ruled “out, absent”.

Cricket, tennis, rugby, football and every other game that has become professional are no longer associated with lazy days in the sun, or played as an excuse for a post-match booze-up on a Saturday evening. Games these days are competitive and won only if the athletes are prepared to sacrifice their long-term muscular-skeletal systems for the greater glory of their team and encouraging entries on their bank statements.

The risk of being asked to make an irremedial sacrifice may not be as great as it was for the Roman gladiator but the same principle applies. The crowds have their spectacles and, in return, the players receive medals and, occasionally, a cup to carry home to the trophy cupboard. They also get early arthritic hips, damaged knees and ankles, painful, immobile shoulders and prematurely aged spines.

Whatever the sport, an athlete, once he is no longer able to maintain the rigorous exercise schedules needed to remain in peak athletic condition, becomes a candidate for obesity and cardiovascular and metabolic diseases.

As most of the immediate damage is to joints, tendons and ligaments, the role of anti-inflammatory drugs is all-important in the treatment of athletes. For the past 40 years doctors have used aspirin and paracetamol to supplement the non-steroidal anti-inflammatory drugs (NSAIDs) that counteract the pain and stiffness of inflamed joints.

The increasing number of NSAIDs include ibuprofen, indomethacin, mefenamic acid (Ponstan), diclofenac (Voltarol) and my favourite, Arthrotec — a combination of diclofenac and misoprostol. The latter serves to avert some of the gastrointestinal troubles that can result from taking NSAIDs.

The NSAIDs inhibit the enzyme COX-1 (which speeds up the action of chemical messengers, called prostaglandins, within the stomach). An apparent advance about 15 years ago was the introduction of COX-2 inhibitors. These are less likely to cause the potentially dangerous gastrointestinal bleeding that is the curse of COX-1 NSAIDs.

Unfortunately the COX-2s were associated with a small increase in the incidence of heart disease and many were withdrawn as a result.

This was perhaps overly cautious — no effective drug is without side effects. Some former cricketers might be prepared to increase their chances of coronary arterial disease by a fraction if it meant that they could walk to the shops, climb stairs and enjoy the odd trip to Lord’s.

Etoricoxib (Arcoxia), one of the COX-2 inhibitors that is a reliable treatment for the pain and inflammation caused by arthritis, is equally effective in dealing with other forms of arthritis and inflammatory conditions.

Fortunately it escaped the strictures applied to other selective COX-2 inhibitors. A recent study conducted in 38 countries over four years, involving 34,000 patients, has shown that my faith in etoricoxib has not been misplaced.

The COX-2s were developed to provide pain relief and anti-inflammatory treatment that is just as effective as that provided traditionally by the COX-1 NSAIDs, but with improved gastrointestinal safety.

The trial has shown that there was no increased incidence of coronary thrombosis in those patients taking etoricoxib instead of diclofenac, which is the most commonly prescribed anti-inflammatory agent worldwide.

In patients taking etoricoxib there was the expected reduction in gut problems. When extoricoxib was given in very large doses there was some increase in blood pressure and its associated symptoms, but these were not found in patients given the usual standard dose.

SPORT CAN SERIOUSLY DAMAGE YOUR HEALTH

It is not only the traditional sports of cricket, football, tennis and rugby that are associated with injury:

Squash, paintballing and football have the highest records of eye injuries.