Article

Performance success or failure is explained by weeks lost to injury and illness in elite Australian Track and Field athletes: a 5-year prospective study

January 2016
Journal of Science and Medicine in Sport 19(10)

DOI:10.1016/j.jsams.2015.12.515

Authors:

Ben Raysmith

Western Australia Institute of Sport

Michael Keith Drew

Institution

Objectives To investigate the impact of training modification on achieving performance goals. Previous research demonstrates an inverse relationship between injury burden and success in team sports. It is unknown whether this relationship exists within individual sport such as athletics. Design A prospective, cohort study (n = 33 International Track and Field Athletes; 76 athlete seasons) across five international competition seasons. Methods Athlete training status was recorded weekly over a 5-year period. Over the 6-month preparation season, relationships between training weeks completed, the number of injury/illness events and the success or failure of a performance goal at major championships was investigated. Two-by-two table were constructed and attributable risks in the exposed (AFE) calculated. A mixed-model, logistic regression was used to determine the relationship between failure and burden per injury/illness. Receiver Operator Curve (ROC) analysis was performed to ascertain the optimal threshold of training week completion to maximise the chance of success. Results Likelihood of achieving a performance goal increased by 7-times in those that completed >80% of planned training weeks (AUC, 0.72; 95%CI 0.64-0.81). Training availability accounted for 86% of successful seasons (AFE = 0.86, 95%CI, 0.46 to 0.96). The majority of new injuries occurred within the first month of the preparation season (30%) and most illnesses occurred within 2-months of the event (50%). For every modified training week the chance of success significantly reduced (OR = 0.74, 95%CI 0.58 to 0.94). Conclusions Injuries and illnesses, and their influence on training availability, during preparation are major determinants of an athlete's chance of performance goal success or failure at the international level.

Sprint Acceleration Mechanical Outputs and Lower Limb Injuries: A Follow-Up of Sprint, Jumps and Combined Events Athletes during an Athletics Season

Article

Jun 2024

Problem: We aimed to explore the potential association between sprint running horizontal force production capacities (the theoretical maximum horizontal force that the lower limbs can produce at zero velocity: FH0, and the theoretical maximum velocity until which they can produce force (velocity at zero force): v0 ) and occurrence of lower limb injuries (LLI) in athletics (track and field) athletes through a season. Methods: We performed a prospective cohort study with data collection of FH0 and v0 and their week-to-week changes (dFH0 and dv0 , respectively) and LLI in 16 athletes practicing sprints, jumps or combined events in the same training group during the 2021/2022 season (37 weeks). We performed a multivariable binomial logistic regression with LLI (yes/no) as the dependent variable, and FH0 and v0 , dFH0 and dv0 as explanatory variables, adjusted for individual athletes and LLI during the previous week (yes/no). Risk indicators were presented as odd ratios (OR) and 95% confidence intervals (95% CI). › Results: The multivariable binomial logistic regression showed that a higher FH0 was associated with lower LLI risk (OR=0.12 (95%CI: 0.00-0.89). Conclusion: Lower FH0 was associated with higher risk of sustaining a new lower limb injury during the next week. Although caution should be taken on these preliminary results (e.g., small athletes’ sample, missing measurements, few confounding factors included), monitoring the FH0 could be one additional relevant approach to detect LLI in athletics.

Injury and illness in short-course triathletes: A systematic review

Article

Full-text available

Mar 2023

Background: Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of prevention strategies. This study synthesizes the existing evidence on the incidence and/or prevalence of injury and illness and summarizes reported injury or illness etiology and risk factors affecting short-course triathletes. Method: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies reporting health problems (injury and illness) in triathletes (all sexes, ages, and experience levels) training and/or competing in short-course distances were included. Six electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, Embase, APA PsychINFO, Web of Science Core Collection, and SPORTDiscus) were searched. Risk of bias was independently assessed by 2 reviewers using the Newcastle-Ottawa Quality Assessment Scale. Two authors independently completed data extraction. Results: The search yielded 7998 studies, with 42 studies eligible for inclusion. Twenty-three studies investigated injury, 24 studies investigated illnesses, and 4 studies investigated both injuries and illnesses. The injury incidence rate was 15.7-24.3 per 1000 athlete exposures, and the illness incidence rate was 1.8-13.1 per 1000 athlete days. Injury and illness prevalence ranged between 2%-15% and 6%-84% respectively. Most injuries reported occurred during running (45%-92%), and the most frequently reported illnesses affected the gastrointestinal (7%-70%), cardiovascular (14%-59%), and respiratory systems (5%-60%). Conclusion: The most frequently reported health problems in short-course triathletes were: overuse, lower limb injuries associated with running; gastrointestinal illnesses and altered cardiac function, primarily attributable to environmental factors; and respiratory illness mostly caused by infection.

Faulty Hip and Pelvis Biomechanics Do Not Differentiate Between 5k Performance in NCAA Division II Cross-Country Runners: Original Research

Article

Full-text available

Jan 2023

Introduction: Excessive hip adduction (HADD) and contralateral pelvis drop (CPD) angles during running are associated with running-related injuries. Their influence on performance is less known. Therefore, we aimed to determine if HADD and CPD could differentiate between high and low race performers, and if there were relationships between CPD, HADD and race performance. Methods: Twenty-six healthy male and female NCAA Division II cross-country runners participated in this prospective study. They underwent 3D motion analysis of their HADD and CPD during pre-participation physical examinations. Times from the first race of the season were converted to International Association of Athletics Federation (IAAF) points and high and low performance groups were created. Pearson correlation coefficients were used to examine the associations between HADD, CPD and IAAF points, and Independent Samples T-tests were used to determine differences in HADD and CPD between high and low performance groups. Results: There were no significant relationships between IAAF points and left HADD (r=0.11, p=0.59), right HADD (r=0.19, p=0.35), left CPD (r=-0.06, p=0.79), or right CPD (r=-0.06, p=0.76). There were no significant differences between high and low performance groups in left HADD (t(24)=0.48, p=0.64), right HADD (t(24)=0.45, p=0.33), left CPD (t(24)=0.62, p=0.27), or right CPD (t(24)=0.53, p=0.30). Conclusions: The RRI biomechanics of excessive CPD and HADD do not influence 5k race performance in collegiate distance runners.

Relative Energy Deficiency in Sport (RED-S): Scientific, Clinical, and Practical Implications for the Female Athlete

Article

Full-text available

Jul 2022

Problem: If athletes develop low energy availability (LEA), it can lead to a Relative Energy Deficiency in Sport (RED-S) syndrome which has severe health consequences if not treated. Methodology: A narrative review of the most recent and pertinent literature on the topic, with special emphasis on women. Results: In assessing the current literature, we have synthesized: i) the scientific implications of LEA and RED-S, ii) the clinical manifestations of the conditions currently available for detection, as well as iii) the practical implications for healthcare and support for female athletes and teams in planning intervention or prevention strategies (maintaining EA >45 kcal/kg FFM/day). Discussion: The 'Female Athlete Triad" emerged in the 1990s as researchers understood more of the etiological adaptation of female athlete health to sports training. In the last 10 years, the scientific community has recognized that the 'Triad' approach was too narrow in focus, and the broader concept of RED-S emerged. Both the Triad and RED-S are consequences of a frequently prevalent LEA in athletes (<30 kcal/kg FFM/day). Developing LEA and RED-S compromises training adaptation, performance capacity, and health in athletes. For these reasons, it is critical that an athlete's support team recognize the behaviors that may indicate RED-S evolution. In this way, we can assist female athletes in reaching their full potential in sports while protecting their health.

Beyond Menstrual Dysfunction: Does Altered Endocrine Function Caused by Problematic Low Energy Availability Impair Health and Sports Performance in Female Athletes?

Article

Full-text available

Jul 2024
SPORTS MED

Low energy availability, particularly when problematic (i.e., prolonged and/or severe), has numerous negative consequences for health and sports performance as characterized in relative energy deficiency in sport. These consequences may be driven by disturbances in endocrine function, although scientific evidence clearly linking endocrine dysfunction to decreased sports performance and blunted or diminished training adaptations is limited. We describe how low energy availability-induced changes in sex hormones manifest as menstrual dysfunction and accompanying hormonal dysfunction in other endocrine axes that lead to adverse health outcomes, including negative bone health, impaired metabolic activity, undesired outcomes for body composition, altered immune response, problematic cardiovascular outcomes, iron deficiency, as well as impaired endurance performance and force production, all of which ultimately may influence athlete health and performance. Where identifiable menstrual dysfunction indicates hypothalamic-pituitary-ovarian axis dysfunction, concomitant disturbances in other hormonal axes and their impact on the athlete’s health and sports performance must be recognized as well. Given that the margin between podium positions and “losing” in competitive sports can be very small, several important questions regarding low energy availability, endocrinology, and the mechanisms behind impaired training adaptations and sports performance have yet to be explored.

Epidemiology of bone injuries in elite athletics: A prospective 9-year cohort study

Article

Mar 2024

Injury risk reduction perceptions in athletics: Survey on elite athletes and stakeholders participating at the Munich 2022 European Championships.

Article

Full-text available

Oct 2023

Problem: We aimed to explore the perceptions and behaviours of athletics (track and field) stakeholders towards injury risk reduction. Methods: We conducted a cross-sectional study in athletes, coaches, health professionals and team leaders registered for athletics at the 2022 European Athletics championships in Munich (Germany), using an online questionnaire asking about their perceptions and behaviours towards injury risk reduction scored with a scale from disagree-0 to agree-100. Results: There were 71 participants (2.9%): 30 athletes, 10 coaches, 28 health professionals and 3 team leaders from 16 countries. In general, they were very likely to agree that injury is part of the sport (mean±SD) 80±22), injury risk should be taken into account for life choices (75±23), while less likely to think that risking injury is not totally necessary to achieve peak performance (53±32). Most of them were likely to adopt injury risk reduction strategies in their daily life/practice (82±19), warm-up, hydration, and listening to pain were the most frequently adopted/ suggested strategies, while digestive naps, psychological support, and mental preparation being the less likely. Conclusions: These results provide a clear and relevant orientation to improve and develop injury risk reduction measures/ strategies and their adoption and implementation.

Direct and indirect impact of low energy availability on sports performance

Article

Full-text available

Mar 2023
SCAND J MED SCI SPOR

Low energy availability (LEA) occurs inadvertently and purposefully in many athletes across numerous sports; and well planned, supervised periods with moderate LEA can improve body composition and power to weight ratio possibly enhancing performance in some sports. LEA however has the potential to have negative effects on a multitude of physiological and psychological systems in female and male athletes. Systems such as the endocrine, cardiovascular, metabolism, reproductive, immune, mental perception, and motivation as well as behaviors can all be impacted by severe (serious and/or prolonged or chronic) LEA. Such widely diverse effects can influence the health status, training adaptation, and performance outcomes of athletes leading to both direct changes (e.g., decreased strength and endurance) as well as indirect changes (e.g., reduced training response, increased risk of injury) in performance. To date, performance implications have not been well examined relative to LEA. Therefore, the intent of this narrative review is to characterize the effects of short-, medium-, and longterm exposure to LEA on direct and indirect sports performance outcomes. In doing so we have focused both on laboratory settings as well as descriptive athletic case-study-type experiential evidence.

The Relationship Between Training Load and Injury in Competitive Swimming: A Two-Year Longitudinal Study

Article

Full-text available

Nov 2024

Training load monitoring is employed to quantify training demands, to determine individual physiological adaptions and to examine the dose-response relationship, ultimately reducing the likelihood of injury and making a meaningful impact on performance. The purpose of this study is to explore the relationship between training load and injury in competitive swimmers, using the session rate of perceived exertion (sRPE) method. Data were collected using a prospective, longitudinal study design across 104 weeks. Data were collected from 34 athletes centralised in two of Swim Ireland's National Centres. Bayesian mixed effects logistic regression models were used to analyse the relationship between sRPE-TL and medical attention injuries. The average weekly swim volume was 33.5 ± 12.9 km. The weekly total training load (AU) averaged 3838 ± 1616.1. A total of 58 medical attention injury events were recorded. The probability of an association between training load and injury ranged from 70% to 98%; however, evidence for these relationships was deemed weak or highly uncertain. The findings suggest that using a single training load metric in isolation cannot decisively inform when an injury will occur. Instead, coaches should utilise monitoring tools to ensure that the athletes are exposed to an appropriate training load to optimise physiological adaptation. Future research should strive to investigate the relationship between additional risk factors (e.g., wellbeing, lifestyle factors or previous injury history), in combination with training load and injury, in competitive swimmers.

Boston Marathon athlete performance outcomes and intra-event medical encounter risk associated with low energy availability indicators

Article

Full-text available

Nov 2024

Objective To determine the association between survey-based self-reported problematic low energy availability indicators (LEA-I) and race performance and intra-event medical encounters during the Boston Marathon. Methods 1030 runners who were registered for the 2022 Boston Marathon completed an electronic survey (1–4 weeks pre-race) assessing LEA-I, training and medical history. De-identified survey data were linked to event wearable timing chips and medical encounter records. LEA-I was defined as: an elevated Eating Disorder Examination Questionnaire score, elevated Low Energy Availability (LEA) in Females Questionnaire score, LEA in Males Questionnaire with a focus on gonadal dysfunction score and/or self-report of diagnosed eating disorder/disordered eating. Results The prevalence of LEA-I was 232/546 (42.5%) in females and 85/484 (17.6%) in males. Athletes without LEA-I (non-LEA-I) achieved significantly better race times versus those with LEA-I (accounting for demographic and anthropomorphic data, training history and marathon experience), along with better division finishing place (DFP) mean outcomes (women’s DFP: 948.9±57.6 versus 1377.4±82.9, p<0.001; men’s DFP: 794.6±41.0 versus 1262.4±103.3, p<0.001). Compared with non-LEA-I athletes, LEA-I athletes had 1.99-fold (95% CI: 1.15 to 3.43) increased relative risk (RR) of an intra-event medical encounter of any severity level, and a 2.86-fold increased RR (95% CI:1.31 to 6.24) of a major medical encounter. Conclusion This is the largest study to link LEA-I to intra-event athletic performance and medical encounters. LEA-I were associated with worse race performance and increased risk of intra-event medical encounters, supporting the negative performance and medical risks associated with problematic LEA-I in marathon athletes.

Effect of L-Citrulline on Creatine Kinase MM (CK-MM) Isoenzymes in Mice: An In Vivo Study Focusing on Immunohistochemistry Analysis

Article

Full-text available

Sep 2024

Highlights:1. This study elucidates the effect of L-citrulline supplementation on creatine kinase MM (CK-MM) expression post-eccentric exercise, offering novel insights into its potential role in mitigating muscle damage.2. The findings demonstrate that L-citrulline administration significantly reduces CK-MM expression levels in skeletal muscle tissue, suggesting its therapeutic potential in enhancing muscle recovery and performance following exercise-induced damage.3. This study contributes valuable insights into the multifaceted benefits of L-citrulline supplementation for supporting overall muscle health and performance by identifying its protective effects under different mechanisms, including improved blood flow, antioxidant activity, enhanced mitochondrial function, and promotion of muscle protein synthesis. Abstract Eccentric exercise often induces muscle injuries in athletes, resulting in impaired performance and prolonged recovery time. Creatine kinase MM (CK-MM) is a biomarker for assessing muscle damage, with elevated levels indicating injury. L-citrulline, an amino acid, has shown promise in enhancing performance and reducing recovery time. However, its specific effect on CK-MM remains unclear. This study utilized immunohistochemistry analysis to investigate the effect of L-citrulline supplementation on CK-MM expression post-eccentric exercise in male BALB/c mice. This in vivo study was conducted with a post-test-only design. A total of 25 mice were divided into two control groups (normal/C1 and negative/C2) and three treatment groups (T1, T2, and T3), each containing five mice. The T1, T2, and T3 groups were daily administered 250, 500, and 1,000 mg/kg bw of L-citrulline for seven days, respectively. All mice, except the C1 group, performed a downhill running procedure. The CK-MM expression in skeletal muscle tissue post-eccentric exercise was assessed using immunohistochemistry analysis. The statistical analysis included the Shapiro-Wilk test for data distribution and the Kruskal-Wallis and Mann-Whitney post-hoc tests for significant differences (p<0.05). The results showed that CK-MM expression in the C2 group (91.00±2.24%) was significantly higher (p=0.008) than that of the C1 group (70.00±10.0%). Subsequently, the T1 (68.00±9.08%, p=0.008), T2 (72.00±7.58%, p=0.008), and T3 (67.00±9.75%, p=0.008) groups exhibited significantly lower expressions than the C2 group. These results were consistent with the role of CK-MM as a marker for muscle damage, and they indicated that L-citrulline might have a protective effect against muscle damage post-eccentric exercise. However, no significant differences were observed among the C1, T1, T2, and T3 groups. In conclusion, L-citrulline supplementation demonstrates promise in attenuating muscle damage following eccentric exercise, as evidenced by reduced CK-MM expression levels. These findings highlight the potential therapeutic role of L-citrulline in enhancing muscle recovery and performance.

Training Model for Extended Career Athletes: A Narrative Review

Article

Full-text available

Oct 2024

Toni Caparros

Context Today’s elite and professional sports tend to feature older, more seasoned athletes, who have longer sporting careers. As advancing age can potentially limit peak performance, balancing training load is necessary to maintain an optimal state of performance and extend their sports career. Objective To describe an appropriate training model for extended career athletes. Data Sources Medline (PubMed), SPORTDiscus, ScienceDirect, Web of Science, and Google Scholar. Study Selection A search of the literature between January 1, 2015 and November 22, 2023 was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study Design Narrative review. Level of Evidence Level 4. Data Extraction Data were extracted from studies related to the management of training and performance of athletes with extended and long careers. Results A total of 21 articles related to extended careers were found. Key themes from these papers included: expertise, biological maturation, and specificity; epidemiology and health; athlete monitoring; strength training; load management and detraining; success management. Conclusion A training model for extended career athletes should balance the deleterious effects of age with the athletes’ knowledge of, and expertise within, the sport. Designing specific training that accommodates previous injuries, training load intolerances, and caters for quality of life after retirement should be key considerations. Load management strategies for athletes with extended careers should include strength training adaptations to minimize pain, load-response monitoring, a broad range of movement, recovery and intensity activities, and the avoidance of large training load peaks and periods of inactivity.

Methodology and evaluation in sports analytics: challenges, approaches, and lessons learned

Article

Full-text available

Jul 2024
MACH LEARN

There has been an explosion of data collected about sports. Because such data is extremely rich and complex, machine learning is increasingly being used to extract actionable insights from it. Typically, machine learning is used to build models and indicators that capture the skills, capabilities, and tendencies of athletes and teams. Such indicators and models are in turn used to inform decision-making at professional clubs. Designing these indicators requires paying careful attention to a number of subtle issues from a methodological and evaluation perspective. In this paper, we highlight these challenges in sports and discuss a variety of approaches for handling them. Methodologically, we highlight that dependencies affect how to perform data partitioning for evaluation as well as the need to consider contextual factors. From an evaluation perspective, we draw a distinction between evaluating the developed indicators themselves versus the underlying models that power them. We argue that both aspects must be considered, but that they require different approaches. We hope that this article helps bridge the gap between traditional sports expertise and modern data analytics by providing a structured framework with practical examples.

Injuries in Athletics (Track and Field): A Narrative Review Presenting the Current Problem of Injuries

Article

Full-text available

Jun 2024

Objective: In Athletics (Track and Field), athletes can be affected by injuries, especially in their quest for top performance. Therefore, we aim to provide an overview of the current knowledge about the problem of injuries in Athletics. Main findings: It is necessary to maintain a clear definition of “injury” when stakeholders in Athletics discuss clinical, administrative, and/ or research perspectives. There are several possible methodological approaches to collect injury data in Athletics depending on the context, population, and injury definition. In general, about two thirds of Athletics athletes sustain at least one injury during an Athletics season, and there are about 100 injuries per 1000 registered athletes during an international championship. The injury rates and characteristics vary by sex and discipline. The injuries can affect athletes physically, psychologically, and socially, with short- and long-term consequences for musculoskeletal function, athletics performance and athletics career. Although it is logical to try to reduce the injury risk, little scientific evidence is currently available to help Athletics-related stakeholders. Conclusions: Injury can currently be considered as an omnipresent problem in Athletics, which affects their practice, with consequences on performance and health. Injury risk is today an undeniable part of the life of Athletics athletes, which implies that there is a pressing need to continue the development of injury risk reduction strategies, to scientifically evaluate their efficacy, and to implement them in sports practice.

What impact have the IOC medical consensus statements made on athlete health? A survey of medical commissions from National Olympic/Paralympic Committees and International Sports Federations

Article

Full-text available

Apr 2024

Background The International Olympic Committee (IOC) Medical and Scientific Commission has supported collating and sharing evidence globally by developing sports medicine consensus statements (‘Statements’'). Publishing the Statements requires substantial resources that must be balanced by use and impact on policy and practice. This study aimed to gain a better understanding of awareness and uptake of the Statements globally through a survey of the National Olympic Committees (NOC), National Paralympic Committees (NPC) and International Federations (IF). Method A cross-sectional survey of medical commission representatives from NOCs/NPCs/IFs. A structured questionnaire was distributed through the IOC head office, informed by prior research. Questions comprised a mix of closed and open-text responses with results presented descriptively by organisation type and total. Results 55 responses were included: 29 (52%) from NOC/NPC representatives (response rate 14%) and 26 (47%) from IF representatives (response rate 63%). All Statements had been used by at least one respondent, with the Statement addressing concussion ranked highest (used by 33/55). The main barriers to use were financial limitations (n=21), club/sport culture and behaviours (n=19) and lack of understanding from coaches/team sport personnel (n=19). Participants believed the Statements were a successful strategy for improving athlete health (n=39/51 agree or strongly agree). Conclusion There was clear support for the continued development of sports medicine guidance, including in the format of these Statements. To ensure Statements lead to demonstrable health benefits for athletes, input from athletes, coaches and supporting staff is needed, as well as clearer identification of the purpose and audience of each topic developed.

Coach Motivational Approaches for Youth Athletes Exercise Training and Racing Pace

Conference Paper

Full-text available

Jul 2024

Becoming a top-level athlete requires a substantial investment of time and effort in training and competing. While it's a well-known fact that pacing behavior plays a significant role in achieving peak performance, it remains an elusive skill among athletes. This crucial aspect involves making strategic decisions about effort regulation over an extended period of time, whether it's for a single event or an entire competitive season. Without proper management, the consequences can be severe, including injury, overtraining, and even quitting altogether. However, there is still much to be explored in how young athletes learn and refine their pacing abilities. As an athlete matures from infancy to adolescence, their pacing behavior undergoes a transformation. This change is thought to be closely connected to their physical growth, the development of pre-frontal cortex-linked cognitive processes, and the acquisition of exercise task experience. Furthermore, an athlete's motivation plays a crucial role in determining their pacing strategy for a single race and their distribution of effort over a prolonged period of time. Coaches should closely monitor the development of pacing behavior in adolescents, by tracking split times and physiological data during training and competition. They should also consider key factors like motivation, cognitive and physical maturity, and the use of targeted training to effectively shape pacing behavior. Providing training that replicates the environment and challenges of upcoming competitions can give young athletes valuable experience and preparation.

Sex Differences in Exercise-Induced Effects on Respiratory Infection and Immune Function

Article

Full-text available

Apr 2024

A physically active lifestyle has health benefits, including enhanced vaccination responses, improved neutrophil and macrophage function, increased T cell proliferative capacity, lower numbers of senescent T cells, and lower levels of inflammatory cytokines. Therefore, exercise or physical activity is effective for preventing and treating chronic diseases. A more robust immune response is generally thought to be exerted in females than males in response to various challenges. Sex hormones in both sexes have been suggested as mediators of immune function, but research on this topic has not been designed with a sex-specific lens. The authors reviewed and summarized the experimental and clinical evidence in the available literature linking exercise, immune function, and risk of upper respiratory infections, as well as associated mechanisms. Collectively, the available literature indicates that moderate exercise improves immune function and risk for upper respiratory infections in both sexes. In contrast, prolonged and high-intensity exercise temporarily impairs immune responses and upper respiratory infection risk at a higher degree in females than males. Therefore, moderate exercise and activity may enhance immune function regardless of sex, whereas prolonged and high-intensity exercise temporarily impairs immune responses, predominantly in females more than their male counterparts.

Decision-making on injury prevention and rehabilitation in professional football -A coach, medical staff, and player perspective

Article

Full-text available

Mar 2024

The aim of this study is to research how the decision-making on RTP from the medical staff impact on the perceived short-and long-term performance of the player and the team, from a coach, medical staff, and player perspective. Methods: Two professional football players, one physical coach, one physiotherapist and one assistant coach were interviewed in-depth and recruited because of their insight, experience, and expertise from one Norwegian premiere league club. Results: The decision-making process on RTP in the club were partly based on the hierarchy in the club, where the coach was on the top among these actors. Despite that the actor´s describes the process as a natural dynamic, and felt a shared responsibility in the process, their different roles impact on the decisions. The RTP decision was affected by aspects such as the period in the season, earlier injury experience of the player and the medical staff and coach collaboration. Conclusions: Even though the medical staff and the injury prevention could mean that the player could have a longer career, the choices made in the process of RTP is often based on short term player and team performance. Applications in sport: Professional football players have competition as a living and are expected to enjoy and embrace competing against both other teams related to winning trophies and teammates related to a place on the team in matches. This degree of competition was also seen as a part of the RTP process since the competition with teammates gave the players motivation to overcome their injury situation and get back to compete for their "spot" on the team. Even though this study only includes experiences from one professional football club, it gives insight into how the RTP process is done in a professional football context. Future studies should consider recruiting representatives from the club management, which also could give insight on how the macro aspects of a club impact on the RTP decisions in the coaching team of a professional football club.

Relationship Between Postural Stability and Proprioception, Pain, Quadriceps Strength, and Muscle Tightness in Athletes With Patellar Tendinopathy

Article

Mar 2024

Background Athletes with patellar tendinopathy (PT) have postural stability deficits; however, the underlying mechanisms and factors responsible remain unknown. The effect on postural stability in PT of decreased quadriceps strength, altered proprioception, lower-limb muscle tightness, and knee pain, which explain postural stability deficiency in other populations, is uninvestigated. Hypothesis Proprioceptive acuity, muscle tightness, quadriceps strength, and pain predict postural stability in athletes with PT. Study Design Cross-sectional comparative study. Level of Evidence Level 2. Methods A total of 43 athletes with PT and 43 healthy athletes were enrolled. Static and dynamic postural stability, proprioceptive acuity, muscle tightness, quadriceps strength, and pain were evaluated using a force platform, Y-balance test (YBT), a weight discrimination protocol, a goniometer, an isometric dynamometer, and a valid questionnaire, respectively. Results Athletes with PT had significantly worse static and dynamic postural stability in the affected limb (AL) compared with the nonaffected limb (NAL) ( P < 0.01) and the control group ( P < 0.01). Athletes suffering from PT revealed lower quadriceps strength ( P < 0.01), proprioceptive acuity ( P = 0.02), and higher muscle tightness in the AL compared with the NAL and controls. Quadriceps weakness of the AL and pain in athletes with PT explained the variance of dynamic postural stability impairment. Conclusion Athletes with PT have postural stability deficiency compared with healthy peers. Our results demonstrate that quadriceps muscle weakness and pain are the factors that explain postural stability impairment. Clinical Relevance These results can assist clinicians in the design of therapeutic balance rehabilitation programs by acting not only on pain relief but also on quadriceps strengthening through resistance training to avoid subsequent injuries in athletes with PT.

Understanding the first injury in athletics and its effect on dropout from sport: an online survey on 544 high-level youth and junior athletics (track and field) athletes

Article

Full-text available

Jan 2024

Objective To describe the first injury and to investigate whether it plays a role in altering athletics’ sustainable practice. Methods We conducted a cross-sectional study using an exploratory survey on the first injury and its consequences on athletics practice. In 2021, we asked all high-level athletes licensed with the French Federation of Athletics (FFA) under 18 years, under 20 years and under 23 years categories between 2007 and 2021. Results Out of 6560 emails sent by FFA, 544 athletes responded, and 93.6% (n=510) reported experiencing at least one injury during their career. The first injury occurred at a mean age of 17.5±3.3 years after 6.1±4.1 years of athletics practice. The main locations of the first injury were the posterior thigh (28.9%), the ankle (16.5%) and the knee (12.6%), and the principal reported injury types were muscle (37.7%), tendon (17.5%) and ligament (15.5%). More than a third of injured athletes (36.7%) reported experiencing ongoing symptoms or sequelae after their first injury, and about half (48.5%) experienced recurrences. About 20% had stopped athletics at the time of the survey, with injury problems the primary cause of athletes dropping out (46.2%), including the first injury (9.4%). Conclusions Injuries played an important role in altering sustainable athletics practice, with injury accounting for about 50% of all reported dropouts and the first injury accounting for about 10% of all reported causes. Our results provide evidence to target the prevention of the first injury, which could be considered the origin of the ‘vicious circle’ of injuries.

Combined Turmeric, Vitamin C, and Vitamin D Ready-to-Drink Supplements Reduce Upper Respiratory Illness Symptoms and Gastrointestinal Discomfort in Elite Male Football Players

Article

Full-text available

Jan 2024

Citation: Clayton, D.J.; Burbeary, R.; Parker, C.; James, R.M.; Saward, C.; Procter, E.L.; Mode, W.J.A.; Baker, C.; Hough, J.; Williams, N.C.; et al. Combined Turmeric, Vitamin C, and Abstract: Elite football is associated with the increased risk of illness, although targeted supplemen-tation can reduce illness risk. This study assessed the effects of a supplement containing turmeric root within a black pepper and fat-soluble blend, vitamin C and vitamin D, on upper respiratory symptoms (URS), gastrointestinal symptoms (GIS), muscle soreness, and markers of inflammation and gut permeability in elite male footballers. Twenty-three footballers completed 3 weeks of no intervention (CON), followed by 16 weeks of daily consuming 60 mL of a commercially available supplement containing raw turmeric root (17.5 g, estimated to contain 700 mg of curcumin), vitamin C (1000 mg), and vitamin D3 (3000 IU/75 mcg) (SUP). URS and GIS were measured daily. Immediately (0 h), 40, and 64 h after six competitive matches (two in CON, four in SUP), the subjective soreness and plasma concentrations of creatine kinase [CK], c-reactive protein [CRP], and intestinal fatty-acid binding protein [I-FABP] were assessed. URS incidence (p < 0.001), GIS (p < 0.05), and plasma [I-FABP] at 0 h (p < 0.05) were greater during CON versus SUP. At 40 h, [CRP] was greater than 0 h during CON (p < 0.01) but not SUP (p = 0.204). There were no differences in soreness or [CK]. This study indicates that turmeric root, vitamin C, and vitamin D supplementation over 16 weeks can reduce URS, GIS, and post-match [I-FABP] in elite footballers.

Not All Injuries Are the Same: Different Patterns in Sports Injuries and Their Psychosocial Correlates

Article

Full-text available

Dec 2023

Sports injuries are ubiquitous and can have far-reaching consequences for athletes (e.g., health, performance). Previous studies have examined various psychosocial influencing factors (e.g., stress), but have mostly focused on only one or two injury characteristics (e.g., frequency), neglecting the broader injury pattern. Thus, the present study aimed to obtain a more differentiated picture of potentially different injury patterns and related profiles of psychosocial factors. We investigated a sample of 213 athletes from a cross-sectional online study. Current injury status, frequency, severity, chronicity, medical treatment, and rehabilitation measures were subjected to cluster analysis indicating a 3-cluster solution with predominantly chronically injured athletes (n = 54), athletes not seeking treatment (n = 62), and athletes utilizing medical treatment and rehabilitation (n = 97). Building on the Model of Stress and Athletic Injury, we subsequently conducted three multivariate analyses of variance (MANOVAs) to examine whether the obtained clusters differed in terms of personality factors (e.g., athletic identity), history of stressors (e.g., life events), and coping resources (e.g., self-compassion). We observed significant differences in all three categories of psychosocial variables implying different intervention possibilities for different injury patterns in the future.

Female Athlete Triad (FAT) Screening Using LEAF Questionnaire: A Cross-Sectional Study in Indonesia Pencak Silat Athletes

Article

Full-text available

Sep 2022

Health information acquired from a health examination or screening is one of the requirements for participating in the Pencak Silat tournament. Unfortunately, the most common health tests cover only vital signs and weight checks. Those tests cannot accurately describe a person's health status, such as digestive and menstrual disorders, common among female athletes due to intensive physical training and the pressure to maintain body weight according to the tournament category. The Female Athlete Triad (FAT) is the name given to this condition. This is the first study to use the LEAF questionnaire to assess the risk of FAT in female Indonesian Pencak Silat athletes. This is an observational study using a cross-sectional design. Data were collected online from 207 participants using a purposive random sampling approach. According to the findings of this study, 53.6% (N = 111) of 207 respondents were at risk of FAT. The risk variables were closely associated with the number of exercise hours per week (P = 0.012) and education level (P = 0.023). The high prevalence of FAT and its high risk indicate the necessity for FAT screening as a requirement for competing in the Pencak Silat tournament and prevention of early osteoporosis and uterine function abnormalities in female Indonesian Pencak Silat athletes. Furthermore, FAT screening on female athletes in all sports is required to prevent the long-term clinical implications of FAT.

Quantifying demands on the hamstrings during high-speed running: A systematic review and meta-analysis

Article

Full-text available

Sep 2023
SCAND J MED SCI SPOR

Introduction: Hamstring strain injury (HSI) remains a performance, economic, and player availability burden in sport. High-speed running (HSR) is cited as a common mechanism for HSI. While evidence exists regarding the high physical demands on the hamstring muscles in HSR, meta-analytical synthesis of related activation and kinetic variables is lacking. Methods: A systematic search of Medline, Embase, Scopus, CINAHL, SportDiscus, and Cochrane library databases was conducted in accordance with the PRISMA 2020 guidelines. Studies reporting hamstring activation (electromyographic [EMG]) or hamstring muscle/related joint kinetics were included where healthy adult participants ran at or beyond 60% of maximum speed (activation studies) or 4 m per second (m/s (kinetic studies). Results: A total of 96 studies met the inclusion criteria. Run intensities were categorized as “slow,” “moderate,” or “fast” in both activation and kinetic based studies with appropriate relative, and raw measures, respectively. Meta-analysis revealed pooled mean lateral hamstring muscle activation levels of 108.1% (95% CI: 84.4%–131.7%) of maximal voluntary isometric contraction (MVIC) during “fast” running. Meta-analysis found swing phase peak knee flexion internal moment and power at 2.2 Newton meters/kilogram (Nm/kg) (95% CI: 1.9–2.5) and 40.3 Watts/kilogram (W/kg) (95% CI: 31.4–49.2), respectively. Hip extension peak moment and power was estimated as 4.8 Nm/kg (95% CI: 3.9–5.7) and 33.1 W/kg (95% CI: 17.4–48.9), respectively. Conclusions: As run intensity/speed increases, so do the activation and kinetic demands on the hamstrings. The presented data will enable clinicians to incorporate more objective measures into the design of injury prevention and return-to- play decision-making strategies.

Are return-to-play times longer in lower-limb muscle injuries involving the intramuscular tendon? A systematic review

Article

Full-text available

Oct 2023
J SCI MED SPORT

Methodology for studying Relative Energy Deficiency in Sport (REDs): a narrative review by a subgroup of the International Olympic Committee (IOC) consensus on REDs

Article

Sep 2023

In the past decade, the study of relationships among nutrition, exercise and the effects on health and athletic performance, has substantially increased. The 2014 introduction of Relative Energy Deficiency in Sport (REDs) prompted sports scientists and clinicians to investigate these relationships in more populations and with more outcomes than had been previously pursued in mostly white, adolescent or young adult, female athletes. Much of the existing physiology and concepts, however, are either based on or extrapolated from limited studies, and the comparison of studies is hindered by the lack of standardised protocols. In this review, we have evaluated and outlined current best practice methodologies to study REDs in an attempt to guide future research. This includes an agreement on the definition of key terms, a summary of study designs with appropriate applications, descriptions of best practices for blood collection and assessment and a description of methods used to assess specific REDs sequelae, stratified as either Preferred , Used and Recommended or Potential . Researchers can use the compiled information herein when planning studies to more consistently select the proper tools to investigate their domain of interest. Thus, the goal of this review is to standardise REDs research methods to strengthen future studies and improve REDs prevention, diagnosis and care.

Review of the scientific rationale, development and validation of the International Olympic Committee Relative Energy Deficiency in Sport Clinical Assessment Tool: V.2 (IOC REDs CAT2)—by a subgroup of the IOC consensus on REDs

Article

Full-text available

Sep 2023

Relative Energy Deficiency in Sport (REDs) has various different risk factors, numerous signs and symptoms and is heavily influenced by one’s environment. Accordingly, there is no singular validated diagnostic test. This 2023 International Olympic Committee’s REDs Clinical Assessment Tool—V.2 (IOC REDs CAT2) implements a three-step process of: (1) initial screening; (2) severity/risk stratification based on any identified REDs signs/symptoms (primary and secondary indicators) and (3) a physician-led final diagnosis and treatment plan developed with the athlete, coach and their entire health and performance team. The CAT2 also introduces a more clinically nuanced four-level traffic-light (green, yellow, orange and red) severity/risk stratification with associated sport participation guidelines. Various REDs primary and secondary indicators have been identified and ‘weighted’ in terms of scientific support, clinical severity/risk and methodological validity and usability, allowing for objective scoring of athletes based on the presence or absence of each indicator. Early draft versions of the CAT2 were developed with associated athlete-testing, feedback and refinement, followed by REDs expert validation via voting statements (ie, online questionnaire to assess agreement on each indicator). Physician and practitioner validity and usability assessments were also implemented. The aim of the IOC REDs CAT2 is to assist qualified clinical professionals in the early and accurate diagnosis of REDs, with an appropriate clinical severity and risk assessment, in order to protect athlete health and prevent prolonged and irreversible outcomes of REDs.

Do Female University Varsity Athletes Have a Greater Risk of Injury Within a Competitive Varsity Season?

Article

Full-text available

Jan 2023

Previous varsity sport injury research has analyzed how acute and chronic injury severity, type, and location differs between sport and sexes, with limited research in time to injury. Canadian university varsity sport injury research is especially sparse and mostly retrospective. Thus, we aimed to understand injury differences in male and female competitive university athletes competing in the same sport. Athletes who competed on the basketball, volleyball, soccer, ice hockey, football (male), rugby (female), and wrestling teams were eligible for the study. There were 182 male and 113 female athletes who provided informed consent to be prospectively followed over a season. Injury date, type, location, chronicity, and events missed due to injury were recorded on a weekly basis. Overall, the percentage of male (68.7%) and female (68.1%) athletes injured was not different. No overall sex differences (variables collapsed) were observed in injury chronicity, location, type, events lost, mean number of injuries, or time to injury. Within sport differences existed for mean number of injuries, injury location, type of injury, and events missed. Mean time to injury in female basketball (28 days) and volleyball athletes (14 days) was significantly shorter compared to male basketball (67 days) and volleyball (65 days). Time to a concussion was significantly shorter in females overall compared to males. These results indicate that Canadian female university age athletes are not inherently more susceptible to injury, but female athletes within certain sports may have increased injury risk which could shorten time to injury (basketball, volleyball) and increase the number of events missed due to injury (hockey).

Sex Differences in Exercise-Induced Effects on Immune Function

Preprint

Full-text available

Jan 2023

The practice of physical activity is an effective non-pharmacological strategy for preventing and treating chronic diseases. A large body of evidence has contributed to establishing a positive correlation between a physically active lifestyle and health benefits, including enhanced vaccination responses, lower numbers of senescent T-cells, increased T-cell proliferative capacity, lower levels of inflammatory cytokines, and improved neutrophil and macrophage function. While females are generally thought to exert more robust immune responses than males in response to a variety of challenges, and both male and female sex hormones have been suggested as mediators of immune function, research on this topic has not always been designed with a sex-specific lens. The goal of this review is to summarize the available experimental and clinical evidence linking exercise and immune function in male and female subjects, with an emphasis on sex differences and sex-specific mechanisms. Overall, the available evidence indicates that moderate exercise and physical activity improves immune function in both sexes, whereas prolonged and high-intensity exercise temporarily impairs immune responses at a higher degree in females. A role of male and female sex hormones in these sex-specific effects is also discussed.

What Contributes to Athlete Performance Health? A Concept Mapping Approach

Article

Full-text available

Dec 2022
Int J Environ Res Publ Health

Background: In high-performance sport, athlete performance health encompasses a state of optimal physical, mental, and social wellbeing related to an athlete's sporting success. The aim of this study was to identify the priority areas for achieving athlete performance health in Australia's high-performance sport system (HPSS). Methods: Participants across five socioecological levels of Australia's HPSS were invited to contribute to this study. Concept mapping, a mixed-methods approach incorporating qualitative and quantitative data collection, was used. Participants brainstormed ideas for what athlete performance health requires, sorted the ideas into groups based on similar meaning and rated the importance, and ease of achieving each idea on a scale from 1 (not important/easiest to overcome) to 5 (extremely important/hardest to overcome). Results: Forty-nine participants generated 97 unique statements that were grouped into 12 clusters following multidimensional scaling and hierarchical cluster analysis. The three clusters with highest mean importance rating were (mean importance rating (1-5), mean ease of overcoming (1-5)): 'Behavioral competency' (4.37, 2.30); 'Collaboration and teamwork' (4.19, 2.65); 'Valuing athlete wellbeing' (4.17, 2.77). The 12 clusters were grouped into five overarching domains: Domain one-Performance health culture; Domain two-Integrated strategy; Domain three-Operational effectiveness; Domain four-Skilled people; Domain five-Leadership. Conclusion: A diverse sample of key stakeholders from Australia's HPSS identified five overarching domains that contribute to athlete performance health. The themes that need to be addressed in a strategy to achieve athlete performance health in Australia's HPSS are 'Leadership', 'Skilled people', 'Performance health culture', 'Operational effectiveness', and 'Integrated strategy'.

Sex Differences in Exercise-Induced Effects on Immune Function

Preprint

Full-text available

Dec 2022

Higher, Faster, Further: Performance Heterogeneity and Social Facilitation in Professional Track and Field

Article

Oct 2024
J SPORT ECON

Finn Spilker

To explore the effects of COVID-19-related spectator variations on elite track and field athletes, the current article measures individual outcomes according to World Athletics Scores and then leverages these measures in fixed effects regression models to gauge athletes’ performance. Using a dataset of 5284 observations over 6 years and controlling for athlete, venue, and discipline fixed effects, as well as competition characteristics, we address task complexity and task experience. Thereby, we establish that field (in more complex tasks) but not track athletes (in simpler tasks) benefit from spectator exclusion. Furthermore, younger rather than older (more experienced) track athletes benefit from the lack of spectators, implying that experienced athletes handle social pressure better.

Coverage from medical teams and injury/illness epidemiology within youth athletics in Africa: A prospective study during the 2023 African Youth Under 18/20 Athletics Championships

Article

Jul 2024
J SCI MED SPORT

Diving Into the Health Problems of Competitive Divers: A Systematic Review of Injuries and Illnesses in Pre-elite and Elite Diving Athletes

Article

Jun 2024

Context The Olympic sport of diving involves the competitive disciplines of 3 m springboard and 10 m platform. Although it is generally accepted that lumbar spine injuries are common in diving athletes, the existing literature of health problems in diving athletes remains scarce. Objective To identify the incidence, prevalence, and type of health problems that occur in competitive diving athletes. Data Sources Medline, EMBASE, SportsDiscus, PsycINFO, and Google Scholar. Study Selection Studies written in English investigating elite or pre-elite competitive diving (springboard, platform) injuries and/or illnesses were eligible. Two independent reviewers screened for inclusion by title, abstract, and full text in accordance with the eligibility criteria. Study Design Systematic review. Level of Evidence Level 4. Data Extraction Data extraction was completed by 1 author using a structured form. A second author then independently reviewed and verified the extracted data, any discrepancies were resolved through consensus. Results The search identified 2554 potential articles, with 28 studies meeting eligibility criteria. The surveillance setting of most studies was restricted to competition-based events, with the reported injury incidence proportion ranging from 2.1% to 22.2%. The reported injury incidence rate ranged from 1.9 to 15.5 per 1000 athlete-exposures. Injuries to the shoulder, lower back/lumbar spine, trunk, and wrist/hand were reported most frequently. The prevalence of low back pain was reported as high as 89% (lifetime), 43.1% (period), and 37.3% (point). The illness incidence proportion ranged from 0.0% to 22.2%, with respiratory and gastrointestinal illness reported most frequently. Conclusion Up to 1 in 5 diving athletes sustain an injury and/or illness during periods of competition. A reporting bias was observed, with most cohort studies limiting surveillance to short competition-based periods only. This limits the current understanding of the health problems experienced by diving athletes to competition periods only and requires expansion to whole-of-year surveillance.

Nutrition Needs During Recovery Following Athletic Injury

Chapter

Apr 2024

Sports Risk Prediction and Evaluation Model Based on Single Layer Feed Forward Neural Network

Conference Paper

Mar 2024

Nutrition Needs During Recovery Following Athletic Injury

Chapter

Full-text available

Nov 2023

Athletes who have already experienced an injury are more prone to adhere to an injury risk reduction approach than those who do not: an online survey of 7870 French athletics (track and field) athletes

Article

Full-text available

Feb 2024

Objective To compare the perception towards injury risk reduction approach between athletes who have already experienced an injury and those who have not. Methods We conducted a cross-sectional study using a one-time online survey asking athletics athletes licensed at the French Federation of Athletics ( http://www.athle.fr ) about their perceptions regarding injuries and injury risk reduction behaviours. We statistically compared athletes who already experienced an injury and those who did not. Results A total of 7870 athletes were included. 90% of athletes declared having experienced at least one injury. They (1) were proportionally more men than women, (2) had significantly more years of experience in athletics, (3) had a significant difference in disciplines (more hurdles, jumps and combined events and fewer sprint athletes), (4) had a significant difference in competition levels (more national and less departmental levels) and (5) reported significantly higher values or agreements in favour of injury risk reduction approach, compared with uninjured athletes. There were significantly more athletes declaring following injury risk reduction programmes among athletes who experienced at least one injury than those who did not. Conclusions Athletes who experienced at least one injury during their lifetime were more prone to adhere to injury risk reduction strategies than athletes who have never experienced an injury. Their entourage (coaches and health professionals) should use this fertile ground to implement injury risk reduction strategies. In addition, their experience should be disseminated to uninjured athletes to help them adhere to injury risk reduction without injury experience.

Infographie : évaluation de l’efficacité d’un programme de prévention des blessures en athlétisme dans un essai randomisé contrôlé incluant 840 athlètes sur 39 semaines

Article

Dec 2023
J Traumatol Sport

Sleep, Nutrition, and Injury Risk in Adolescent Athletes: A Narrative Review

Article

Full-text available

Dec 2023

This narrative review explores the impact of sleep and nutrition on injury risk in adolescent athletes. Sleep is viewed as essential to the recuperation process and is distinguished as an active participant in recovery through its involvement in growth, repair, regeneration, and immunity. Furthermore, the literature has shown that the sleep of athletes impacts elements of athletic performance including both physical and cognitive performance, recovery, injury risk, and mental well-being. For sleep to have a restorative effect on the body, it must meet an individual’s sleep needs whilst also lasting for an adequate duration and being of adequate quality, which is age-dependent. The literature has suggested that athletes have increased sleep needs compared to those of the general population and thus the standard recommendations may not be sufficient for athletic populations. Therefore, a more individualised approach accounting for overall sleep health may be more appropriate for addressing sleep needs in individuals including athletes. The literature has demonstrated that adolescent athletes achieve, on average, ~6.3 h of sleep, demonstrating a discrepancy between sleep recommendations (8–10 h) and actual sleep achieved. Sleep–wake cycles undergo development during adolescence whereby adaptation occurs in sleep regulation during this phase. These adaptations increase sleep pressure tolerance and are driven by the maturation of physiological, psychological, and cognitive functioning along with delays in circadian rhythmicity, thus creating an environment for inadequate sleep during adolescence. As such, the adolescent period is a phase of rapid growth and maturation that presents multiple challenges to both sleep and nutrition; consequently, this places a significant burden on an adolescent athletes’ ability to recover, thus increasing the likelihood of injury. Therefore, this article aims to provide a comprehensive review of the available literature on the importance of sleep and nutrition interactions in injury risk in adolescent athletes. Furthermore, it provides foundations for informing further investigations exploring the relation of sleep and nutrition interactions to recovery during adolescence.

Immunosurveillance associated with upper respiratory symptoms in elite swimmers: 8-month period leading into commonwealth games

Article

Nov 2023
J SCI MED SPORT

The impact of long haul travel on the sleep of elite athletes

Article

Sep 2023

In order to manage and implement strategies to alleviate the symptoms of jet lag it is essential to assess the impact of jet lag in athletes. The aim of this study was to assess the impact of long haul eastward travel on elite athletes' (n = 7 elite national track cyclists; male n = 3, and female n = 4) sleep. The athletes’ sleep was monitored before, during and after travel using both actigraphy and self-report measures. Participants wore an activity monitor for 5 days prior to travel, during the long haul travel and 5 days upon arrival at their destination and completed a daily online sleep diary Actigraphy highlighted significant reductions in time in bed, total sleep time and sleep efficiency (%) due to long haul eastward travel, particularly in the 48 h after travel. Sleep diary data exhibited significant reductions in time in bed, total sleep time, sleep efficiency, sleep quality and a significant increase in fatigue going to bed as a result of long haul eastward travel. In order to facilitate the development of interventions to reduce the symptoms and severity of jet lag objective and subjective assessments of sleep should be coupled with assessments of chronotype and perceived sleep need.

Lien entre les blessures et croissance en gymnastique artistique féminine de haut-niveau : étude rétrospective sur six saisons

Article

Sep 2023
J Traumatol Sport

Prevalence, diagnosis and management of musculoskeletal disorders in elite athletes: A mini-review

Article

Sep 2023
DM-DIS MON

Increasing Step Rate Reduces Peak and Cumulative Insole Force in Collegiate Runners

Article

Jul 2023
MED SCI SPORT EXER

Purpose: The primary goal of this study was to examine changes in peak insole force and cumulative weighted peak force (CWPF)/km with increased step rate in collegiate runners. The secondary goal was to determine whether sacral acceleration correlates with insole force when increasing step rate. Methods: 12 collegiate distance runners ran 1000 m outdoors at 3.83 m/s at preferred and 10% increased step rates while insole force and sacral acceleration were recorded. CWPF/km was calculated from insole force based on cumulative damage models. The effects of step rate on peak insole force and CWPF/km were tested using paired t-tests or Wilcoxon tests. Correlation coefficients between peak axial (approximately vertical) sacral acceleration times body mass and peak insole force were calculated on cohort and individual levels. Results: Peak insole force and CWPF/km decreased (p < 0.001) with increased step rate. Peak axial sacral acceleration did not correlate with peak insole force on the cohort level (r = 0.35, p = 0.109) but did within individuals (mean r = 0.69-0.78, p < 0.05). Conclusions: Increasing step rate may reduce peak vGRF and CWPF/km in collegiate runners. Therefore, clinicians should consider step rate interventions to reduce peak and cumulative vGRF in this population. Individual-specific calibrations may be required to assess changes in peak vGRF in response to increasing step rate using wearable accelerometers.

Aspects médicaux non traumatiques et pratique de l’athlétisme

Chapter

Jan 2022

Traumatologie en athlétisme

Chapter

Jan 2022

Effectiveness of a judo-specific injury prevention programme: a randomised controlled trial in recreational judo athletes

Article

Full-text available

Jan 2023

Objectives To evaluate the effectiveness of a trainer-supervised judo-specific injury prevention warm-up programme on overall injury prevalence. Methods We conducted a two-arm, cluster randomised controlled trial; the Injury Prevention and Performance Optimization Netherlands (IPPON) study. Judo athletes aged≥12 years were randomised by judo school to IPPON intervention or control group who performed their usual warm-up. Primary outcome was overall injury prevalence (%) over the follow-up period (16–26 weeks) measured fortnightly with the Oslo Sports and Trauma Research Centre Questionnaire. A modified intention-to-treat analysis was performed due to COVID-19, with estimates for the primary outcome obtained using generalised linear mixed models. Secondary outcomes included: prevalence of severe injuries, overall incidence, time-loss injuries, exposure, adherence and experiences of trainers and athletes. Results 269 judo athletes (IPPON: 117, Control: 152) were included. Mean injury prevalence over 16–26 weeks was 23% (95% CI 20% to 26%) in the IPPON and 28% (95% CI 25% to 30%) in the control group. We observed no significant difference of all reported injuries (OR 0.72 in favour of the IPPON group; 95% CI 0.37 to 1.39). Secondary outcomes also demonstrated no significant differences between groups. Specifically, no significant difference of severe injuries was reported (OR 0.80 in favour of the IPPON group; 95% CI 0.36 to 1.78). All trainers and 70% of athletes perceived the IPPON intervention as successful. Conclusion The IPPON intervention did not significantly reduce the overall and severe injury prevalence. Despite this, we suggest the IPPON intervention be considered as an useful alternative to regular judo warm-up, given the high adherence and the positive clinical experiences of trainers and athletes. Trial registration number NTR7698.

Comparison of injury profiles between elite Australian male and female cricket players

Article

Dec 2022
J SCI MED SPORT

Objectives This study presents seven seasons of injury surveillance data for both elite Australian male and female cricket players, revealing injury statistics and allowing for comparison between sexes. Design Retrospective cohort. Methods Participants were elite Australian male and female cricket players who were contracted to play for a national and/or state/territory team and/or T20 franchise between 2015 and 16 and 2021–22 (7 seasons). Injury data was recorded in Cricket Australia's Athlete Management System database and combined with match data. The STROBE-SIIS statement was used as the relevant guideline for this study. Results Data for 1345 male player seasons and 959 female player seasons revealed sex-related differences in the injury incidence rates and prevalence. Males had higher incidence (average 136 vs 101 injuries per 1000 match days) and prevalence of match time-loss injuries (average 10.4% vs 6.5% players unavailable). However, the overall incidence of all medical attention injuries were similar between sexes (Incidence Rate Ratio (IRR) 0.9, 95%CI 0.8–1.0). The most frequent match time-loss injuries for males were hamstring strains (7.4 new injuries per 100 players per season), side and abdominal strains (5.5), concussion (5.0), lumbar stress fractures (4.3), and wrist and hand fractures (3.9). The most frequent match time-loss injuries for females over the 7 seasons were hamstring strains (3.1), concussion (2.3), quadriceps strains (2.4) and shin/ft/ankle stress fractures (2.0). The IRR of medical attention injuries for males compared to females was higher for lumbosacral stress fractures (IRR 2.3), elbow and forearm injuries (1.5), and concussion (1.4), and lower for lower leg, foot, and ankle stress fractures (0.6), shoulder and upper arm injuries (0.7), and quadriceps strains (0.6). Conclusions Robust long-term injury surveillance enabled the injury profiles of elite Australian male and female cricket players to be understood and compared. Males had a higher incidence and prevalence of match time-loss injuries, likely reflecting a higher match exposure.

Adolescent Running Injuries

Chapter

Nov 2022

At the most primitive level, humans were made to run. The ability to run long distances may have given humans a competitive advantage in persistence hunting that provided essential food for survival (Lieberman et al., 2007). In modern times, most distance running is performed for athletic competition, physical fitness or play. Participation in the sport of running has seen a steady upward trend over the last few decades, including in adolescents. This trend creates a specific opportunity for pediatric clinicians. Running can be beneficial for health and wellness, however a significant proportion of habitual runners sustain an overuse injury annually. Running can improve mental health by decreasing symptoms of anxiety and depression, but it can play a role in exercise addiction and eating disorders (Paluska and Schwenk, 2000; Yates et al., 1983). For clinicians to effectively care for the adolescent runner, knowledge of the unique developmental physical, physiologic, and psychological aspects of their patients must be applied to optimize their health and wellness.

Preparticipation injury complaint is a risk factor for injury: A prospective study of the Moscow 2013 IAAF Championships

Article

Full-text available

Feb 2015

To determine the health status of athletes before the start of an international athletics championship and to determine whether preparticipation risk factors predicted in-championship injuries. At the beginning of the 2013 International Association of Athletics Federations (IAAF) World Championships, all registered athletes (n=1784) were invited to complete a preparticipation health questionnaire (PHQ) on health status during the month preceding the championships. New injuries that occurred at the championships were prospectively recorded. The PHQ was completed by 698 (39%) athletes; 204 (29.2%) reported an injury complaint during the month before the championships. The most common mode of onset of preparticipation injury complaints was gradual (43.6%). Forty-nine athletes in the study reported at least one injury during the championships. Athletes who reported a preparticipation injury complaint were at twofold increased risk for an in-championship injury (OR=2.09; 95% CI 1.16 to 3.77); p=0.014). Those who reported a preparticipation gradual-onset injury complaint were at an almost fourfold increased risk for an in-championship time-loss injury (OR=3.92; 95% CI 1.69 to 9.08); p=0.001). Importantly, the preparticipation injury complaint severity score was associated with the risk of sustaining an in-championship injury (OR=1.14; 95% CI 1.06 to 1.22); p=0.001). About one-third of the athletes participating in the study reported an injury complaint during the month before the championships, which represented a risk factor for sustaining an injury during the championship. This study emphasises the importance of the PHQ as a screening tool to identify athletes at risk of injuries before international championships. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Relationship Between Workloads, Physical Performance, Injury and Illness in Adolescent Male Football Players

Article

Full-text available

Apr 2014
SPORTS MED

The expectation that training enhances performance is well explored in professional sport. However, the additional challenges of physical and cognitive maturation may require careful consideration when determining workloads to enhance performance in adolescents. The objective of this study was to determine the state of knowledge on the relationship between workloads, physical performance, injury and/or illness in adolescent male football players. A systematic review of workloads, physical performance, injury and illness in male adolescent football players was conducted. Studies for this review were identified through a systematic search of six electronic databases (Academic Search Complete, CINAHL, PsycINFO, PubMed, SPORTDiscus, and Web of Science). For the purpose of this review, load was defined as the cumulative amount of stress placed on an individual from multiple training sessions and games over a period of time, expressed in terms of either the external workloads performed (e.g., resistance lifted, kilometres run) or the internal response (e.g., heart rate, rating of perceived exertion) to that workload. A total of 2,081 studies were initially retrieved from the six databases, of which 892 were duplicates. After screening the titles, abstracts and full texts, we identified 23 articles meeting our criteria around adolescent football players, workloads, physical performance, injury and/or illness. Seventeen articles addressed the relationship between load and physical performance, four articles addressed the relationship between load and injury and two articles addressed both. A wide range of training modalities were employed to improve the physical performance of adolescent football players, with strength training, high-intensity interval training, dribbling and small-sided games training, and a combination of these modalities in addition to normal football training, resulting in improved performances on a wide range of physiological and skill assessments. Furthermore, there was some (limited) evidence that higher workloads may be associated with the development of better physical qualities, with one study demonstrating enhanced submaximal interval shuttle run performance with each additional hour of training or game play. Of the few studies examining negative consequences associated with workloads, increases in training load led to increases in injury rates, while longer training duration was associated with a greater incidence of illness. The combined capacity for adolescent males to grow, train and improve physical performance highlights and underscores an exciting responsiveness to training in the football environment. However, the capacity to train has some established barriers for adolescents experiencing high workloads, which could also result in negative consequences. Additional research on stage-appropriate training for adolescent male footballers is required in order to address the knowledge gaps and enhance safe and efficient training practices.

Injury and illness definitions and data collection procedures for use in epidemiological studies in Athletics (track and field): Consensus statement

Article

Full-text available

Apr 2014
BRIT J SPORT MED

Movement towards sport safety in Athletics through the introduction of preventive strategies requires consensus on definitions and methods for reporting epidemiological data in the various populations of athletes. To define health-related incidents (injuries and illnesses) that should be recorded in epidemiological studies in Athletics, and the criteria for recording their nature, cause and severity, as well as standards for data collection and analysis procedures. A 1-day meeting of 14 experts from eight countries representing a range of Athletics stakeholders and sport science researchers was facilitated. Definitions of injuries and illnesses, study design and data collection for epidemiological studies in Athletics were discussed during the meeting. Two members of the group produced a draft statement after this meeting, and distributed to the group members for their input. A revision was prepared, and the procedure was repeated to finalise the consensus statement. Definitions of injuries and illnesses and categories for recording of their nature, cause and severity were provided. Essential baseline information was listed. Guidelines on the recording of exposure data during competition and training and the calculation of prevalence and incidences were given. Finally, methodological guidance for consistent recording and reporting on injury and illness in athletics was described. This consensus statement provides definitions and methodological guidance for epidemiological studies in Athletics. Consistent use of the definitions and methodological guidance would lead to more reliable and comparable evidence.

Spikes in acute workload are associated with increased injury risk in elite cricket fast bowlers

Article

Full-text available

Aug 2013
BRIT J SPORT MED

To determine if the comparison of acute and chronic workload is associated with increased injury risk in elite cricket fast bowlers. Data were collected from 28 fast bowlers who completed a total of 43 individual seasons over a 6-year period. Workloads were estimated by summarising the total number of balls bowled per week (external workload), and by multiplying the session rating of perceived exertion by the session duration (internal workload). One-week data (acute workload), together with 4-week rolling average data (chronic workload), were calculated for external and internal workloads. The size of the acute workload in relation to the chronic workload provided either a negative or positive training-stress balance. A negative training-stress balance was associated with an increased risk of injury in the week after exposure, for internal workload (relative risk (RR)=2.2 (CI 1.91 to 2.53), p=0.009), and external workload (RR=2.1 (CI 1.81 to 2.44), p=0.01). Fast bowlers with an internal workload training-stress balance of greater than 200% had a RR of injury of 4.5 (CI 3.43 to 5.90, p=0.009) compared with those with a training-stress balance between 50% and 99%. Fast bowlers with an external workload training-stress balance of more than 200% had a RR of injury of 3.3 (CI 1.50 to 7.25, p=0.033) in comparison to fast bowlers with an external workload training-stress balance between 50% and 99%. These findings demonstrate that large increases in acute workload are associated with increased injury risk in elite cricket fast bowlers.

Injuries affect team performance negatively in professional football: An 11-year follow-up of the UEFA Champions League injury study

Article

Full-text available

May 2013
BRIT J SPORT MED

Background: The influence of injuries on team performance in football has only been scarcely investigated. Aim: To study the association between injury rates and team performance in the domestic league play, and in European cups, in male professional football. Methods: 24 football teams from nine European countries were followed prospectively for 11 seasons (2001-2012), including 155 team-seasons. Individual training and match exposure and time-loss injuries were registered. To analyse the effect of injury rates on performance, a Generalised Estimating Equation was used to fit a linear regression on team-level data. Each team's season injury rate and performance were evaluated using its own preceding season data for comparison in the analyses. Results: 7792 injuries were reported during 1 026 104 exposure hours. The total injury incidence was 7.7 injuries/1000 h, injury burden 130 injury days lost/1000 h and player match availability 86%. Lower injury burden (p=0.011) and higher match availability (p=0.031) were associated with higher final league ranking. Similarly, lower injury incidence (p=0.035), lower injury burden (p<0.001) and higher match availability (p<0.001) were associated with increased points per league match. Finally, lower injury burden (p=0.043) and higher match availability (p=0.048) were associated with an increase in the Union of European Football Association (UEFA) Season Club Coefficient, reflecting success in the UEFA Champions League or Europa League. Conclusions: Injuries had a significant influence on performance in the league play and in European cups in male professional football. The findings stress the importance of injury prevention to increase a team's chances of success.

Sport injuries and illnesses during the London Summer Olympic Games 2012

Article

Full-text available

Mar 2013
BRIT J SPORT MED

Background: The Olympic Movement Medical Code encourages all stakeholders to ensure that sport is practised without danger to the health of the athletes. Systematic surveillance of injuries and illnesses is the foundation for developing preventive measures in sport. Aim: To analyse the injuries and illnesses that occurred during the Games of the XXX Olympiad, held in London in 2012. Methods: We recorded the daily occurrence (or non-occurrence) of injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the London Organising Committee of the Olympic and Paralympic Games' (LOCOG) medical staff. Results: In total, 10 568 athletes (4676 women and 5892 men) from 204 NOCs participated in the study. NOC and LOCOG medical staff reported 1361 injuries and 758 illnesses, equalling incidences of 128.8 injuries and 71.7 illnesses per 1000 athletes. Altogether, 11% and 7% of the athletes incurred at least one injury or illness, respectively. The risk of an athlete being injured was the highest in taekwondo, football, BMX, handball, mountain bike, athletics, weightlifting, hockey and badminton, and the lowest in archery, canoe slalom and sprint, track cycling, rowing, shooting and equestrian. 35% of the injuries were expected to prevent the athlete from participating during competition or training. Women suffered 60% more illnesses than men (86.0 vs 53.3 illnesses per 1000 athletes). The rate of illness was the highest in athletics, beach volleyball, football, sailing, synchronised swimming and taekwondo. A total of 310 illnesses (41%) affected the respiratory system and the most common cause of illness was infection (n=347, 46%). Conclusions: At least 11% of the athletes incurred an injury during the games and 7% of the athletes' an illness. The incidence of injuries and illnesses varied substantially among sports. Future initiatives should include the development of preventive measures tailored for each specific sport and the continued focus among sport bodies to institute and further develop scientific injury and illness surveillance systems.

Categorising sports injuries in epidemiological studies: The subsequent injury categorisation (SIC) model to address multiple, recurrent and exacerbation of injuries

Article

Full-text available

Mar 2013
BRIT J SPORT MED

Objective Sports injuries are often recurrent and there is wide recognition that a subsequent injury (of either the same or a different type) can be strongly influenced by a previous injury. Correctly categorising subsequent injuries (multiple, recurrent, exacerbation or new) requires substantial clinical expertise, but there is also considerable value in combining this expertise with more objective statistical criteria. This paper presents a new model, the subsequent injury categorisation (SIC) model, for categorising subsequent sports injuries that takes into account the need to include both acute and overuse injuries and ten different dependency structures between injury types. Methods The suitability of the SIC model was demonstrated with date ordered sports injury data from a large injury database from community Australian football players over one playing season. A subsequent injury was defined to have occurred in the subset of players with two or more reported injuries. Results 282 players sustained 469 subsequent injuries of which 15.6% were coded to categories representing injuries that were directly related to previous index injuries. This demonstrates that players can sustain a number of injuries over one playing season. Many of these will be unrelated to previous injuries but subsequent injuries that are related to previous injury occurrences are not uncommon. Conclusion The handling of subsequent sports injuries is a substantial challenge for the sports medicine field—both in terms of injury treatment and in epidemiological research to quantify them. Application of the SIC model allows for multiple different injury types and relationships within players, as well as different index injuries.

Training and game loads and injury risk in elite Australian footballers

Article

Full-text available

Jan 2013

Objectives: To examine the relationship between combined training and game loads and injury risk in elite Australian footballers. Design: Prospective cohort study. Methods: Forty-six elite Australian footballers (mean±SD age of 22.2±2.9 y) from one club were involved in a one-season study. Training and game loads (session-RPE multiplied by duration in min) and injuries were recorded each time an athlete exerted an exercise load. Rolling weekly sums and week-to-week changes in load were then modelled against injury data using a logistic regression model. Odds ratios (OR) were reported against a reference group of the lowest training load range. Results: Larger 1 weekly (>1750 AU, OR=2.44-3.38), 2 weekly (>4000 AU, OR=4.74) and previous to current week changes in load (>1250 AU, OR=2.58) significantly related (p<0.05) to a larger injury risk throughout the in-season phase. Players with 2-3 and 4-6 years of experience had a significantly lower injury risk compared to 7+ years players (OR=0.22, OR=0.28) when the previous to current week change in load was more than 1000 AU. No significant relationships were found between all derived load values and injury risk during the pre-season phase. Conclusions: In-season, as the amount of 1-2 weekly load or previous to current week increment in load increases, so does the risk of injury in elite Australian footballers. To reduce the risk of injury, derived training and game load values of weekly loads and previous week-to-week load changes should be individually monitored in elite Australian footballers.

Prevalence of Musculoskeletal Injuries in Swedish Elite Track and Field Athletes

Article

Full-text available

Nov 2011

Little is known of injury patterns in track and field (athletics). Injury prevalence has been proposed as the most appropriate measure of the injury rate in sports where athletes are at risk for overuse problems. To ascertain 1-year retrospective and current prevalence of injury in elite track and field athletes to help plan injury prevention programs for this sport. Descriptive epidemiology study. Two hundred seventy-eight youth (16 years old) and adult athletes from an eligible study population of 321 athletes were included. The 1-year retrospective injury prevalence was 42.8% (95% confidence interval [CI], 36.9%-49.0%); the point prevalence was 35.4% (95% CI, 29.7%-41.4%). The diagnosis group displaying the highest injury prevalence was inflammation and pain in the gradual onset category (1-year prevalence, 20.9%; 95% CI, 16.2%-26.2%; and point prevalence, 23.2%; 95% CI, 18.4%-28.7%). A strong tendency for higher 1-year prevalence of 16.5% (95% CI, 12.2%-21.4%) than point prevalence of 8.5% (95% CI, 5.5%-12.5%) was recorded for sudden onset injuries in the diagnosis group sprain, strain, and rupture. The body region showing the highest injury prevalence was the knee and lower leg with 15.0% (95% CI, 11.0%-19.8%) 1-year prevalence and 13.7% (95% CI, 9.8%-18.3%) point prevalence, followed by the Achilles tendon, ankle, and foot/toe with 11.7% (95% CI, 8.2%-16.1%) 1-year prevalence and 11.4% (95% CI, 7.9%-15.8%) point prevalence. The injury prevalence is high among Swedish elite track and field athletes. Most of the injuries affect the lower extremities and are associated with a gradual onset. Although it is associated with a potential recall bias, the 1-year retrospective prevalence measure captured more sudden onset injuries than the point prevalence measure. Future prospective studies in track and field are needed to identify groups of athletes at increased risk.

Occurrence of injuries and illnesses during the 2009 IAAF World Athletics Championships

Article

Full-text available

Dec 2010
BRIT J SPORT MED

To analyse the frequency and characteristics of sports injuries and illnesses incurred during the World Athletics Championships. Prospective recording of newly occurred injuries and illnesses. Twelfth International Association of Athletics Federations World Championships in Athletics 2009 in Berlin, Germany. National team physicians and physiotherapists and 1979 accredited athletes; Local Organising Committee physicians working in the Medical Centres. Incidence and characteristics of newly incurred injuries and illnesses. 236 injury incidents with 262 injured body parts and 269 different injury types were reported, representing an incidence of 135.4 injuries per 1000 registered athletes. Eighty percent affected the lower extremity. Thigh strain (13.8%) was the main diagnosis. Overuse (44.1%) was the predominant cause. Most injuries were incurred during competition (85.9%). About 43.8% of all injury events were expected to result in time-loss. 135 illnesses were reported, signifying an incidence of 68.2 per 1000 registered athletes. Upper respiratory tract infection was the most common condition (30.4%) and infection was the most frequent cause (32.6%). The incidence of injury and illnesses varied substantially among the events. The risk of injury varied with each discipline. Preventive measures should be specific and focused on minimising the potential for overuse. Attention should be paid to ensure adequate rehabilitation of previous injuries. The addition of the illness part to the injury surveillance system proved to be feasible. As most illnesses were caused by infection of the respiratory tract or were environmentally related, preventive interventions should focus on decreasing the risk of transmission, appropriate event scheduling and heat acclimatisation.

The Orchard Sports Injury Classification System (OSICS) version 10

Article

Full-text available

Nov 2007

Sports Injuries During the Summer Olympic Games 2008

Article

Full-text available

Sep 2009

Standardized assessment of sports injuries provides important epidemiological information and also directions for injury prevention. To analyze the frequency, characteristics, and causes of injuries incurred during the Summer Olympic Games 2008. Descriptive epidemiology study. The chief physicians and/or chief medical officers of the national teams were asked to report daily all injuries newly incurred during the Olympic Games on a standardized injury report form. In addition, injuries were reported daily by the physicians at the medical stations at the different Olympic venues and at the polyclinic in the Olympic Village. Physicians and/or therapists of 92 national teams covering 88% of the 10,977 registered athletes took part in the study. In total, 1055 injuries were reported, resulting in an incidence of 96.1 injuries per 1000 registered athletes. Half of the injuries (49.6%) were expected to prevent the athlete from participating in competition or training. The most prevalent diagnoses were ankle sprains and thigh strains. The majority (72.5%) of injuries were incurred in competition. One third of the injuries were caused by contact with another athlete, followed by overuse (22%) and noncontact incidences (20%). Injuries were reported from all sports, but their incidence and characteristics varied substantially. In relation to the number of registered athletes, the risk of incurring an injury was highest in soccer, taekwondo, hockey, handball, weightlifting, and boxing (all >or=15% of the athletes) and lowest for sailing, canoeing/kayaking, rowing, synchronized swimming, diving, fencing, and swimming. The data indicate that the injury surveillance system covered almost all of the participating athletes, and the results highlight areas of high risk for sport injury such as the in-competition period, the ankle and thigh, and specific sports. The identification of these factors should stimulate future research and subsequent policy change to prevent injury in elite athletes.

Sports Injuries Surveillance During the 2007 IAAF World Athletics Championships

Article

Full-text available

Feb 2009

The aim of this study was to analyze all sports injuries incurred in competitions and/or training during the 2007 World Athletics Championships and to prove the feasibility of the injury surveillance system developed for the 2008 Olympic Games for individual sports. Prospective recording of injuries. 11 IAAF World Championships in Athletics 2007 in Osaka, Japan. All national team physicians and physiotherapists; Local Organising Committee (LOC) physicians working in the Medical Centres at the stadium and warm-up area. Frequency, characteristics, and incidence of injuries. 192 injuries were reported, resulting in an incidence of 97 injuries per 1000 registered athletes. More than half of the injuries (56%) were expected to prevent the athlete from participating in competition or training. Eighty percent affected the lower extremity; the most common diagnosis was thigh strain (16%). In most cases, the injury was caused by overuse (44%). A quarter of the injuries were incurred during training and 137 (71%) in competition. On average, 72.4 injuries per 1000 competing athletes were incurred in competitions. The incidence of injury varied substantially among the disciplines. The risk of a time-loss injury was highest in heptathlon, women's 10,000 m, women's 3000 m steeplechase, decathlon, and men's marathon. The injury surveillance system proved feasible for individual sports. Risk of injury varied among the disciplines, with highest risk in combined disciplines, steeplechase, and long-distance runs. Preventive interventions should mainly focus on overuse injuries and adequate rehabilitation of previous injuries.

Epidemiology of Musculoskeletal Injuries among High School Cross-Country Runners

Article

Full-text available

Jan 2006
AM J EPIDEMIOL

To determine the incidence of lower-extremity injury among high school cross-country runners and to identify risk factors for injury, the authors prospectively monitored a cohort of 421 runners competing on 23 cross-country teams in 12 Seattle, Washington, high schools during the 1996 cross-country season. Collected were daily injury and athletic exposure (AE) reports, a baseline questionnaire on prior running and injury experience, anthropometric measurements, and coaches' training logs. The overall incidence rate of injury was 17.0/1,000 AEs. Girls had a significantly higher overall injury rate (19.6/1,000 AEs) than boys did (15.0/1,000 AEs) (incidence rate ratio = 1.3, 95% confidence interval: 1.0, 1.6). Compared with boys, girls had significantly higher rates of injuries resulting in >or=15 days of disability. For the overall sample and for girls, Cox regression revealed that a quadriceps angle of >or=20 degrees and an injury during summer running prior to the season were the most important predictors of injury. For boys, a quadriceps angle of >or=15 degrees and a history of multiple running injuries were most associated with injury. Results suggest that the incidence of lower-extremity injuries is high for cross-country runners, especially girls. Preseason screening to determine risk factors should be examined as a preventive approach for identifying high-risk runners.

Meta-narrative analysis of sports injury reporting practices based on the Injury Definitions Concept Framework (IDCF): A review of consensus statements and epidemiological studies in athletics (track and field)

Article

Dec 2014
J SCI MED SPORT

Consistency in routines for reporting injury has been a focus of development efforts in sports epidemiology for a long time. To gain an improved understanding of current reporting practices, we applied the Injury Definitions Concept Framework (IDCF) in a review of injury reporting in a subset of the field. Meta-narrative review, An analysis of injury definitions reported in consensus statements for different sports and studies of injury epidemiology in athletics (track and field) published in PubMed between 1980 and 2013 was performed. Separate narratives for each of the three reporting contexts in the IDCF were constructed from the data. Six consensus statements and 14 studies reporting on athletics injury epidemiology fulfilled the selection criteria. The narratives on sports performance, clinical examination, and athlete self-report contexts were evenly represented in the eligible studies. The sports performance and athlete self-report narratives covered both professional and community athletes as well as training and competition settings. In the clinical examination narrative, data collection by health service professionals was linked to studies of professional athletes at international championships. From an application of the IDCF in a review of injury reporting in sports epidemiology we observed a parallel usage of reporting contexts in this field of research. The co-existence of reporting methodologies does not necessarily reflect a problematic situation, but only provided that firm precautions are taken when comparing studies performed in the different contexts. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Subsequent injury in National Sporting Organisations: Towards a National Reporting System

Conference Paper

Oct 2014
J SCI MED SPORT

Michael Keith Drew

Introduction The Australian Institute of Sport (AIS) has recently invested in an online data management system (AMS) which incorporates injury and illness data, clinical notes, training loads, wellness reporting, as well as many other performance-related variables. This management system has been adopted by 19 National Sporting Organisations (NSO) with four more planned later in 2014 and 4 State Institutes of Sport/Academies of Sport (SISSAS) have formally agreed, with implementation at various stages throughout 2014. The adoption of this monitoring system has grown exponentially with current estimations indicating approximately 10,000 injuries will be recorded over the next 5 years. Clinically, it is understood that any injury will disrupt training and exposes the athlete to risk of injury on return competition due to the relative shift in training volume and modality, thus injury prevention programs and ongoing monitoring systems are imperative for the success of Australian athletes. This presentation outlines the methodology that the AIS is undertaking to monitor and prevent subsequent injuries. Methods Monitoring of injuries and illness was undertaken across the 19 NSOs over a 6 month period. A data dictionary was created with common definitions of injury and illness. The definition of injury and illness was defined as “Any physical or medical complaint that results in an athlete being unable to participate in training or competition, as planned by coaching staff, for greater than 24 hours”. Subsequent injuries were defined as an injury sustained following an index injury (SIC model). Index injuries were defined as the first new injury within this period. Results 2318 athletes were monitored with 577 injuries recorded (new, n=414; recurrent, n=163; insidious onset, n=164; overuse, n=208, trauma, n=205). Thirty-seven percent of all injuries recorded were subsequent to an index injury (n=216, median=2/injured athlete, range=0-6). The overall servicing cost of all injuries equated to 2187 physiotherapy treatments, 1980 “maintenance” treatments (treatment in the absence of current injury) and 1121 soft-tissue therapy treatment (21% directly related to injury management) spread across 60 physiotherapy staff nationally. The estimated financial cost of these treatments was estimated as $650,000AU. Discussion The results of this study show a comparatively high subsequent injury rate compared to previous studies. It highlights the need to monitor and implement injury prevention programs for subsequent injuries. This study presents the methodology the Australian Institute of Sport is undertaking to monitor subsequent injuries in Australian National Sporting Organisations.

Extending in-competition Athletics injury and illness surveillance with pre-participation risk factor screening: A pilot study

Article

Jun 2014
PHYS THER SPORT

Objectives To explore the performance of retrospective health data collected from athletes before Athletics championships for the analysis of risk factors for in-competition injury and illness (I&I). Methods For the 2013 European Athletics Indoor Championships, a self-report questionnaire (PHQ) was developed to record the health status of 127 athletes during the 4 weeks prior to the championship. Physician-based surveillance of in-competition I&I among all 577 athletes registered to compete was pursued during the championships. Results 74 athletes (58.3%) from the sample submitted a complete PHQ. 21 (28%) of these athletes sustained at least one injury and/or illness during the championships. Training more than 12h/week predisposed for sustaining an in-competition injury, and a recent health problem for in-competition illness. Among the 577 registered athletes, 60 injuries (104/1000 registered athletes) were reported. 31% of injuries were caused by the track, and 29% by overuse. 29 illnesses were reported (50/1000 registered athletes); upper respiratory tract infection and gastro-enteritis/diarrhoea were the most reported diagnoses. Conclusions Pre-participation screening using athletes’ self-report PHQ showed promising results with regard to identification of individuals at risk. Indoor injury types could be attributed to extrinsic factors, such as small track size, track inclination, and race tactics.

Time Trends for Injuries and Illness, and Their Relation to Performance in the National Basketball Association

Article

May 2014
J SCI MED SPORT

Objectives To survey injury/illness in the National Basketball Association (NBA) over a 25-year period and examine the relationship of injury/illness to team performance. Design A retrospective correlational design. Method Trends were examined in reported numbers of players injured/ill during a season and games missed due to injury/illness from seasons ending in 1986 through 2005. This period was compared to years 2006-2010, when NBA teams were allowed to increase the total number of players on the team from 12 to 15. Results There was a highly significant trend (p <0.0001) of increasing numbers of players injured/ill and games missed from 1986 through 2005. After the team expansion in 2006, these rates fell abruptly by 13% and 39% respectively (both p <0.0001 compared to the previous 5-year period). We also found a significant inverse association between games missed due to injury/illness and percent games won (r = -0.29, p <0.0001). Conclusions Results demonstrate an increased rate of injury in the NBA up until the expansion of team size in 2006. Following 2006, team expansion was positively associated with decreased injury/illness rates. The latter finding suggests the importance of maintaining a healthy roster with respect to winning outcomes.

Injury patterns in Swedish elite athletics: Annual incidence, injury types and risk factors

Article

Mar 2013
BRIT J SPORT MED

Objective To estimate the incidence, type and severity of musculoskeletal injuries in youth and adult elite athletics athletes and to explore risk factors for sustaining injuries. Design Prospective cohort study conducted during a 52-week period. Setting Male and female youth and adult athletics athletes ranked in the top 10 in Sweden (n=292). Results 199 (68%) athletes reported an injury during the study season. Ninety-six per cent of the reported injuries were non-traumatic (associated with overuse). Most injuries (51%) were severe, causing a period of absence from normal training exceeding 3 weeks. Log-rank tests revealed risk differences with regard to athlete category (p=0.046), recent previous injury (>3 weeks time-loss; p=0.039) and training load rank index (TLRI; p=0.019). Cox proportional hazards regression analyses showed that athletes in the third (HR 1.79; 95% CI 1.54 to 2.78) and fourth TLRI quartiles (HR 1.79; 95% CI 1.16 to 2.74) had almost a twofold increased risk of injury compared with their peers in the first quartile and interaction effects between athlete category and previous injury; youth male athletes with a previous serious injury had more than a fourfold increased risk of injury (HR=4.39; 95% CI 2.20 to 8.77) compared with youth females with no previous injury. Conclusions The injury incidence among both youth and adult elite athletics athletes is high. A training load index combing hours and intensity and a history of severe injury the previous year were predictors for injury. Further studies on measures to quantify training content and protocols for safe return to athletics are warranted.

The Jackknife Estimate of Variance

Article

May 1981
ANN STAT

Tukey's jackknife estimate of variance for a statistic

S(X_1, X_2, \cdots, X_n)

which is a symmetric function of i.i.d. random variables

X_i

, is investigated using an ANOVA-like decomposition of S. It is shown that the jackknife variance estimate tends always to be biased upwards, a theorem to this effect being proved for the natural jackknife estimate of

\operatorname{Var} S(X_1, X_2, \cdots, X_{n-1})

based on

X_1, X_2, \cdots, X_n

Comparing the Areas under Two or More Correlated Receiver Operating Characteristic Curves: A Nonparametric Approach

Article

Oct 1988

Methods of evaluating and comparing the performance of diagnostic tests are of increasing importance as new tests are developed and marketed. When a test is based on an observed variable that lies on a continuous or graded scale, an assessment of the overall value of the test can be made through the use of a receiver operating characteristic (ROC) curve. The curve is constructed by varying the cutpoint used to determine which values of the observed variable will be considered abnormal and then plotting the resulting sensitivities against the corresponding false positive rates. When two or more empirical curves are constructed based on tests performed on the same individuals, statistical analysis on differences between curves must take into account the correlated nature of the data. This paper presents a nonparametric approach to the analysis of areas under correlated ROC curves, by using the theory on generalized U-statistics to generate an estimated covariance matrix.

Injuries in Runners

Article

Mar 1987
AM J SPORT MED

Sixty runners belonging to two clubs were followed for 1 year with regard to training and injury. There were 55 injuries in 39 athletes. The injury rate per 1,000 hours of training was 2.5 in long-distance/marathon runners and 5.6 to 5.8 in sprinters and middle-distance runners. There were significant differences in the injury rate in different periods of the 12 month study, the highest rates occurring in spring and summer. In marathon runners there was a significant correlation between the injury rate during any 1 month and the distance covered during the preceding month (r = 0.59). In a retrospective analysis of the cause of injury, a training error alone or in combination with other factors was the most common injury-provoking factor (72%). The injury pattern varied among the three groups of runners: hamstring strain and tendinitis were most common in sprinters, backache and hip problems were most common in middle-distance runners, and foot problems were most common in marathon runners.

Track and field athletics injuries - a one-year survey

Article

Oct 1994

D D'Souza

The training programmes and competitive performances of 147 track and field athletes, from many different clubs within the UK, were analysed retrospectively in order to study the incidence, severity and types of injuries which they had suffered during the year September 1989-September 1990. This information was then related to the particular event in which they specialized as well as a number of hypothetical risk factors proposed for making them more prone to injury. Of the athletes 96 (65.3%) were male and 51 (34.7%) were female, and their ages ranged from 14 to 32 years, with their levels of competition ranging from 'competitive spectators' to UK internationals. A marked correlation was noted between their age, level of competition, number of supervised training sessions which they attended, and their incidence of injuries. However, certain other factors which were studied, such as their sex, the hours they trained, and the particular event in which they specialized appeared to provide no obvious relationship.

Musculoskeletal injuries in track and field: Incidence, distribution and risk factors

Article

Sep 1996
Aust J Sci Med Sport

This study evaluated the incidence, distribution and types of musculoskeletal injuries sustained by 95 track and field athletes in a 12 month period using a retrospective cohort design, and analysed selected training, anthropometric, menstrual and clinical biomechanical risk factors. Overall, 72 athletes sustained 130 injuries giving an athlete incidence rate of 76% and an injury exposure rate of 3.9 per 1000 training hours. The majority of injuries were overuse in nature and approximately one-third of all injuries were recurrent. The risk of injury was not influenced by gender or event group. The most common sites of injury were the leg (28%), thigh (22%) and knee (16%) with the most common diagnoses being stress fractures (21%) and hamstring strains (14%). Injury patterns varied between event groups with middle-distance and distance runners sustaining more overuse injuries, and sprinters, hurdlers, jumpers and multi event athletes more acute injuries (p < 0.05). Increasing age, greater overall flexibility and a greater prevalence of menstrual disturbances were associated with a greater likelihood of injury. The results of this study show that track and field athletes are at high risk for musculoskeletal injury and that it may be possible to identify those who are more likely to sustain an injury.

The Orchard Sports Injury Classification System (OSICS) version 10

Article

Jun 2007
CLIN J SPORT MED

Injury classification systems are generally used in sports medicine (1) to accurately classify diagnoses for summary studies, permitting easy grouping into parent categories for tabulation and (2) to create a database from which cases can be extracted for research on specific injuries. Clarity is most important for the first purpose, whereas diagnostic detail is particularly important for the second. An ideal classification system is versatile and appropriate for all sports and all data collection scenarios. The Orchard Sports Injury Classification System (OSICS) was developed in 1992 primarily for the first purpose, a specific study examining the incidence of injury at the elite level of football in Australia. As usage of the OSICS expanded into different sports, limitations were noted and therefore many revisions have been made. A recent study found the OSICS-8, whilst superior to the International Classification of Diseases Australian Modification (ICD-10-AM) in both speed of use and 3-coder agreement, still achieved a lower level of agreement than expected. The study also revealed weaknesses in the OSICS-8 that needed to be addressed. A recent major revision resulted in the development of the new 4-character OSICS-10. This revision attempts to improve interuser agreement, partly by including more diagnoses encountered in a sports medicine setting. The OSICS-10 should provide far greater depth in classifications for the benefit of those looking to maintain diagnostic information. It is also structured to easily collapse down into parent classifications for those wanting to preserve basic information only. For those researchers wanting information collected under broader injury headings, particularly those not using fully computerized systems, the simplicity of the OSICS-8 system may still suffice.

Data dictionary for the national injury and illness database.

Drew M.K.
Wallis M.
Hughes D.

Drew MK, Wallis M, Hughes D. Data dictionary for the national injury and illness database, In: AIS best practice handbook. 1st ed. Canberra, Australian Sports Commission, 2014. p. 1-9.

Preparticipation injury complaint is a risk factor for injury: a prospective study of the Moscow 2013 IAAF Championships.

Jan 2015
1-8

Alonso J.-M
Jacobsson J.
Timpka T.

Performance success or failure is explained by weeks lost to injury and illness in elite Australian Track and Field athletes: a 5-year prospective study

Abstract

No full-text available

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