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

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 prevalence of injury and illness and summarizes reported injury or illness etiology and risk factors affecting short-course triathletes.Methods:This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 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 injuries,24 studies investigated illnesses,and 5 studies investigated both injuries and illnesses.The injury incidence rate ranged 15.7-24.3 per 1000 athlete exposures,and the illness incidence rate ranged 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 and lower limb injuries associated with running;gastrointestinal illnesses and altered cardiac function,primarily attributable to environmental factors;and respiratory illness mostly caused by infection.

Increased number of symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged time to return to full sports performance—AWAREⅧ

Purpose The aim of the study was to identify factors associated with prolonged time to return to full performance(RTFP)in athletes with recent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Methods Prospective cohort study with cross sectional analysis.A total of 84 athletes with confirmed SARS-CoV-2 infection assessed at a coronavirus disease 2019 recovery clinic gave a history of age,sex,type/level of sport,co-morbidities,pre-infection training hours,and 26 acute SARS-CoV-2 symptoms from 3 categories(“nose and throat”,“chest and neck”,and“whole body”/systemic).Data on days to RTFP were obtained by structured interviews.Factors associated with RTFP were demographics,sport participation,history of co-morbidities,pre-infection training history,and acute symptoms(type,number).Outcomes were:(a)days to RTFP(median,interquartile range(IQR))in asymptomatic(n=7)and symptomatic athletes(n=77),and(b)hazard ratios(HRs;95%confidence interval)for symptomatic athletes with vs.without a factor(univariate,multiple models).HR<1 was predictive of higher percentage chance of prolonged RTFP.Significance was p<0.05.Results Days to RTFP were 30 days(IQR:23–40)for asymptomatic and 64 days(IQR:42–91)for symptomatic participants(p>0.05).Factors associated with prolonged RTFP(univariate models)were:females(HR=0.57;p=0.014),endurance athletes(HR=0.41;p<0.0001),co-morbidity number(HR=0.75;p=0.001),and respiratory disease history(HR=0.54;p=0.026).In symptomatic athletes,prolonged RTFP(multiple models)was significantly associated with increased“chest and neck”(HR=0.85;p=0.017)and“nose and throat”(HR=0.84;p=0.013)symptoms,but the association was more profound between prolonged RFTP and increased total number of“all symptoms”(HR=0.91;p=0.001)and“whole body”/systemic(HR=0.82;p=0.007)symptoms.Conclusion A larger number of total symptoms and specifically“whole body”/systemic symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged RTFP.

Ready,set,go:Medical preparations for the Paris 2024 Paralympic Games

1.Introduction In August 2024,over 4400 Paralympic athletes will gather in Paris for the Paralympic Summer Games—the pinnacle of every Paralympian’s(Para athletes competing at the Paralympic Games)career to showcase their ability and skills.Their training,preparation,and effort in the years leading up to the Games are unparalleled.To achieve success,Paralympians specifically rely on a medical support team to achieve their goals.So,what is required of the medical support team to prepare Paralympians to get ready,set,and go to Paris 2024?

Revisiting the stretch-induced force deficit:A systematic review with multilevel meta-analysis of acute effects

Background:When recommending avoidance of static stretching prior to athletic performance,authors and practitioners commonly refer to available systematic reviews.However,effect sizes(ES)in previous reviews were extracted in major part from studies lacking control conditions and/or prepost testing designs.Also,currently available reviews conducted calculations without accounting for multiple study outcomes,with ES:0.03 to 0.10,which would commonly be classified as trivial.Methods:Since new meta-analytical software and controlled research articles have appeared since 2013,we revisited the available literatures and performed a multilevel meta-analysis using robust variance estimation of controlled prepost trials to provide updated evidence.Furthermore,previous research described reduced electromyography activity—also attributable to fatiguing training routines—as being responsible for decreased subsequent performance.The second part of this study opposed stretching and alternative interventions sufficient to induce general fatigue to examine whether static stretching induces higher performance losses compared to other exercise routines.Results:Including 83 studies with more than 400 ES from 2012 participants,our results indicate a significant,small ES for a static stretch-induced maximal strength loss(ES=0.21,p=0.003),with high magnitude ES(ES=0.84,p=0.004)for stretching durations≥60 s per bout when compared to passive controls.When opposed to active controls,the maximal strength loss ranges between ES:0.17 to0.28,p<0.001 and 0.040 with mostly no to small heterogeneity.However,stretching did not negatively influence athletic performance in general(when compared to both passive and active controls);in fact,a positive effect on subsequent jumping performance(ES=0.15,p=0.006)was found in adults.Conclusion:Regarding strength testing of isolated muscles(e.g.,leg extensions or calf raises),our results confirm previous findings.Nevertheless,since no(or even positive)effects could be found for athletic performance,our results do not support previous recommendations to exclude static stretching from warm-up routines prior to,for example,jumping or sprinting.

Review and update on the management of triangular fibrocartilage complex injuries in professional athletes

Triangular fibrocartilage complex injuries are common in amateur and professional sports.These injuries are mainly caused by acute or chronic repetitive axial loads on the wrist,particularly on the ulnar side and in association with rotations or radial/ulnar deviations.In order to treat professional athletes,a detailed specific knowledge of the pathology is needed.Moreover,the clinician should fully understand the specific and unique environment and needs of the athletes,their priorities and goals,the type of sport,the time of the season,and the position played.An early diagnosis and appropriate management with the quickest possible recovery time are the uppermost goals for both the athlete and the surgeon.A compromise between conservative vs surgical indications,athletes’needs and expectations,and financial implications should be achieved.Arthroscopic procedures should be timely planned when indicated as they could allow early diagnosis and treatment at the same time.Conservative measures are often used as first line treatment when possible.Peripheral lesions are treated by arthroscopic repair,whilst central lesions are treated by arthroscopic debridement.Further procedures(such as the Wafer procedure,ulnar osteotomies,etc.)have specific indications and great implications with regard to rehabilitation.

How University Athletics Can Impact Mental Health among Student Athletes at the University of Evansville

In recent years, the NCAA student athlete population in the United States has surpassed 500,000, and is continuing to rise each year [1]. These student athletes work their entire lives academically and athletically to reach the ultimate goal: competing in university athletics. However, when these athletes reach university, they are met with non-stop training, homework, exams, and evolving social lives. We have conducted a study at the University of Evansville evaluating how participation in university athletics may impact mental health status among these student athletes, as well as measuring players’ awareness of accessible mental health resources. Over fifty percent of participants reported experiencing at least one mental health condition while competing in their sport;eighty percent reported having knowledge of the mental health resources available to them on campus, however, nearly thirty percent of those knowledgeable reported not knowing how to access these resources. This has indicated a gap in awareness and utilization of mental health resources among student athletes at the University of Evansville.

Barriers and Motivators of Young Dutch Elite Athletes for Optimizing Their Nutritional Intake

Many young elite athletes do not meet their daily energy and nutrient requirements. However, little research has been done on why these athletes do not meet their daily needs. The aim was to research the barriers and motivators of young Dutch elite athletes to optimize their nutritional intake. Quantitative and qualitative research was conducted among 8 handball and 4 volleyball players at the Dutch National Sports Center (17.2 ± 0.8 years). First, the nutritional intake was tracked through food diaries and analyzed in Nutritics. Thereupon, five semi-structured interviews based on the COM-B model were carried out. The interviews were transcribed and coded. The athletes had a reduced intake of energy, carbohydrates, vitamins A, C, E, D, calcium, potassium, zinc, and iron compared to their requirements. Seven themes for optimizing their nutritional intake emerged in the interviews: needs assessment, practical translation, portion size, lack of time, involvement, individuality, and food distribution. Barriers that the athletes experienced were that they did not know what their total daily nutritional needs were and how this translates into practice. In addition, the portion size at dinner was too small. They also had little time to eat a full meal due to time pressure from training and school. On the other hand, motivators were receiving meal options to translate their needs into practice with a distribution of moments when they need to eat. Covering these topics in nutritional workshops where athletes actively participate with more individual focus, could contribute to the optimization of their nutritional intake.

Oxidative Stress in Collegiate Cross Country Skiers in Mid- and Post-Seasons

Purpose: The oxidative stress (OS) hypothesis of overtraining syndrome argues that increased production of free radicals through exercise cause muscle fatigue and damage resulting in lower athletic performance. Several studies have investigated OS immediately before and after exercise bouts in a training macrocycle. Our study aimed to compare OS of endurance athletes between a competition macrocycle and the immediate post-season recovery macrocycle. In addition, we aimed to identify athletes who experienced an unexplainable drop in athletic performance during the competition season in order to compare their OS to those who experienced no drop in performance. Methods: Fifteen members of the University of Alaska Fairbanks cross country ski team volunteered for this study. Blood samples were taken in early February (“mid-season”) and late April (“post-season”). Participants completed questionnaires regarding physical activity and athletic performance at the time of the blood draws. Plasma was analyzed for 4-hydroxynonenal (HNE), nitrotyrosine, nitric oxide (NOX), and superoxide dismutase (SOD). Significance was determined by Wilcoxon and Mann-Whitney tests. Results: Participants displayed significantly higher (p Conclusion: Signs of oxidative stress and mitigation during the post-season recovery macrocycle were higher in athletes who reported experiencing a drop in athletic performance during the competition season macrocycle.

Osgood Schlatter Disease: Study of 2 Observations in Conakry, Guinea

Introduction: OSD is a growth osteochondrosis affecting the apophyseal cartilage of the anterior tibial tuberosity of the knee, 20 to 30% of young growing athletes suffer from this pathology, described by Osgood and Schlatter in 1903. Objective: To report 2 observations and review the literature. Observation 1: This was a 14-year-old Guinean teenager, Halpoular, living in Conakry, a right-handed footballer who presented with a painful swelling of the right knee that looked mechanical, whose father had HLA B27 positive ankylosing spondylitis. X-ray of the right knee showed fragmentation of the anterior tibial tuberosities, and ossicle with edema of the patellar tendons at stage 4 according to Ehrenbord and Lagergren (1961). Thus, the disease of OSD is retained, He received 120 mg of diclofenac, 20 mg omeprazole for 1 month and the cessation of sports activity, the evolution was favorably marked by the regression of pain. Observation 2: A 16-year-old girl, initials M.L.T, Guinean, residing in Coyah (Republic of Guinea), a handball player, consulted for intense pain (VAS: 8/10) in her knees after a violent shock received when she hit the post. The physical examination found a painful, soft swelling at the anterior tibial tuberosity of the right knee, the rest of the examination was normal. The X-ray of the right knee shows fragmentation of the anterior tibial tuberosity, and ossicle with edema of the patellar tendon at stage 4 according to Ehrenbord and Lagergren 1961, thus the OSD disease is retained, the treatment instituted was 120 mg of diclofenac, the cessation of sports activity which gives a good evolution (EVA at 2/10). Conclusion: OSD is a growth osteochondrosis affecting the apophyseal cartilage of the anterior tibial tuberosity of the knee in young growing athletes, resolving at rest.

A unique pseudo-eligibility analysis of longitudinal laboratory performance data from a transgender female competitive cyclist

Background and Aims:The Union Cycliste Internationale has deemed transgender female athlete’s ineligible for the female category due to concerns about performance advantages.We conducted a follow-up analysis on laboratorybased performance indicators of sports performance using data from a longitudinally assessed transgender woman athlete undergoing gender-affrming hormone therapy(GAHT).Methods:We evaluated laboratory performance indicators in transgender and cisgender women athletes using dualenergy X-ray absorptiometry scanning,handgrip strength measurement,jump testing,and cardiopulmonary exercise.Additionally,we assessed a transgender sub-elite cyclist before and after undergoing GAHT.Results:After one year of GAHT,the transgender athlete showed declines in handgrip strength(7–13%),countermovement jump(23–29%),and V̇O_(2)max(15–30%).After 3 months,several performance indicators(absolute handgrip,peak power,relative peak power,average power,relative average power,V̇O2max and relative V̇O_(2)max)were above the mean of cisgender female athletes,while others(Relative handgrip,countermovement jump and relative countermovement jump)were below.Similar trends were observed at 6 months and 1 year.Summary:This hypothetical analysis,although with limited evidence,suggests the transgender athlete could compete equitably in elite cycling events within the female category after one year of GAHT.Adjustments based on competition data would ensure fairness.Further analysis after an additional 12 months is recommended to assess the impact of 2 years of GAHT.An outright ineligibility for the female category for transgender women athletes would hinder a true assessment of performance fairness.

Ultrasound-Guided Athletic Pubalgia Prolotherapy: A Novel Treatment

Research background: Athletic Pubalgia is a common, debilitating sports condition encountered by athletes who participate in competitive sports requiring pivoting movements. Athletic Pubalgia is often multifactorial with several pathologies overlapping to cause groin pain. Soft tissue disruptions at the insertions of adductor longus and rectus abdominis to the pubic symphysis are often encountered. Prolotherapy is the method of injecting an irritant solution into a joint space, ligament or tendon insertion site. The solution is thought to induce a regenerative response in the affected area through several mechanisms, including the induction of inflammation and vascular reconfiguration. Research objectives: The use of prolotherapy to treat Athletic Pubalgia has not been reported. The aim of this study was to assess ultrasound-guided prolotherapy as a therapeutic option in the treatment of Athletic Pubalgia. Methods: A case report, with informed consent (human material or human data were performed in accordance with the Declaration of Helsinki), involving a 24-year-old female presenting with Athletic Pubalgia. The patient presented with severe chronic right groin pain sustained while playing camogie. Conservative management options, including rest and rehabilitation with physiotherapy had failed to control this pain. Through dynamic ultrasound scanning, focal lesions were identified in the insertions of rectus abdominis and adductor longus to the pubic symphysis. Prolotherapy with 5% dextrose to the affected areas was performed. Assessment of analgesic and rehabilitation response was planned. Results: A sustained analgesic effect was observed at clinical follow-up at 6 weeks. Patient returned to full sporting activity. Conclusions: Ultrasound-guided prolotherapy has not yet been described as a treatment option in Athletic Pubalgia. In this case report, it was an effective pain-relieving therapy with improved rehabilitation. Larger studies are required to evaluate its efficacy.

Acute effects of transcranial direct current stimulation on cycling performance in trained male athletes

Objectives The purpose of this study is to examine the effects of applying anodal tDCS(2 mA for 20 min)over the scalp from T3(anodal-tDCS)to Fp2(cathodal-tDCS)on the perceptual,physiological and performance responses during maximal incremental and constant-load exercise(CLE)in trained cyclists.Methods Eleven male cyclists performed maximal incremental exercise(MIE)on a cycle ergometer under either tDCS or sham,with power output,heart rate(HR),oxygen uptake(V̇O_(2)),ratings of perceived exertion(RPE)assessed throughout,and blood samples collected before and after MIE.On two separate occasions,nine subjects performed CLE at 62%of the peak power output followed by a 15 km time trial under either tDCS or sham(n=8 for the time trial).Results HR,V̇O_(2),RPE and blood samples were collected at regular intervals.There were no differences between tDCS and sham in any variable during the MIE.tDCS elicited a decreased HR(F_(4,8)=9.232;p=0.016;η_(p)^(2)=0.54),increased V̇O_(2)(F_(4,8)=8.920;p=0.015;η_(p)^(2)=0.50)and increased blood non-esterified fatty acids(F_(6,8)=11.754;p=0.009;η_(p)^(2)=0.60)and glycerol(F_(6,8)=6.603;p=0.037;η_(p)^(2)=0.49)concentrations during the CLE when compared to sham.tDCS also improved 15 km time trial performance by 3.6%(p=0.02;d=0.47)without affecting RPE,HR and blood lactate.Conclusions The application of tDCS over the temporal cortex in trained cyclists improved cycling performance during a self-paced time trial but did not enhance performance during maximal incremental exercise.These results are encouraging and merit further investigation of the ergogenic effects of tDCS in trained athletes.

The Influence of Swimming Athletes’ Burnout on Their Sports Participation Motivation in Hunan, China

Objective:This study aims to explore the effect of swimming athletes’burnout on their sports motivation in Hunan University,China.It seeks to understand how burnout influences various motivational factors,providing insights for optimizing swimming sports courses and enhancing student participation.Method:Employing random sampling,the study surveyed 260 swimming athletes from Hunan University.The research utilized a questionnaire divided into three parts:demographic information,the Athlete Burnout Questionnaire(ABQ),and the Intrinsic Motivation Inventory(IMI).Pearson’s r correlation analysis was conducted using SPSS to examine the relationships between burnout dimensions and motivational factors.Results:The study found significant correlations between a reduced sense of accomplishment and various motivational dimensions,including“interest/enjoyment,”“perceived competence,”“perceived choice,”and particularly“perceived tension.”Physical exhaustion showed a significant correlation only with“perceived tension,”indicating a strong link between psychological stress and physical fatigue.Sports devaluation was significantly correlated with“perceived tension,”suggesting that psychological stress impacts athletes’valuation of their sport.Conclusion:The findings highlight the complex interplay between burnout and motivation in swimming athletes.Psychological stress,as indicated by“perceived tension,”emerges as a key factor influencing both the physical and emotional aspects of burnout.The study underscores the need for holistic training approaches that balance physical training with psychological well-being,personalized coaching,and supportive environments to enhance intrinsic motivation and manage stress effectively.

电感耦合等离子体质谱法(ICP-MS)测定运动员食品中铅、砷、镉、铜

Inductively coupled plasma mass spectrometry (ICP-MS) was applied to determine copper, arsenic, cadmium, lead in athletic food using Sc, Ge, In, Bi as an internal standard. The linear correlation factor for four elements are higher than 0.999. Recoveries of spiked samples are in the range of 85.5%-115.5% and precision was fine, RSD is lower than 5.0%. And these are close agreement with the reference values in three standard reference materials of GBW08503, NBS1568, GBW08571. It indicates that the method is simple, rapid, sensitive and accurate, which can meet the demand for copper, arsenic, cadmium, lead analysis in athletic food.

超临界水冷堆燃料性能验证实验回路的冷却剂丧失事故分析

超临界水冷堆燃料性能验证实验(SCWR-FQT)将对1个小型燃料组件在超临界水环境下进行堆内性能测试。本工作应用修改过的ATHLET程序对包含该燃料组件的超临界水冷实验回路进行建模,并对其冷却剂管道破口导致的失水事故进行分析计算。计算结果表明,现有安全系统设计基本能保证在这些事故情况下维持燃料棒实验段的有效冷却。结果显示,修改过的ATHLET程序对超临界水冷系统的模拟具有良好的适用性。

ATHLET程序的钠冷快堆应用扩展及其验证

系统分析程序是对钠冷快堆的冷却剂回路系统进行全局模拟、瞬态及事故安全分析的重要工具。本工作对德国核设施与反应堆安全机构(GRS)开发的轻水堆最佳估算系统程序ATHLET进行修改,增加了钠的物性公式和传热关系式,将其适用范围扩展到钠冷快堆。为验证修改过的ATHLET程序,对法国凤凰(Phenix)反应堆系统建模,并对其自然对流实验进行模拟,将计算结果与实验数据进行比较。结果显示,ATHLET程序的钠冷快堆应用扩展具有良好的适用性。

我国花样滑冰双人滑运动员自信心培养策略研究

根据花样滑冰双人滑运动的特点和现状,提出了对我国花样滑冰双人滑运动员自信心培养的策略,通过科学训练完善技术,加强运动员的艺术修养和对比赛成功情景的体验及加强赛前心理干预和赛后心理恢复等手段,帮助运动员在训练和比赛中提高自信心水平及专项心理能力,从而提高运动员竞技水平和运动成绩。

SCWR-FQT回路的冷却剂流量丧失事故研究

超临界水冷堆燃料验证实验(SCWR-FQT)将对1个小型燃料组件在超临界水环境下进行堆内性能测试。为了对该实验回路进行系统设计和安全分析,应用修改过的ATHLET程序建立实验回路计算模型,对两种造成燃料组件实验段冷却剂流量部分或全部丧失的设计基准事故进行模拟分析,即由于装载实验段的压力管内部的导向管破裂导致流经实验段的冷却剂旁通和主冷却剂泵卡轴事故。计算结果显示:实验段冷却剂旁通事故中,燃料包壳温度在事故初期出现约920℃的峰值;而主泵卡轴事故中,燃料包壳温度未明显升高。计算结果表明,现有的安全系统设计能保证在事故情况下维持燃料组件实验段的有效冷却。

ATHLET程序及其在低温供热堆中的应用

ATHLET程序是德国核设施安全评审中心GRS开发的一个重要的反应堆热工水力学分析程序。它可分析除堆芯熔化事故之外的其他设计基准事故 ,可应用于美欧传统和先进的压水堆和沸水堆 ,原苏联设计的压水堆 (VVER)和石墨水冷堆 (RBMK) ,以及加拿大的CANDU堆等反应堆系统的热工分析。介绍了微机版ATHLET程序 ,并用它对 5MW低温供热堆自然循环稳态运行工况进行了计算 。

Management and prevention of acute and chronic lateral ankle instability in athletic patient populations

Acute and chronic lateral ankle instability are common in high-demand patient populations. If not managed appropriately, patients may experience recurrent instability, chronic pain, osteochondral lesions of the talus, premature osteoarthritis, and other significantlong-term disability. Certain populations, including young athletes, military personnel and those involved in frequent running, jumping, and cutting motions, are at increased risk. Proposed risk factors include prior ankle sprain, elevated body weight or body mass index, female gender, neuromuscular deficits, postural imbalance, foot/ankle malalignment, and exposure to at-risk athletic activity. Prompt, accurate diagnosis is crucial, and evidence-based, functional rehabilitation regimens have a proven track record in returning active patients to work and sport. When patients fail to improve with physical therapy and external bracing, multiple surgical techniques have been described with reliable results, including both anatomic and nonanatomic reconstructive methods. Anatomic repair of the lateral ligamentous complex remains the gold standard for recurrent ankle instability, and it effectively restores native ankle anatomy and joint kinematics while preserving physiologic ankle and subtalar motion. Further preventative measures may minimize the risk of ankle instability in athletic cohorts, including prophylactic bracing and combined neuromuscular and proprioceptive training programs. These interventions have demonstrated benefit in patients at heightened risk for lateral ankle sprain and allow active cohorts to return to full activity without adversely affecting athletic performance.