Single leg hop for distance symmetry masks lower limb biomechanics:

http://dx.doi.org/10.1136/bjsports-2020-103677

Time to discuss Single Leg Hop distance as decision criteria for return to sport after #ACL reconstruction ?

A MUST read paper and not surprised after seeing the authors associated with the work

The study evaluated the lower limb status of athletes after anterior cruciate ligament reconstruction (ACLR) during the propulsion and landing phases of a single leg hop for distance (SLHD) task after they had been cleared to return to sport.

The Authors wanted to evaluate the biomechanical components of the involved (operated) and uninvolved legs of athletes with ACLR and compare these legs with those of uninjured athletes (controls).

For the full paper click on the link : bjsports-2020-103677.full

 

Anterior cruciate ligament injury: towards a gendered environmental approach

Authors:

  1. Joanne L Parsons
  2. Stephanie E Coen
  3. Sheree Bekke

Anterior cruciate ligament injury: towards a gendered environmental approach | British Journal of Sports Medicine (bmj.com)

For all coaches out there, If you work with female athletes of any level in a coaching, clinical or performance role….. This is a must read.

The paper discusses the curious absence of gender as an influencer in the dialogue surrounding ACL injuries. the study proposes adding gender as a pervasive developmental environment as a new theoretical overlay to an established injury model to illustrate how gender can operate as an extrinsic determinant from the pre-sport, training and competition environments through to ACL injury and the treatment environment.

 

For a full read of the paper click here : bjsports-2020-103173.full

 

Suicidal thoughts (ideation) among elite athletics (track and field) athletes:

This is an original research paper published in the British Journal of Sports Medicine first published in 2020.

A sobering paper on the current issues of suicide thoughts among Elite athletes, reading this paper it is also applicable to the lower tiers of sport including Amateur on Male and Female players in all sports where issues of suicide go unreported, National Bodies must take action.

The paper examined associations between suicidal ideation and sexual and physical abuse among active and recently retired elite athletics (track and field) in Sweden.
For the full paper click on the link :

Suicidal thoughts (ideation) among elite athletics (track and field) athletes: associations with sports participation, psychological resourcefulness and having been a victim of sexual and/or physical abuse

 

Mental health in elite athletes: International Olympic Committee consensus statement (2019)

Authors:
Claudia L Reardon,  Brian Hainline,  Cindy Miller Aron, David Baron, Antonia L Baum, Abhinav Bindra, Richard Budgett, Niccolo Campriani, João Mauricio Castaldelli-Maia, Alan Currie, Jeffrey Lee Derevensky, Ira D Glick, Paul Gorczynski, Vincent Gouttebarge, Michael A Grandner, Doug Hyun Han, David McDuff, Margo Mountjoy, Aslihan Polat, Rosemary Purcell, Margot Putukian, Simon Rice, Allen Sills,Todd Stull, Leslie Swartz, Li Jing Zhu, Lars Engebretsen
Reference: Claudia L Reardon et al. Br J Sports Med 2019;53:667-699

Abstract

Mental health symptoms and disorders are common among elite athletes, may have sport related manifestations within this population and impair performance. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. There are no evidence or consensus based guidelines for diagnosis and management of mental health symptoms and disorders in elite athletes. Diagnosis must differentiate character traits particular to elite athletes from psychosocial maladaptations.

Management strategies should address all contributors to mental health symptoms and consider biopsychosocial factors relevant to athletes to maximise benefit and minimise harm. Management must involve both treatment of affected individual athletes and optimising environments in which all elite athletes train and compete. To advance a more standardised, evidence based approach to mental health symptoms and disorders in elite athletes, an International Olympic Committee Consensus Work Group critically evaluated the current state of science and provided recommendations.

This is a very thorough and in depth study of Mental Health, a few things that stand out for me

The reported prevalence of mental health symptoms and disorders among male elite athletes from team sports (cricket, football, handball, ice hockey and rugby) varies from 5% for burnout and adverse alcohol use to nearly 45% for anxiety and depression.

Men’s:

The reported prevalence of mental health symptoms and disorders among male elite athletes from team sports (cricket, football, handball, ice hockey and rugby) varies from 5% for burnout and adverse alcohol use to nearly 45% for anxiety and depression.

Prospective studies have reported that mental health disorders occur in 5% to 35% of elite athletes over a follow-up period of up to 12 months.

The sports with the highest general substance use/misuse rates across all substances for men’s elite sports are lacrosse, ice hockey, football, rugby, baseball, soccer, wrestling, weightlifting, skiing, biathlon, bobsleigh and swimming, and lowest for track, tennis and basketball.

Women’s

For women’s elite sports, the highest rates occur in ice hockey, gymnastics, lacrosse, softball, swimming, and rowing, and lowest in track, tennis, basketball and golf.

As women continue to engage in elite sport opportunities, their participation has led to varying degrees of cultural acceptance.

Women competing in sports traditionally considered ‘male’ may face being marginalised and stereotyped and may experience unequal training opportunities and resources.

Sexualisation, traditional gender roles, religion and ethnic beliefs all influence opportunities for women.

Tension may also exist between what is functionally optimal for women elite athletes to be wearing and what is culturally deemed acceptable. Gender stereotyping in the media may influence how women athletes view themselves.

Women athletes may be stereotyped as ‘lesbian’ to keep them from playing certain sports, or from playing for certain coaches or with certain teams. Some professional women athletes must train outside their native countries and may struggle to find a support network and cultural understanding from teammates in their new location

Summary on Male and Female

In general, those who participate in team sports are more likely to use or misuse substances than athletes in individual sports.

Common risk factors for use include: sport context and culture (eg, normative beliefs about heavy peer drinking or illicit drug use); situational temptation (eg, drinking games); permissive on attitudes among athletes, coaches and parents; male sex; use of performance enhancing substances or tobacco; identification as lesbian, gay, bisexual, transgender or queer; party lifestyle or drinking game participation; sensation seeking; overestimating peer use; achievement orientation; lower use of protective measures (eg, avoiding serious intoxication, using a designated driver); leadership position; fraternity/sorority membership; problem gambling; and injury.

Summary

The IOC has committed to improve the mental health of elite athletes, recognising that doing so will reduce suffering and improve quality of life in elite athletes and serve as a model for society at large. The IOC hopes that all involved in sport will increasingly recognise that mental health symptoms and disorders should be viewed in a similar light as other medical illnesses and musculoskeletal injuries; all can be severe and disabling, and nearly all can be managed properly by well informed medical providers, coaches and other stakeholders. Mental health is an integral dimension of elite athlete wellbeing and performance and cannot be separated from physical health.

Mental health assessment and management in elite athletes should be as commonplace and accessible as their other medical care; ideally elite athletes should have access to the best interdisciplinary care. To advance a more unified, evidence informed approach to mental health assessment and management in elite athletes, the IOC Consensus Group has critically evaluated the current state of the science and practice of mental health in elite athletes.

Click on the link for the full report: Report

Methods

Sleep and the Athlete: Narrative Review and 2021 expert consensus recommendations

AUTHORS: Neil P Walsh1, Shona L Halson2, Charli Sargent3, Gregory D Roach3, Mathieu Nédélec4, Luke Gupta5, Jonathan Leeder6, Hugh H Fullagar7, Aaron J Coutts7, Ben J Edwards1, Samuel A Pullinger1,8, Colin M Robertson9, Jatin G Burniston1, Michele Lastella3, Yann Le Meur4, Christophe Hausswirth10, Amy M Bender11, Michael A Grandner12, Charles H Samuels13

Abstract

Elite athletes are particularly susceptible to sleep inadequacies, characterised by habitual short sleep (<7 hours/night) and poor sleep quality (eg, sleep fragmentation). Athletic performance is reduced by a night or more without sleep, but the influence on performance of partial sleep restriction over 1–3 nights, a more real-world scenario, remains unclear.

Studies investigating sleep in athletes often suffer from inadequate experimental control, a lack of females and questions concerning the validity of the chosen sleep assessment tools. Research only scratches the surface on how sleep influences athlete health.

For example, athlete sleep is influenced by sport-specific factors (relating to training, travel, and competition) and non-sport factors (eg, female gender, stress and anxiety).

The study recommends an individualised approach that should consider the athlete’s perceived sleep needs. Research is needed into the benefits of napping and sleep extension (eg, banking sleep).

For the full article and understanding of Sleep and elite athletes click on the link bjsports-2020-102025.full

Mental health management of elite athletes during COVID-19: a narrative review and recommendations

Reardon CL, et al. Br J Sports Med 2020;0:1–10. doi:10.1136/bjsports-2020-102884

Authors:
Claudia L Reardon, Abhinav Bindra, Cheri Blauwet,
Richard Budgett, Niccolo Campriani,Alan Currie, Vincent Gouttebarge, David McDuff,
Margo Mountjoy, Rosemary Purcell, Margot Putukian, Simon Rice, Brian Hainline

Article Abstract:

ABSTRACT: Elite athletes suffer many mental health symptoms and disorders at rates equivalent to or exceeding those of the general population. COVID-19 has created new strains on elite athletes, thus potentially increasing their vulnerability to mental health symptoms. This manuscript serves as a narrative review of the impact of the pandemic on management of those symptoms in elite athletes and ensuing recommendations to guide that management. It specifically addresses psychotherapy, pharmacotherapy, and higher levels of care. Within the realm of psychotherapy, crisis counselling might be indicated. Individual, couple/ family and group psychotherapy modalities all may be helpful during the pandemic, with novel content and means of delivery. Regarding pharmacotherapy for mental health symptoms and disorders, some important aspects of management have changed during the pandemic, particularly for certain classes of medication including stimulants, medications for bipolar and psychotic disorders, antidepressants, and medications for substance use disorders. Providers must consider when in-person management (eg, for physical examination, laboratory testing) or higher levels of care (eg, for crisis stabilisation) is necessary, despite potential risk of viral exposure during the pandemic. Management ultimately should continue to follow general principles of quality health care with some flexibility. Finally, the current pandemic provides an important opportunity for research on new methods of providing mental health care for athletes, and consideration for whether these new methods should extend beyond the pandemic.

The study states :

What is already known:

► Elite athletes suffer from many mental health symptoms and disorders at rates equivalent to or exceeding those in the general population.

► The COVID-19 pandemic has created several new stressors for elite athletes.

► Management for athletes during the COVID-19 pandemic has focused on cardiac complications, screening for asymptomatic disease and return to sport, incorporating hygiene measures

What are the new findings:

► The COVID-19 pandemic has created changes in the way in which management of mental health symptoms and disorders in elite athletes—inclusive of community-based or outpatient psychotherapy, outpatient pharmacotherapy and higher levels of care—should be delivered.

► Within the realm of psychotherapy, crisis counselling and other forms of individual psychotherapy, couple/family and group psychotherapy all may be helpful during the COVID-19 pandemic, with novel content and means of delivery.

► Some important aspects of pharmacotherapy for management of mental health symptoms and disorders in elite athletes have changed during the pandemic, particularly for certain classes of medication including stimulants, medications for bipolar and psychotic disorders, antidepressants and medications for substance use disorders.

► It is important for providers to consider when in-person management or higher levels of care for mental health symptoms and disorders are necessary for elite athletes, despite potential risk of viral exposure during the COVID-19 pandemic.

Full Article Click here bjsports-2020-102884.full

Cardiorespiratory considerations for return-to-play in elite athletes after COVID-19 infection: a practical guide for sport and exercise medicine physicians

Published on the 5/9/2020 from the BJSM : Scans and cardiological tests for return to play, in athletes who have suffered covid 19.

Wilson MG, et al. Br J Sports Med 2020;54:1157–1161. doi:10.1136/bjsports-2020-102710

Authors:

1.Mathew G Wilson1,2,  2. James H Hull1,3,4, 3. John Rogers5,6,7, 4. Noel Pollock1,8, 5. Miranda Dodd2, 6. Jemma Haines5,6,9, 7. Sally Harris5,7, 8. Mike Loosemore1,4,
9. Aneil Malhotra5,6,10, 10. Guido Pieles1,11, 11. Anand Shah3,12, 12. Lesley Taylor5,7, 13. Aashish Vyas5,6,13, 14. Fares S Haddad1,2,14, 15. Sanjay Sharma15

Abstract:

SARS-CoV-2 is the causative virus responsible for the COVID-19 pandemic. This pandemic has necessitated that all professional and elite sport is either suspended, postponed or cancelled altogether to minimise the risk of viral spread. As infection rates drop and quarantine restrictions are lifted, the question how athletes can safely resume competitive sport is being asked. Given the rapidly evolving knowledge base about the virus and changing governmental and public health recommendations, a precise answer to this question is fraught with complexity and nuance. Without robust data to inform policy, return-to-play (RTP) decisions are especially difficult for elite athletes on the suspicion that the COVID-19 virus could result in significant cardiorespiratory compromise in a minority of afflicted athletes. There are now consistent reports of athletes reporting persistent and residual symptoms many weeks to months after initial COVID-19 infection. These symptoms include cough, tachycardia and extreme fatigue. To support safe RTP, we provide sport and exercise medicine physicians with practical recommendations on how to exclude cardiorespiratory complications of COVID-19 in elite athletes who place high demand on their cardiorespiratory system. As new evidence emerges, guidance for a safe RTP should be updated.

Read the full article here: RTP Covid

Fig 1 RTP pathway in those elite athletes confirmed (or suspected) COVID-19 positive. *History and physical examination should also consider other organ systems where COVID-19 can have pathological consequences such as neurological, gastrointestinal and dermatological. CPET,
cardiopulmonary exercise test; CRP, C reactive protein; CXR, chest X-ray; ECG, electrocardiogram; ECHO, echocardiography; hs-cTnT; high-sensitivity cardiac troponin T; MRI, magnetic resonance imaging; RTP, return to play.