Elite athletes competing at high-intensity in the hot and humid ambient conditions of the upcoming Games of the XXXII Olympiad (Tokyo 2020) are likely to reach elevated core temperature (≈41.5°C) as previously reported in elite competitions in the heat and the risk of exertional heat stroke (EHS) is heightened.1 EHS is a medical condition defined as an internal body temperature exceeding 40.5°C with

Genetic testing has had a major impact in many areas of medicine, including sports cardiology. Here we discuss cardiac genetic testing not as a screening tool but rather as an evidence-based follow-up test in an athlete with an abnormal ECG or medical history to identify those athletes who have a potentially life-threatening cardiac genetic disorder. Cardiac genetic testing is a valuable investigation

In their well-designed, case–control investigation of mouthguard use in youth ice hockey players and the risk of concussion, Chisholm and colleagues1 report that those wearing a mouthguard—whether custom-made or off-the-shelf—had lower rates of concussion than control participants. The point estimate suggests a considerably reduced risk, although the CIs are broad. The authors report differences in

I first started playing when I was 13 when my hometown got some wheelchairs and started a team. I know a lot of guys who are 10 years older than myself whose shoulders were pretty shot by the time they were 45, because all they did was push and push and did no counterbalance work. Being a daily wheelchair user, as well as playing wheelchair sport, that wear and tear is continuous and ongoing on the

My mother had a total hip replacement (THR) 20 years ago, at age 50, just after my dad had died of a brain tumour. She would say, ‘at least this hip problem is not life threatening’. After mum’s joint replacement surgery, I saw her live life to the full—including jet-skiing, tandem paragliding! Her replaced hip (the early small-headed Charnley prosthesis) is still doing great. As a young physiotherapist

In early 2020, the world is facing a global emergency called COVID-19 (coronavirus disease 2019). On 11 March 2020, the WHO has declared the ‘Pandemic state’ calling the governments to take ‘urgent and aggressive action’ to delay and mitigate the peak of infection. The seriousness of the situation is evidenced by the extreme uncertainty of the measures taken by the governments of the various countries

Objectives To test (i) if greater foot pronation (measured as midfoot width mobility) is associated with better outcomes with foot orthoses treatment, compared with hip exercises and (ii) if hip exercises are superior to foot orthoses, irrespective of midfoot width mobility. Methods A two-arm parallel, randomised superiority clinical trial was conducted in Australia and Denmark. Participants (18–40

In the past two decades, there has been a revolution in literature relating to the epidemiology, aetiology, early recognition, prevention, diagnosis and treatment of sports-related concussion (SRC). This research has resulted in the publication of five international concussion in sport consensus statements.1 Are those recommendations impacting on pitch-side rulings and contributing to the real-life

I ran as a schoolboy at both cross-country and middle distance athletics. After a knee injury at university, a school friend introduced me to the pleasures of cycling as a leisure pursuit. In my mid-30s, I joined my local cycle club and I continued to ride for leisure. My peak weight in my early 40s was around 73 kg. At the age of 48, I regained my interest in cycling and started doing club time trials

Rapid advances in technologies in the field of genomics such as high throughput DNA sequencing, big data processing by machine learning algorithms and gene-editing techniques are expected to make precision medicine and gene-therapy a greater reality. However, this development will raise many important new issues, including ethical, moral, social and privacy issues. The field of exercise genomics has

“After months of dieting and frustration, Cain found herself choosing between training with the best team in the world, or potentially developing osteoporosis or even infertility. She lost her period for 3 years and broke five bones. She went from being a once-in-a-generation Olympic hopeful to having suicidal thoughts.” 1 (Lindsay Crouse on Mary Cain) “And so trying to shame somebody into losing weight

Changing a sport system requires the appointment of new leaders or a grass roots cultural revolution. ‘I got caught in a system designed by and for men, which destroys the bodies of young girls,’ said Mary Cain as she cast light on her toxic coach/athlete relationship and exposed unhealthy coaching and nutrition practices. Her candour has inspired a social media movement calling for changes to women’s

Sport-related concussion is a major public health concern. In a recent BJSM publication, McGuine et al conducted a randomised controlled trial (RCT) to evaluate whether soccer headgear would reduce the rate or severity of concussions in adolescent athletes (nheadgear = 1505, nno_headgear = 1545).1 Both ‘control’ athletes (who wore no helmets) and the athletes who wore soccer headgear had similar concussion

Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport-specific or setting-specific consensus statements on sports injury (and, eventually, illness) epidemiology

In 2013, the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O) was developed to record the magnitude, symptoms and consequences of overuse injuries in sport. Shortly afterwards, a modified version of the OSTRC-O was developed to capture all types of injuries and illnesses-The Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H). Since then, users from

Coding in sports medicine generally uses sports-specific coding systems rather than the International Classification of Diseases (ICD), because of superior applicability to the profile of injury and illness presentations in sport. New categories for coding were agreed on in the 'International Olympic Committee (IOC) consensus statement: Methods for recording and reporting of epidemiological data on

OBJECTIVES Glucocorticoids are commonly prescribed in medicine. When administered via certain routes, glucocorticoids are prohibited for incompetition use by WADA. The glucocorticoid prescribing habits of sports medicine doctors have not been reported. METHODS An online survey was distributed internationally to physicians working in high-performance sports. The survey queried the doctors about their

Background There have been no large randomised controlled trials to determine whether soccer headgear reduces the incidence or severity of sport-related concussion (SRC) in US high school athletes. Objective We aimed to determine whether headgear reduces the incidence or severity (days out from soccer) of SRCs in soccer players. Methods 2766 participants (67% female, age 15.6±1.2) (who undertook 3050

Objective To compare rates of injury and concussion among non-elite (lowest 60% by division of play) Bantam (ages 13–14 years) ice hockey leagues that disallow body checking to non-elite Bantam leagues that allow body checking. Methods In this 2-year cohort study, Bantam non-elite ice hockey players were recruited from leagues where policy allowed body checking in games (Calgary/Edmonton 2014–2015

Objectives The objective was to describe the typical duration of absence following the most common injury diagnoses in professional football. Methods Injuries were registered by medical staff members of football clubs participating in the Union of European Football Association Elite Club Injury Study. Duration of absence due to an injury was defined by the number of days that passed between the date

Background It has been hypothesised that injury risk after return to play following an injury absence is influenced by the amount of training completed before return to competition. Aim To analyse if the number of completed training sessions between return to play and the first subsequent match appearance was associated with the odds of injury in men’s professional football. Methods From a cohort study

Can a healthcare intervention appear to have a substantial impact on an important outcome metric without really making a difference? Understanding whether an intervention can really increase the likelihood of a positive outcome is essential when translating research findings into clinical practice. Selectively reporting outcome metrics in randomised controlled trials (RCTs) can mislead readers to believe

Coronary artery calcification (CAC) is a strong marker of subclinical coronary atherosclerosis and leading authorities recommend CAC scoring to help inform patient management decisions in cardiovascular disease (CVD) prevention.1 2 This will result in an increasing number of athlete-patients with subclinical coronary atherosclerosis presenting to sport and exercise medicine physicians, raising questions

Background It is widely accepted that athletes sustain sports injury if they train ‘too much, too soon’. However, not all athletes are built the same; some can tolerate more training than others. It is for this reason that prescribing the same training programme to all athletes to reduce injury risk is not optimal from a coaching perspective. Rather, athletes require individualised training plans.

Owen PJ, Miller CT, Mundell NL, et al . Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. Br J Sports Med Published Online First: 30 October 2019. Doi. 10.1136/bjsports-2019-100886 The manuscript …

As sport and exercise medicine continues to establish itself as a fertile discipline for clinically relevant research, we are making discoveries across a broad spectrum of content—from the harmful effects of sitting to the best injury prevention protocols for elite athletes, and everything in between. There is one area that our community should pay more attention to: implementation. As more laboratory

OBJECTIVE To examine the overall effectiveness of interventions for reducing adult sedentary behaviour and to directly compare environmental, behavioural and multicomponent interventions. DESIGN Intervention systematic review with meta-analysis. DATA SOURCES Ovid PsycINFO, Ovid MEDLINE, EBSCOHost CINAHL, EBSCOHost SPORTDiscus and PubMed were searched from inception to 26 July 2017. ELIGIBILITY CRITERIA

OBJECTIVE To establish the meaning of the term 'adherence' (including conceptual and measurement definitions) in the context of therapeutic exercise (TE) for musculoskeletal (MSK) pain. DESIGN Systematic review using a search strategy including terms for: adherence, TE and MSK pain. Identified studies were independently screened for inclusion by two researchers. Two independent researchers extracted

OBJECTIVE To determine the accuracy of wrist and arm-worn activity monitors' estimates of energy expenditure (EE). DATA SOURCES SportDISCUS (EBSCOHost), PubMed, MEDLINE (Ovid), PsycINFO (EBSCOHost), Embase (Ovid) and CINAHL (EBSCOHost). DESIGN A random effects meta-analysis was performed to evaluate the difference in EE estimates between activity monitors and criterion measurements. Moderator analyses

OBJECTIVE To examine the effects of short-term, medium-term and long-term resistance exercise training (RET) on measures of cardiometabolic health in adults. DESIGN Intervention systematic review. DATA SOURCES MEDLINE and Cochrane Library databases were searched from inception to February 2018. The search strategy included the following keywords: resistance exercise, strength training and randomised

OBJECTIVE Preparticipation evaluation of veteran athletes should focus on accurate cardiovascular (CV) risk stratification and subclinical detection of coronary artery disease (CAD), which is the main cause of sudden cardiac death in this population. We aimed to investigate the effectiveness of current preparticipation methodology used to identify veteran athletes with high coronary atherosclerotic

OBJECTIVES To examine the ability of surgeons to predict the outcome of treatment for meniscal tears by arthroscopic partial meniscectomy (APM) and exercise therapy in middle-aged patients. DESIGN AND SETTING Electronic survey. Orthopaedic surgeon survey participants were presented 20 patient profiles. These profiles were derived from a randomised clinical trial comparing APM with exercise therapy

The Society of Obstetricians and Gynaecologists of Canada/Canadian Society for Exercise Physiology 2019 Canadian guideline for physical activity throughout pregnancy provides evidence-based recommendations for pregnant women to optimise maternal/fetal health.1–4 It was developed by a pan-Canadian panel of clinicians, exercise professionals, researchers and methodologists following rigorous, gold-standard

Despite its incontrovertible physical, psychological and social benefits, sport is a leading cause of joint injuries. In the short term, injuries may lead to missed training and competition, kinesiophobia, depression, social isolation, withdrawal from sport, reinjury and physical inactivity. In the long term, injuries are associated with obesity and reduced quality of life. Sport-related joint injuries

By the time I was 17, I had already spent 2 years going in/out of hospital. Having been told at the age of 9 that I would make the Olympics, I was very focused on my sporting goals. I had no prior family history of Crohn’s. It took 2 years for me to get a diagnosis and this severely affected my athletic development by preventing me from training/competing. I lost my opportunity to go to college in

The 2020 Tokyo Olympics will be held from 24 July to 9 August, in hot and humid environments, in the world’s largest metropolitan area. Two years to the day before the 2020 Olympics, temperatures surpassed 41°C with over 65 heat-related deaths recorded in a single week. Protecting the health and performance of the athlete under these conditions is a shared responsibility among the International Olympic

Many sporting teams, leagues and federations now mandate cardiac screening of athletes. The most common screening protocol in Australian sports involves a personal/family history and physical examination, together with a resting 12-lead ECG.1 Some bodies, such as the Union Cycliste Internationale, the England and Wales Cricket Board and the UK Football Association also mandate two-dimensional transthoracic

OBJECTIVE To examine associations between suicidal ideation and sexual and physical abuse among active and recently retired elite athletics (track and field) athletes. METHODS The study population consisted of all athletes (n=402) selected for a Swedish Athletics team between 2011 and 2017. Data on suicidal ideation, suicidal events (estimated through the 1 year non-sports injury prevalence), lifetime

It has been proposed to bin the term ‘overuse’ injury and replace it with ‘training load error’ as a more accurate term.1 There are several concerns with this proposal. To warrant a name change, the new name should provide additional benefit beyond that which overuse currently provides, be based on reasonable and sound arguments and assumptions, and be coherent with the best practice and evidence available

Using an expert consensus-based approach, a rugby union Video Analysis Consensus (RUVAC) group was formed to develop a framework for video analysis research in rugby union. The aim of the framework is to improve the consistency of video analysis work in rugby union and help enhance the overall quality of future research in the sport. To reach consensus, a systematic review and Delphi method study design

Life was good, playing football, going out with friends and working as a boilermaker! Even after my first two concussions this pattern continued; I had no idea what was ahead. My first concussion was in 2012 playing football. I took a big hit, was disorientated and confused, but recovered quickly. I went out drinking with friends the next day and played, symptom free, the following week. A year later

> Specialisation - the process of becoming an expert in a particular area of work, study or business; the fact of spending more time on one area of work. Oxford dictionary For the field of sports medicine, 2019 will stand in the history of New Zealand (NZ) physiotherapy. When the NZ Board of Physiotherapy first released the areas of specialisation, the category ‘sports’ was left off the list. Some

Knee osteoarthritis (OA), characterised by knee pain and functional limitation,1 2 is widely understood to imply that symptoms are due to structural damage. This view leads to the belief that non-surgical approaches are futile and the structural damage needs to be ‘fixed’.3 4 In contrast, contemporary evidence supports knee OA as a ‘whole person condition’ in which knee health is influenced by the

There you are, spending hours, days, months maybe even years on your research. You go ahead and publish it and alas! Those stress-filled seasons turn into a meagre 10 downloads. ‘ No one gets how important this is!’ you cry. Let us at the B ritish Journal of Sports Medicine (BJSM), prepare cushions around you and break it to you: it’s not them, it’s you! You expected a dopamine reward kick, but you

Persistent tendon pain that impairs function has inconsistent medical terms that can influence choice of treatment.1 When a person is told they have tendinopathy by clinician A or tendinitis by clinician B, they might feel confused or be alarmed at receiving what they might perceive as two different diagnoses. This may lead to loss of confidence in their health professional and likely adds to uncertainty

OBJECTIVES To determine, in people with knee osteoarthritis (KOA): i) the effectiveness of adding hip strengthening exercises to quadriceps exercises and ii) the type of hip strengthening exercise with the greatest evidence for improving pain, function and quality of life. DESIGN Systematic review with meta-analysis. DATA SOURCES Medline, Embase, Cochrane, CINAHL and SportDiscus databases were searched

OBJECTIVE To assess whether aerobic exercise was superior to usual care in alleviating depressive symptoms in patients living with a major non-communicable disease. DATA SOURCES Data were obtained from online databases (PubMed, PsycINFO and SPORTDiscus) as well as from reference lists. The search and collection of eligible studies was conducted up to 18 October 2018 (PROSPERO registration number CRD42017069089)

OBJECTIVE To test a physical activity intervention (MOVI-KIDS) on obesity indicators, physical fitness and blood pressure (BP) in children. METHODS A crossover randomised cluster trial was conducted, which comprised 1434 children (4-7 years old) from 21 schools in the provinces of Cuenca and Ciudad Real in the Castilla-La Mancha region of Spain. The intervention consisted of three 60 min sessions/week

OBJECTIVES We investigated the temporal trend and the geographical variation in the rate of an anterior cruciate ligament (ACL) reconstruction and meniscal repair (MR) performed in England during a 20-year window. METHODS All hospital episodes for patients undergoing ACL reconstruction or MR between 1 April 1997 and 31 March 2017 were extracted by procedure code from the national hospital episode statistics

BACKGROUND Exercise is considered important in the management of patients with rheumatic diseases, but the effect of high intensity exercises on disease activity is unknown. OBJECTIVE To investigate the effectiveness of high intensity exercises on disease activity in patients with axial spondyloarthritis (axSpA). METHOD Assessor blinded multicentre randomised controlled trial. 100 patients (aged from

Concussions in rugby union (rugby) impact not only player welfare but parental and players’ decisions around participation, a concern for rugby administrators around the world.1 2 To ensure player welfare, World Rugby has developed concussion management recommendations (http://playerwelfare.worldrugby.org/concussion)3; however, the practical application and enforcement of these recommendations presents

Rugby union (rugby) is a popular full-contact team sport played by 8.5 million individuals in 121 countries across the globe (https://www.world.rugby/development/player-numbers). In New Zealand (NZ), rugby is played by 157 218 individuals and engages all genders, ethnicities and socioeconomic diversities throughout the population. A key focus of both the international governing body of rugby (World

Running economy (RE) is an important determinant of distance running performance that expresses running efficiency as the oxygen uptake necessary to sustain a fixed submaximal running speed.1 Many interventions have been proposed to improve RE (ie, reduce oxygen uptake), with strength training (ST) being one of the most frequently investigated training strategies.1 2 The literature indicates that 6

Caffeine has been used as a performance-enhancing aid by athletes for many years. The first known study to explore the effects of caffeine ingestion on exercise performance dates back to 1907.1 Until recently, however, findings on this topic remained equivocal, despite a large number of published studies over the last 30 to 40 years.2 There are many possible reasons for the discrepant results between

My PhD comprised studies that identified: (1) the efficacy of physiotherapist-led physical activity (PA) interventions; (2) the behaviour change techniques (BCTs), or individual strategies, Australian physiotherapists use to promote PA to improve general health (non-treatment physical activity [NTPA]) and (3) the factors influencing their decision to promote NTPA.1–5 Physiotherapists are expected to

The narrative review by Professor Stamatakis and colleagues1 published in the British Journal of Sports Medicine ( BJSM ) challenges the appropriateness of having quantitative public health guidelines on sedentary behaviour at this time. The authors argue that we still know little about the independent health effects of sitting, and the possibility that sitting is merely the inverse of physical activity

In the autumn of 2016, I completed my second marathon. I was an ambitious 35-year-old athlete, participating year-round in activities that included running, road cycling, triathlon and alpine skiing. I was fit and well, and apart from pollen allergies I had not had any medical treatment. Approximately 3 hours after the marathon, I developed my first episode of bloody diarrhoea. As a doctor, I suspected

Davenport MH, Nagpal TS, Mottola M, et al . Prenatal exercise (including but not limited to pelvic floor muscle training) and urinary incontinence during and following pregnancy: …

Hip-related pain is a well-recognised complaint among active young and middle-aged active adults. People experiencing hip-related disorders commonly report pain and reduced functional capacity, including difficulties in executing activities of daily living. Patient-reported outcome measures (PROMs) are essential to accurately examine and compare the effects of different treatments on disability in

Intermittent claudication (IC) is pain or discomfort in the muscles of the calf, thigh or buttock that occurs during walking and is relieved by rest. It affects 4% of people over 60 years of age and is the most common symptom of peripheral arterial disease (PAD). For people with IC, the goals of treatment are twofold: (1) secondary prevention of cardiovascular disease through management of risk factors