My PhD aimed to explore the influence of cortical and corticospinal mechanisms of motor control and their influence in plantarflexor performance in runners with Achilles tendinopathy and whether it affected each muscle of the triceps surae differently (figure 1). Alongside neurophysiological measures, I also measured plantarflexor peak isometric torque, using isokinetic dynamometry, and endurance,

Bone stress injuries (BSIs) are common overuse injuries affecting an athlete’s ability to participate in sport. Advancements in understanding the pathophysiology, risk factors and management strategies related to BSIs can improve clinical care. This infographic informs clinicians on how to translate the latest research findings from an international Delphi consensus on BSIs in athletes1 into clinical

This five-study thesis aimed to establish the comparative effectiveness, optimal application and clinical transferability of isometric exercise training (IET) to better understand its potential role in future exercise guideline recommendations. Study 1 laid the foundations for the thesis with a large-scale comparative systematic review and network meta-analysis comparing IET against other guideline-recommended

People experiencing social disadvantage (eg, financial hardship) are at risk of poor health.1 Physical activity is an evidence-based strategy to improve physical and mental health,2 and free, tailored programs may enhance participation in underserved populations.3 Founded in 2022, Addi Moves is a free, culturally responsive and trauma-informed physical activity service for individuals experiencing

Objective To determine the frequency and diagnostic utility of visible signs identified through video review for sport-related concussion detection and to evaluate the role of injury mechanism in predicting concussions. Design Systematic review. Data sources MEDLINE, SPORTDiscus, Web of Science and Cochrane Library from 2001 to June 2024. Eligibility criteria Original, peer-reviewed studies focusing

Sport, exercise and physical activity are vital for women’s health and well-being, yet returning to these activities following injury, postpartum and through ageing can be challenging.1–3 There has been an ongoing fight for women to be treated the same as men, including the battle for equal pay, respect, access and media coverage. However, there is a growing demand, fuelled by an increase in the understanding

Plantar heel pain is the most common foot and ankle condition treated in clinical settings, often leading to persistent symptoms and functional limitations.1 Although multiple factors contribute to its development, most research has focused on the plantar fascia as the primary structure involved. Regarding its natural history, studies indicate that symptom reduction generally occurs over 12 months;

Low back pain is the leading cause of years lived with disability, imposing an enormous economic burden on society. In the UK, the cost of treating low back pain in general practice alone was estimated to be £3.2 billion in 2015, with 80% of these costs attributed to healthcare consultations.1 The healthcare costs of low back pain and neck pain were estimated to be US$134.5 billion in the USA in 2016

Hip dysplasia is a developmental condition that can be congenital or occur throughout childhood and increases the risk of hip osteoarthritis. It is associated with pain and impairments in young adults and can be career-ending for professional athletes. Rehabilitation often involves high-level goals and expectations, and there is no guarantee that interventions (both surgical and non-surgical) can always

Pelvic floor health is recognised as one of the 10 domains of female athlete health that should be included in illness and injury surveillance.1 However, pelvic floor health and dysfunction are not typically covered within sport and exercise medicine (SEM) training. Consequently, many females report not being asked about their pelvic health, and athletes, in particular, report being unlikely to disclose

The absence of agreed methods to diagnose Achilles tendinopathy impedes research and clinical practice. This gap results in heterogeneous and/or poorly described study samples, making it challenging to apply findings in clinical practice. The aim of this Delphi study was to define consensus on (1) diagnostic domains; (2) differential diagnoses; and (3) conditions requiring further medical attention

Knee cartilage lesions are frequent in football players, but evidence for surgical treatment is lacking. The aim of this International Cartilage Regeneration & Joint Preservation Society, Fédération Internationale de Football Association, and Aspetar (ICRS-FIFA-Aspetar) consensus was to develop specific expert-based, patient-specific practical recommendations on the appropriateness of non-surgical

Objective This study investigated the efficacy of cognitive functional therapy (CFT) versus a sham procedure for pain intensity and disability for patients with non-specific chronic low back pain (CLBP). Methods This is a randomised sham-controlled trial conducted in a primary care public health service. A total of 152 participants were randomly assigned to the CFT group (n=76) and the sham group (n=76)

Objectives Non-anaemic iron deficiency (IDNA) is highly prevalent in exercising females. Although iron therapy can be used to correct this issue, its impact on exercise performance is equivocal. Our aim was to assess the efficacy of intravenous iron therapy on exercise performance, fatigue, mood states, and quality of life in recreationally active IDNA females of reproductive age. Methods Twenty-six

Objective To evaluate differences in sport-specific concomitant injuries, return-to-sport (RTS), second ACL injuries and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales after adolescent ACL reconstruction (ACLR) across popular sports. Methods This prospective cohort study included patients aged 10–18 years at ACLR. Demographic and injury-related data and KOOS subscales before ACLR and

Objective There is a need to explore the many factors that may have a more subtle influence on, or relationship with, sensorimotor control as it pertains to anterior cruciate ligament injury risk. Due to well-established sex/gender-related differences in sensorimotor control, a close examination of key sociocultural constructs is warranted. This scoping review examined the connection between sociocultural

This position statement from the Faculty of Sport and Exercise Medicine (FSEM) has been developed to assist sporting organisations, individuals, athletes, coaches, medical and dental professionals to integrate comprehensive medical guidance regarding the use of well-fitted mouthguards in at-risk sports (such as American Football, Boxing, Ice Hockey, Field Hockey, Lacrosse, Martial Arts, Rugby, Australian

As a junior doctor in my fourth year of radiology training, work plays an outsized role in my life—and there never seem to be enough hours in the day to complete all my tasks. For a long time, I survived on oven pizza and regularly skipped exercise, lacking the time, energy, motivation—or often all three. Over 4 years of specialisation, I had fallen into a routine where engaging in physical activity

Retirement from sport can elicit significant psychological distress, particularly when unexpected; however, it is unknown whether former athletes experience poorer mental health and worse sleep than currently competing athletes.1 Therefore, the aim of this PhD project was to understand the risk prevalence of sleep and mental health disorders in diverse samples of current and former athletes. Doing

The second edition of the Kabaddi World Cup, held in the West Midlands, England, from 17 March 2025 to 23 March 2025, showcased the thrilling sport of kabaddi on a global stage. This event not only highlighted the athletic talent of participants from around the world but also highlighted the crucial role of sports therapists in safeguarding the athlete’s health and performance. Coventry University

Some of the earliest recommendations around physical activity (PA) were published in the 1970s and focused largely on aerobic fitness. These recommendations were followed by national-level PA guidelines in the US in 2008 and global-level guidelines from the WHO in 2010.1 Since these earlier guidelines, much attention has turned to the converse of PA—sedentary time. In 2016, the Canadian 24-Hour Movement

The PhD project centred around the ‘Power Training in Older People with Multiple Sclerosis’ (PoTOMS) trial (figure 1). The primary aim of the PoTOMS trial was to compare the effect of a 24-week progressive power training programme (PPT) on whole-brain atrophy rate in older people with multiple sclerosis (MS). The secondary aim was to investigate the effects of PPT on brain microstructures and macrostructures

The global prevalence of pelvic organ prolapse (PoP) varies widely, but it is estimated that up to 40% of women will experience some degree of PoP in their lifetime. The likelihood of developing PoP increases with age, multiparity, obesity, chronic cough and certain occupational or lifestyle factors.1 Women with PoP often report a fear of engaging in physical activity (PA), driven by concerns that

Growing evidence suggests that although leisure time physical activity (LTPA) (ie, performed for sports and recreation) leads to positive cardiovascular disease (CVD) outcomes, occupational physical activity (OPA) (ie, activity occurring at work) may not decrease the risk of CVD morbidity and mortality. The potentially contradictory health effects of LTPA and OPA are referred to as the physical activity

Objective To compare hyperthermia and physiological dehydration risk during exercise heat stress between children of different ages and adults and evaluate an existing adult sweat rate calculator in children. Methods 68 fit and recreationally active children aged 10–16 years (31 girls), and 24 adults aged 18–40 years (11 females) completed three separate 45 min treadmill walking/running trials at different

By 2050, the global human population is expected to have more than 10 billion people with~17% adults over 65 years old.1 This ageing population is at higher risk of age-associated declines in motor function and an increased prevalence of multiple health disorders.2 3 Research and public policies aimed at detecting and preventing the accelerated decline of motor functional status throughout the life

Type 1 diabetes (T1D) impacts around 9.5 million people (1.9 million people under 20) across the world and is a leading chronic health condition impacting those under the age of 18.1 As the condition is lifelong and requires exogenous insulin following diagnosis, it is also classified as a hidden disability in the UK, under the Equality Act 2010. However, when it comes to sport and exercise, mainstream

Objectives The primary objective of this study was to explore the experiences and beliefs of elite female athletes, athlete support staff and sport organisational staff regarding preconception and pregnancy in Australian elite athletes. Secondary objectives were to identify barriers and enablers encountered by elite athletes during preconception and pregnancy, and to use the study findings to develop

Objective To investigate the occurrence and inciting events of hamstring injuries (HSIs) in elite women’s football through video analysis, describing the mechanism, situational patterns and biomechanics of the sport-specific activities performed before and at the time of injury. Methods A descriptive observational study was conducted using video analysis of HSIs from top national and international

The impact and consequences of sports-related injuries involve a complex interplay between biological, psychological and social factors. Psychological factors are important because anxiety, fear of reinjury, kinesiophobia, optimism, self-motivation and perceived social support are linked with sports injury rehabilitation and return-to-sport outcomes.1–3 Wiese-Bjornstal et al. 4 proposed an integrated

The aim of my PhD was to investigate how different approaches to prescribing aerobic high-intensity interval training (HIIT) influence cardiorespiratory fitness and performance in distance runners. Specifically, I compared three methods: a physiological approach (PHY), which individualises intensity using the Delta concept, based on the second lactate threshold (vLT2) and peak treadmill speed (Vpeak);

Mental health and well-being among elite athletes are accepted as central to athletic performance. Maximising health, and more recently, mental health,1 2 in elite sport is thus pivotal to the physical competencies that underpin athletic success. Neurodiversity is an umbrella term used to recognise the natural variations of all individuals, with neurodivergence often used to refer to attention-deficit/hyperactivity

Objectives To investigate challenges associated with mental health help-seeking among Olympic and Paralympic coaches. The study also sought to identify which challenges were most important and feasible to address. Methods The study employed a mixed-methods group concept mapping methodology. Participants brainstormed, sorted (into groups) and rated (for importance and feasibility) statements on 5-point

Objective The aims of this study, which uses a trial within a cohort design, were to determine the efficacy of a web-based intervention to increase moderate-to-vigorous intensity physical activity (MVPA) and decrease sedentary behaviour in cancer survivors. Methods Participants (n=415) in this trial were randomised 2:1 to an interactive physical activity website or a static balance and flexibility

Despite being an avid sportsman growing up, injuries and illnesses were never really something I encountered. I acquired nicknames such as ‘Roy Keane’ when I played football and ‘McCarry’ when I played rugby. These nicknames usually arose from my love for getting stuck in and putting my body in places most wouldn’t. At age 20, my whole life changed. Without warning, I collapsed on 3 June 2017, later

The link between health and physical activity has been enshrined in medical lore since ancient times. Over 2000 years ago, practitioners in India, China, Greece and the Roman Empire espoused the importance of exercise for the maintenance and restoration of health.1 In the centuries that followed, the writings of Hippocrates and Galen centralised the role of physical activity in healthcare, a mantra

By 2050, there will be two billion people in the world aged over 60. Such population ageing will inevitably lead to increases in the prevalence of chronic diseases and healthcare burdens. In the UK alone, over 17 million people live with one or more chronic conditions, taking up 50% of all general practitioner appointments and 70% of the UK’s (c. £200 billion) health and care budget. Finding cost-effective

Have you ever encountered an athlete who suddenly shouts out or someone who seems disengaged? What was your initial reaction? Did you assume the athlete was being offensive or underperforming that day? Or did you wonder whether they might be neurodiverse? Neurodiversity refers to the natural variations in the human brain that influence how people process information, communicate and engage with their

Historically, much of the research in exercise science and sports medicine has collected, reported and discussed sex and gender as synonymous and interchangeable. This conflation has hindered scientific progress, limiting our understanding and potentially reinforcing social biases through poorly framed research questions, flawed methodological designs and misinterpretations of findings related to sex

Despite a renaissance in menopause awareness, the over-medicalisation of women’s midlife health threatens to eclipse foundational interventions like physical activity. Menopause is a pivotal milestone in the female lifespan, marked by important physiological, psychological and musculoskeletal changes. While ‘menopause’, by definition, is a point in time, the perimenopause and postmenopause stages vary

Objectives To describe age-related differences in the absolute and relative intensity of physical activity (PA) and associations with mortality. Methods UK Biobank participants with accelerometer-assessed PA (m g ) and fitness data (N=11 463; age: 43–76 years) were included. The intensity distribution of PA was expressed in absolute and relative terms. The outcome was mortality. Results PA volume (average

Objectives To investigate associations between daily physical activity, activity intensity and step counts with incident cancer risk. Methods Prospective analysis of UK Biobank participants who wore wrist-based accelerometers for 7 days, followed for cancer incidence (mean follow-up 5.8 years, SD 1.3). Time-series machine-learning models derived total physical activity, sedentary behaviour (SB), light-intensity

Objective To assess the impact of depression and physical activity (PA) of different intensities on the incidence of heart disease. Methods A prospective cohort study with 20 645 European middle-aged and older adults (mean baseline age 63 years; 55.1% women; median follow-up 9.5 years) was conducted using data from the Survey of Health, Ageing and Retirement in Europe. The EURO-D 12-item scale assessed

Objective To synthesise data on the associations between cardiorespiratory fitness (CRF) and health in children and adolescents, evaluate the certainty of evidence and identify knowledge gaps. Design An overview of systematic reviews with meta-analyses. Results were pooled using forest plots and certainty of evidence evaluated with GRADE. Data sources Medline, Embase, Scopus, CINAHL and SPORTDiscus

Objective To evaluate systematic reviews of randomised controlled trials (RCTs) on the effects of exercise on general cognition, memory and executive function across all populations and ages. Methods Systematic reviews and meta-analyses of RCTs evaluating the effects of exercise on general cognition, memory and executive function were eligible. Data extraction and risk of bias scoring were conducted

The primary focus of my PhD research was to investigate the relationship between physical exercise and lung function, with a particular emphasis on imaging radiomic features derived from quantitative CT (qCT). My study aimed to uncover how different levels and intensities of physical exercise influence lung structural and functional parameters, as quantified by advanced radiomic analysis. Specifically

Je Bouge Pour Mon Moral is a French not-for-profit organisation founded in 2021. It is dedicated to supporting individuals suffering from mental health disorders through regular physical activity. The organisation aims to improve the mental well-being of its participants by combining exercise and social connection. Mental health is a major issue in France, affecting 13 million people each year. In

Cognitive function, encompassing essential processes such as perception, attention, memory, language, thinking and executive function, is fundamental to daily life. It drives individual development by enhancing academic achievement and mitigating cognitive decline,1 while also fueling societal progress through improvements in education, productivity and economic outcomes.2 Even transient cognitive

Preparticipation screening, including history, physical examination and often a 12-lead ECG, aims to identify athletes with structural and/or arrhythmic cardiovascular conditions that may increase the risk of sudden cardiac death (SCD).1 Importantly, there is often a diagnostic ‘grey zone’ between findings reflective of exercise-induced cardiac remodelling versus true high-risk pathology, highlighting

The desire to enhance athletic performance drives research into potential ergogenic aids. Carbon monoxide (CO) is a colourless, odourless and poisonous gas that is difficult to detect, making it known as the ‘silent killer’.1 Despite its toxicity, CO has found varied applications in medicine and sport.2–9 Although CO can serve as a tool for monitoring performance gains through the measurement of haemoglobin

Sudden cardiac death is the leading medical cause of death among football players. Determining the optimal cardiac screening, the use of carefully selected medical assessments to detect underlying cardiovascular conditions associated with sudden cardiac arrest/death, is a desired objective of the Fédération Internationale de Football Association (FIFA) for football players of all ages. To date, cardiac

Objective To evaluate the psychological reactions, perceptions and opinions of cardiovascular preparticipation screening (PPS) among young competitive athletes. Methods This convergent parallel mixed-methods study recruited 222 athletes (mean age: 18.7 years) who underwent PPS at a Canadian university. All athletes completed a cardiovascular history questionnaire, and a subgroup (n=165) additionally

Objectives Physical activity (PA) provides protective effects against cardiovascular diseases, including ischaemic heart disease. However, recommending moderate to vigorous PA (MVPA) to patients with recent acute coronary syndrome (ACS) raises concerns owing to potential risk of recurrent ACS or fatal arrhythmias. This study investigated the association between longitudinal PA changes following an

Objective Energy-saving sedentary behaviour may be an evolutionarily selected trait that is no longer advantageous. We investigated the associations between genetic liability to sedentary behaviour and the incidence of the most common cardiovascular disease (CVD). Methods We constructed and validated a genome-wide polygenic score for leisure screen time (PGS LST) as a measure of genetic liability to

Objective To compare physical activity (PA) over midlife between (1) former collegiate athletes and non-athletes and (2) among athletes in different sports. Methods The Harvard Alumni Health Study (HAHS) is a prospective cohort study of male undergraduates who completed serial questionnaires regarding PA and health status between 1962 and 1993. PA was categorised by intensity (<3 METs, light; 3 to

Objective To synthesise the existing literature relating to barriers and enablers encountered by elite athletes during preconception and pregnancy for the purpose of identifying key recommendations and actionable steps to inform the development of pregnancy guidelines to support preconception and pregnancy in national sporting organisations. Design Mixed-methods systematic review with thematic analysis

An adolescent athlete presented with chest pain and elevated troponin (troponin T level of 2038 ng/L (normal range <10 ng/L)). Viral swabs, including COVID-19 screening, were negative. The 12-lead ECG demonstrated T-wave inversion with preceding convex ST-elevation in leads V3-V5, I and aVL (figure 1A). Following cardiac magnetic resonance (CMR) imaging, a diagnosis of myocarditis was confirmed, and

I investigated how physical exercise influences esports performance and examined fundamental issues in esports development through five interconnected studies. This research focused on establishing standardised terminology, analysing health impacts, exploring gender participation patterns and evaluating the effectiveness of structured exercise programmes in enhancing competitive gaming performance

Objective To investigate the association between sprint running biomechanics and sprint-related hamstring strain injury (HSI) in elite male football players. Methods This prospective cohort study recruited 126 professional male football players from eight clubs in the English football league, who were followed across a 6-month period. Maximal velocity sprint running videos (240 fps) were collected

My doctoral work aimed to advance understanding of the interactions between physical activity, falls and physical function from mid-life to older age. My PhD involved seven papers written over four years. Figure 1 overviews the designs and results of studies included in the thesis. Figure 1 Overview of studies included in the thesis. ALSWH, Australian Longitudinal Study on Women’s Health. Witnessing