Tag: athletes

Categories : Gender Injury & TraumaTags :

Females Less Able to Recover from ACL Injuries

On By ModernMedia
Photo by Andrea Piacquadio on Pexels

Injuries of the knee’s anterior cruciate ligament (ACL) are typically thought to be caused by acute traumatic events, such as sudden twists. Published in the Journal of Orthopaedic Research, new work analysing an animal model of ACLs suggests that such injuries can also occur as a result of chronic overuse, specifically due to a reduced ability to repair microtraumas associated with overuse. Importantly, the team said, females also are less able to heal from these microtraumas than males, which may explain why females are two to eight times more likely to tear their ACL ligaments than males.

“ACL tears are one of the most common injuries, affecting more than 200 000 people in the US each year, and women are known to be particularly susceptible,” said principal investigator Spencer Szczesny, associate professor of biomedical engineering and of orthopaedics and rehabilitation at Penn State. “While recent research suggests that chronic overuse can lead to ACL injuries, until now, no one had investigated the differential biological response of female and male ACLs to applied force.”

In the Penn State-led study, researchers placed ACLs from deceased male and female rabbits in a custom-made bioreactor that simulated the conditions of a living animal but allowed direct observation and measurement of the tissue. Next, they applied repetitive forces to the ACLs that mimicked those that would naturally occur during activities such as standing, walking and trotting and measured the expression of genes related to healing.

In male samples, the team found that low and moderate applied forces, such as those that would occur during standing or walking, resulted in increased expression of anabolic genes, which are related to building molecules needed for healing. By contrast, larger applied forces, such as those that would occur with repetitive trotting, decreased expression of these anabolic genes. For female samples, however, the amount of force applied did not influence the level of anabolic gene expression.

“It didn’t matter whether there was low, medium or high activity for females,” said Lauren Paschall, graduate student in biomedical engineering at Penn State and first author on the paper. “Female ACLs exposed to chronic use just didn’t heal as well as male ACLs, which may explain why women are predisposed to injuries. This supports the hypothesis that noncontact ACL injuries are attributed to microtraumas associated with chronic overuse that predispose the ACL to injury.”

According to the researchers, one explanation for the sex differences the team observed could be due to the higher amounts of oestrogen in females.

“Some studies have found that the overall effect of oestrogen on ACL injury is negative,” Paschall said. “Specifically, studies have shown that human women are more likely to tear their ACLs during the preovulatory phase, when oestrogen levels are high, than during the postovulatory phase, when oestrogen levels are low.”

She said the team plans to further investigate the role of oestrogen on ACL injury.

Szczesny noted that although the team’s study was not in humans, the findings may suggest that providing additional recovery time for women following injuries could be advantageous.

“Ultimately, this work could also help to identify targets for therapeutics to prevent ACL injuries in women,” he said.

Source: Penn State

Categories : Diet and Nutrition ExerciseTags :

Female Athletes’ Metabolism Drops if They Cut Energy Intake

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Photo by Andrea Piacquadio on Pexels

Most athletes know that diet and training go hand in hand for the best results, and many of them closely monitor their energy intake and training. However, a new study from Aarhus University shows that the bodies of female athletes are negatively affected when they consume too little energy through their diet in comparison with their training volume, explains PhD student Mikkel Oxfeldt. He and Associate Professor Mette Hansen are behind the study, which is published in the Journal of Physiology.

“We know that both elite female athletes and active women at times, either consciously or unconsciously, don’t have an energy intake that matches their energy expenditure when training. The study shows that insufficient energy intake can negatively affect muscles’ ability to respond to training. After just ten days of low energy intake, we began seeing changes to the hormonal system such as a decrease in the metabolic hormone followed by a decrease in metabolism.”

The study shows that it is important that women are careful not to reduce their energy intake too much. In fact, they should actually be increasing their energy intake if they increase their training volume, says Mikkel Oxfeldt:

“When you don’t get enough energy from your diet, your body will begun to pare down processes that require a lot of energy, just like a mobile phone that goes into battery-saving mode. We know from previous studies that it can cause some women’s periods to stop. However, our results show that other processes in the body, such as building new muscle proteins, are also affected.”

We must confront the unilateral focus on weight

Thirty fit women aged 18–30 participated in the study which is part of the Novo Nordic-funded Team Denmark network called ‘competition preparation and training optimisation’. All the women started the study right after the start of their menstrual period and followed a very controlled training and diet regimen for three weeks.

“Under the supervision of the researchers, the participants carried out individual training programmes aimed at increasing muscle mass, strength and overall fitness. The women’s meals were also provided by us. By controlling their training regimen and their diets, we were able to see how much energy they expended and what they ate during the study,” says Mikkel Oxfeldt and continues:

“This is the first time that such a well-controlled study has been carried out in this area, where both the diet and training of a group of fit women has been regulated to this extent. During the study, all participants drank doubly labelled water, which is enriched with a trace material. When we combine this tracer technique with the retrieval and subsequent analysis of muscle tissue samples, we can gain detailed insight into the muscles’ response to the experimental protocol,” explains Mikkel Oxfeldt.

Mikkel and the research group believe it’s necessary to confront the idea that weight loss leads to medals when in fact weight loss can negatively impact a number of the body’s systems, including muscles.

“In recent years, we’ve heard about public weigh-ins within some elite sports. They are part of promoting a culture in which some women are constantly trying to lose weight. However, our results show that this focus on weight loss can have short and potentially long-term negative consequences for women, both in relation to their health and training results. The study will hopefully provide athletes and coaches with a more nuanced picture of possible side effects.”

In collaboration with colleagues from the University of Copenhagen and University of Southern Denmark, the researchers behind the study are now investigating how physical performance, the immune system and metabolism are affected by an insufficient energy intake. They hope to one day be able to establish whether there is a difference between how women’s and men’s bodies react to inadequate energy intake.

Source: Aarhus University

Categories : Injury & TraumaTags :

Slower Concussion Recovery for Athletes not All Bad News

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Rugby players
Photo by Olga Guryanova

Athletes who recover more slowly from concussion may be able to return to play with an additional month of recovery beyond the typical recovery time, according to a new study published in the journal Neurology. Slow recovery was defined as taking more than 14 days for symptoms to resolve or taking more than 24 days to return to play, both of which are considered the typical recovery times for about 80% of athletes with concussion.

“Although an athlete may experience a slow or delayed recovery, there is reason to believe recovery is achievable with additional time and injury management,” said study author Thomas W. McAllister, MD, of the Indiana University School of Medicine in Indianapolis. “This is an encouraging message that may help to relieve some of the discouragement that athletes can feel when trying to return to their sport. While some athletes took longer than 24 days to return to play, we found that three-quarters of them were able to return to sports if given just one more month to recover.”

The study looked at 1751 American college athletes diagnosed with a concussion by a team physician. Of Male athletes (63%) participated primarily in football, soccer and basketball. Female athletes (37%) participated primarily in soccer, volleyball and basketball.

Participants were evaluated five times: within six hours after their injury, one to two days later, once free of symptoms, once cleared to return to play and at six months.

Participants reported symptoms daily to medical staff, up to 14 days following injury and then weekly if they had not yet returned to play.

A total of 399 athletes, or 23%, had a slow recovery.

Researchers found that of the athletes who took longer than 24 days to return to play, more than three-fourths, or 78%, were able to return to play within 60 days of injury, and four-fifths, or 83%, were able to return to play within 90 days of injury. Only 11% had not returned to play six months after injury.

For the slow recovery group, the average time for returning to play was 35 days after injury, compared to 13 days in the overall group.

“The results of this study provide helpful information for athletes and medical teams to consider in evaluating expectations and making difficult decisions about medical disqualification and the value of continuing in their sport,” McAllister said.

A limitation of the study is that participants were all collegiate varsity athletes and may not be representative of other age groups or levels of sport, and the results may not apply to other types of mild brain injuries.

Source: American Academy of Neurology

Categories : COVID ExerciseTags :

Returning to Sport after COVID Infection

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Rugby players
Photo by Olga Guryanova

A first-of-its-kind study published in Scientific Reports has investigated how the immune system of elite student-athletes responded to the COVID virus. Unlike older adults with comorbidities, American Football players who were diagnosed with COVID were able to have their immune system back to its baseline after their CDC-recommended isolation period.

“When COVID really started moving out of control, we met with Neil Johannsen, an exercise physiologist at LSU, and the athletic trainers Derek Calvert and Jack Marucci, and we discussed what we could do to make sure our athletes remained healthy. We especially wanted to make sure that athletes were not at risk for secondary infections when they came back from isolation,” said Guillaume Spielmann, associate professor in LSU’s School of Kinesiology.

Isolation effective after COVID infection

“When the idea started for the research, we discussed why not turn something negative into a positive, and assist with the research to find some answers. If we can do things to understand the virus better, let’s do it,” said Jack Marucci, LSU’s Director of Athletic Training. “The student-athletes were willing to be a part of it.”

During that time at the start of the COVID pandemic, the CDC had recommended 14 days of isolation.

“There was a lot unknown during this time. We are looking at a population that are extremely close to each other during plays and during games. We wanted to make sure that since they are literally face-to-face with other players, that their salivary defences, their oral defences were pretty much intact and that that part of their immune system was not affected by the disease; that there were no long-lasting effects of the disease,” Assoc Proff Spielmann said.

Saliva samples were collected from 29 student-athletes in 2020, before a COVID vaccine. Fourteen were COVID positive and 15 had no history of infection. Of the 14, only six reported mild symptoms from the virus, the other eight were asymptomatic throughout the isolation period.

“Salivary immunity is extremely important to ensure that people don’t contract secondary infections, so when athletes are coming back we need to make sure they are as healthy as can be. We found that the isolation period was sufficient to restore the athletes’ salivary immunity to the level seen in non-infected players,” Assoc Prof Spielmann said.

Safely return to play after COVID

These findings suggested the student-athletes could safely return to practice and play football without a risk of secondary infection; that their immune system wasn’t at risk when playing the close contact sport.

“I was worried a bit about long-haulers and other more significant outcomes like the concerns for the development of myocarditis. Engaging in athletic activities at an elite level can be stressful on the body and you would want to arm yourselves with the best scientific information to help understand potential outcomes. This data helped to validate some of these decisions that were made. Providing a safe environment for your student-athletes is paramount and this helped that process along,” said Shelly Mullenix, LSU’s Senior Associate Athletics Director for Health & Wellness.

For this study, three graduate students also participated in the research.

“This kind of access is unique in Division I sports. You typically don’t have access to football players, so the fact that we have access is hugely instrumental as well,” Assoc Prof Spielmann said. “LSU is a great place for this field.”

“I think this COVID research is something that we are really proud to be a part of and contribute to finding answers to such a devastating virus,” Marucci said.

Assoc Prof Spielmann, an immunologist, researches the impact of stress on the immune system of elite and tactical athletes, including astronauts and fire fighters. But this study isn’t the first for Spielmann and LSU Athletics. They have worked together to study psychological and physiological health, along with performance measures in other student-athletes and sports teams. A new study will take a closer look at female athletes’ mental, physiological and immune resilience to stress.

Source: Louisiana State University

Categories : Diet and Nutrition ExerciseTags :

IV Nutrition is a Growing and Potentially Dangerous Trend among Athletes

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Intravenous IV drip
Source: Marcelo Leal on Unsplash

Once a last resort solution, intravenous (IV) nutrition is threatening to become the norm for competitive athletes, despite no scientific evidence that it works or that it is safe, warn experts in an editorial in the British Journal of Sports Medicine.

To halt this trend, the experts urge that ‘food first’ and ‘no needle’ messages need to be amplified among all athletes and their support teams.

The authors, who interact with professional team players in European and American leagues and their support teams on a regular basis, have become increasingly aware of the practice.

While it is not known how common it is, anecdotally, some players are hooked up to IV nutrition drips as often as every week as part of a pre- or post-game routine, they say. 

So-called ‘drip bars’ and concierge IV nutrition services claim to boost health and performance, restore hydration and speed up recovery. These services offer a menu of B vitamins, amino acids, glutathione, vitamin C and electrolytes, which could potentially boost levels beyond any therapeutic range.

These services seemed to have slipped under the regulatory radar despite being quite visible, and there is no guidance on their use for players or practitioners, the authors pointed out.

The principle of reducing needle use in sport and a ‘food first’ approach is taught in sports nutrition courses around the world, and a ban on needle use by athletes at the Olympic Games, except for appropriate medical use, and where a therapeutic use exemption (TUE) is obtained, has been in place for all recent Games, they highlight.

IV nutrition drips have traditionally been reserved for serious clinical conditions, such as anaemia, symptoms caused by nutrient deficiencies, or to correct severe dehydration caused by marathon running in a desert, for example. But they are now being used for tiredness, fatigue, or recovery, say the authors.

“But the evidence is sparse and not supportive. We are aware of just two studies assessing vitamin injections in otherwise healthy participants, neither of which yielded an effect for the injection group,” note the authors.

They add that these drips are risk-free, potentially interfering with the liver and gut microbes with implications for detoxification and immunity.

“Bypassing these mechanisms appears foolhardy unless there is a significant clinical rationale,” they write, adding that IV drips also carry risks of infection at the needle site and of blood clots.

Excessive vitamin B6 is associated with peripheral neuropathy, while athletes regularly receiving IV iron risk liver disease, they point out.

“Given that the long-term effects of supratherapeutic doses of B vitamins and other nutrients are unknown in athletes, it does not appear to be worth the risk, especially given the lack of evidence-based benefits,” they write. 

“More than this is the reputational risk to sport if it is normalised for athletes to regularly partake in self-directed IV [nutrition] use with a worrying shift away from what ‘works’ (according to scientific standards), to that which is unproven. 

“Furthermore, some athletes risk an anti-doping violation by participating in self-directed IV [nutrition] use.”

Figures on the prevalence of IV nutrition need to be gathered in tandem with governing bodies and players’ associations in the professional leagues providing guidance on the potential risks of IV nutrition use, say the authors.

“The ‘food first’ and ‘no needle’ messages need to be amplified among all athletes and multidisciplinary support teams to avoid what was previously a ‘last resort’ treatment becoming normal without scientific evidence of benefit,” they warn.

Source: EurekAlert!

Categories : Exercise Injury & Trauma PaediatricsTags :

Young Athletes’ Recovery Helped by New Concussion Guidelines

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A study has found that the adoption of new concussion guidelines, which emphasises a more active form of rest, reduced the duration of symptoms among athletes aged 11 to 18.

Concussions are the most common form of traumatic brain injury, often occurring either as a direct result of a blow to the head, or from forces experienced by the body that impart an acceleration to the head. Symptoms include mood changes, cognitive changes, sensory phenomena such as headaches or dizziness, and changes in sleep pattern.

The researchers compared medical records from 2016-18, which used the newer guidelines, to a set from 2011-13, which used the older guidelines.

Lead researcher John Neidecker, DO, and Sports Concussion Specialist, explained: “The most significant change in care involved a shift from strict rest or cocoon therapy to a return to low-intensity physical or cognitive activity after 24 to 48 hours. Our results show active rest dramatically improved recovery times among young athletes with first-time concussions.”

Active rest involves light activity that steadily increases under supervision, with minimal head movement.

“If diagnosis of a pre-existing condition has never been given, patients cannot be expected to report one during our concussion assessment,” said Dr. Neidecker. “This is especially true in the adolescent age group, as some may have a condition that they are not aware of yet. This makes screening for preexisting conditions more complex, yet even more essential for this age group.”

For example, intolerance to 3D movies could indicate an unrelated pre-existing condition. Information from parents about preinjury personality and behaviour could uncover anxiety.

“This more individualised, osteopathic approach in screening the athletes’ past medical history helped us identify health issues that may have been overlooked in the past,” said Dr Neidecker. This allows treatment to be more effectively tailored, he explained.

Knowledge about concussions has improved; in the 2011-13 dataset, the counselling given was more cautious and ominous, Dr Neidecker noted. Adequate communication and a positive outlook may have helped reduce reported symptoms, and may be essential for patients with anxiety. 

Source: News-Medical.Net


Journal information: Neidecker, J. M., et al. (2021) First-time sports-related concussion recovery revisited: management changes and impact on recovery. Journal of Osteopathic Medicine. doi.org/10.1515/jom-2020-0106.