Pub Date : 2025-09-22DOI: 10.1007/s40279-025-02300-8
Yohan Rousse,Benoit Sautillet,Guillaume Costalat,Franck Brocherie,Grégoire P Millet
The optimisation of muscle recovery from exercise-induced muscle damage (EIMD) is a major issue in sports medicine. This comprehensive review examines the effects of four environmental stressors, including cold (cold therapy), heat (heat therapy), hot-cold alternation (contrast therapy) and reduced oxygen availability (hypoxia therapy), on muscle recovery following EIMD. The analysis of related randomised controlled trials assessed the influences of these stressors on five markers of recovery (muscular performance, joint amplitude, muscle pain, swelling and blood biomarkers). Although cold therapy has been widely studied, the lack of consensus on its application modalities leads to controversial debates regarding its effectiveness for muscle recovery. Heat therapy, particularly hot water immersion, appears to be the most effective method for restoring muscle function. However, the use of local heating techniques is less well understood. Moreover, contrast therapy seems to be promising for reducing swelling post-EIMD; however, the lack of studies and the variety of utilised techniques involving contrast therapy limit conclusions. Finally, local hypoxia, which is elicited by intermittent blood flow restriction, demonstrates potential for reducing inflammation and improving the recovery of muscle function, based on the appropriate application of protocols. By synthesising existing data, this comprehensive review shows that most environmental stress-based therapies can be effective, if the modalities of application-such as dose or frequency-are appropriate. It offers practical recommendations for optimising muscle recovery. This review also highlights the need for further research to refine protocols and better understand the potential synergistic effects of these environmental stress-based interventions.
{"title":"Isolated and Combined Effects of Cold, Heat and Hypoxia Therapies on Muscle Recovery Following Exercise-Induced Muscle Damage.","authors":"Yohan Rousse,Benoit Sautillet,Guillaume Costalat,Franck Brocherie,Grégoire P Millet","doi":"10.1007/s40279-025-02300-8","DOIUrl":"https://doi.org/10.1007/s40279-025-02300-8","url":null,"abstract":"The optimisation of muscle recovery from exercise-induced muscle damage (EIMD) is a major issue in sports medicine. This comprehensive review examines the effects of four environmental stressors, including cold (cold therapy), heat (heat therapy), hot-cold alternation (contrast therapy) and reduced oxygen availability (hypoxia therapy), on muscle recovery following EIMD. The analysis of related randomised controlled trials assessed the influences of these stressors on five markers of recovery (muscular performance, joint amplitude, muscle pain, swelling and blood biomarkers). Although cold therapy has been widely studied, the lack of consensus on its application modalities leads to controversial debates regarding its effectiveness for muscle recovery. Heat therapy, particularly hot water immersion, appears to be the most effective method for restoring muscle function. However, the use of local heating techniques is less well understood. Moreover, contrast therapy seems to be promising for reducing swelling post-EIMD; however, the lack of studies and the variety of utilised techniques involving contrast therapy limit conclusions. Finally, local hypoxia, which is elicited by intermittent blood flow restriction, demonstrates potential for reducing inflammation and improving the recovery of muscle function, based on the appropriate application of protocols. By synthesising existing data, this comprehensive review shows that most environmental stress-based therapies can be effective, if the modalities of application-such as dose or frequency-are appropriate. It offers practical recommendations for optimising muscle recovery. This review also highlights the need for further research to refine protocols and better understand the potential synergistic effects of these environmental stress-based interventions.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"41 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-19DOI: 10.1007/s40279-025-02308-0
Gregory Tierney, Ross Tucker, James Tooby, Lindsay Starling, Éanna Falvey, Danielle Salmon, James Brown, Sam Hudson, Keith Stokes, Ben Jones, Simon Kemp, Patrick O'Halloran, Matt Cross, Melanie Bussey, David Allan
Objectives: In elite rugby union, suspected concussions lead to immediate removal from play for either permanent exclusion or a temporary 12-min assessment as part of the Head Injury Assessment 1 (HIA1) protocol. The study aims to retrospectively identify a head acceleration event (HAE) severity measure associated with HIA1 removals in elite rugby union using instrumented mouthguards (iMGs).
Methods: HAEs were recorded from 215 men and 325 women, with 30 and 28 HIA1 removals from men and women, respectively. Logistical regression was calculated to identify whether peak power, maximum principal strain (MPS) and/or the Head Acceleration Response Metric (HARM) were associated with HIA1 events compared to non-cases. Optimal threshold values were determined using the Youden Index. Area under the curve (AUC) was compared using a paired-sample approach. Significant differences were set at p < 0.05.
Results: All three severity measures (peak power, HARM, MPS) were associated with HIA1 removals in both the men's and women's game. Peak power performed most consistent of the three severity measures for HIA1 removals based on paired-sample AUC comparisons in the men's and women's games. The HARM and MPS were found to perform lower than peak linear acceleration in the women's game based on AUC comparisons (p = 0.006 and 0.001, respectively), with MPS performing lower than peak angular acceleration (p = 0.001).
Conclusion: Peak power, a measure based on fundamental mechanics and commonly communicated in sports performance, was the most effective metric associated with HIA1 removals in elite rugby. The study bridges the gap by identifying a consistent HAE severity measure applicable across sexes.
{"title":"Peak Power: A Severity Measure for Head Acceleration Events Associated with Suspected Concussions.","authors":"Gregory Tierney, Ross Tucker, James Tooby, Lindsay Starling, Éanna Falvey, Danielle Salmon, James Brown, Sam Hudson, Keith Stokes, Ben Jones, Simon Kemp, Patrick O'Halloran, Matt Cross, Melanie Bussey, David Allan","doi":"10.1007/s40279-025-02308-0","DOIUrl":"https://doi.org/10.1007/s40279-025-02308-0","url":null,"abstract":"<p><strong>Objectives: </strong>In elite rugby union, suspected concussions lead to immediate removal from play for either permanent exclusion or a temporary 12-min assessment as part of the Head Injury Assessment 1 (HIA1) protocol. The study aims to retrospectively identify a head acceleration event (HAE) severity measure associated with HIA1 removals in elite rugby union using instrumented mouthguards (iMGs).</p><p><strong>Methods: </strong>HAEs were recorded from 215 men and 325 women, with 30 and 28 HIA1 removals from men and women, respectively. Logistical regression was calculated to identify whether peak power, maximum principal strain (MPS) and/or the Head Acceleration Response Metric (HARM) were associated with HIA1 events compared to non-cases. Optimal threshold values were determined using the Youden Index. Area under the curve (AUC) was compared using a paired-sample approach. Significant differences were set at p < 0.05.</p><p><strong>Results: </strong>All three severity measures (peak power, HARM, MPS) were associated with HIA1 removals in both the men's and women's game. Peak power performed most consistent of the three severity measures for HIA1 removals based on paired-sample AUC comparisons in the men's and women's games. The HARM and MPS were found to perform lower than peak linear acceleration in the women's game based on AUC comparisons (p = 0.006 and 0.001, respectively), with MPS performing lower than peak angular acceleration (p = 0.001).</p><p><strong>Conclusion: </strong>Peak power, a measure based on fundamental mechanics and commonly communicated in sports performance, was the most effective metric associated with HIA1 removals in elite rugby. The study bridges the gap by identifying a consistent HAE severity measure applicable across sexes.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-17DOI: 10.1007/s40279-025-02314-2
Melanie D Bussey,Danielle Salmon,Bridie Nanai,Janelle Romanchuk,Raul M Gomez,Darryl Tong,Gisela Sole,Ross Tucker,Éanna Falvey
BACKGROUNDRugby Union has attracted increased scrutiny because of concerns over head acceleration events (HAEs), particularly regarding their frequency, severity and potential long-term health implications. While substantial efforts by governing bodies have focused on reducing head impact risks through education, regulatory changes and the introduction of instrumented mouthguards, limited data exist for the community rugby context, especially across different age grades and playing positions.OBJECTIVEWe aimed to quantify HAE across playing positions, age grades and contact phases in community rugby and to identify match scenarios associated with high-magnitude head loading.METHODSA prospective observational cohort study included 259 male players across U13, U15, U19, and Premier senior men's grades. Players were fitted with instrumented mouthguards, and match play was video recorded for verification. Head acceleration events were identified from instrumented mouthguard-triggered sensor acceleration events > 5 g and coded for match context, player position and contact event characteristics. Statistical models evaluated differences in HAE frequency, incidence rates and head kinematics (peak linear acceleration, peak angular acceleration, rotational velocity change index) across grades, positions and contact scenarios.RESULTSA total of 7358 HAEs were verified from 8593 sensor acceleration events across 72 matches. Tackles and rucks accounted for ~ 60% of all HAEs. High tackles significantly increased head loading in ball carriers (peak linear acceleration: + 4.16 g, p = 0.02; peak angular acceleration: + 443 rad/s2, p = 0.002; rotational velocity change index: + 1.87 rad/s, p = 0.04), while low tackles elevated head loading in tacklers (peak linear acceleration: + 4.9 g, p = 0.004). Upright tacklers were more likely to produce high tackles (p < 0.001) and head-to-head contacts (p = 0.019). U13 ball carriers showed higher rotational loading than tacklers (rotational velocity change index: + 5.01 rad/s, p = 0.008), likely reflecting frequent secondary mechanisms such as head-to-ground and body-to-ground. Defensive rucks carried a greater HAE risk than attacking rucks (all p < 0.05), particularly for U19 jacklers (incidence rate ratio = 2.27, p < 0.0001).CONCLUSIONSTackles and rucks are primary sources of HAEs, with risk shaped by posture, tackle height and player role. Lower tackle heights reduce ball carrier load but increase tackler exposure, indicating a potential safety trade-off. Younger players, particularly U13s, were more susceptible to secondary impacts (e.g. head-to-ground), potentially because of limited task-specific experience and underdeveloped control during the tackled phase. Position- and age-specific strategies may be required to optimise safety and reduce HAE risk across all levels of community rugby.
由于对头部加速事件（HAEs）的关注，特别是其频率、严重程度和潜在的长期健康影响，drugby Union吸引了越来越多的审查。虽然管理机构已经做出了大量努力，通过教育、监管改革和引入带器械的护齿器来减少头部撞击风险，但社区橄榄球环境的数据有限，特别是不同年龄等级和比赛位置的数据。目的：我们旨在量化社区橄榄球比赛中不同位置、年龄等级和接触阶段的HAE，并确定与高强度头部负荷相关的比赛场景。方法前瞻性观察队列研究包括259名U13、U15、U19和Premier高年级男子运动员。球员配备了仪器护齿器，并录制了比赛视频以进行验证。头部加速事件从牙套触发的传感器加速事件> 5 g中识别出来，并根据比赛背景、球员位置和接触事件特征进行编码。统计模型评估了不同等级、位置和接触情况下HAE频率、发病率和头部运动学（峰值线加速度、峰值角加速度、旋转速度变化指数）的差异。结果72场比赛中8593个传感器加速度事件共验证了7358个HAEs。抢断和抢球占所有HAEs的约60%。高铲球显著增加了持球者的头部负荷（峰值线加速度：+ 4.16 g, p = 0.02；峰值角加速度：+ 443 rad/s2， p = 0.002；转速变化指数：+ 1.87 rad/s, p = 0.04），而低铲球增加了铲球者的头部负荷（峰值线加速度：+ 4.9 g, p = 0.004）。直立铲球者更有可能产生高铲球（p < 0.001）和头与头接触（p = 0.019）。U13持球者的旋转载荷高于抢手（旋转速度变化指数：+ 5.01 rad/s, p = 0.008），这可能反映了频繁的二次机制，如头对地和身体对地。防守队员发生HAE的风险高于进攻队员（均p < 0.05），特别是U19劫机者（发病率比= 2.27,p < 0.0001）。结论铲球和铲球是HAEs的主要来源，其危险性受铲球姿势、铲球高度和球员角色的影响。较低的铲球高度减少了球载体的负荷，但增加了铲球者的暴露，表明了潜在的安全权衡。年轻球员，特别是u13球员，更容易受到二次撞击（例如头着地），这可能是因为他们在处理阶段的特定任务经验有限，控制能力不发达。在所有级别的社区橄榄球运动中，可能需要针对位置和年龄的策略来优化安全性并降低HAE风险。
{"title":"Contact Role and Tackle Characteristics Shape Head Acceleration Exposure in Male Community Rugby: A Cohort Study Utilising Instrumented Mouthguards.","authors":"Melanie D Bussey,Danielle Salmon,Bridie Nanai,Janelle Romanchuk,Raul M Gomez,Darryl Tong,Gisela Sole,Ross Tucker,Éanna Falvey","doi":"10.1007/s40279-025-02314-2","DOIUrl":"https://doi.org/10.1007/s40279-025-02314-2","url":null,"abstract":"BACKGROUNDRugby Union has attracted increased scrutiny because of concerns over head acceleration events (HAEs), particularly regarding their frequency, severity and potential long-term health implications. While substantial efforts by governing bodies have focused on reducing head impact risks through education, regulatory changes and the introduction of instrumented mouthguards, limited data exist for the community rugby context, especially across different age grades and playing positions.OBJECTIVEWe aimed to quantify HAE across playing positions, age grades and contact phases in community rugby and to identify match scenarios associated with high-magnitude head loading.METHODSA prospective observational cohort study included 259 male players across U13, U15, U19, and Premier senior men's grades. Players were fitted with instrumented mouthguards, and match play was video recorded for verification. Head acceleration events were identified from instrumented mouthguard-triggered sensor acceleration events > 5 g and coded for match context, player position and contact event characteristics. Statistical models evaluated differences in HAE frequency, incidence rates and head kinematics (peak linear acceleration, peak angular acceleration, rotational velocity change index) across grades, positions and contact scenarios.RESULTSA total of 7358 HAEs were verified from 8593 sensor acceleration events across 72 matches. Tackles and rucks accounted for ~ 60% of all HAEs. High tackles significantly increased head loading in ball carriers (peak linear acceleration: + 4.16 g, p = 0.02; peak angular acceleration: + 443 rad/s2, p = 0.002; rotational velocity change index: + 1.87 rad/s, p = 0.04), while low tackles elevated head loading in tacklers (peak linear acceleration: + 4.9 g, p = 0.004). Upright tacklers were more likely to produce high tackles (p < 0.001) and head-to-head contacts (p = 0.019). U13 ball carriers showed higher rotational loading than tacklers (rotational velocity change index: + 5.01 rad/s, p = 0.008), likely reflecting frequent secondary mechanisms such as head-to-ground and body-to-ground. Defensive rucks carried a greater HAE risk than attacking rucks (all p < 0.05), particularly for U19 jacklers (incidence rate ratio = 2.27, p < 0.0001).CONCLUSIONSTackles and rucks are primary sources of HAEs, with risk shaped by posture, tackle height and player role. Lower tackle heights reduce ball carrier load but increase tackler exposure, indicating a potential safety trade-off. Younger players, particularly U13s, were more susceptible to secondary impacts (e.g. head-to-ground), potentially because of limited task-specific experience and underdeveloped control during the tackled phase. Position- and age-specific strategies may be required to optimise safety and reduce HAE risk across all levels of community rugby.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"171 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-17DOI: 10.1007/s40279-025-02313-3
Kevin Till,Sergio Lara-Bercial,Joseph Baker,David Morley
There are current global concerns surrounding the lifestyle behaviours and future health and well-being of youth. One concept that has gained traction to address these concerns is physical literacy (PL). Organised youth sport is one context that can promote PL, offering multiple benefits coupled with a range of challenges. This Leading Article aims to provide a balanced overview of the key challenges associated with supporting PL within youth sport and offers solutions to overcome these challenges. The first challenge focuses upon attracting youth (and parents) to sport through increasing recruitment against social constraints (e.g., socioeconomic), popular entertainment (e.g., streaming) and family issues (e.g., scheduling). The second centres on retaining children in sport to maximise participation through the appropriate design, organisation and delivery of training and competition opportunities. The final challenge relates to the talent pathway and how sports can structure (e.g., [de]selection) and deliver (e.g., training intensification) a pathway to ensure that all youth athletes flourish along their PL journey. Our solutions focus on organisations (e.g., national governing bodies, clubs) understanding and considering, (1) PL as an individual's relationship with movement and physical activity throughout life, (2) children's rights (e.g., interests, opportunities, expression of views), and (3) sport policies and practices when designing and delivering sport experiences. Whilst these challenges and solutions are wide ranging and complex, our belief is that the adoption of a PL approach by stakeholders when designing, delivering and enacting sport programs can enhance the experiences of youth involved in sport and ultimately support their lifelong PL journey.
{"title":"Challenges and Solutions to Supporting Physical Literacy within Youth Sport.","authors":"Kevin Till,Sergio Lara-Bercial,Joseph Baker,David Morley","doi":"10.1007/s40279-025-02313-3","DOIUrl":"https://doi.org/10.1007/s40279-025-02313-3","url":null,"abstract":"There are current global concerns surrounding the lifestyle behaviours and future health and well-being of youth. One concept that has gained traction to address these concerns is physical literacy (PL). Organised youth sport is one context that can promote PL, offering multiple benefits coupled with a range of challenges. This Leading Article aims to provide a balanced overview of the key challenges associated with supporting PL within youth sport and offers solutions to overcome these challenges. The first challenge focuses upon attracting youth (and parents) to sport through increasing recruitment against social constraints (e.g., socioeconomic), popular entertainment (e.g., streaming) and family issues (e.g., scheduling). The second centres on retaining children in sport to maximise participation through the appropriate design, organisation and delivery of training and competition opportunities. The final challenge relates to the talent pathway and how sports can structure (e.g., [de]selection) and deliver (e.g., training intensification) a pathway to ensure that all youth athletes flourish along their PL journey. Our solutions focus on organisations (e.g., national governing bodies, clubs) understanding and considering, (1) PL as an individual's relationship with movement and physical activity throughout life, (2) children's rights (e.g., interests, opportunities, expression of views), and (3) sport policies and practices when designing and delivering sport experiences. Whilst these challenges and solutions are wide ranging and complex, our belief is that the adoption of a PL approach by stakeholders when designing, delivering and enacting sport programs can enhance the experiences of youth involved in sport and ultimately support their lifelong PL journey.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"17 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-13DOI: 10.1007/s40279-025-02319-x
Kai Xu,Anthony J Blazevich,Daniel Boullosa,Rodrigo Ramirez-Campillo,MingYue Yin,YuMing Zhong,YuHang Tian,Mitchell Finlay,Paul J Byrne,Francisco Cuenca-Fernández,Ran Wang
{"title":"Response to Comment on \"Optimizing Post-Activation Performance Enhancement in Athletic Tasks: A Systematic Review with Meta-Analysis for Prescription Variables and Research Methods\".","authors":"Kai Xu,Anthony J Blazevich,Daniel Boullosa,Rodrigo Ramirez-Campillo,MingYue Yin,YuMing Zhong,YuHang Tian,Mitchell Finlay,Paul J Byrne,Francisco Cuenca-Fernández,Ran Wang","doi":"10.1007/s40279-025-02319-x","DOIUrl":"https://doi.org/10.1007/s40279-025-02319-x","url":null,"abstract":"","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"53 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-11DOI: 10.1007/s40279-025-02307-1
Konstantin Warneke,Anthony J Blazevich,Daniel Jochum,David G Behm,Ewan Thomas,Masatoshi Nakamura,José Afonso
Muscle stretching is widely used in clinical, athletic, and otherwise healthy populations, yet a consensual definition of stretch intensity-a key component of stretch load-does not exist. This is important because the effects of stretch intensity on range of motion and strength are controversial but suggested to affect clinical practice and scientific research. Most commonly, stretch intensity is defined in relation to an individual's perceived level of discomfort or pain; however, these definitions are problematic for several reasons, including that consensual and objective quantifiable definitions of 'pain' and 'discomfort' do not exist, perceptions vary widely (and may not be sensed in some populations), and their ordinal (interval) nature is problematic from a statistical (research) point of view. The maximal range of motion or stretch distance may instead be useful; however, it can be difficult to define the 'start of stretch' and tissue stress varies non-linearly with range of motion or distance, meaning tissue load (stress) varies markedly with small changes in joint angle or distance near the stretch limit but varies less when stretches are performed further from it. Alternatively, setting joint angles or stretch distances as a percentage of the peak passive torque or resistive force can circumvent these issues, removing the need to define the 'start of stretch' and ensuring that intensity changes largely reflect changes in tissue load; however, torque/force measurement can sometimes be difficult or impossible to assess. A concerted research effort is thus required to produce an accepted definition of stretch intensity, and then to clarify how this can be quantified in scientific and practical settings.
{"title":"Perception-Based Methods and Beyond: A Current Opinion on How to Assess Static Stretching Intensity.","authors":"Konstantin Warneke,Anthony J Blazevich,Daniel Jochum,David G Behm,Ewan Thomas,Masatoshi Nakamura,José Afonso","doi":"10.1007/s40279-025-02307-1","DOIUrl":"https://doi.org/10.1007/s40279-025-02307-1","url":null,"abstract":"Muscle stretching is widely used in clinical, athletic, and otherwise healthy populations, yet a consensual definition of stretch intensity-a key component of stretch load-does not exist. This is important because the effects of stretch intensity on range of motion and strength are controversial but suggested to affect clinical practice and scientific research. Most commonly, stretch intensity is defined in relation to an individual's perceived level of discomfort or pain; however, these definitions are problematic for several reasons, including that consensual and objective quantifiable definitions of 'pain' and 'discomfort' do not exist, perceptions vary widely (and may not be sensed in some populations), and their ordinal (interval) nature is problematic from a statistical (research) point of view. The maximal range of motion or stretch distance may instead be useful; however, it can be difficult to define the 'start of stretch' and tissue stress varies non-linearly with range of motion or distance, meaning tissue load (stress) varies markedly with small changes in joint angle or distance near the stretch limit but varies less when stretches are performed further from it. Alternatively, setting joint angles or stretch distances as a percentage of the peak passive torque or resistive force can circumvent these issues, removing the need to define the 'start of stretch' and ensuring that intensity changes largely reflect changes in tissue load; however, torque/force measurement can sometimes be difficult or impossible to assess. A concerted research effort is thus required to produce an accepted definition of stretch intensity, and then to clarify how this can be quantified in scientific and practical settings.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"24 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-10DOI: 10.1007/s40279-025-02312-4
Avinash Chandran,Ben Clarsen,Ian Varley,Karim Khan,Stephen W Marshall,Roald Bahr
Sports injury surveillance programs have been vital in advancing the understanding of injury epidemiology across various athlete populations. Surveillance-based epidemiological measures of injury occurrence are ubiquitous in the sports medicine literature, and the injury rate is one such commonly used measure. Traditional approaches to calculating injury rates have predominantly relied on frequentist methods, which, while informative, have limitations in addressing certain practical questions. We explore an alternative Bayesian framework for analyzing injury rates, highlighting its potential to enhance sports medicine practice. We delineate the practical implications of adopting a Bayesian approach, contrasting key analytical outputs such as credible intervals with their frequentist counterparts. Through simulated and real-world examples, we demonstrate the types of analyses and inferences that are only possible within this framework. We particularly discuss how Bayesian methods allow for direct calculation of probabilities for specific outcomes and provide intuitive interpretations of uncertainty. We discuss the computational and inferential advantages of the Bayesian approach, illustrating how it can offer more nuanced insights into injury incidence in sport injury epidemiology.
{"title":"The Practical Value of Bayesian Inference in Describing the Epidemiology of Sports Injuries.","authors":"Avinash Chandran,Ben Clarsen,Ian Varley,Karim Khan,Stephen W Marshall,Roald Bahr","doi":"10.1007/s40279-025-02312-4","DOIUrl":"https://doi.org/10.1007/s40279-025-02312-4","url":null,"abstract":"Sports injury surveillance programs have been vital in advancing the understanding of injury epidemiology across various athlete populations. Surveillance-based epidemiological measures of injury occurrence are ubiquitous in the sports medicine literature, and the injury rate is one such commonly used measure. Traditional approaches to calculating injury rates have predominantly relied on frequentist methods, which, while informative, have limitations in addressing certain practical questions. We explore an alternative Bayesian framework for analyzing injury rates, highlighting its potential to enhance sports medicine practice. We delineate the practical implications of adopting a Bayesian approach, contrasting key analytical outputs such as credible intervals with their frequentist counterparts. Through simulated and real-world examples, we demonstrate the types of analyses and inferences that are only possible within this framework. We particularly discuss how Bayesian methods allow for direct calculation of probabilities for specific outcomes and provide intuitive interpretations of uncertainty. We discuss the computational and inferential advantages of the Bayesian approach, illustrating how it can offer more nuanced insights into injury incidence in sport injury epidemiology.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"38 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-09DOI: 10.1007/s40279-025-02317-z
Alan M Nevill,Matthew Wyon,Jonathan Myers,Matthew P Harber,Tony D Myers
{"title":"Response to Lolli's Comment on \"Predicting VO2max Using Lung Function and Three-Dimensional (3D) Allometry Provides New Insights into the Allometric Cascade (M0.75)\".","authors":"Alan M Nevill,Matthew Wyon,Jonathan Myers,Matthew P Harber,Tony D Myers","doi":"10.1007/s40279-025-02317-z","DOIUrl":"https://doi.org/10.1007/s40279-025-02317-z","url":null,"abstract":"","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"115 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-09DOI: 10.1007/s40279-025-02305-3
Kade Silverthorne,Matthew Morrison,Nicholas Cowley,Gabriella Munteanu,Mark W Creaby,Ryan G Timmins,Chieh-Ying Chiang,Jonathon Weakley
BACKGROUNDPowerlifting is a strength sport featuring some of the world's strongest athletes. Recent decades have seen an exponential increase in research into the applied sport science and medicine of powerlifting and its Paralympic counterpart, para powerlifting. A scoping review of the area would provide athletes, coaches, policymakers, and researchers with an overview of the existing evidence to support performance, reduce injury, and foster further growth of these sports.OBJECTIVESThe primary objectives were to identify the current research into the applied sport science and medicine of powerlifting and para powerlifting, analyse the characteristics of the research, provide a brief summary of the research in each area of sport science and medicine, identify gaps in the current literature, and provide recommendations for future research.METHODSSystematic searches of SPORTDiscus, CINAHL, MEDLINE, and Scopus were performed from the earliest record to June 2025 (Open Science Framework registration: https://osf.io/fkjsz ), and the reference lists of several pre-existing systematic reviews were manually searched. Studies were eligible for inclusion if they investigated powerlifting or para powerlifting as a sport or the applied sport science of powerlifters or para powerlifters from a performance or injury perspective.RESULTSA total of 2117 articles were identified in the database search, with three additional eligible studies discovered through other sources. In total, 218 studies met the inclusion criteria and were ultimately included in the review. The most researched sport science and medicine topic was physical qualities (n = 48), followed by competition (n = 45), training (n = 38), biomechanics (n = 36), nutrition and supplementation (n = 25), injury (n = 18), and psychology (n = 8). More than half of the included studies were published in 2020 or later, and researchers from the USA were the most prolific with 57 publications. Para powerlifting was investigated in 45 studies, which mostly originated from Brazil (n = 31). Participants represented varying levels of competition, powerlifting divisions, and age categories, although many studies did not clearly report these characteristics. Only seven studies investigated female athletes exclusively.CONCLUSIONThis scoping review summarises the current literature investigating powerlifting and para powerlifting and can be used to enhance the applied sport science and medicine within the sports. While the amount of research has grown considerably in recent years, it is evident that certain demographics and areas remain under-investigated (e.g., injury mechanisms) or warrant updated examination (e.g., the prevalence of performance-enhancing drug use, which was last reported in 2003 and is currently unknown). Thus, this review highlights several areas for future research based on the gaps in the existing literature and provides a range of recommendations that can be implemented to improve reporting, t
{"title":"The Applied Sport Science and Medicine of Powerlifting and Para Powerlifting: A Systematic Scoping Review with Recommendations for Future Research.","authors":"Kade Silverthorne,Matthew Morrison,Nicholas Cowley,Gabriella Munteanu,Mark W Creaby,Ryan G Timmins,Chieh-Ying Chiang,Jonathon Weakley","doi":"10.1007/s40279-025-02305-3","DOIUrl":"https://doi.org/10.1007/s40279-025-02305-3","url":null,"abstract":"BACKGROUNDPowerlifting is a strength sport featuring some of the world's strongest athletes. Recent decades have seen an exponential increase in research into the applied sport science and medicine of powerlifting and its Paralympic counterpart, para powerlifting. A scoping review of the area would provide athletes, coaches, policymakers, and researchers with an overview of the existing evidence to support performance, reduce injury, and foster further growth of these sports.OBJECTIVESThe primary objectives were to identify the current research into the applied sport science and medicine of powerlifting and para powerlifting, analyse the characteristics of the research, provide a brief summary of the research in each area of sport science and medicine, identify gaps in the current literature, and provide recommendations for future research.METHODSSystematic searches of SPORTDiscus, CINAHL, MEDLINE, and Scopus were performed from the earliest record to June 2025 (Open Science Framework registration: https://osf.io/fkjsz ), and the reference lists of several pre-existing systematic reviews were manually searched. Studies were eligible for inclusion if they investigated powerlifting or para powerlifting as a sport or the applied sport science of powerlifters or para powerlifters from a performance or injury perspective.RESULTSA total of 2117 articles were identified in the database search, with three additional eligible studies discovered through other sources. In total, 218 studies met the inclusion criteria and were ultimately included in the review. The most researched sport science and medicine topic was physical qualities (n = 48), followed by competition (n = 45), training (n = 38), biomechanics (n = 36), nutrition and supplementation (n = 25), injury (n = 18), and psychology (n = 8). More than half of the included studies were published in 2020 or later, and researchers from the USA were the most prolific with 57 publications. Para powerlifting was investigated in 45 studies, which mostly originated from Brazil (n = 31). Participants represented varying levels of competition, powerlifting divisions, and age categories, although many studies did not clearly report these characteristics. Only seven studies investigated female athletes exclusively.CONCLUSIONThis scoping review summarises the current literature investigating powerlifting and para powerlifting and can be used to enhance the applied sport science and medicine within the sports. While the amount of research has grown considerably in recent years, it is evident that certain demographics and areas remain under-investigated (e.g., injury mechanisms) or warrant updated examination (e.g., the prevalence of performance-enhancing drug use, which was last reported in 2003 and is currently unknown). Thus, this review highlights several areas for future research based on the gaps in the existing literature and provides a range of recommendations that can be implemented to improve reporting, t","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"35 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-06DOI: 10.1007/s40279-025-02304-4
Alexandra F DeJong Lempke,Kathryn E Ackerman,Trent Stellingwerff,Louise M Burke,Aaron L Baggish,Pierre A d'Hemecourt,Sophia Dyer,Chris Troyanos,Grace H Saville,Kaya Adelzadeh,Bryan Holtzman,Anthony C Hackney,Kristin E Whitney
BACKGROUNDPhysical training influences competitive marathon performance, including training volume and training frequency changes (TFCs) pre-race. Training intensity distribution (i.e., steady-state, quality sessions, interval training) and cross-training contribute to volume and TFCs that may influence performance.OBJECTIVEThe aim of this study is to assess the relationships among training and TFCs preceding the 2022 Boston Marathon and race performance.METHODSAdult 2022 Boston Marathon registrants were contacted via email 1 month pre-race. Athletes reported demographics, training/racing experience, and training pre-race. TFCs were calculated by comparing two timeframes: 12-4 and 4-0 month pre-race training. Official race performance was obtained from chip timing data and demographics. Separate linear regressions were used to assess the effects of training and cross-training in 12-4 and 4-0 months pre-race and TFCs on performance, accounting for experience and demographics.RESULTSIn total, 917 athletes were included (female: n = 495, 3:53 ± 0:37 h race times, 64.4 ± 24 km/week weekly distance; male: n = 422; 3:35 ± 0:39 h race times, 67.6 ± 26.2 km/week weekly distance). Higher running distance/week, running sessions/week (n), quality sessions/week ("hard sessions"; n), average distance in the 12-4 and 4-0 months pre-race (p ≤ 0.050), and more cross-training (p < 0.001) in the 4-0 months pre-race were associated with faster times and performance. Runners with TFCs of decreased running sessions/week (p = 0.035) had faster times and better performance versus athletes who maintained/increased volume.CONCLUSIONHabitually higher training exposure 12-4 and 4-0 months, but relatively reduced training frequency 4-0 months pre-race, contributed to better marathon performance.
{"title":"Training Volume and Training Frequency Changes Associated with Boston Marathon Race Performance.","authors":"Alexandra F DeJong Lempke,Kathryn E Ackerman,Trent Stellingwerff,Louise M Burke,Aaron L Baggish,Pierre A d'Hemecourt,Sophia Dyer,Chris Troyanos,Grace H Saville,Kaya Adelzadeh,Bryan Holtzman,Anthony C Hackney,Kristin E Whitney","doi":"10.1007/s40279-025-02304-4","DOIUrl":"https://doi.org/10.1007/s40279-025-02304-4","url":null,"abstract":"BACKGROUNDPhysical training influences competitive marathon performance, including training volume and training frequency changes (TFCs) pre-race. Training intensity distribution (i.e., steady-state, quality sessions, interval training) and cross-training contribute to volume and TFCs that may influence performance.OBJECTIVEThe aim of this study is to assess the relationships among training and TFCs preceding the 2022 Boston Marathon and race performance.METHODSAdult 2022 Boston Marathon registrants were contacted via email 1 month pre-race. Athletes reported demographics, training/racing experience, and training pre-race. TFCs were calculated by comparing two timeframes: 12-4 and 4-0 month pre-race training. Official race performance was obtained from chip timing data and demographics. Separate linear regressions were used to assess the effects of training and cross-training in 12-4 and 4-0 months pre-race and TFCs on performance, accounting for experience and demographics.RESULTSIn total, 917 athletes were included (female: n = 495, 3:53 ± 0:37 h race times, 64.4 ± 24 km/week weekly distance; male: n = 422; 3:35 ± 0:39 h race times, 67.6 ± 26.2 km/week weekly distance). Higher running distance/week, running sessions/week (n), quality sessions/week (\"hard sessions\"; n), average distance in the 12-4 and 4-0 months pre-race (p ≤ 0.050), and more cross-training (p < 0.001) in the 4-0 months pre-race were associated with faster times and performance. Runners with TFCs of decreased running sessions/week (p = 0.035) had faster times and better performance versus athletes who maintained/increased volume.CONCLUSIONHabitually higher training exposure 12-4 and 4-0 months, but relatively reduced training frequency 4-0 months pre-race, contributed to better marathon performance.","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":"72 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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