Athletic Career Research Articles

Paper 11: Hip Cartilage Defects in Elite Athletes: Their Association with Specific Sports and ‘At-risk’ Motions

Objectives: Chondral injuries, especially in high-level athletes, can have drastic functional detriments. Much of the prior work on osteochondral injury has studied the knee, however emphasis on the hip has emerged with advances in hip preservation techniques. While hip chondral defects have been shown to be associated with femoroacetabular impingement (FAI), a more in-depth understanding of the determining factors is needed due to the limited spontaneous repair capacity of cartilage. It is currently unclear if the type of sport or specific motions are related to the prevalence or severity of chondral defects seen in athletes. The purpose of this study is to evaluate the prevalence of chondral defects across specific sports and characterize the corresponding articular cartilage injury patterns in the hip, as found in elite and professional athletes. Methods: Elite athletes at least 18 years old, defined as those competing in college or professionally, who underwent arthroscopy for symptomatic FAI by a single surgeon between January 2005 and November 2018 were considered for inclusion. A review of records was performed of all the patients’ operative information was reviewed from the patient records database, including operative reports, operative photos, and extensive operative details. Exclusion criteria consisted of prior ipsilateral hip surgery, presence of osteoarthritis (joint space < 2 mm), history of confounding injury or prior hip conditions. Patients were then classified by their sport using a classification system based on ‘at-risk’ hip motions (rotational, repetitive, extreme, contact, and high-speed). Prevalence, size, severity (Outerbridge grade), and location of chondral defects were compared. Results: The cohort consisted of a total of 431 hips (107 female, 324 male, mean age 26.8 ± 5.1) of elite athletes, representing 24 sports at various elite levels of play. Chondral defects (grade I-IV) were found in 408 (95%) of cases. Severe chondral defects (grade III/IV) were seen in 218 (51%) of cases and most commonly found in football, soccer, and baseball players. Microfracture was performed in 72 (17%) of total cases. There was significantly higher prevalence of acetabular (p=.046), femoral head (p=.038), and combined (p=.035) grade III/IV lesions in the rotational versus non-rotational group, as well as acetabular (p=<.001) and combined (p=.018) grade III/IV lesions in the contact sport group versus non-contact group. Non-high speed sports (p=0.029) had significantly higher percentages of femoral head grade III/IV lesions compared to non-high speed, and non-extreme ranges of motion sports (p=0.002) had higher rates of grade III/IV lesions compared to extreme range of motion sports. Conclusions: In elite athletes, the prevalence of chondral defects was high when undergoing hip arthroscopy. The severity, size, and location varied based on type of motion and stress on the hip that was determined by the sport. The more severe (grade III/IV) defects were more common in the rotational and contact athletes according to the motion classification system. The nature of high speed and extreme range of motion sports may be somewhat protective or select-out for athletes with hip chondral defects. This classification system can be used to identify athletes at risk of chondral damage for close monitoring and injury prevention. This information can also be used to pre-operatively counsel these athletes on the likely findings and to set expectations. This can also inform the discussion as to timing of surgery for rehabilitative purposes and athletic career management. [Table: see text][Table: see text]

Athletes with Eating Disorders: Analysis of Their Clinical Characteristics, Psychopathology and Response to Treatment.

Eating disorders (ED) have frequently been described among athletes. However, their specific features and therapy responses are lacking in the literature. The aims of this article were to compare clinical, psychopathological and personality traits between ED patients who were professional athletes (ED-A) with those who were not (ED-NA) and to explore differences in response to treatment. The sample comprised n = 104 patients with ED (n = 52 ED-A and n = 52 matched ED-NA) diagnosed according to DSM-5 criteria. Evaluation consisted of a semi-structured face-to-face clinical interview conducted by expert clinicians and a psychometric battery. Treatment outcome was evaluated when the treatment program ended. ED-A patients showed less body dissatisfaction and psychological distress. No differences were found in treatment outcome among the groups. Within the ED-A group, those participants who performed individual sport activities and aesthetic sports presented higher eating psychopathology, more general psychopathology, differential personality traits and poor therapy outcome. Individual and aesthetic sports presented more severity and worse prognosis. Although usual treatment for ED might be similarly effective in ED-A and ED-NA, it might be important to develop preventive and early detection programs involving sports physicians and psychologists, coaches and family throughout the entire athletic career and afterwards.

Athletic identity and career engagement as predictors of mental well-being in North American professional athletes

ABSTRACT The support of athlete career excellence in sport is a growing societal issue. For professional athletes within North America, the factors that contribute to athlete career excellence are not well understood. The current investigation examined the relationships between three athlete career excellence resources: athletic identity; career engagement; and mental well-being. Using a non-random convenience sampling strategy, 72 professional athletes currently active in the sports of baseball, football, and ice hockey in North America participated in the study. It was found that athletic identity and career engagement significantly predicted mental well-being in North American professional athletes. Furthermore, both athletic identity and career engagement added significantly to the prediction model. The current investigation supports the conceptualisation and understanding of how North American professional athletes’ career engagement and mental well-being contribute to athletes' striving for career excellence. Recommendations for further research and practical applications are considered.

SOCIAL MEDIA AND DUAL CAREER PROMOTION FOR SPORTS HIGH SCHOOL STUDENTS

Human communication is achieved with the help of the interaction between two types of relationships: direct (when we talk about interpersonal communication) and indirect (when technological support also intervenes in mediating communication). Nowadays, social media is spreading all over the world with the help of digital progress, which opens new approaches to a multitude of platforms and applications (Gabelaia, 2019). Because social media catalyzes the transmission of information between people, allowing them to amplify their voices and reach large audiences in fractions of a second and at no cost (Kocak & Kibris, 2022), it follows that social media is becoming an important factor in daily life. In the present research, it was analyzed which social network is, from the subjects' point of view, the most suitable to promote the phrase "dual career" in the online environment. The Levene's Test for equality of variances and the Chi-square Test of Independence were used to determine whether there were associations between the responses obtained. The conclusions of the research are obvious: there is a social network that can successfully promote the dual career of athletes among young people.

Ulnar Collateral Ligament Internal Bracing Repair Technique for High-Grade Partial Proximal Tears in the Throwing Athlete

The use of ulnar collateral ligament (UCL) repair with concomitant internal bracing for throwing athletes is a viable treatment option, but must take into account tear location, ligament quality, the expected length of the athlete's career, desire to advance to the next level of competition, and age. There has been increased interest in repair of UCL injuries in overhead athletes due to advancements in surgical technique, as well as improved technologies of anchor and suture material. In addition, return to sport can be accelerated compared to reconstruction. In this Technical Note, we demonstrate an ulnar collateral ligament repair technique, with internal bracing augmentation for high-grade partial proximal tears in the throwing athlete that is reliable, strong, and easily reproducible.

Descriptive Statistical Analysis of the Coach-Player Relationship with CART-Q and SCI

Providing maximum performance in a long-term competitive load is associated with a quality relationship between the player and his coach. A coach plays one of the most important roles in an athlete's sports career and has the potential to positively or negatively impact the mental health of athletes. The aim of the presented paper is to map the bond between the quality of the relationship between the player and the coach and the sports self-confidence of elite junior tennis players. The research sample consisted of 236 elite junior tennis players competing at the national and international levels. The average age was 17.2 years. Data collection was carried out using the questionnaire methods of the Coach-Athlete Relationship Questionnaire (CART-Q) and the Sport Confidence Inventory (SCI). The results found significant differences in the perception of the quality of the coaching relationship between Czech and foreign athletes. Gender differences were also found among Czech athletes. A significant relationship was found between the quality of the player-coach relationship and sports self-confidence. The results point to the connections between performance, mental well-being, and the quality of the relationship between the player and the coach and can be the basis for further studies and motivate coaches to think about whether there is a need to modify the ways of training and dealing with their athletes. Doi: 10.28991/HIJ-2023-04-02-01 Full Text: PDF

Provision of legal assistance by a lawyer to professional athletes in negotiating and concluding of contracts

This article is devoted to the disclosure of some features of providing legal assistance to professional athletes in relation to the representation of their interests at the stage of negotiations and conclusion of contracts. Other possible activities of a lawyer in the field of sports are also analyzed. Within the framework of this article, attention is focused on the fact that, despite the significant range of types of possible lawyer activity, when the client of the lawyer is a professional athlete, in many cases such activity is limited to help (support) in concluding contracts of the professional athlete primarily with his future club (employer). Attention is focused on the importance of such a contract, taking into account the fact that regardless of whether it is the first contract in the athlete's professional career or the current one, in many ways it determines the further sports future of the professional athlete. This article also examines the special legal nature of a sports contract and draws attention to different points of view regarding its definition (some scholars hold the position that a contract with a professional athlete is an employment contract, others a civil contract and some point out that it has dual legal nature). It is concluded that the contract with the athlete is a type of employment contract, and between the parties, there is an employment relationship, not forgetting the need to take into account its features, based on the specifics of the professional activity of athletes. The position is also argued (based on the variety of sports and the ways athletes participate in competitions) about the possible civil-law nature of relations regarding the participation of professional athletes in competitions (for example, regarding the participation of professional tennis players who are self-employed and represent themselves at competitions).

Does right ventricular remodeling in elite athletes persist years after training cessation?

Abstract Funding Acknowledgements Type of funding sources: None. Background Intense and prolonged exercise training induces morpho-functional cardiac changes, known as "athlete’s heart". The physiologic nature of this cardiac remodeling has been questioned and data on reversibility of cardiac remodeling, especially of the right ventricle (RV), after the suspension of high intensity training are scarce. Purpose To describe cardiac morpho-functional changes by echocardiography in a group of Olympic athletes prior the Olympic games (T1) and years after cessation of their competitive athletic career (T2). Methods Endurance athletes evaluated prior their participation to the Olympic games (edition 2004-2008-2012) and after cessation of their athletic career (> 3 years of cessation of intensive exercise training) were invited to be evaluated at our Institute. 12-lead ECG, exercise ECG test and echocardiogram were performed. Echocardiogram parameters at T1 and T2 were compared including left ventricle (LV) and RV dimension, systolic and diastolic function. Results 25 athletes were enrolled (mean age 47±2 years). The mean time from the end of their agonistic activity was 12 ± 7 years. No differences in terms of LV dimensions and function were observed (Table). Veterans showed a significant decrease in RV dimensions and improvement in function at T2 compared to T1. Conclusion After suspension of competitive training, Veteran athletes showed reverse remodeling of the right ventricle compared with the evaluation during the peak training by echocardiography.

In-Season Management of Shoulder Instability: How to Evaluate, Treat, and Safely Return to Sport.

Anterior glenohumeral instability is a common injury in contact and collision athletes, and in-season management remains a controversial topic. Several recent studies have examined non-operative and operative management of in-season athletes after instability events. Non-operative treatment is associated with faster return to play and higher rates of recurrent instability. Dislocations and subluxations have similar rates of recurrent instability but non-operatively treated subluxations have a quicker return to play than dislocations. Operative treatment is often a season ending decision but is associated with high rates of return to sport and significantly lower rates of recurrent instability. Indications for in-season operative intervention may include critical glenoid bone loss (>15%), an off-track Hill-Sachs lesion, an acutely reparable bony Bankart lesion, high-risk soft tissue injures such as a humeral avulsion of the glenohumeral ligament or displaced anterior labral periosteal sleeve avulsion, recurrent instability, insufficient time remaining in season to rehabilitate from injury, and inability to successfully return to sport with rehabilitation. It is the role of the team physician to appropriately educate athletes on risks and benefits of operative and non-operative treatment strategies and guide athletes through the shared decision-making process that balances these risks against their long-term health and athletic career goals.

Prospective Implications of Insufficient Sleep for Athletes.

Poor sleep is common in collegiate student-athletes and is associated with heterogeneous self-reported complaints at baseline. However, the long-term implications of poor sleep at baseline have been less well studied. To examine the implications of insufficient sleep at baseline, as well as factors such as symptom reporting and neurocognitive performance at baseline associated with insufficient sleep, for the risk of sport-related concussion (SRC). Cross-sectional study. Undergraduate institution. Student-athletes (N = 614) were divided into 2 groups based on the hours slept the night before baseline testing: sufficient (>7.07 hours) or insufficient (≤5.78 hours) sleepers. Athletes who went on to sustain an SRC during their athletic careers at our university were identified. Four symptom clusters (cognitive, physical, affective, and sleep) and headache were examined as self-reported outcomes. Four neurocognitive outcome measures were explored: mean composite of memory, mean composite of attention/processing speed, memory intraindividual variability (IIV), and attention/processing speed IIV. Insufficient sleepers at baseline were nearly twice as likely (15.69%) as sufficient sleepers (8.79%) to go on to sustain an SRC. Insufficient sleepers at baseline, whether or not they went on to sustain an SRC, reported a higher number of baseline symptoms than did sufficient sleepers. When compared with either insufficient sleepers at baseline who did not go on to incur an SRC or with sufficient sleepers who did go on to sustain an SRC, the insufficient sleep group that went on to incur an SRC performed worse at baseline on mean attention/processing speed. The combination of insufficient sleep and worse attention/processing speed performance at baseline may increase the risk of sustaining a future SRC.

The Effect of Music Listening on Athletes' Anxiety, Depression, and Pain: A Mini Review

Athletes are at risk for a wide range of psychological and physical disorders due to the stressors and injuries associated with sports. Anxiety, depression, and pain are the most frequent disorders, and they can all have a severe impact on an athlete's performance and potential career. This review has shown that several studies have demonstrated that listening to music, especially motivational and relaxing music, before, during, and after sports can be an emotionally engaging distraction that can help reduce negative emotions, the feeling of pain, as well as the accompanying negative affective experience. This mini review lays the groundwork for understanding how listening to music affects athletes, making it a non-invasive and less expensive way to treat anxiety, depression, and pain caused by sports.

Investigation of social capital, empathy and individual responsibility parameters in dual career athletes: an exploratory study

Background and Study Aim. The main purpose of the study is to investigate whether the individual responsibility and empathy levels of athlete-students affect the level of social capital. The secondary purpose is to examine the social capital, empathy and individual responsibility levels of athlete-students in terms of various variables and to reveal the relationship between them. Material and Methods. In this context, "Social Capital Scale" , "Empathy Scale in Sports Environment" and "Student Individual Responsibility Scale" were used as data collection tools. University students participating in sports competitions in the 2021-2022 academic year were included in the study on a voluntary basis. The inclusion criteria were determined as being both an athlete and a student, being over the age of 18 and being a competitor. A total of 284 (N female=110; N male=174) athlete-students who met these criteria participated in the study. Since the normal distribution conditions were met in the analysis of the data, independent t-test was used for pairwise comparisons, one-way anova for multiple comparisons, and pearson correlation test for relationship analysis. After the assumptions were met, linear regression test was used to determine the effect levels. Results. As a result of the study, all dependent variables were high in favour of men, and the variables were positively affected as age and years of experience increased. In addition, a positive and moderate relationship was found between the dependent variables. As the main result of the study, the effect rate was determined as 39% by the regression analysis conducted to evaluate empathy and individual responsibility as predictors of social capital. Conclusions. As a result, the concept of social capital, which expresses the continuity and sustainability of our life-related social relations, seriously affects the levels of empathy and social responsibility in the sample of athlete-students in the sports environment. It is thought that the studies to be carried out for the development of these skills will positively affect the concepts of safety, social communication and fair-play in sports.

Perfectionistic Environments and Irrational Beliefs on the Transition to Elite Athletic Performance: A Longitudinal Study.

This study aimed to longitudinally evaluate talented athletes' levels of perfectionism, irrational beliefs, and motivations with regard to their athletic careers. A total of 390 athletes from U14, U16, and junior categories (MageT1 = 15.42) answered shortened versions of the Sport-MPS2, iPBI, and BRSQ during two consecutive seasons, along with questions referring to their current and predicted prioritization of sports and education. Participants reported high levels of perfectionistic strivings and medium to low levels of socially prescribed perfectionism and concern over mistakes decreasing from T1 to T2. A decrease was also found for demandingness and awfulizing, but increased levels were found for depreciation in T2. Participants report very high intrinsic motivation with low levels of external regulation and amotivation, but intrinsic motivation decreased from season to season. This general profile varied depending upon future expectancies toward dedication to sports and education. Those who foresaw a prioritized dedication to sports presented significantly higher levels of socially prescribed perfectionism, perfectionistic strivings, and intrinsic motivation, while those who considered that sports would not be prioritized in the following 5 years reported higher levels of demandingness, awfulizing, depreciation, and amotivation. Additionally, while current levels of motivation (T2) seemed to be predicted mainly by previous motivation levels (T1), significant predictive capacity was also detected for socially prescribed perfectionism positively predicting external regulations and amotivation, perfectionistic strivings negatively predicting amotivation, and depreciation negatively predicting intrinsic motivation and positively predicting both extrinsic regulation and amotivation. We discuss the potential perils of developing extremely demanding environments, as they could potentially result in poor motivational profiles of athletes in their talent development stage during the junior to senior transition.

Sex-Specific Considerations and Evaluation of Trochlear Dysplasia in the Treatment of Patellofemoral Instability

Patella dislocation is a serious problem that disrupts athletic careers and influences quality of life, particularly when it is recurrent. The incidence of patellar dislocation has been shown to be most common in female adolescents. The causes of patellar dislocation are multifactorial, and the reasons for such sex-related differences are not well understood. A better understanding of risk factors such as trochlear dysplasia can help improve our treatment for this condition. While true for all athletes, attention to core stability, particularly with regard to lower limb mechanics, may be particularly important in female athletes with regard to reducing patella dislocation risk as well as ligament injury prevention, and should be explored further.

Correlation between Ethical Sensitivity as Well as Doping Attitude and Dispositions in Taekwondo Kyorugi Athletes: Athlete Career and National Team Moderation Effect.

We aimed to examine the effect of ethical sensitivity on doping attitude and dispositions for Taekwondo athletes, as well as whether there was a difference depending on the athlete's career and national team status. Overall, 331 Korean adult Taekwondo athletes were enrolled. Data were collected using sports ethical sensitivity and Performance Enhancement Attitude Scale (PEAS) tools as the research tools. For data processing, frequency analysis was performed to confirm demographic characteristics, and the fitness index was calculated by applying the Rasch model to confirm the validity and reliability of ethical sensitivity and PEAS. An independent sample t-test was performed to confirm the difference between ethical sensitivity and doping attitude and dispositions according to demographic characteristics. Pairwise parameter comparison values were used using multi-group analysis of path analysis to confirm the effect of ethical sensitivity on PEAS and the moderating effect was calculated. First, according to the demographic characteristics of Taekwondo athletes, there were statistically significant differences in ethical sensitivity and PEAS only by gender. Second, as ethical sensitivity factors, both intentional behavior factors and intentional collusion factors had statistically significant effect on PEAS. Third, in the effect of ethical sensitivity on doping attitude and dispositions, there was no moderating effect of athlete experience and national representative status. Ethical sensitivity has a positive linear correlation with PEAS. In other words, enhancing the ethical sensitivity of sports players will enhance athletes' ethical consciousness and prevent unethical behavior, and furthermore, doping.

Prevalence of vertical movement asymmetries at trot in Standardbred and Swedish Warmblood foals.

Many horses, just before and during their athletic career, show vertical movement asymmetries, to the same degree as clinically lame horses. It is unknown whether these asymmetries are caused by pain or have alternative explanations, such as inherent biological variation. In the latter case, movement asymmetries would be expected to be present at a very young age. This study aimed to investigate the prevalence of movement asymmetries in foals. Motion analysis, using an inertial measurement unit-based system (Equinosis), was performed on 54 foals (31 Swedish Warmbloods, 23 Standardbreds) during straight-line trot. The foals were between 4-13 weeks old and considered sound by their owners. Differences between the vertical minimum and maximum values recorded for the head (HDmin, HDmax) and pelvis (PDmin, PDmax) between left and right stance were calculated for each stride and an average was computed for each trial. Thresholds for asymmetry were defined as absolute trial mean >6 mm for HDmin and HDmax, and >3 mm for PDmin and PDmax. These thresholds were exceeded for one or several parameters by 83% of Standardbred foals and 45% of Swedish Warmblood foals, demonstrating surprisingly high prevalence of asymmetries in young foals, although the risk of repetitive strain injuries and cumulative risk of trauma injuries was expected to be low in this age group. Standardbred foals showed similar prevalence of asymmetries to that reported previously for yearling Standardbred trotters, so relatively higher prevalence of movement asymmetries may be expected among trotters as a breed. In general, vertical head and pelvic movement asymmetries can be anticipated among foals considered sound by their owners. A better understanding of the aetiology of asymmetries is needed for correct interpretation of objective symmetry measurements in different populations of horses.

Talented athletes as high achievers—only in sports? Analysis of academic performance and the impact of dual career assistance programmes in upper secondary school

The simultaneous pursuit of success in elite sport and the highest school qualification is considered to be one of the challenges for adolescents who are sporting talents. Dual career assistance programmes (DCAPs) for student-athletes are designed to help master this challenge in the best possible way. This study focusses on the upper secondary school performance of 200 student-athletes from an elite sports school. First, the school performance of student-athletes enrolled in two different DCAPs was compared. In addition to the educational services in DCAP‑1, DCAP‑2 includes a 1-year extension of the school period and the option of spreading the final exam phase out over several school years. Second, the school performance of student-athletes was compared with the performance of the entire student population. The analyses yielded the following findings: 1) student-athletes’ school performance is well above the average of the entire student population. 2) Although, DCAP‑2 users are much more involved in elite sport, their school performance and performance development do not differ from DCAP‑1 users. These results do not provide any indication of a systematic neglect of student-athletes’ academic career in favour of their athletic career. DCAPs appear to ensure the success of student-athletes’ academic careers effectively.

Neonatal sepsis – Pathology and clinical signs

SummarySepsis, also known as septicaemia, is defined as a dysregulated host systemic inflammatory response to infection. Neonatal sepsis is one of the main diseases that can affect young foals with a short‐term survival rate of only 50%–60%. While the pathogenesis of this disease is the same as for adult equids, the clinical signs seen can be very different. Sick foals may manifest a variety of clinical signs all related to a common infection and its systemic effects including tachycardia, tachypnoea, depression, anorexia, colitis, and fever. Less commonly, foals may show petechiation, swollen joints, anterior uveitis, and coma. The rapid changes seen in foals are reflective of their low endogenous reserves of glucose and innate immune mediators as well as the poor ability to self‐regulate their metabolism. The neonatal immune system is reliant on maternal antibodies at birth and development of the foal's own system takes a significant amount of time. This non‐competent immune system changes how the foal responds to infection when compared to the adult. Given the significant range of clinical signs and comorbidities, the prognosis for a full athletic career can vary from grave to excellent when compared to their healthy counterparts.

After the gathering comes the scattering?

Although the transition phase from elite sport to retirement has been the subject of numerous studies, there is currently no research addressing financial security, particularly in high-income sports such as football. However, financial security is a significant influencing factor for the quality of this transition. This study analyses how professional football players perceive the loss of sport-related income after the end of their athletic careers, and the behaviour that they develop to successfully cope with the financial transition. 25 German professional football players (15 of whom had already retired) were interviewed. The data generated were analysed using qualitative content analysis. The results show that the significant loss of income poses a serious problem and may raise existential concerns among some players. Following retirement, the ability to adapt (reduce) expenditure behaviour and generate new income is crucial for a positive transition into retirement. Various scenarios of financial transition emerge when the perspectives of these coping behaviours are combined.

A Smartphone Enabled Slow-Paced Breathing Intervention in Dual Career Athletes

Dual career athletes are exposed to many stressors, for example, balancing deadlines with competition schedules. Slow-paced breathing (SPB) is an accessible relaxation technique, which can be practiced via smartphone applications, however delivery through applications has limited exploration. We discuss a four-week intervention delivered to dual career athletes which included screening stress and wellbeing, and a focus group discussion to capture athlete reflections on the SPB intervention. Athletes reported SPB reduced pre-performance anxiety, increased focus during performance, and increased relaxation before sleep. Findings suggest SPB is successfully delivered via smartphones, positively influences stress management, sleep and performance, and may be a simple tool for practitioners and athletes to utilize.