Collegiate Hockey Research Articles

Occupational and Recreational Noise Exposure from Indoor Arena Hockey Games

Occupational and recreational noise exposures were evaluated at two sporting arenas hosting collegiate hockey games (Venue 1) and semi-professional hockey (Venue 2). A total of 54 personal noise dosimetry samples were taken over the course of seven home hockey games: 15 workers and 9 fans at Venue 1, and 19 workers and 11 fans at Venue 2. None of the sampled workers were overexposed to noise based on Occupational Safety and Health Administration criteria. However, 40% and 57% of workers at Venue 1 and 33% and 91% of fans at Venue 2 were overexposed based on ACGIH noise exposure criteria. Noise exposures for fans were significantly different between venues, but worker noise exposures between venues were not significantly different. In addition, extensive area noise monitoring was conducted at each venue to further characterize the stadium noise on a location-by-location basis. Mean equivalent sound pressure levels ranged from 81 to 96 dBA at Venue 1 and from 85 to 97 dBA at Venue 2. Mean noise peak levels ranged from 105 to 124 dBA at Venue 1, and from 110 to 117 dBA at Venue 2. These data reflect the potential for overexposure at indoor hockey events and are useful in characterizing occupational noise exposure of indoor arena support staff and may also provide a foundation for future noise control research in indoor sports arenas.

Nutritional Knowledge and Attitudes Towards Healthy Eating of College-going Women Hockey Players

The purpose of this study was to determine the nutritional knowledge of female collegiate hockey players and how effectively they apply their nutritional knowledge to their everyday eating habits. The sample studied included female hockey players (n=30) from different college teams of Haryana in the age group of 17-23years. The instrument was a self-administered questionnaire designed to assess nutritional knowledge and attitudes of the subjects. The mean score on nutritional knowledge test was 22.85/55 (38.80% Correct). While incorrect and uncertain responses accounted for the majority of answers, the lowest correct responses were recorded for fiber and energy (21.4 and 25.9% respectively). The attitude towards gaining nutrition information was very positive (93.3%) but a massive impact of family food habits was observed. This study suggests that athletes lack knowledge of nutrition, healthy food choices, components of a well-balanced diet, and the implications of nutrition on performance. The results can be used to develop training semina rs and educational materials to promote greater nutritional knowledge and healthy attitudes among players.

The Determination of Critical Rest Interval from the Intermittent Critical Velocity Test in Club-Level Collegiate Hockey and Rugby Players

The intermittent critical velocity (ICV) test is used to quantify the relationship between velocity and time to exhaustion, yielding an aerobic parameter (ICV), an anaerobic parameter (anaerobic running capacity [ARC]), and critical rest interval (CRI). Critical rest interval is the theoretical rest period needed to maintain repeated bouts of exercise for an extended period of time without inducing fatigue during intermittent treadmill running. Fourteen collegiate, club-level male participants (mean ± SD; age: 21.4 ± 1.8 years; weight: 82.8 ± 5.9 kg; body fat: 11.8 ± 5.4%; and VO2max: 51.2 ± 2.8 ml · kg · min), primarily hockey and rugby players, completed the ICV test, using 15-second repeated sprints to exhaustion during separate sessions of treadmill running at varying supramaximal intensities. The time and total distance for each running session were used to determine ICV and ARC via linear regression. The CRI was calculated using the relationship between total distance during the ICV test and the number of intervals completed. Mean ICV and ARC (± SD) values were calculated as 4.80 ± 0.3 m · s and 154.1 ± 36 m, respectively. The mean ICV values were significantly different from the mean peak velocity (± SD) (4.67 ± 0.17 m · s) achieved during the VO2max test (p = 0.011). The CRI was calculated as mean ± SD: 33.9 ± 1.9 seconds. Body fat percentage measured by air displacement plethysmography (BOD POD®; r = -0.649; p = 0.012), lean body mass (r = -0.556; p = 0.039), fat mass (r = -0.634; p = 0.015), body weight (r = -0.669; p = 0.006), and relative VO2max (r = 0.562; p = 0.036) were significantly correlated with ICV. The ARC (r = 0.804; p = 0.001) and velocity at ventilatory threshold (r = -0.630; p = 0.016) were significantly correlated with CRI. The ability to quantify CRI, an additional variable derived from the ICV test, provides a possible measure that can be used in the prescription and evaluation of training methods.

High Prevalence of Pelvic and Hip Magnetic Resonance Imaging Findings in Asymptomatic Collegiate and Professional Hockey Players

Background: Prior retrospective studies have reported magnetic resonance imaging (MRI) findings of common adductor–abdominal rectus enthesopathy and acetabular labral tear in athletes treated for athletic pubalgia and hip pain. The true prevalence of these findings and association with symptoms in this population is unknown. Purpose: This study was undertaken to determine the prevalence of pelvic and hip MRI findings and association with clinical symptoms in professional and collegiate hockey players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The study included 21 professional and 18 collegiate hockey players. Self-reported symptoms were measured using a modified Oswestry Disability Questionnaire. Participants underwent 3-T MRI evaluation of the pelvis and hips. The MRI scans were interpreted independently by 3 musculoskeletal radiologists in 2 sessions separated by 3 months using a 5-point Likert scale to assess for features associated with common adductor–abdominal rectus dysfunction and hip pathology. To estimate prevalence, MRI findings rated 4 or higher on 4 of the 6 interpretations were considered positive. A variance component analysis was applied to determine intrareader and interreader reliability and the lower 95% confidence limits (CLs). Results: No participants reported symptoms related to pelvic or hip disorders. The MRI findings of common adductor–abdominal rectus dysfunction were observed in 14 of 39 participants (36%) and hip pathologic changes in 25 of 39 (64%). There was moderate agreement between readings, with intrareader and interreader reliabilities ranging from 0.37 to 1.00. The interreader reliability was less for evaluation of hip pathologic abnormalities than for groin pathologic abnormalities, with the lowest reliability observed in reporting of hip osteochondral lesions (0.37 with lower 95% CL of 0.22) and fluid in the primary cleft (0.45 with lower 95% CL of 0.29) and perfect reliability in the absence of effusion and abdominal rectus tendon tears. Overall, 30 of 39 (77%) asymptomatic hockey players demonstrated MRI findings of hip or groin pathologic abnormalities. Conclusion: Given the high prevalence of MRI findings in asymptomatic hockey players, it is necessary to cautiously interpret the significance of these findings in association with clinical presentation. Future investigations will determine whether these asymptomatic findings predict future disabilities.

Comparison of on-ice and off-ice graded exercise testing in collegiate hockey players

The purpose of this study was to compare lactate thresholds (LT) and maximal aerobic capacities (VO(2 max) during sport-specific skating (on ice) and cycle ergometry (off ice) in collegiate hockey players. We hypothesized that VO(2 max) and LT would be higher on ice. We also sought to determine if on-ice and off-ice VO(2 max) values were correlated. Twelve collegiate hockey players performed both graded exercise protocols in randomized order to fatigue. Both protocols included 80 s of work during each stage, followed by 40 s of rest to allow for blood lactate sampling. VO(2 max) was significantly higher on ice (46.9 +/- 1.0 mL*kg(-1)*min(-1)) than off ice (43.6 +/- 0.9 mL*kg(-1)*min(-1); p < 0.05). Maximal heart rate (HR(max)) was also higher on ice (192.2 +/- 1.8 beats*min(-1)) than off ice (186.0 +/- 1.5 beats*min(-1); p < 0.01). LT was drastically higher on ice than off ice as a percentage of VO(2 max) (85.9% +/- 1.9% vs. 69.7% +/- 1.3%; p < 0.01) and HR(max) (90.1% +/- 1.3% vs. 79.4% +/- 1.6%; p < 0.01). Finally, no correlation existed between VO(2 max) values off ice and on ice (r = -0.002; p = 0.99). Our results indicate that off-ice VO(2 max) and LT are not adequate predictors of on-ice VO(2 max) and LT in collegiate hockey players. These findings challenge the use of cycle ergometry to assess aerobic capacity at events such as the National Hockey League Entry Draft combine. We suggest that hockey players be tested in a sport-specific manner, regardless of whether those tests are performed on ice or off ice.

Club Sport National Tournament: Economic Impact of a Small Event on a Mid-Size Community

Recreational sporting events are big business and cities throughout the United States are competing fiercely to host events (Saayman, &amp; Saayman, &amp; du Plessis, 2005). March (1984) suggested that the reason why smaller sporting events have received relatively little attention is because it is assumed that they are economically less significant. The purpose of this study was to estimate the economic impact of hosting a club sport national tournament on a midsize community. The current study estimates the economic impact of hosting the American Collegiate Hockey Association (ACHA) Division II National Championship. The survey consisted of 105 questionnaires that were completed during the three day tournament of which all 105 were used. The findings of the survey indicated that hosting a national tournament can have a positive effect on the local economy. It was estimated that nearly $2 million of new money may have been injected into the community of Fort Collins, Colorado. This research provides midsize cities with information to justify hosting one-time events and working favorably with the community university.

Coaching Continuity: Sustaining a 30+ Year Career as a Female Collegiate Coach

A case study design was implemented to examine how a female coach has sustained her career. A collegiate field hockey coach with over 30 years of experience and two of her former athletes, both of whom returned to serve as assistant coaches, were interviewed. Following evaluation of higher order themes emerging from the data, the manner in which the coach sustained a lengthy coaching career was found to be analogous to a field hockey player performing in the sport. Much like an athlete who has honed her individual skills, surrounded herself with talented teammates, allowed teammates to assist, used variety in implementing skills, and maintained balance in life, the coach has crafted a successful coaching career. Her internal attributes and maintenance of support, the discovery of an inclusive work environment, seeking variety over time, and achieving balance aided her continuity. The experiences of the coach illuminate the importance of creating favorable working conditions and employing coping strategies in order to sustain a lengthy coaching career.

Sport-specific assessment of lactate threshold and aerobic capacity throughout a collegiate hockey season

The purpose of this study was to examine lactate threshold (LT) and maximal aerobic capacity with a sport-specific skating protocol throughout a competitive season in collegiate hockey players. We hypothesized that maximal aerobic capacity and skating velocity at LT would increase as the season progressed. Sixteen Division I college hockey players performed a graded exercise skating protocol to fatigue at 3 different times (pre-, mid-, and postseason). Subjects skated for 80 s during each stage, followed by 40 s of rest to allow for blood lactate sampling. Velocity at LT was similar during preseason (4.44 +/- 0.08 m.s-1) and postseason (4.52 +/- 0.05 m.s-1) testing, but was significantly elevated at midseason (4.70 +/- 0.08 m.s-1; p < 0.01), compared with preseason. In contrast, LT as a percentage of maximal heart rate (HRmax) was unchanged throughout the season. HRmax remained constant throughout the season, at approximately 190 beats.min-1. Preseason maximal aerobic capacity (48.7 +/- 0.8 mL.kg-1.min-1) was significantly higher than that at postseason (45.0 +/- 1.1 mL.kg-1.min-1; p < 0.01). In conclusion, skating velocity at LT improved from pre- to midseason, but this adaptation was not maintained at postseason. Additionally, maximal aerobic capacity was reduced from pre- to postseason. These findings suggest a need for aerobic training throughout the college hockey season.

The Canadian Hockey Player Problem: Cultural Reckoning and National Identities in American Collegiate Sport, 1947–80

This article is a study in the social history of Canadian-American relations and it performs two functions. First, it traces the increasing presence of Canadian student athletes in American collegiate hockey, 1947–80, and the efforts of coaches, recruiters, administrators, and alumni to draw Canadians to US hockey programs. By the end of the 1950s Canadian student athletes dominated the American collegiate game – a pattern that abated only in the late 1970s. Second, this essay analyzes the heated debates that emerged in these years about the threats that these students posed to American collegiate athletics and to Canadian amateur hockey. The Canadianization of US college hockey from 1947 to 1980 was hardly universally welcomed in the United States or in Canada and it produced no small amount of rancour among American and Canadian commentators. Canadian hockey players in American schools personified the commercialization of amateur collegiate sport, according to some in the United States. In Canada, expatriate collegians were seen alternately as victims of American 'talent raiders' and disloyal to the communities that raised, invested in, and trained them. This essay demonstrates how hockey generated concerns about national identity in Canada and the United States in the sixties and seventies, and asserts, more generally, that the study of sport – hockey in particular – provides an important window on the historical and quotidian construction of national identities. L'article porte sur l'histoire sociale des relations entre les Canadiens et les Américains, et il a deux objectifs. Le premier est de parler de la présence accrue d'étudiantsathlè tes canadiens dans les équipes de hockey collégiales américaines, entre 1947 et 1980, et des efforts déployés par les entraîneurs, les recruteurs, les administrateurs et les anciens élèves pour attirer les Canadiens vers les programmes de hockey aux États-Unis. Á la fin des années 1950, les étudiants-athlètes canadiens dominaient le hockey collégial américain, une tendance qui ne s'est atténuée que vers la fin des années 1970. Le deuxième objectif est d'analyser les débats suscités durant ces années sur la menace que ces joueurs représentaient pour le sport collégial américain et le hockey amateur canadien. La canadianisation du hockey collégial américain n'a pas fait l'unanimité aux États-Unis, ni au Canada. Elle a d'ailleurs engendré une certaine rancoeur chez les commentateurs américains et canadiens. De l'avis de certains Américains, le fait que des hockeyeurs canadiens jouent dans des équipes américaines était un reflet de la commercialisation du sport collégial amateur. Au Canada, les collégiens expatriés étaient perçus à la fois comme les victimes des «chasseurs de talents» et comme des êtres déloyaux envers les collectivités qui ont contribué à leur éducation et à leur formation. Dans l'essai, on montre l'effet du hockey sur l'identité nationale au Canada et auxÉtats-Unis, durant la période de la guerre froide. De plus, on soutient que l'étude du sport en général, et du hockey en particulier, ouvre une fenêtre importante sur la construction historique et quotidienne de l'identité nationale.

The Canadian Hockey Player Problem: Cultural Reckoning and National Identities in American Collegiate Sport, 1947–80

This article is a study in the social history of Canadian-American relations and it performs two functions. First, it traces the increasing presence of Canadian student athletes in American collegiate hockey, 1947–80, and the efforts of coaches, recruiters, administrators, and alumni to draw Canadians to US hockey programs. By the end of the 1950s Canadian student athletes dominated the American collegiate game – a pattern that abated only in the late 1970s. Second, this essay analyzes the heated debates that emerged in these years about the threats that these students posed to American collegiate athletics and to Canadian amateur hockey. The Canadianization of US college hockey from 1947 to 1980 was hardly universally welcomed in the United States or in Canada and it produced no small amount of rancour among American and Canadian commentators. Canadian hockey players in American schools personified the commercialization of amateur collegiate sport, according to some in the United States. In Canada, expatriate collegians were seen alternately as victims of American ‘talent raiders’ and disloyal to the communities that raised, invested in, and trained them. This essay demonstrates how hockey generated concerns about national identity in Canada and the United States in the sixties and seventies, and asserts, more generally, that the study of sport – hockey in particular – provides an important window on the historical and quotidian construction of national identities.

Effects of a Four Week Plyometric Training Program on Measurements of Power in Male Collegiate Hockey Players

Color poster with text describing research conducted by C. Reyment, M. Bonis, and J. Lundquist advised by L. Dalleck and J. Janot.

Do Hockey Players Need Aerobic Fitness? Relation Between Vo2max and Fatigue During High-Intensity Intermittent Ice Skating

The primary objective of this study was to assess the relationship between aerobic capacity, as measured by the VO(2)max test, and recovery from high-intensity intermittent exercise. Eleven female collegiate hockey players agreed to participate. Subjects skated 5 1-lap intervals around the hockey rink at maximal intensity with a 30-second recovery period between skates. The VO(2)max test was performed on a motor-driven treadmill after a modified Bruce protocol. A fatigue index was calculated by measuring the total increase in skate time from trial 1 to trial 5. This fatigue index was then correlated to VO(2)max. This correlation coefficient (-0.422) was not significant (p > 0.05) and indicated that only 17.8% of the variance in VO(2)max could be explained by the fatigue index. It was concluded that ability to recover from high-intensity intermittent exercise is not related to aerobic capacity. Coaches and trainers probably do not need to include aerobic training in their practices, because the high-intensity interval training commonly seen in hockey training also improves aerobic capacity, as reflected in the high VO(2)max values of these subjects.

Patterns of Ephedra and Other Stimulant Use in Collegiate Hockey Athletes

This study examined trends in stimulant use and attitudes toward use among American collegiate hockey athletes. All 139 players in one college hockey conference completed a comprehensive questionnaire. Over half of the athletes (51.8%) confirmed stimulant use before a hockey game or practice. About half of the respondents (48.5%) reported having used ephedra at least one time to improve athletic performance. Additionally, 17.4% reported using pseudoephedrine to improve performance in the 30 days prior to survey administration. Over half (55.4%) were aware of the recent national ban on ephedra. Fifty-nine percent stated the national ban made them less likely to use ephedra products. The majority of athletes began use prior to college. Coaches, athletic trainers, and team physicians should be aware of athletes' patterns of stimulant use. Improved educational efforts directed at younger athletes are necessary to deter abuse of metabolic stimulants.

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Shoulder Pain

Attitudes of Central Collegiate Hockey Association Ice Hockey Players Toward Athletic Mouthguard Usage

The purpose of this study was to examine Central Collegiate Hockey Association ice hockey players' attitudes regarding the use of athletic mouthguards and to determine the effects of mouthguard type, player position, education, and usage time with respect to attitudes. A questionnaire measuring players' attitudes toward mouthguards was sent to certified athletic trainers (ATC) responsible for providing healthcare coverage at 10 institutions of the Central Collegiate Hockey Association (CCHA). The ATC's distributed the surveys to all the players on their respective collegiate teams. Out of a total of 265 players listed on the roosters of the CCHA, one hundred and sixty five (62%) players returned the surveys, with 158 surveys used in the analyses (60%). Approximately 13.3% of players (n=21) reported wearing mouthguards 50% of the time or greater during games and 3.8% (n=6) reported wearing mouthguards 50% of the time or greater during practices. Twenty-six percent (n=41) of the players never received educational information regarding using mouthguards. Thirty-nine percent (n=59) of the players reported altering mouthguards to obtain a better fit while 91% of the players were not influenced by the cost of the mouthguard. A 2 x 2 x 2 ANOVA revealed a significant interaction among player position and mouthguard type with respect to player attitudes (F(1,131) = 4.96, P < 0.05), with defensive players having more negative attitudes toward mouthguard usage compared to offensive players. No one specific factor affecting attitudes was identified, however, players reported limited educational opportunities to learn about the effectiveness of mouthguards. Therefore, coaches, dentists, and healthcare providers should engage in more preventive educational programs to increase player attitudes and compliance.

Ephedrine and pseudoephedrine use in college hockey players.

The use of stimulants to enhance performance appears to be a significant problem in collegiate hockey. Although improved drug testing may provide a greater deterrent, it will likely require the institution of effective educational interventions to curb this alarming trend.

Ephedrine, Pseudoephedrine, and Amphetamine Prevalence in College Hockey Players

ABSTRACTBACKGROUND: Performance-enhancing drugs are used by some athletes, even though the substances may be potentially dangerous and some are banned.OBJECTIVE: To assess the use of metabolic stimulants among collegiate hockey players.METHODS: Surveys were administered to college hockey players on five teams. Participation was voluntary, and respondents remained anonymous. The survey included questions regarding use of specific stimulants (eg, ephedrine, amphetamines, pseudoephedrine), awareness of potential side effects, and knowledge of National Collegiate Athletic Association (NCAA) rules.RESULTS: More than half (58%) of the 122 college hockey players who completed the survey reported past or present use of the specific stimulants. Almost half (46%) reported pseudoephedrine use to enhance performance, including 24% who indicated current use, and 38% reported ephedrine use, including 11% who admitted current use. Stimulant users had good knowledge about the potential side effects of ephedrine, including sudden death, hypertension, and insomnia. Nearly all (92%) stimulant users were aware of the current NCAA ban of ephedrine. Over 33% stated they would use a banned substance if it would help them get to the National Hockey League.CONCLUSION: A large number of collegiate hockey players admit to using metabolic stimulants despite knowledge of side effects and the NCAA ban on two of these substances. More effective educational interventions, perhaps coupled with a stronger testing policy, may be necessary to curb this potentially dangerous practice.

An investigation of multidimensional worry dispositions in a high contact sport

Objectives: To (a) investigate the dimensionality of competitive worry in the high contact sport of Canadian football, (b) examine the extent to which athletes were predisposed towards worrying about factors relating to personal performance failure, negative social evaluation, injury or physical danger, and situational uncertainty, and (c) determine the degree to which dispositional worry tendencies predicted pre-competitive cognitive and somatic state anxiety. Method: Male Canadian Football players (n=170, M age=18.24 years) completed the Football Worry Scale (FWS), a football-specific version of the Collegiate Hockey Worry Scale (Dunn, J.G.H. (1999). Journal of Sport and Exercise Psychology, 21, 259–279), to measure athletes’ dispositional tendencies to experience competitive worry across four domains. A sub-sample of athletes (n=100) also completed the Competitive State Anxiety Inventory-2 (CSAI-2) (Martens, Burton, Vealey, Bump, & Smith (1990). Competitive anxiety in sport (pp. 117–190). Champaign, IL: Human Kinetics.) to measure pre-competitive state anxiety. Results: Confirmatory factor analyses of FWS data supported the retention of four factors to reflect the latent dimensionality of competitive worry. Repeated measures ANOVA revealed that performance failure was the most characteristic type of worry. Correlation and multiple regression analyses revealed that worry about situational uncertainties (i.e. fear of the unknown) was the strongest predictor of both somatic and cognitive state anxiety. Conclusions: Findings reinforce the importance of treating competitive worry as a multidimensional construct in future competitive sport anxiety research.

Relationships Among the Sport Competition Anxiety Test, the Sport Anxiety Scale, and the Collegiate Hockey Worry Scale

This study examined the degree to which the Sport Competition Anxiety Test (SCAT; Martens, 1977) and the Sport Anxiety Scale (SAS; Smith, Smoll, & Schutz, 1990) shared variance with the four subscales of the Collegiate Hockey Worry Scale (CHWS; Dunn, 1999)a sport-specific measure of athletes' dispositional tendencies to worry about performance failure, negative social evaluation, physical danger, and situational uncertainty. Participants were 178 male intercollegiate ice hockey players. Correlation and regression analyses reinforced the links between worries about failure and negative social evaluation to competitive trait anxiety (CTA). However, neither the SCAT nor the SAS shared more than 5.8% of the variance surrounding athletes' worries pertaining to physical danger and situational uncertainty. Findings are discussed in the context of Martens, Vealey, and Burtons' (1990) recommendation to develop instruments with separate subscales measuring different situational components of CTA.

HYPERTENSION - HOCKEY PLAYER

HISTORY A 21 year old Caucasian male collegiate hockey player was seen in the off season at the University Health Center for a laceration sustained while using a kitchen knife. The blood pressure at that time was noted to be significantly elevated and the athlete was referred to the team physician for further evaluation. Blood pressures recorded 8 and 12 months prior were normal. Further history revealed that the athlete had started on a creatine supplement 4 weeks prior. He reports he loaded with 5 gm/day for 4 days and was currently taking a maintenance dose of 5–10 mg/day. He denied use of any other supplements, herbal remidies, prescription or over the counter medications. He further denied use of any anabolic steroids, alcohol or illicit drugs including cocaine or amphetamines. Family history was positive for mother and sister with hypertension. There was no family history of hypercholesterolemia, renal disease, or premature coronary artery disease. PHYSICAL EXAM Generally, a healthy appearing male. Height 73 inches, weight 215 lbs. BP 158/92 RAS, 150/90 LAS. No orthostatic blood pressure changes were noted. Fundoscopic exam showed no AV nicking or hemorrhages. Skin exam was negative xanthomas. Arterial pulses were strong and equal. No carotid, renal or femoral bruits to auscultation. No JVD or thyromegally noted. Cardiac exam without murmur or extra heart sounds. Lung and abdomen exams normal. DIFFERENTIAL DIAGNOSIS Renal disease including renal artery stenosis, pyelonephritis and diabetic proteinuria; coarctation of the aorta; aldosterone producing adrenal disease; pheochromocytoma; sleep apnea; alcohol abuse; CNS lesions including CVA and tumor; drugs including decongestants, cyclosporine, street drugs; endocrinopathies including thyroid, parathyroid and pituitary etiologies. TESTS/RESULTS CBC, BUN, creatine, UA, blood glucose, TSH all normal. CLINICAL COURSE The patient was instructed to discontinue the use of creatine and serial BP measurements were taken. Within 6 weeks his BP returned to normal. Ten weeks later the athlete presented for his PPE and a BP of 180/120 was recorded. He stated he had restarted creatine 4 weeks prior because his blood pressure was back to normal. Again the athlete was instructed to discontinue creatine and held from athletic competition due to his elevated BP. Serial BP measurements taken over the ensuing 14 weks again showed a linear downward trend to normotensive values and the patient was cleared for athletic participation. FINAL WORKING DIAGNOSIS Hypertension secondary to creatine supplementation.