Media coverage of doping almost always focuses solely on athletes. But do they even read reports on doping? How do athletes evaluate doping coverage? And what impact can doping reports have on elite athletes? In 2025, aquantitative online survey was conducted among German national team athletes. Using descriptive and inferential statistics, 349 questionnaires were analyzed. Of the athletes, 85% read doping reports to learn how adoping case arises and how the media handles it. Of the respondents, 62% are pleased when doping offenders are caught and subsequently exposed through media coverage. Disappointment sets in for 60% because doping reports can damage the image of their own sport, and 38% of athletes expressed frustration with the media's tendency to almost exclusively criticize athletes but not other groups who share responsibility for doping. Approximately 15% of respondents believe doping reports can influence mental or physical performance, with some respondents suggesting increased training intensity and greater motivation in competition, while others suspect reduced training and demotivation in competition. The variables of age and gender do not play arole in the response patterns. The majority of athletes follow doping reports primarily out of aneed for information and support the media's role in providing normative criticism and control. While doping reports are perceived as damaging to the image of their own sport, the media's educational efforts and the exposure of doping offenders are also seen as an important contribution to maintaining fair competition in sports.

Brain lateralization, the hemispheric specialization of functional networks, is essential for motor and cognitive functions. However, how intensive athletic training shapes hemispheric organization remains poorly understood. This study investigated the formation of functional lateralization in elite athletes through long-term intensive training and its potential alteration by external factors, specifically sport-related concussions. Resting-state functional magnetic resonance imaging data were collected from 13 world class gymnasts (WCGs) and 14 nonathletic controls. Longitudinal data were collected from 18 soccer players and eight golfers before and after one season, with concussions monitored in the soccer players. Laterality indices of hemispheric integration and segregation (LI int and LI seg ) were calculated to quantify hemispheric differences in information processing for each brain region, and the standard laterality index (LI) was employed to measure hemispheric asymmetry. Associations between laterality indices and neurotransmitter receptor/transporter densities were examined. Postseason changes in these indices were assessed to evaluate the effects of concussion on brain lateralization. The WCGs showed significantly increased LI int in several left-hemispheric regions, including the precentral gyrus, cingulate gyrus, thalamus, superior parietal lobule, and lateral occipital cortex compared with the healthy controls, although no significant differences were found in LI seg . Furthermore, the LI analysis revealed that the WCGs showed higher hemispheric asymmetry in the left precentral gyrus, cingulate gyrus, and thalamus. These laterality indices also were positively correlated with certain neurotransmitters. Similar patterns of enhanced lateralization and neurotransmitter associations were observed in soccer players and golfers. However, no significant changes in laterality indices were observed as a result of concussions sustained during the season. Long-term intensive training enhances functional integration in the left hemisphere, leading to stable brain lateralization patterns resilient to sport-related concussions.

Rapid weight loss (RWL) is widely practiced in combat sports, yet comparative data across sports and sexes are limited. This study aimed to compare RWL patterns, methods, and associated physical and psychological difficulties by sport and sex among elite Korean combat sports athletes. A cross-sectional analysis was conducted in 414 elite athletes from taekwondo, judo, wrestling, and boxing. Body mass was recorded before RWL, at the official weigh-in, and prior to competition. RWL practices, sources of information, and physical and psychological difficulties were assessed using validated questionnaires. One-way analysis of variance (ANOVA) and multivariate analysis of variance (MANOVA) were performed separately for male and female athletes. Athletes engaged in RWL for an average of 6.53 days, losing 5.49% of body mass and regaining approximately 95% before competition. RWL duration did not differ by sport or sex. However, significant sport-specific differences were observed in absolute and relative weight loss and weight regain, with judo and wrestling athletes showing greater weight loss and wrestlers exhibiting the highest regain. No significant differences were found among sports in RWL methods, sources of information, or reported physical and psychological difficulties. Athletes predominantly relied on coaches and peers and commonly reported fatigue, dizziness, irritability, and impaired concentration. While RWL duration is similar across sports and sexes, the magnitude of weight loss and regain varies according to sport-specific regulations. Despite these differences, RWL methods and associated difficulties are consistent, emphasizing the need for evidence-based weight management and greater involvement of health professionals.

Tsukahara, Y, Torii, S, Taniguchi, Y, Kusakabe, T, Murakami, H, Yamasawa, F, and Akama, T. Mood disturbances, eating attitudes, and their effect on body composition changes in elite female athletes. J Strength Cond Res 40(7): e721-e726, 2026-Body composition is an important factor in athletic performance at high levels. However, seasonal changes and the effects of mood disturbances and eating attitudes in elite female athletes are not fully understood. In this study, measurements were taken during the season and off-season from 115 athletes. Athletes also completed the Profile of Mood States second edition and the Eating Attitudes Test (EAT-26). Compared with the on-season, body mass did not significantly change in the off-season (54.3 ± 4.4 kg during season and 54.5 ± 4.2 kg during off-season, p = 0.085). However, body fat percentage decreased significantly during the off-season compared with the on-season (17.8 ± 3.8% during on-season and 17.1 ± 3.2% during off-season, p = 0.004). Although anger-hostility scores increased during the off-season, other domains and EAT-26 scores remained stable. Multiple linear regression analysis revealed that body fat percentage decreased in older athletes (coefficient = -2.829, 95% confidence interval [CI] -4.466 to -1.192, p < 0.001) and increased in those with lower tension-anxiety (TA; coefficient = 0.739, 95% CI 0.172 to 1.306, p = 0.011) and higher fatigue-inertia (FI) (coefficient = -0.572, 95% CI -1.106 to -0.038, p = 0.036). These findings suggest that psychological stress indicators, such as TA and FI, may be associated with changes in body fat percentage. Overthinking and mood disturbances may have a negative physiological impact, highlighting the importance of psychological monitoring in elite athletes.

This study investigated the neural timing control characteristics of countermovement jumps between elite athletes and nonathletes using muscle synergy theory. Twenty male participants (high-level group [HLG, N = 10] and untrained group [UG, N = 10]) performed the countermovement jump while surface electromyography from eight lower limb muscles and three-dimensional force plate data were recorded. Nonnegative matrix factorization extracted three muscle synergy modules, and bootstrap resampling with bias-corrected 95% confidence intervals (CIs) analyzed temporal parameters. Results demonstrated: (a)HLG achieved significantly greater jump height (95% CI: [-0.139, -0.026]); (b)HLG exhibited delayed activation onset (95% CI: [-0.227, -0.015]), peak timing (95% CI: [-0.300, -0.028]), and offset (95% CI: [-0.216, -0.014]) in Synergy module 1, delayed onset (95% CI: [-0.225, -0.054]) and offset (95% CI: [-0.224, -0.072]) in Synergy module 2, and delayed offset in Synergy module 3 (95% CI: [-0.197, -0.017]); and (c)HLG showed narrower full width at half maximum in Synergy module 1 (95% CI: [0.009, 0.094]), with no group differences in amplitude parameters. These findings suggest that, compared with UG, HLG exhibit delayed synergy activation timing during the countermovement jump. This temporal pattern may be associated with more effective use of the eccentric phase and more coordinated interjoint timing during propulsion.

Training alone, driven together: The impact of social identity on physical effort in cycling endurance tasks.

Effects of basic psychological needs on Chinese youth athlete burnout under coach burnout: Using hierarchical linear modeling.

Elite athletes face unique mental health challenges, yet the use of antidepressants in this population remains underresearched. Despite the prevalence of depressive and anxiety symptoms, there are no specific pharmacological guidelines tailored to athletes' mental health needs or performance demands. This scoping review aimed to explore the current literature on the use of antidepressant medications among elite athletes with symptoms of or who were diagnosed with depressive or anxiety disorders, focusing on treatment effectiveness, safety, performance, and, mainly, the athlete's well-being. A systematic search of PubMed, Embase, and PsycINFO (February 18-20, 2025) was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. Predefined terms related to athletes, antidepressants, and psychiatric disorders were employed. Studies were included if they involved elite athletes treated with antidepressants for major depressive disorder, bipolar depression, or generalized anxiety disorder. The data were charted and narratively synthesized. Among the 34,131 records screened, 15 met the inclusion criteria: 11 narrative reviews, 2 systematic reviews, 1 survey, and 1 position statement. Most studies provide recommendations on the basis of the general population, offering limited data on elite athletes with formal diagnoses. Few studies have reported treatment durations or mental health outcomes. While performance effects have been emphasized, psychological recovery is rarely addressed. Selective serotonin reuptake inhibitors-particularly escitalopram, fluoxetine, and sertraline-were the most commonly suggested drugs. There is a lack of robust evidence to guide antidepressant use among elite athletes. Future research should prioritize trials involving clinically diagnosed athletes, structured protocols, and outcomes centered on mental health and well-being rather than merely performance.

Elite athletes undergo intense physical training and experience substantial physiological stress, which could affect the composition and function of their gut microbiome. This study compared the gut microbiomes of 148 German junior and senior elite athletes with those of 108 healthy adults to identify taxonomic and functional features associated with elite athletic status. Group comparisons were conducted between healthy adults, senior athletes, and junior athletes, and a matched-subgroup analysis was performed in adults only, controlling for age, sex, body mass index, and dietary pattern. Significant differences in taxonomic composition were observed between athletes and healthy adults. Healthy adults exhibited greater microbial evenness and diversity than junior athletes, whereas senior athletes displayed higher microbial richness. Principal coordinate analysis revealed distinct clustering by athletic status. Linear discriminant analysis effect size identified taxa such as Escherichia-Shigella as being enriched in athletes. Predictive metagenomic profiling (PICRUSt2) indicated differences in microbial functional potential between adult athletes and matched controls, including pathways related to amino acid metabolism, glycolysis, fatty acid β-oxidation, and quinone biosynthesis. Together, these findings demonstrate distinct taxonomic and predicted functional microbiome signatures associated with elite athletic status.IMPORTANCEElite athletic training and lifestyle are associated with the gut microbiome. Our research has revealed distinct microbial structures in elite athletes, characterized by reduced evenness in junior athletes and increased richness in senior athletes, compared to healthy adults. Matched-subgroup analyses confirmed these group-specific differences. The gut microbiomes of athletes were enriched in pathways related to amino acid biosynthesis, glycolysis, fatty acid β-oxidation, and quinone synthesis. These microbiome features may be relevant for metabolic efficiency and resilience to oxidative stress. Combining taxonomic and functional prediction data from a uniquely characterized cohort of junior and senior elite athletes provides novel insight into microbiome signatures associated with sustained physical and psychological stress, with potential implications for performance, recovery, and health.CLINICAL TRIALSThis study is registered with ClinicalTrials.gov as NCT03582020.

The phenomenon of "choking" under pressure remains a significant challenge in elite sports, where traditional psychological skills training (PST) often yields limited efficacy and transferability due to its subjective nature. This study investigated the efficacy of "Cognitive Armor," a novel neurofeedback protocol designed to enhance performance under pressure by training athletes to self-regulate neural activity associated with an optimal performance state. Forty-five elite athletes from precision-based sports were randomly assigned to one of three groups: a Neurofeedback Group (NG) receiving the Cognitive Armor protocol, an Active Control Group (ACG) receiving sham neurofeedback, and a traditional PST Group (PSTG). Over a 12-week intervention, participants underwent baseline and post-intervention assessments, including quantitative EEG (qEEG), sport-specific performance tests under normal and induced pressure conditions, and psychological questionnaires. A follow-up assessment was conducted after 3 months. Results indicated that the NG demonstrated a significantly greater ability to increase the sensorimotor rhythm (SMR)/high-beta ratio compared to both control groups (F(2, 42) = 21.34, p < .001, ηp2 = 0.50). Crucially, the NG showed significantly smaller performance degradation under high-pressure conditions than the ACG and PSTG (F(2, 42) = 8.91, p < .01, ηp2 = 0.30), and these gains were maintained at follow-up. These findings provide promising evidence that objective, EEG-based neurofeedback can be a superior intervention for building mental resilience and preventing performance decrements in elite athletes, offering an evidence-based tool for mental conditioning in competitive sports.

Elite athletes perform visually guided actions under severe temporal constraints. Reconsidering conscious versus unconscious vision, we present evidence from elite athletes that challenges the conceptualization of unconscious action guidance and propose instead distinguishing seeing-for-movement and seeing-for-thought. Elite athletes appear to use both in a coordinated manner when performing visually guided actions.

Background: Female athletes face unique health challenges related to the menstrual cycle and hormonal contraceptives. Despite increased research, knowledge gaps persist, leading to inadequate training adaptations, underreported menstrual irregularities and insufficient support. Societal pressures and critical comments exacerbate body dissatisfaction and stress. The aim was to explore experiences of management regarding female health issues related to the menstrual cycle and hormonal contraceptives in Swedish female elite athletes from various sports. Methods A descriptive design with a qualitative inductive approach was used. Semi-structured interviews were conducted with 16 female elite athletes. Purposeful sampling ensured diversity in sport type, years of involvement, training hours, age and onset of menstruation. Qualitative content analysis was used, and an overarching theme, categories and subcategories were constructed based on the participants’ experiences and perceptions. Results An overarching theme, ‘A self-contained path towards optimization and awareness’, and five categories described the participants’ management: ‘Ignoring the symptoms’, ‘Eliminating the symptoms’, ‘Adaptation to the menstrual cycle’, ‘Taboos, security and communication’, and ‘Gaining knowledge and seeking support’. Twelve subcategories further illuminated these categories. The overarching theme reflected the athletes’ way of dealing with female health issues on their own due to lack of support, and the categories described how they handled the circumstances. Conclusion Although not all athletes experienced symptoms related to the menstrual cycle or hormonal contraception, many managed their menstrual health independently, highlighting the need for better education and support from coaches, medical teams and sports organisations. Future research should integrate menstrual health management into athlete development programs.

Asymmetry in unilateral functional performance may affect both performance outcomes and injury risk in elite athletes. Understanding the relationship between asymmetry ratios and performance parameters in handball players can inform training and monitoring strategies. This study aimed to investigate the relationship between asymmetry ratios obtained from unilateral functional performance tests in elite male handball players and to determine the effect of a 10% asymmetry threshold on performance outcomes. Asymmetry ratios above 10% in lower extremity functional tests negatively influence performance outcomes in elite male handball players. Cross-sectional study with randomized measurements. Level 3. A total of 41 elite male handball players (age, 20.98 ± 2.15 years; height, 185.90 ± 7.58 cm; weight, 92.61 ± 14.72 kg; body mass index, 26.76 ± 3.52 kg/m2; training experience, 11.27 ± 3.45 years) participated voluntarily. Lower extremity strength was evaluated using vertical jump (VJ), counter movement jump (CMJ), and 5 single-leg hop tests (SLHTs): single hop for distance (SH), triple hop (TH), crossover hop (CH), medial side triple hop (MSTH), and 90° medial rotation hop (MRH). Dynamic balance was assessed via the Y balance test (YBT). Participants were classified according to a 10% asymmetry threshold for comparison. Moderate positive correlations were observed between asymmetry ratios in certain multidirectional jump tests and dynamic balance parameters (P < 0.05). Significant differences between the left and right sides were observed in the VJ, CMJ, SH, TH, MRH, and anterior (ANT) scores (P < 0.05). Participants within the <10% asymmetry threshold outperformed the >10% group across all tests. Notably, effect sizes were large (d = 0.85-2.62) for VJ, CMJ, SH, MRH, ANT, and posteromedial scores (P < 0.05). A 10% strength asymmetry ratio represents a critical reference point in elite male handball players. Systematic monitoring of asymmetry ratios is important not only for injury prevention but also for optimizing performance outcomes. Identifying and correcting strength asymmetry, and maintaining them below the 10% threshold, can improve performance and reduce the risk of injury in elite handball athletes.

ABSTRACT A substantial number of elite athletes need to work alongside their athletic careers, yet limited research has focused on working-athletes. Instead, dual career (DC) research, including 19 reviews, has focused almost exclusively on student-athletes. To improve the understanding of how to support working-athletes, we aimed to: (a) summarize the research on working-athletes’ DCs, (b) identify key contributions, and (c) provide recommendations for future research. To this end, we employed a critical systematic review of research on working-athletes’ DCs, using the introduction of the term DC as our starting point and the seven postulates outlining the pursuit of DC excellence as our critical lens. Through our review we identified 30 articles, which were appraised, synthesized, and critically analyzed. Our review indicates that research on working-athletes’ DCs is growing, with pioneering authors making important contributions to understanding how to support working-athletes. Still, research gaps and future challenges remain. We have provided recommendations (e.g. terminological coherence) to guide researchers in addressing these gaps and challenges and advance understanding of how to facilitate working-athletes’ pursuit of DC excellence, helping them become winners in both the short and long run.

Research priorities for advancing mental health in elite sport: a companion to the IOC consensus statement on mental health in elite athletes.

Fixture congestion has emerged as one of the defining challenges of modern professional soccer, exposing players to repeated high-intensity demands with limited opportunities for recovery. Such cumulative exposure taxes multiple physiological systems and may lead to sustained biological strain throughout the competitive season. However, the integrated systemic impact of congested schedules remains incompletely characterized. We aimed to characterize the systemic physiological impact of cumulative competitive load across a full professional soccer season using an integrated biomarker framework. In this prospective longitudinal investigation, we employed the systemic degree of perturbation score, an adaptation of the molecular degree of perturbation, to circulating biochemical, hematological, and metabolic biomarkers obtained from professional soccer players across a full competitive season. Multi-dimensional analyses were employed to characterize systemic alterations associated with cumulative competitive load. A progressive increase in systemic perturbation was observed across the competitive season. The relative contribution of individual biomarkers shifted over time, with late-season phases characterized by more integrated muscular-inflammatory-metabolic profiles. Myoglobin and monocyte-related markers consistently contributed to systemic degree of perturbation values across competitive quarters, and network analyses demonstrated progressive changes in correlation architecture involving muscular, inflammatory, and metabolic mediators. These results provide a comprehensive view of the physiological burden imposed by a professional soccer season and describe a progressive integration of muscular, inflammatory, and metabolic responses under cumulative competitive load. This integrated perspective supports the potential utility of biomarker-based monitoring frameworks for characterizing seasonal biological strain in elite athletes.

An exaggerated blood pressure response (eBPR) to exercise is associated with increased cardiovascular risk. The systolic blood pressure-to-achieved metabolic equivalent (SBP/METpeak) ratio was proposed as a fitness-indexed marker of eBPR in the general population, with > 18 mmHg/METpeak suggested as a pragmatic threshold. We aimed to define stage-specific SBP/METpeak reference limits in male elite athletes and examine this comparator. We examined 474 healthy male elite athletes (age 25.5 ± 5 y) from mixed sports who underwent a standardized maximal graded cycling test. SBP/METpeak was calculated as the quotient of SBP and peak METs at each workload stage and at peak exercise. Stage-specific percentiles, exceedance rates, and associations with fitness were analysed. Mean achieved workload was 360.7 ± 92.8 W, METpeak 13.1 ± 3.1, maximal SBP 196.9 ± 20.7 mmHg, and peak SBP/METpeak 15.68 ± 3.53 mmHg/METpeak. Stage-wise SBP/METpeak showed a non-linear pattern, increasing from 11.63 ± 2.79 at 100 W to 14.49 ± 3.59 at 250 W and 14.50 ± 3.43 at 300 W, then declining at 350 W (13.40 ± 3.01) and 400 W (12.14 ± 2.89). Stage-specific P75 values peaked at 16.7 mmHg/METpeak at 250-300 W, whereas P90 values reached 18.20-19.27 mmHg/METpeak at 200-300 W. Overall, 21.9% exceeded 18 mmHg/METpeak at least once up to 400 W. Fitness was strongly inversely associated with peak SBP/METpeak (r = -0.811, P < 0.001). In male elite athletes, SBP/METpeak is workload-dependent and closely linked to aerobic fitness. The 18 mmHg/METpeak comparator aligned primarily with moderate workloads, whereas upper reference values around 16 mmHg/METpeak may better describe the upper range during standardized exercise testing stages in athletes.

Genome-Wide association study of genetic variants influencing creatine kinase levels in Chinese winter sports athletes.

We sought to generate recommendations for the tennis community regarding the provision of mental healthcare and the promotion of mental wellness among elite tennis athletes, including junior tennis athletes. Recommendations were generated using a multimethod approach that included an in-person summit held during the 2022 US Open Tennis Championships in New York, New York, USA, and an asynchronous Delphi consensus process. Participants (n=83) were purposively selected to ensure diverse representation from all seven governing bodies of tennis and the broader tennis ecosystem, including: current and former elite adult and junior players, coaches, sport administrators, parents, physiotherapists, athletic trainers, physicians (sports medicine, psychiatry, neurology), other licensed mental health providers, epidemiologists and other academic subject matter experts. The summit included expert presentations and cross-organisation group discussion, which were used to generate provisional consensus statements. Statements were rated anonymously and refined iteratively based on synthesis of open-ended feedback until predetermined numeric thresholds were reached. The summit also included discussion of implementation challenges and priorities. As a result of this process, 2 foundational principles and 25 actionable recommendations were adopted, covering 5 domains: (1) standards of care, (2) education, (3) media and social media, (4) safeguarding and (5) research. The foundational principles emphasised that mental health must be prioritised by tennis governing bodies and that these bodies should collaborate across the tennis ecosystem. This output is a starting point for coordinated mental health efforts in tennis. More broadly, this pragmatic process is a replicable model for cross-organisational collaboration in other high-performance sports.

To systematically map and synthesise the scientific literature on substance use patterns among elite athletes, encompassing recreational substances, performance-enhancing drugs (PEDs) and polysubstance use. This study was a scoping review conducted in accordance with the Joanna Briggs Institute (JBI) methodological framework and reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guidelines. The review protocol was prospectively registered on the Open Science Framework. A comprehensive search was conducted in PubMed/MEDLINE, PsycINFO, Scopus and SportDiscus from inception to March 2025. Eligible studies were peer-reviewed original research articles examining substance use, misuse or substance use disorders among elite athletes, including collegiate, professional, Olympic, Paralympic or national-level competitors. Both recreational substances (eg, alcohol, cannabis, nicotine, prescription drugs) and PEDs were included. From 3292 unique records screened, 119 studies met inclusion criteria. Alcohol was the most extensively studied substance, particularly among National Collegiate Athletic Association collegiate athletes, with consistent evidence of heavy consumption in certain sports, especially those with strong social and team-based norms. PED studies revealed marked sport-specific patterns, largely informed by anti-doping surveillance data, but offered limited insight into psychosocial mechanisms. Research on other substances and polysubstance use was heterogeneous, fragmented, and methodologically variable. Across all domains, the literature was dominated by cross-sectional designs, self-reported data and Western populations. The existing evidence base demonstrates substantial substance-related vulnerability among elite athletes but is characterised by significant conceptual, methodological and geographical gaps. Future research should prioritise longitudinal and theory-driven designs, broader representation of professional and non-Western athletes, integration of mental health frameworks and rigorous evaluation of prevention and intervention strategies. The review protocol was prospectively registered on the Open Science Framework (OSF) (DOI: 10.17605/OSF.IO/3PJDN) on 8 January 2025.