High-level Athlete Research Articles

Concomitant Rupture of the Anterior Cruciate Ligament and the Patellar Tendon in a High-Level Athlete: A Case Report

Concomitant Rupture of the Anterior Cruciate Ligament and the Patellar Tendon in a High-Level Athlete: A Case Report

Multidisciplinary Team Discussions and the Inclusion of Individualized Patient Factors May Improve Informed Consent in Sports Medicine

Informed consent allows for the maintenance of patient autonomy and is essential in establishing trusting relationships between physicians and their patients. This process involves thorough discussion of the risks and alternatives, as well as the short- and long-term outcomes, of proposed treatment options. Inadequacies with informed consent can lead to inferior patient outcomes and may be subject to severe legal consequences. Individualized discussions are warranted to address the questions of these patients, whether it be the high-level athlete or the weekend warrior. This review highlights factors, identifies barriers, and proposes potential solutions to improve informed consent within orthopaedic sports medicine.

The role of coronary CT angiography in athletes.

The sudden death of a young or high-level athlete or adolescent during recreational sports is one of the events with the greatest impact on public opinion in modern society. Sudden cardiac death (SCD) is the principal medical cause of death in athletes and can be the first and last clinical presentation of underlying disease. To prevent such episodes, pre-participation screening has been introduced in many countries to guarantee cardiovascular safety during sports and has become a common target among medical sports/governing organizations. Different cardiac conditions may cause SCD, with incidence depending on definition, evaluation methods, and studied populations, and a prevalence and etiology changing according to the age of athletes, with CAD most frequent in master athletes, while coronary anomalies and non-ischemic causes prevalent in young. To detect silent underlying causes early would be of considerable clinical value. This review summarizes the pre-participation screening in athletes, the specialist agonistic suitability visit performed in Italy, the anatomical characteristics of malignant coronary anomalies, and finally, the role of coronary CT angiography in such arena. In particular, the anatomical conditions suggesting potential disqualification from sport, the post-treatment follow-up to reintegrate young athletes, the diagnostic workflow to rule-out CAD in master athletes, and their clinical management are analyzed.

Molecular profiling of high-level athlete skeletal muscle after acute endurance or resistance exercise – A systems biology approach

ObjectiveLong-term high-level exercise training leads to improvements in physical performance and multi-tissue adaptation following changes in molecular pathways. While skeletal muscle baseline differences between exercise-trained and untrained individuals have been previously investigated, it remains unclear how training history influences human multi-omics responses to acute exercise. MethodsWe recruited and extensively characterized 24 individuals categorized as endurance athletes with >15 years of training history, strength athletes or control subjects. Timeseries skeletal muscle biopsies were taken from M. vastus lateralis at three time-points after endurance or resistance exercise was performed and multi-omics molecular analysis performed. ResultsOur analyses revealed distinct activation differences of molecular processes such as fatty- and amino acid metabolism and transcription factors such as HIF1A and the MYF-family. We show that endurance athletes have an increased abundance of carnitine-derivates while strength athletes increase specific phospholipid metabolites compared to control subjects. Additionally, for the first time, we show the metabolite sorbitol to be substantially increased with acute exercise. On transcriptional level, we show that acute resistance exercise stimulates more gene expression than acute endurance exercise. This follows a specific pattern, with endurance athletes uniquely down-regulating pathways related to mitochondria, translation and ribosomes. Finally, both forms of exercise training specialize in diverging transcriptional directions, differentiating themselves from the transcriptome of the untrained control group. ConclusionsWe identify a “transcriptional specialization effect” by transcriptional narrowing and intensification, and molecular specialization effects on metabolomic level Additionally, we performed multi-omics network and cluster analysis, providing a novel resource of skeletal muscle transcriptomic and metabolomic profiling in highly trained and untrained individuals.

Profound First-Degree Atrioventricular Block in a High-Level Basketball Athlete

First-degree atrioventricular (AV) block (PR interval >200 ms) is commonly observed among screening electrocardiogram (ECG) in athletes. Profound first-degree AV block (PR interval >400 ms) and Mobitz type I (Wenckebach) second-degree AV block are generally uncommon and often require further workup on a case-by-case basis, particularly when there is concern for a structural cardiac abnormality. In this case, we present an example of an asymptomatic profound first-degree AV block with Mobitz type I (Wenckebach) second-degree AV block. Transthoracic echocardiogram and stress echocardiogram were unremarkable and the patient was cleared to participate in sports without any restriction. Physicians managing athletes should be aware of ECG features that require additional evaluation and cardiology consultation.

Critical Reflexivity and Positionality on the Scholar-Practitioner Continuum: Researching Women's Embodied Subjectivities in Sport.

The sports world has many prejudices that have been converted into common sense. Some relate to the idea of athletes being strong or pretty but endowed with little intelligence. There is another view, perhaps a little more accurate, around the reification of consciousness in the name of the automation and maximum outcome of the body. Both views are informed by Cartesian thinking, perpetuating the mind-body dichotomy. Such a dichotomy is spread in several other areas in our society, expressed as binaries. We meet a binary when conducting research as well, disembodying the researcher as someone who is neutral, objective, and highly rational, and someone who, in synthesis, performs good mental work, but who must not let feelings intrude. On the contrary, we argue that we are embodied beings who are often not able to (and maybe should not) become detached from previous experiences and knowledge when conducting research. Even though this can present itself as a challenge, we consider that a fluid non-binary positioning encompasses actions holistically and leads to tasks being performed on a continuum. The purpose of this paper is to explore the reflexive process embedded in carrying out a PhD project committed to studying the production of the embodied subjectivities of a group of women high-level athletes in karate. The researcher inserted in the researched environment was not a high-level athlete; however, she had several experiences competing at the amateur level in different countries and faced experiences that were, to some extent, similar to those of the elite athletes. She used her previous experiences as a karateka, researcher, and woman to inform her research-doing since the intersectional social issues faced by her and lived queer feelings motivated her research questions. She plunged into a process of self-reflection and counted on the guidance of the other authors to organise her learning in order to use it in her scholarship. That was, primarily, an experience of "practice" of subjectivity through examining others' production of subjectivity, besides strengthening a positionality that lacked self-confidence. Thus, we explore issues around the researcher-practitioner theoretical-practical continuum of research-doing, presenting a journey that became empowering.

One to Two Days of Rest Is Recommended Before Returning to Sport After Intra-Articular Corticosteroid Injection in the High-Level Athlete

Return to sport following a corticosteroid injection is a complex decision. Multiple considerations should be taken into account, including steroid dose and formulation, involvement of the affected joint in the activity, and intensity of the activity. Research investigating the adverse effects of corticosteroid injections with early initiation of high-intensity activity is limited and has produced mixed results. Rest following injections has typically been recommended to minimize both chondrotoxic effects and systemic absorption. Based on the current research and extensive experience treating professional athletes, we recommend 1 to 2 days of rest of the affected joint or region with a progressive increase of activity following a corticosteroid injection with possible benefits including maximizing the beneficial effects of the injection and a reduced systemic effect. Level of EvidenceLevel V, expert opinion.

Isolated Epiphyseal Detachment of the Greater Trochanter in a Judoka

Epiphyseal detachment of the greater trochanter is a rare entity. Femoral head necrosis is the most dreaded complication. We report the case of a displaced Salter I epiphyseal detachment in a young high-level athlete who resumed his sports activities after synthesis by bracing.

Developing an Annual Training Program for the Mixed Martial Arts Athlete

ABSTRACT Mixed martial arts (MMA) is a multidimensional combat sport combining various forms of grappling and striking methodologies. The sport challenges the strength and conditioning professional because of the conflicting metabolic demands, high degree of variability, and a lack of a fixed competitive schedule. The existing literature identifies the need for highly developed neuromuscular qualities and high aerobic and anaerobic capacities. Although previous research has identified the physiological profile of a high-level MMA athlete, there is limited peer-reviewed research identifying the most optimal periodization strategy to improve performance. Furthermore, there seems to be no existing literature investigating the implementation of velocity-based training (VBT). This training methodology uses movement velocity to assign training loads to mitigate fatigue and improve strength and power adaptations. Existing literature on VBT suggests that it is a superior method of assigning training load compared with traditional percentage-based training. Therefore, this article serves to identify the physiological profile of the MMA athlete, outline VBT, and provide a guideline for designing an MMA strength and conditioning program to optimize performance using VBT.

A Comparative Research Based on the Enrollment Policies of High-Level Athletes in Chinese and American Universities

The United States, one of the world's most prosperous countries in the development of college sports, has a relatively complete admissions policy. In order to ensure the overall quality of high-level athletes, it is essential to guarantee good enrollment. By comparing the enrollment policies of high-level athletes between Chinese and American universities, this paper examines the problems existing in the enrollment of high-level athletes in Chinese universities. It is found that in China, the first problem is the semi-transparency of the individualized admissions process of colleges and universities leads to unequal admissions; next, the schools give athletes candidates fewer majors to choose from; then, the unified national admissions will reduce the opportunities of candidates; finally, there is an information communication barrier between universities and candidates. Based on the above problems, this article, by referring to the admissions policy adopted by the United States, suggests collages in China objectively judge the situation of candidates and formulate a reasonable enrollment plan. First, establishing a third-party organization and improving the supervision system; next, giving candidates more opportunities to choose majors; then, establish a communication platform between colleges and candidates, so as to promote the continuous positive development of high-level athlete enrollment in Chinese colleges and universities.

Contradiction Analysis Method and High-level Athlete Training in Colleges

Since April 1987, the State Education Commission and the State Sports Commission jointly issued the Notice on the Trial Recruitment of High-level Athletes in Some Ordinary Colleges and Universities, and colleges and universities have undertaken the arduous task of cultivating high-level competitive sports talents. After years of exploration and practice, the training of high-level athletes in China’s colleges and universities has gained a lot. However, the training of high-level athletes in colleges and universities is a complex system engineering with many problems. This paper uses literature and comparative analysis to explore the necessity of contradiction analysis to study the training of high-level athletes in colleges and universities, and uses the contradiction analysis method to give relevant measures in view of the problems existing in the current training process of high-level athletes in colleges and universities.

Profil hormonal des sportifs

AbstractStarting a regular physical and sports activity (PSA) according to the World Health Organization's recommendations or at the other end of the PSA spectrum, being a highly trained or even high-level athlete does not change basal hormonal concentrations, measured at rest, at distance from the last PSA session. In older subjects (60-80 years) some hormones (testosterone, S-DHEA) can be increased with training but their values remain within physiological limits. This is why a trained or a highly trained subject has a normal hormonal profile. Abnormal hormonal values have a priori a pathological value and need to be explained.

Augmented Stress Weight-Bearing CT for Evaluation of Subtle Tibiofemoral Syndesmotic Injuries in the Elite Athlete

Category: Ankle; Sports; Trauma Introduction/Purpose: Tibiofibular syndesmotic injuries occur in association with fractures or in isolation, often referred to as 'high ankle sprains'. Dynamic instability of the syndesmosis in the high-level athlete is difficult to diagnose, requiring a high index of suspicion for the identification and surgical stabilization to prevent late adverse sequelae, such as recurrent ankle pain, anterolateral soft tissue impingement, local synovitis, and chronic instability of distal syndesmosis. Both CT and MRI have been helpful in identifying syndesmotic injuries, but are static, non-weight bearing imaging modalities that cannot demonstrate dynamic instability, which may miss the unstable nature of some injuries. We present a novel imaging technique utilizing weight-bearing CT with syndesmotic stress in which a case is presented to illustrate it's utility in the elite athlete. Methods: Cone beam weight bearing computed tomography (WBCT) is a well-described imaging modality for evaluation of foot and ankle injuries. We have found it highly beneficial to teach our CT technologists about syndesmosis injuries and the importance of augmented physiologic stress applied across the ankle joint (in addition to the standard WBCT) to better demonstrate instability or motion, particularly at the tibiofibular syndesmosis. To perform an augmented stress weight bearing CT, the patient is positioned in the WBCT scanner and initial images are acquired in the standing weight bearing position with feet directed forward and weight distributed equally. A second image acquisition is then performed (augmented stress), where the patient is coached to firmly plant both feet on the ground and internally rotate the shin and knee. This places an external rotational moment on the TFS due to the planted foot and ankle. Results: Our case is of a 21-year-old male collegiate football player, wide receiver, that sustained an eversion injury to his left ankle during game play. He subsequently was unable to bear weight, with pain anteriorly over the distal tibiofibular joint. Pain was reproduced with dorsiflexion and eversion stress; however, he had a negative 'squeeze test' on examination. Initial weight bearing radiographs were negative. An MRI was obtained which did not reveal evidence of syndesmotic injury. Subsequently, weight- bearing CT stress examination of the syndesmosis was obtained and found to have 8 mm widening of the tibiofibular syndesmosis, 4 mm increased when compared to his contralateral, uninjured, ankle. This was also compared with a neutral WBCT without stress that did not illustrate the unstable nature of the injury. The coronal images also demonstrate increased uncovering of the talus underneath the tibial plafond. Conclusion: Tibiofibular syndesmotic injuries have historically been detected with standard x-ray, stress plain films, standard CT, and MRI. In cases where injury and stability are not obvious by these diagnostic studies, more subtle injuries may be frequently missed leading to increased morbidity, chronic instability, and increased return to play times. The addition of a stress view on weight-bearing CT can allow further identification of instability of the syndesmosis. We propose this technique for diagnosing otherwise unrecognized, subtle dynamically unstable syndesmosis injuries where clinical suspicion persists despite negative imaging, particularly in the elite athlete.

Coracoclavicular Ligament Reconstruction Using TightRope for Delayed Grade III Acromioclavicular Joint Injury After Ipsilateral Diaphyseal Clavicle Fracture Fixation: Surgical Technique and Review of Current Literature.

Athletes commonly sustain high-energy direct impact injuries to the shoulder, with acromioclavicular joint (ACJ) injuries accounting for over half. Ipsilateral ACJ injury and diaphyseal clavicle fracture occur nearly 7% of the time. There is limited literature offering treatment suggestions for this unique injury pattern and limited evidence providing guidance to suggest which injury patterns should be treated operatively or nonoperatively. Here, we present successful treatment of a high-level athlete utilizing a Knotless TightRope XP placed through a superior clavicle plate with successful return to full activity at 6 months postoperation. The TightRope technique offers the ability to augment through a preexisting superior clavicular plate in a low-profile manner and promote easy suture tensioning to obtain and maintain reduction of the injured ACJ.

Middorsal Wrist Pain in the High-Level Athlete: Causes, Treatment, and Early Return to Play.

Wrist injuries in the competitive athlete are a common reason for evaluation related to an acute injury or after symptoms have become chronic. While radius- and ulna-sided wrist pain are common topics covered in the literature, middorsal wrist pain is more common than the available literature would suggest. Missed diagnoses and inadequate treatment can significantly increase athlete morbidity and delay return to play. The goal of this article was to review the differential diagnosis of middorsal wrist pain in the athlete and discuss the diagnosis, treatment, and early return to play for each condition.

Homolateral Lisfranc Fracture/Dislocation of 1st - 5th Metatarsals in a Collegiate Quarterback: A Case Study

Category:Sports; Midfoot/ForefootIntroduction/Purpose:Lisfranc injuries encompass a spectrum of injuries to the tarsometatarsal (TMT) joint complex from ligamentous sprains to fractures with dislocation. While studies have shown it is possible to return to sport (RTS) after low- energy injuries, no literature exists demonstrating RTS after homolateral fracture/dislocation of all 5 metatarsals. We present a novel surgical technique for repair of homolateral Lisfranc fracture/dislocation of the 1st-5th metatarsals. Fusion of the 2nd and 3rd TMT joints provides stability of the middle column. Internal bracing of the 1st TMT joint gives stability while preserving greater physiologic motion in a high-level athlete.Methods:A dorsal approach is used for fusion of the 2nd and 3rd TMT joints with medial approach for internal bracing of the 1st TMT joint. 2nd and 3rd metatarsals were denuded of cartilage, and the fusion site was fully prepared. Rigid fixation was applied to the fusion sites. Guidewire for the cannulated Internal Brace system is inserted into the base of the 1st metatarsal. Fluoroscopic imaging confirmed positioning and the 3.4mm drill is passed over the wire, followed by the cannulated tap. A 4.75mm Swivelock anchor with Fibertape suture is inserted into the metatarsal base. The guidewire is placed in a reciprocating position on the medial cuneiform. The 2.7 mm drill is passed over the wire, followed by the 3.5 mm tap. A 3.5 mm Swivelock is then loaded with the Fiberwire from the 1st metatarsal. Tensioning is performed, and the 3.5 mm Swivelock is inserted into the medial cuneiform.Results:The athlete was cleared to return to full competition 9 months following surgery with physical exam demonstrating stability in both dorsiflexion and abduction. Weight bearing x-rays showed no evidence of hardware failure and no instability in the 1st TMT joint. CT scan demonstrated solid fusion of 2nd and 3rd TMT joints and maintained anatomic reduction of the 1st TMT joint. At 1-year post-op, patient was having pain over the 4th TMT joint. He had a second surgery to remove an exostosis at the 4th TMT joint as well as remove the screw from the 3rd metatarsal to the middle cuneiform. His pain had resolved at most recent follow up. He returned to game action in the final game of his senior season.Conclusion:The literature demonstrates return to sport is possible for athletes with Lisfranc injuries though the data focuses on either purely ligamentous injuries or Myerson type B and C fractures. This case study demonstrates a novel surgical approach to homolateral fracture/dislocation. While return to sport in this athlete took longer than lower-energy injuries, it is possible for athletes with homolateral displacement to return to full competition.

ANABOLIC STEROID ABUSE AND CARDIOVASCULAR TOXICITY: CASE REPORT

Despite the development of tests for the detection of doping, Anabolic steroids, are still used to increase sports performance. Unfortunately, studies have clearly shown that overdose of anabolic steroids can induce serious cardiovascular complications that can be life-threatening. This implies the determining role of health professionals in informing the general population and athletes in particular about the lethal effect of these substances. We report the case of a young high-level athlete who consults for palpitations and in whom cardiac imaging reveals abnormalities related to chronic consumption of anabolic steroids.

Homolateral Lisfranc Dislocation 1-5 in a Collegiate Quarterback: A Case Study

Background: Lisfranc injuries encompass a spectrum of injuries to the tarsometatarsal (TMT) joint complex from ligamentous sprains to fractures with dislocation. While studies have shown it is possible to return to sport (RTS) after low-energy injuries, no literature exists demonstrating RTS after homolateral fracture/dislocation of all 5 metatarsals. Indications: We present a novel technique for repair of homolateral Lisfranc fracture/dislocation of metatarsals 1-5 which may be used in high-level athletes attempting to return to competition. Technique Description: A dual approach is utilized, with a dorsal approach to allow for fusion of the 2nd and 3rd TMT joints and medial approach for internal bracing of the 1st TMT joint. The 2nd and 3rd metatarsals were denuded of all cartilage and the fusion site was fully prepared. Rigid fixation was applied to the fusion sites and then stability of the 1st TMT was reassessed. A guidewire for the cannulated InternalBrace (Arthrex; Naples, FL) system is initially inserted into the base of the 1st metatarsal. Positioning is confirmed with fluoroscopic imaging and the 3.4 mm drill is passed over the wire, followed by the cannulated tap. A 4.75 mm SwiveLock anchor (Arthrex; Naples, FL) with FiberTape suture (Arthrex; Naples, FL) is then inserted into the metatarsal base. The guidewire is placed in a reciprocating position on the medial cuneiform. The 2.7 mm drill is passed over the wire, followed by the 3.5 mm tap. A 3.5 mm SwiveLock anchor is then loaded with the FiberTape suture from the 1st metatarsal. Tensioning is performed, and the 3.5 mm SwiveLock anchor is inserted into the medial cuneiform. Results: The athlete was cleared to return to full competition 9 months following surgery. Physical examination demonstrated stability in dorsiflexion and abduction. Both weight-bearing x-rays and computed tomography scans showed no evidence of hardware failure, no instability of the 1st TMT joint, and solid fusion of the 2nd and 3rd TMT joints. Discussion/Conclusion: Current literature demonstrates that RTS is possible for athletes suffering from low-energy Lisfranc injuries. This novel surgical technique is the first to demonstrate return to sport of a high-level athlete from homolateral fracture/dislocation of all 5 metatarsals.

Psychologie du sport : une psychologue aux Jeux Olympiques (1re partie)

Top athletes are often introduce when they are performing at major championships. But what about their daily life and all the things they put together for those success ? Maroussia Paré, high level athlete in track and field and psychologist, propounds in this article an analysis of her 2020–2021 Olympic season. From the beginning of the preparation with setting goals, through the failures and the unpleasant emotions, she comes back on the little-known daily life of the athletes who, at the moment of a race, hope to shine with their results. This interview highlights the psychological resources adopted by athletes such as adaptive capacities, self-control and privileged coping strategies. We can see from her experience that this mad rush for performance, both individual and collective, can also lead to significant psychological vulnerabilities.Thus, between prevention and support, the place of the psychologist within the staff of the athlete seems necessary.

Formation of the system of higher education in the field of physical education in Romania (60-90 years of the XX century)

The peculiarities of the appearance of faculties of physical education at pedagogical and classical higher educational institutions of socialist Romania are considered. The reasons for the government's choice of those 12 higher educational institutions in which in the 60's of the twentieth century. faculties of physical education and sports were opened, the motives of the then authorities for active support of the newly formed training network were singled out, and demonstration at the international level of successes in training a high-level athlete was singled out as a priority. The author notes that foreigners entered the faculties of physical education at the universities of communist Romania - more than 10% (144 people) were foreigners from Cyprus, Colombia, Congo, Côte d'Ivoire, Egypt, Gabon, Libya, Portugal, Syria, Sweden and Tunisia (University of Cluj-Napoca). The changes in higher education in the field that took place in the 70s of the XX century are analyzed: the restructuring of the faculties of physical education and sports in the structure of pedagogical faculties is determined, and later their replacement by sections; changes in the duration of training - reduction to 3 years and further introduction of the year of specialization. It is proved that in 1983 all departments were liquidated and training for children's and youth schools and sports clubs, educational institutions of all levels, physical culture and sports societies was entrusted only to the Institute of Physical Education and Sports of Bucharest.