Sports Recovery Research Articles

Oxidative stress, inflammation, psychological status, and severity of respiratory infections are negatively affected during the pre-contest period in amateur bodybuilders.

We examined whether off-season (OffS) and pre-contest (PreC) periods affect blood oxidative stress, inflammatory, immunological, and psychological markers in 20 bodybuilders. The athletes recorded their food intake (3-day record), physical activities, mood states (Profile of Mood States, POMS), recovery-stress (Recovery-Stress Questionnaire for Athletes, RESTQ-Sport), and upper respiratory symptoms (Wisconsin Upper Respiratory Symptom Survey, WURSS-21), and blood was obtained for biochemical analysis. Almost all athletes were in positive energy balance during OffS, while bodybuilders presented markedly restricted energy intake (∼45%) leading to loss of weight (-9%) and fat mass (-45%) with preservation of fat-free mass in PreC. Protein intake was high during both periods, while lipid and carbohydrate intakes were reduced ∼50% in PreC. Almost all athletes consumed 100% of the Recommended Dietary Allowance (RDA) for micronutrients in OffS, while 45% and 75% of the athletes had intakes below the RDA for vitamins A and E in PreC. Oxidative damage to lipids (thiobarbituric acid reactive substances, TBARS), protein carbonyls, and the TBARS/total antioxidant capacity ratio increased in PreC (32%, 27%, 60%), as did plasma tumor necrosis factor α (4-fold) and WURSS-21 scores (25%). There were no significant changes in serum catalase, glutathione reductase, and superoxide dismutase activities nor in interleukin 1β and immunoglobulins. In PreC, POMS showed negative changes in vigor (-20%), fatigue (23%), and total mood disturbance (35%), and RESTQ-Sport showed alterations for general and sport stress (34% and 50%, respectively) and sport recovery (-23%). Thus, PreC negatively affects nutrient intake, which may worsen oxidative stress, inflammation, psychological status, and the severity of respiratory infections in bodybuilders.

Brief ideas about evidence-based recovery in team sports.

Performance in team sports is the expression of complex, dynamic, interactive, and multidimensional processes. It is now well-established that optimum recovery after practice or match is a key factor of team sport performance. During season and tournaments, improving recovery could offer an advantage for following performance. As a consequence of the professionalization of different roles in staffs, new particular roles have been developed within the team sports physician core in order to improve recovery protocols. Presently, scientific literature presents a big amount of methods used to enhance recovery based on the type of practice, time between session or competitions and equipment and/or staff accessible. These practices, usually used by teams are related to: ergonutritional, water therapy, massages techniques, stretching compression garments, sleep strategies and psychological implements. Besides, travel fatigue has been recognized by athletes and coaches as a challenging problem that could benefit from practical solutions. Nowadays, players have to play a lot of matches without enough time to recover among them, therefore the use of well-managed recovery can lead to a competitive advantage. Although the main purpose of applied sport sciences investigation is to categorize the protocols as well as providing approaches for individual recovery, the stages to recognize the most appropriate recovery plans in the field of team sports come from the analysis of the individual parameters.

SURGICAL TREATMENT OF CLAVICULAR FRACTURES IN SPORT

Clavicular fractures are common in sport practice, they are easily diagnosed and have a relative good forecast. Nevertheless there is no consensus among orthopedic surgeons regarding treatment for displaced midle-third clavicular fractures (Robinson’s classification 2B2) and lateral-third fractures. The tendency toward operative treatment is increasing due to the earlier sport recovery. Objectives: The aim of the paper is to present the results of treatment of 98 clavicular fractures in the Clinic Gastaldi of Traumatology during the period from 1997 to 2016, analyzing the radiologic and clinical results. Methods: The serie consists of 89 patients, 80 males and 9 females, average age 32.2 years. From them, 89 were agude fractures and 9 nonunion (after conservative treatment). According to the Thomsom classification there were 82 middle-third and 16 lateral-third. Motorbike sport trauma was the cause of 49 patients (55%), bike trauma in 18 (20%), 18 (20%) fractures occurred due to contact sports and 3 other causes. All patients were surgically treated. We used an antero-superior approach, open reduction and internal fixation with antero-superior plate osteosynthesis. In case of nonunion we decorticated the fracture callus, adding intramedullary reaming and graft bone. PRP (Platelet Rich-Plasma) was used in 8/9 patients. Postoperatively, the patients were placed in a sling. After that they began a rehabilitation program that consists of isometrics, pendular and active movements until 45° during 3 weeks. From 4th to 6th week, active movements until 90°. The patients began free movements after the 6th week. Results: Fracture healing mean was 10 weeks. Bikes and motorbikes were able to ride again between 10 to 21 days after surgery (once removed stitches). All patients retrieved full shoulder range of motion and returned to their previous activity level. Complications: we had no nonunion rates after surgical treatment, neither infections. 1 case of insufficient plate fixation and 4 re-fractures which required surgical treatment. Conclusion: We suggest surgical treatment for clavicular fractures in adult patients, contact sports with IIB and IIIB fractures, re-fractures and painful nonunion. Surgical treatment with open reduction and internal fixation (ORIF) of displaced middle-third clavicular fractures achieved shorter time to complete return to sport and earlier bone union.

Dietetic-nutritional, physical and physiological recovery methods post-competition in team sports.

To a proper recovery, is absolutely necessary to know that athletes with enhanced recovery after maximal exercise are likely to perform better in sports. Recovery strategies are commonly used in team sports despite limited scientific evidence to support their effectiveness in facilitating optimal recovery and the players spend a much greater proportion of their time recovering than they do in training. According to authors, some studies investigated the effect of recovery strategies on physical performance in team sports, lack of experimental studies about the real origin of the fatigue, certify the need for further study this phenomenon. Thus, developing effective methods for helping athletes to recover is deemed essential. Therefore, the aim of this review is provide information for his practical application, based on scientific evidence about recovery in team sports.

Медико-биологические аспекты восстановления в профессиональном и любительском спорте

Медико-биологические аспекты восстановления в профессиональном и любительском спорте

Return to Sport after ACL Reconstruction using Hamstring Tendon: Analyzing 51 Cases from Maltas Hospital in Dakar

The anterior cruciate ligament (ACL) rupture is a frequent lesion in athletes. It is incompatible with the practice of high-level sport, especially pivot and contact-pivot ones. The purpose of the ACL reconstruction is to allow the athlete to resume the practice of same sport at the same level. The study involved 51 sports patients operated for ACL reconstruction at the Order of Malta’s Hospital center in Dakar during the period from 1 January 2011 to 31 May 2014. The average age of patients was 26.3 years with a male predominance (92.15%). These were professional athletes in 37.25%, amateur in 31.37%, and leisure in 31.37% of the cases. The sport was contact-pivot in 96.6% of the cases, mainly football. The objective functional evaluation was performed using the Lysholm-Tegner scale and laximetry using the GNRB arthrometer. The overall sporting recovery rate was 96% with 54.9% recovery in the same sport at the same level. Professional athletes were 42 times more likely to resume the same sport at the same level as amateurs. Recovery times were 4.7 months for line sports, 9.2 months for pivot / contact-pivot and 11.3 months for the resumption of competition. These delays were shorter for professionals with a return to pivot sport at 8 months. Apprehension and fear of a new injury were the main reason for sport's downtime or decline. Functional and anatomical results were good with a mean Lysholm score of 91% and a GNRB differential of 2.87. No independent factor was predictive of returning to sport at the same level. Returning to sports activity is very likely after an ACL ligamentoplasty, but the return to the same sport at the same level is more uncertain, in the order of 55% despite satisfactory anatomical and functional results, confirming the important role of other factors such as psychological coaching and sport-specific rehabilitation.

Development of two short measures for recovery and stress in sport

The Acute Recovery and Stress Scale (ARSS) and the Short Recovery and Stress Scale were first established in German for the purposes of monitoring athletes’ current recovery-stress states in an economical and multidimensional manner. The aim of this paper is to document the development and initial validation of the English versions of these two psychometric monitoring tools. A total of 267 English-speaking athletes from a variety of team and individual sports participated in the study. The English versions demonstrated satisfactory internal consistency for both instruments (Cronbach α of .74–.89). Furthermore, good model fit was found for the eight scales of the ARSS, matching the structure and results of the German counterparts. Correlations among and between the scales reciprocate the theoretical constructs of stress and recovery, supporting the construct validity of the scales. Correlation coefficients within stress and recovery ranged between rs = .29 and .68. The correlations between stress and recovery varied between rs = −.29 and −.64. These constructs were further supported by correlations with the scores of the Recovery-Stress Questionnaire for Athletes, thereby showing convergent validity. The findings demonstrate initial validity and reliability of the two measures and reflect the results of the German versions. However, further research is needed before applying these scales in practical settings.

Effects of Cold Water Immersion and Contrast Water Therapy for Recovery From Team Sport: A Systematic Review and Meta-analysis.

Higgins, TR, Greene, DA, Baker, MK. Effects of cold water immersion and contrast water therapy for recovery from team sport: a systematic review and meta-analysis. J Strength Cond Res 31(5): 1443-1460, 2017-To enhance recovery from sport, cold water immersion (CWI) and contrast water therapy (CWT) have become common practice within high level team sport. Initially, athletes relied solely on anecdotal support. As there has been an increase in the volume of research into recovery including a number of general reviews, an opportunity existed to narrow the focus specifically examining the use of hydrotherapy for recovery in team sport. A Boolean logic [AND] keyword search of databases was conducted: SPORTDiscus; AMED; CINAHL; MEDLINE. Data were extracted and the standardized mean differences were calculated with 95% confidence interval (CI). The analysis of pooled data was conducted using a random-effect model, with heterogeneity assessed using I. Twenty-three peer reviewed articles (n = 606) met the criteria. Meta-analyses results indicated CWI was beneficial for recovery at 24 hours (countermovement jump: p = 0.05, CI: -0.004 to 0.578; All-out sprint: p = 0.02, -0.056 to 0.801) following team sport. The CWI was beneficial for recovery at 72 hours (fatigue: p = 0.03, CI: 0.061-1.418) and CWT was beneficial for recovery at 48 hours (fatigue: p = 0.04, CI: 0.013-0.942) following team sport. The CWI was beneficial for neuromuscular recovery 24 hours following team sport, whereas CWT was not beneficial for recovery following team sport. In addition, when evaluating accumulated sprinting, CWI was not beneficial for recovery following team sports. In evaluating subjective measures, both CWI (72 hours) and CWT (24 hours) were beneficial for recovery of perceptions of fatigue, following team sport. However neither CWI nor CWT was beneficial for recovery, of perceptions of muscle soreness, following team sport.

Monitoring Fatigue Status in Elite Team-Sport Athletes: Implications for Practice.

The increase in competition demands in elite team sports over recent years has prompted much attention from researchers and practitioners to the monitoring of adaptation and fatigue in athletes. Monitoring fatigue and gaining an understanding of athlete status may also provide insights and beneficial information pertaining to player availability, injury, and illness risk. Traditional methods used to quantify recovery and fatigue in team sports, such as maximal physical-performance assessments, may not be feasible to detect variations in fatigue status throughout competitive periods. Faster, simpler, and nonexhaustive tests such as athlete self-report measures, autonomic nervous system response via heart-rate-derived indices, and to a lesser extent, jump protocols may serve as promising tools to quantify and establish fatigue status in elite team-sport athletes. The robust rationalization and precise detection of a meaningful fluctuation in these measures are of paramount importance for practitioners working alongside athletes and coaches on a daily basis. There are various methods for arriving at a minimal clinically important difference, but these have been rarely adopted by sport scientists and practitioners. The implementation of appropriate, reliable, and sensitive measures of fatigue can provide important information to key stakeholders in team-sport environments. Future research is required to investigate the sensitivity of these tools to fundamental indicators such as performance, injury, and illness.

Injury Risk Is Increased by Changes in Perceived Recovery of Team Sport Players.

The aim of this study is to investigate if changes in perceived stress and recovery over the course of a season are risk factors for acute and overuse injuries. A prospective nonexperimental cohort design. Data were gathered at the SportsFieldLab Groningen and at the facilities of the participating teams. Eighty-six male and female basketball, volleyball, and korfball players aged 21.9 ± 3.5 years. In this 10-month observational study, the independent variables are the changes in perceived stress and recovery. The Recovery-Stress Questionnaire for Athletes (RESTQ-Sport) was filled out every 3 weeks throughout the season to assess changes in perceived stress and recovery. Acute and overuse injuries were registered by the teams' physical therapists. Odds ratios and 95% confidence intervals were calculated. During one season, 66 acute and 62 overuse injuries were registered. Multinomial regression analysis showed that perceived General Recovery, shown in the scales Social Recovery and General Well-Being, decreased in the 6-week period before an acute injury (OR 0.59 and 0.61, respectively, P ≤ 0.05) compared with healthy periods. Risk of overuse injuries increased when perceived Sport Recovery, shown in the Personal Accomplishment scale, decreased in the 3-week period before the injury (OR 0.59, P ≤ 0.05) compared with healthy periods. Therefore, decreased perceived recovery can indicate an increased injury risk. General Recovery affects acute injury risk and Sport Recovery affects the risk of an overuse injury. Monitoring perceived recovery over the course of a season could give guidance for recovery enhancing practices to prevent injuries.

Poster 272 The Question of Age’s Role in Concussion Recovery in Sports: A Retrospective Look at Mixed Martial Arts Fighters and Their First Knockout Loss

Poster 272 The Question of Age’s Role in Concussion Recovery in Sports: A Retrospective Look at Mixed Martial Arts Fighters and Their First Knockout Loss

Evolution of the anteroposterior laxity by GnRB at 6, 9 and 12 months post-surgical anterior cruciate ligament reconstruction

This study aimed to analyze the evolution of the tibiofemoral anterior laxity during the return to sport after anterior cruciate ligament reconstruction. Twenty patients (11 women, 9 men) with mean age of 22.4 ± 5.1 years, operated for ACL reconstruction by a hamstring technique, competitors in a pivot-contact sport, were enrolled between September 2014 and March 2016. They were evaluated at 6 ( n = 20), 9 ( n = 13) and 12 ( n = 13) months postoperatively by laximetry to 250 N using laximètre GnRB ® (GenouROB, Laval, France). The differential between laxity uninjured side and operated side in mm, and the difference in slope of the curve laxity according to the force applied between the two sides percentage, on each testing time, were selected. The average values at each time were compared using a t -test of Student. The average differential laxity increases insignificantly by 1.4 ± 1 mm to 1.7 ± 1.3 mm between 6 and 9 months postoperatively ( P = 0.17) and significantly decreased to 0.95 ± 0.5 mm at 12 months postoperatively ( P = 0.02). The slope difference increased from 9% to 15% between 6 and 9 months after surgery ( P = 0.05). Between 6 and 12 months postoperatively, the difference in slope (9% and 11%, respectively) was not significant ( P = 0.1). Residual laxity was significantly greater in women at 6 months postoperatively, 1.9 mm vs. 0.9 mm ( P = 0.002); this difference was no longer significant at 9 and 12 months postoperatively. Our study reported a significant change in the anterior-posterior laxity between 9 and 12 months postoperatively. These results suggest that the laxity is not only the result of isometric positioning of the transplant but probably also of the transplant ligamentisation phenomena by collagen remodeling to mechanical stress, but also the local muscle condition or exposure to hormonal factors. These results, which show a normalization of laximetry to 12 months postoperatively, make us cautious when a premature return to sport without satisfactory joint control. So, it seems that in sports recovery decision, the analysis of the ligament laxity is a relevant parameter to use.

Expectativas y aprensiones de los pacientes sometidos a cirugía de reconstrucción de ligamento cruzado anterior de rodilla

IntroductionAnterior cruciate ligament (ACL) injury is a common condition and its surgical treatment causes uncertainty in patients about their return to activity. The expectations prior to the procedure influence their perception of treatment success, development of complications, and final results, and can have an impact on post-surgical patient satisfaction. ObjectiveTo determine the concerns and expectations of patients undergoing ACL reconstruction surgery. MethodProspective observational study, in which questionnaires were completed by patients with ACL injury that would undergo reconstructive surgery. The evaluated variables were age, mechanism of injury, sports practice, prior information about the surgery and concerns and expectations about the procedure. ResultsA total of 50 patients completed the questionnaire, of whom 38 were men and 12 women with a mean age of 30 years. The most common injury mechanisms were when practicing football and skiing. Almost all (96%) of respondents played sports regularly (average 5hours a week) before the surgery. A total of 90% of patients had enquired about ACL reconstruction surgery. The main pre-operative concerns were recovery time (40%) and the possibility of reinstatement of sports (38%). Expectations are focused on achieving an early sports recovery (54%) and the presence of postoperative pain (40%). ConclusionPatients undergoing ACL reconstruction have concerns primarily as regards post-surgical recovery time and expectations are focused on achieving an early reinstatement of sports.

A reduced-order model-based study on the effect of intermittent pneumatic compression of limbs on the cardiovascular system

This work investigates the effect that the application of intermittent pneumatic compression to lower limbs has on the cardiovascular system. Intermittent pneumatic compression can be applied to subjects with reduced or null mobility and can be useful for therapeutic purposes in sports recovery, deep vein thrombosis prevention and lymphedema drainage. However, intermittent pneumatic compression performance and the effectiveness are often difficult to predict. This study presents a reduced-order numerical model of the interaction between the cardiovascular system and the intermittent pneumatic compression device. The effect that different intermittent pneumatic compression operating conditions have on the overall circulation is investigated. Our findings confirm (1) that an overall positive effect on hemodynamics can be obtained by properly applying the intermittent pneumatic compression device and (2) that using intermittent pneumatic compression for cardiocirculatory recovery is feasible in subjects affected by lower limb disease.

Commotion cérébrale et étranglement dans le judo de haut niveau : 75 judokas

IntroductionThe concussion is a transient impairment of neurological function following a traumatic brain injury. Strangulation is a compression around the neck. These phenomena can lead to unconsciousness. The objective of this study was to determine the prevalence of these phenomena on a high-level judoka population and study the recovery time. We also wanted to compare the post-critical symptoms in their type, intensity and also duration. MethodsA questionnaire to establish whether or not the athlete has been a victim of concussion and/or of throttling with loss of consciousness, the presence or not of post-critical symptoms, their duration and the sport recovery time, was handed to the judokas. ResultsA total of 75 judokas had responded to our questionnaire. During their years of practice, 27% reported having been the victim of concussion; 71% of concussed remembered post-concussive symptoms lasting on average 1.9 days, with an average recovery time of 5.4 days. 45% reported having been the victim of strangulation with loss of consciousness with inability of immediate recovery in 18% of cases; 25% remembered post-strangulation symptoms of a 1 h 41 span, with a recovery time of 9h. ConclusionConcussion involves an incapacity to continue sporting practice with a variable period of recovery according to the post-concussion syndrome. A standardized management and adapted in a second time would have an interest. The consequences of the restriction appeared more benign. Vagal phenomenon probably explains most cases of loss of consciousness.

Differences in Attentional Focus Associated With Recovery From Sports Injury: Does Injury Induce an Internal Focus?

Although it is commonly believed that focusing too much attention on the injured body area impairs recovery in sports, this has not been directly assessed. The present study investigated attentional focus following sports injury. Experienced baseball position players recovering from knee surgery (Expt 1) and baseball pitchers recovering from elbow surgery (Expt 2) performed simulated batting and pitching respectively. They also performed three different secondary tasks: leg angle judgments, arm angle judgments, and judgments about the ball leaving their bat/hand. Injured athletes were compared with expert and novice control groups. Performance on the secondary tasks indicated that the injured batters had an internal focus of attention localized on the area of the injury resulting in significantly poorer batting performance as compared with the expert controls. Injured pitchers had a diffuse, internal attentional focus similar to that of novices resulting in poorer pitching performance as compared with the expert controls.

SportsTech: sport recovery technology

21st century athletes have a whole host of options for assisting with recovery from competition and injury. At the most `basic' level are Hyperice's ergonomically designed compression wraps for various parts of the body, which combine with an ice cell that uses an ultra-thin skin and an air release valve to allow for optimal compression. A similar innovation is the `Firefly', a small electronic device designed to accelerate recovery of the muscles in the lower leg and knee after strenuous exercise or minor injury. The Firefly is portable, so it can be taken to sports events and on travels. It's worn behind the knee and delivers painless electrical impulses to gently activate the muscles of the lower leg to increase blood circulation. A slightly more high-tech recovery method, and one of the latest devices to hit the market, is the EMPpad Omniumi, an Android tablet that powers a 'pad' on which the athlete lies to receive a pulsed magnetic field. It is claimed it can speed up muscle tissue recovery and assist with injury healing. It seems possible that some of these studies in tissue repair may be on to something, with preliminary positive results, but nothing is conclusively proven yet. It seems wholly unreasonable to conflate all of this early and somewhat speculative science into a conclusion that lying on a mat for eight minutes a day will provide all of these health benefits. There is absolutely no proof that this will happen.

Anterior cruciate ligament injury: post-traumatic bone marrow oedema correlates with long-term prognosis.

Bone marrow oedema (BME) in the knee is a feature of several pathological conditions, and it has been described with high frequency in patients with acute anterior cruciate ligament (ACL) injury. The aim of this study is to evaluate the significance of BME, assessed in MRIs performed for ACL injury, with regards to clinical outcome and return to sport. A total of 134 patients (98 men, 36 women) with ACL tear and MRI knee scan within six months from trauma were analysed. The presence of BME was evaluated on MRI images considering: extension and hyperintensity, the WORMS score oedema classification, and measuring the BME area. The clinical results were documented by IKDC-subjective score and the sport activity level by Tegner score at a minimum of five years follow up. BME was present in 74 knees (55.2 %), with a mean area of 523 ± 370 mm². The presence of BME showed a gradual decrease over time (p = 0.008), being detectable in MRIs performed more than three months after trauma in just 25.0 % of cases. Although 54 % of the patients without BME after three months returned to their previous sport level, no patients with oedema reached a full sport recovery (p = 0.01). In the group that underwent ACL reconstruction, the BME area was significantly correlated with a return to the previous sport level at the mid/long-term follow-up (p = 0.038). BME is a common finding, which decreases over time after injury. However, when BME is still detectable it correlates with clinical prognosis, and even in sport-active patients undergoing ACL reconstruction, a higher BME area is a negative predictive factor for a successful outcome at the mid/long-term follow-up.

Utilisation du Plasma Riche en Plaquettes pour le traitement des tendinopathies rotuliennes et achilléennes

The purpose of this study was to retrospectively evaluate the effectiveness of Platelet-Rich Plasma Injection (PRP) for Achilles and patellar tendinopathy refractory to conventional conservative treatments. For this, we compared the data from 34 patients treated with one or two injections of PRP. Pain, functional ability, athletic recovery and satisfaction of patients were evaluated. The results show a significant reduction in pain after the PRP injection treatment, as a significant functional improvement and better sports recovery, without any significant difference according to the affected tendon or the sports. Patients are, on average, satisfied. The PRP is not the miracle treatment but can be however considered in cases of refractory tendinopathy as a possible chance of improvement. Despite the potentially positive effect of PRP injection therapy on patellar and Achilles tendinopathy, there is still not enough scientific literature of high methodological quality about it.

Influence of Contrast Shower and Water Immersion on Recovery in Elite Netballers

Contrast water therapy is a popular recovery modality in sport; however, appropriate facilities can often be difficult to access. Therefore, the present study examined the use of contrast showers as an alternative to contrast water therapy for team sport recovery. In a randomized, crossover design, 10 elite female netball athletes (mean ± SD: age, 20 ± 0.6 years; height, 1.82 ± 0.05 m; body mass, 77.0 ± 9.3 kg) completed 3 experimental trials of a netball specific circuit followed by one of the following 14-minute recovery interventions: (a) contrast water therapy (alternating 1 minute 38° C and 1 minute 15° C water immersion), (b) contrast showers (alternating 1 minute 38° C and 1 minute 18° C showers), or (c) passive recovery (seated rest in 20° C). Repeated agility, skin and core temperature, and perception scales were measured before, immediately after, 5 and 24 hours postexercise. No significant differences in repeated agility were evident between conditions at any time point. No significant differences in core temperature were observed between conditions; however, skin temperature was significantly lower immediately after contrast water therapy and contrast showers compared with the passive condition. Overall perceptions of recovery were superior after contrast water therapy and contrast showers compared with passive recovery. The findings indicate contrast water therapy and contrast showers did not accelerate physical recovery in elite netballers after a netball specific circuit; however, the psychological benefit from both interventions should be considered when determining the suitability of these recovery interventions in team sport.