Sports Doctors Research Articles

ПРОТИВОДЕЙСТВИЕ ДОПИНГУ В СПОРТЕ В ПРАКТИКЕ ВРАЧА: НАПРАВЛЕНИЯ, ПРОБЛЕМЫ, РЕШЕНИЯ

Purpos of the study: to improve educational and information work on anti-doping issues. Materials and methods: a survey of 103 sports doctors of the Federal State Budgetary Institution Federal State Budgetary Institution Federal Scientific and Clinical Center for Sports Medicine and Rehabilitation of the Federal Medical and Biological Agency was conducted in 2022. Results: the research conducted indicates a number of positive trends in the processes being studied, but at the same time confirms the need to continue continuous work to improve the level of knowledge of doctors in matters of anti-doping in sports. The priority areas of this work include educational activities to develop the knowledge, skills and abilities necessary to file requests for TUEs, counseling and outreach on the use and possible risks of using nutritional supplements in athletes.

Place de l’électrocardiogramme dans la visite de non-contre-indication à la pratique sportive de compétition entre 12 et 35 ans : enquête auprès des médecins membres de l'Association Guinéenne des Médecins Sportifs

IntroductionAn electrocardiogram (ECG), combined with a well-conducted clinical examination, is more effective than the clinical examination alone in detecting underlying cardiac pathologies in athletes. The aim of this study was to evaluate the use of ECGs by physicians who are members of the Guinean Association of Sports Physicians, during the non-contraindication visit for competitive sports between the ages of 12 and 35. MethodologyWe conducted a web-survey from July 15 to August 15, 2023. A survey form was created on “Google Docs” and pre-tested. It was then broadcast on all the communication networks used by these doctors. The data were secured using “Google Drive” software. Analyses were performed using SPSS version 20 software. ResultsOf the 51 included, 74.51% said they had received at least one training session on ECG interpretation for athletes. All of them either requested or performed an ECG at least once in a while, as part of the check-up for non-contraindication to competitive sport. The ECG was systematic, according to 72.55% of doctors. Three quarters referred to a sports cardiologist in the event of an abnormal ECG, 66.67% to a cardiology resident and 58.82% to a cardiologist. In the absence of an ECG, the presence of functional signs on exertion, the notion of a family history of cardiovascular disease and the presence of at least two cardiovascular risk factors were the main reasons for seeking an opinion. ConclusionA resting ECG is carried out almost systematically by doctors who are members of the Guinean Association of Sports Doctors, as part of the check-up for non-contraindication to practising sport.

Causes of injuries in professional football referees

The professional activity of a football referee consists of heavy loads and psychological pressure, which significantly affects his health. Unlike professional football players, referees monitor their health most of the time on their own, without having the opportunity to be under the control of sports doctors. During the research, we conducted a survey of 30 referees of the Premier League of Ukraine aged 27-45. Questions related to the occurrence and nature of injuries during various activities of a football referee were included in the questionnaire. It was found that the largest number of injuries of football referees of the Premier League of Ukraine is muscle strain that occurs during intensive work. Еhe highest number of muscle strain injuries 26.0 -1.8 occurs during the performance of the physical training test, which includes: the YO-YO test and the maximum running of 6 segments of 40 m. The number of received injuries related to problems joints, depending on sports activity, are: during training - 11.3 -0.5 injuries, during a match - 6.3 -0.9 and 8.7 -1.1 injuries - during testing. The largest number of dislocations, fractures and other injuries also occurs during training activities and is 3.1 -0.3 injuries and 2.2 -0.3 injuries, respectively.
 The age of the football referee significantly affects the number of sports injuries. Yes, referees after the age of 41 have a tendency to get muscle strains and joint inflammation. During the tests, referees get more injuries than during the game and training, which indicates that the physical training tests do not match the main motor activity.

Archery injuries: A literature review

BACKGROUND: Archery is one of the oldest human skills that survived to the present day. At first, it was used for hunting and war and later became a sport. The interest in archery has grown annually. Each type of sport has specific injuries. Information about archery-related injuries will allow us to develop preventive measures and help make this sport safer. The article will be useful for coaches, sports doctors, physiotherapists, and orthopedic surgeons.
 AIM: To present modern information about frequency, types of archery-related injuries, and preventive methods.
 MATERIALS AND METHODS: The publication search was performed in the PubMed/MEDLINE databases from 1978 to 2023 using combinations of OR, AND operators, and keywords: archery, archery injuries, rotator cuff injuries, arrow injuries, and overuse. Consequently, we extracted 49 foreign and domestic scientific sources.
 RESULTS: Archery injuries occur in 4.4 per 10,000 people involved in this sport. Acute injuries in archers are rare, mainly due to shooting errors and most often lead to soft tissue damage because of a fracture of a bow, arrow, or bowstring during a shot (83.3%) or as a result of touching the bowstring with a bow. Chronic injuries occur in 83.9% of archery athletes. The main risk factors for their occurrence include overuse, high repetitions during training, lack of strength of the athlete, and incorrect technique. Overuse (67.9%) is the most common cause of chronic tendon, ligament, and joint injuries. Injuries occurred in 30%–53% of cases in the shoulders (rotator cuff tear, scapular dyskinesia, and shoulder impingement syndrome), 12.8% in the elbow (medial and lateral epicondylitis and traumatic bursitis), 8.9%–19.9% in the spine and forearm (chronic tendovaginitis and tunnel syndromes).
 CONCLUSIONS: Proper training and safety measures help prevent acute injuries. Practicing archery techniques and strength training are the main measures of preventing muscle overuse and reducing the incidence of chronic injuries.

Educating the upcoming generation of Sports Doctors

The SEMS Journal and the SEMS Education Committee publish an annual “Special Education Issue”. These issues are based on the contents of the individual eight SEMS postgraduate education courses and intend to serve as a reference body of work for all doctors treating athletes. The topics of each course are defined by the education committee. In Nottwil, we traditionally focus on topics of internal medicine such as sports cardiology, pneumology/allergology and sports, gastrointestinal aspects in sport as well as sports haematology and endocrinology. The periodic physical examination of athletes (PPE, or SPU in Swiss German part), with hands-on workshops with athletes, is a major topic in this course.

Hamstring Injury Rehabilitation in the Female Athlete. A Clinical Case

Hamstring injury is a common sports injury in the female athlete. Both rehabilitation and preventive measures are crucial but not standardized yet. In this article we present a female athlete with a fresh hamstring injury which was treated with both physiotherapeutic treatment as well as with regional sugar water injections into the muscular lesion. The goal of this paper is to share this experience with other physical therapists and sports doctors. This case is also an invitation to the medical community to design randomized trials to confirm our clinical experience with this dual management.

A clinical case of post-concussion syndrome in an elite professional football player

Objective: to demonstrate our own clinical case of an athlete with an unusual post-concussion syndrome after repeated concussion of the brain.Materials and methods: presentation of own clinical observation in dynamics of a professional football player with repeated concussion of the brain complicated by post-concussion syndrome with laboratory-instrumental diagnostic methods.Results: a professional football player, as a result of a re-diagnosed concussion of the brain, had headaches, mainly in the temporal and occipital regions, weather dependence, subfebrility, while there was no effect from taking nonsteroidal anti-inflammatory drugs. As a result of instrumental examinations, changes in MCT and MRI were revealed. The conducted examinations, methods of treatment, the plan of an individual rehabilitation program are described.Conclusion: this clinical case is of great interest to practicing sports doctors, due to frequently recurring head injuries, especially in contact sports and the lack of an algorithm for treatment and rehabilitation of highly qualified athletes.

SPORTS INJURIES OF STOMATOGNATHIC SYSTEM WITH REFERENCE TO PREVENTION AND FIRST AID – REVIEW ARTICLE

Introduction: Engaging in sports is crucial for maintaining and enhancing the health of both children and adults. However, it can also be a cause of injuries with temporary or permanent consequences. The primary causes of sports injuries are mechanical forces acting during intense physical exertion. A significant number of sports injuries involve the stomatognathic system, often occurring suddenly and unexpectedly, accompanied by pain and bleeding. The complexity of injuries depends on the type of sport, the athlete's age, and the force's strength, leading to serious aesthetic, functional, psychological, and economic consequences for the injured. Purpose of the study: The purpose of the study is to highlight the significant role of sports in physical and mental health, while also addressing potential injuries that may occur during sports activities, with a particular focus on dental and surrounding tissue injuries. The study emphasizes the importance of preventing traumatic and non-traumatic damage to dental tissues and surrounding structures through the mandatory use of sports mouthguards. Methods: This review article focuses on enriching knowledge about dental traumas caused by sports injuries, their prevention, and trends in the therapy of dentoalveolar traumas. Results: In this work, the authors aimed to briefly summarize, analyze, and present the latest available information from contemporary literature dealing with dentoalveolar traumas, including their causes, diagnosis, and treatment, while emphasizing the importance of prevention. Conclusion: Sports injuries, with a specific emphasis on injuries to the stomatognathic system, whether occurring in recreational or competitive sports, require a serious approach in terms of prevention, diagnosis, and therapy. The education of sports professionals, coaches, sports doctors, parents, and athletes themselves on providing first aid for the occurrence of dentoalveolar traumas is of great importance.

METHODOLOGICAL APPROACHES TO INJURY PREVENTION IN FREESTYLE WRESTLING

The aim of this study was to explore methodological approaches of preventing injuries in freestyle wrestling. The analysis of the sources of the literature under study allows us to draw the following conclusions: prevention of sports injuries involves a number of organizational and methodological measures: continuous improvement of material and technical support, improvement of the conditions of training sessions and competitions, systematic professional development of sports doctors and coaches, compliance with the rules of medical control, improvement of physical, technical and tactical training, moral qualities of athletes, health promotion. From a pedagogical and methodological point of view, it is necessary to introduce into the training process special training on injury prevention at all stages of long-term training aimed at achieving and maintaining an optimal level of flexibility and targeted strengthening of the musculoskeletal system. The optimal level of flexibility is characterized by the fact that the available momentum of specific movements is slightly larger than the width of competitive exercises - the so-called "flexibility reserve", which minimizes the resistance to stretched muscles, so that the exercise is performed without excessive tension and reduces the possibility of injury in similar positions in competitive wrestling. For targeted strengthening of the musculoskeletal system, it is advisable to apply measures aimed at strengthening different parts of the spine, shoulder girdle, knee, tibiofemoral joints and increasing the elasticity of muscles and ligaments. The sets of exercises compiled for these purposes should be used throughout the entire sport career, including them in pre-training, the final part of the lesson, as well as in specialized and individual classes.

Functional rehabilitation of ankle trauma by the graduate in motor science

Sports trauma commonly affects joints of the extremities; ankle injuries are one of the most common. The study aimed to rehabilitate ankle trauma with proprioceptive exercise, performed, by graduate in motor science. Trauma causes joint instability, which is manifested mainly in running and walking. For this reason, baropodometry and motor tests were used as evaluation criteria; evaluating joint instability in both static and dynamic and neuromotor abilities. Seven athletes (aged 17 and 24 years old) are recruited for the study; they had suffered ankle trauma. The rehabilitation program involved the supervision of a multidisciplinary team (neurologist, posturologist, kinesiologist, sports doctor, observers). Each treatment was always at the same time and included 3 phases: the first on specific work to recover joint mobility, in the second the work was focused on recovering strength, third phase was aimed at recovering ankle sprains. The athletes were administered proprioceptive functional rehabilitation programs aimed at recovering the ankle trauma and plantar pressures. The data were positive and encouraging with respect to the planned goal, supporting the importance of proprioception and the role of the graduate in motor science in the functional re- education of trauma.

Experimental study on physical exercise in diabetes: pathophysiology and therapeutic effects.

Diabetes is a chronic disease. Some complications can be prevented, their effects can be slowed down. Sedentary lifestyle increases the risk of obesity and consequently the predisposition to diabetes II. The article aimed to demonstrate the positive and negative effects of exercise on active and sedentary diabetics and on pathophysiology, evaluating the effects after 3 and 6 months. The study involved 90 participants, both male and female, with type II diabetes, aged 45, divided into two groups: Group A (n=50, sedentary) and Group B (n=40, active). We evaluated anthropometric parameters, blood chemistry values, which are fundamental for the transversal evaluation of the results. In group A improvements were less noticeable than group B. The most improved parameter is blood sugar, Glycemic values and BMI. Cholesterol and Hb1Ac decreased but more slowly than previous parameters. The expectations of the study were, not only in recognizing the therapeutic and preventive powers of exercise, but above all in choosing to program a motor protocol after a team work between diabetologist, sports doctor and kinesiologist and/ or personal trainer. Physical activity is an additional therapy to insulin.

Program Evaluation of the Student Sports Education Center (PPLP) for West Sumatra Province Football

The problem in this study is the weak support and attention to coaching the West Sumatra PPLP football branch, still less than expected is still not optimal. So that the expected achievements and coaching of PPLP football have not been achieved. The purpose of this study was to evaluate the coaching and training program of PPLP for West Sumatra football. The method in this study uses a qualitative descriptive approach using the CIPP (Context, Input, Process, Product) method. This research data was obtained through observation, interviews and documentation. The results of the study were found in terms of context that the coaching process and also the training program process that had been implemented were in accordance with what was expected to have run with the vision and mission. In terms of input, it is still not maximal, it can be seen that the athlete rerukmen still does not involve psychologists and sports doctors, facilities and infrastructure are still not optimal, and the funds / budget allocated have run according to the rules but are still not optimal. Process Aspect in program implementation Evaluation and minotoring activities are running and carried out well, the implementation of the training program has gone well as expected, Communication / socialization of the program with athletes is quite maximal. In terms of Product achievement target West Sumatra Football The achievement of West Sumatra pplp athletes in the sport of football has reached the target and is optimal in coaching efforts and also the breeding of athletes can be seen the achievements that have been achieved by west Sumatra pplp football athletes.

Treatment of Grade 1 Hamstring Injury with Glucopuncture: A Clinical Case

Hamstring strain injuries are common among athletes and often require intensive rehabilitation to prepare athletes for a timely return to sport performance. Return to sport is typically achieved within weeks of the hamstring injury. But subsequent athlete performance may be impaired. Both rehabilitation and preventive measures are crucial but not standardized yet. On top of the standard rehabilitation program, it would be interesting to add safe treatment modalities which could speed up recovery from such an injury. In this article we present a young athlete with a large grade 1 hamstring injury which was treated with regional sugar water injections into the muscular lesion. Although they can be biased, both treating physician as well as patient found that injury recovery went smoothly and quickly. The goal of this paper is to share this experience with other sports doctors and to invite the medical community to design randomized trials to confirm the clinical experience with this easy and safe technique. Unfortunately, the injectate is inexpensive and cannot be patented, making the product uninteresting for medical companies.

Evaluation of Antioxidant Defence Systems and Inflammatory Status in Basketball Elite Athletes.

Intense physical activity can induce metabolic changes that modify specific biochemical biomarkers. In this scenario, the purpose of our study was to evaluate how intense physical activity can affect oxidative metabolism. Following this, fifteen professional basketball players and fifteen sedentary controls were recruited and subjected to two samplings of serum and urine in the pre-season (September) and two months after the start of the competitive season (November). Our results have shown an increase in athletes compared to controls in CK and LDH in September (respectively, p-value 0.003 and p-value < 0.001) and in November (both p-value < 0.001), whereas ALT is increased only in November (p-value 0.09). GGT serum levels were decreased in athletes compared to controls in both months (in September p-value 0.001 and in November p-value < 0.001). A gene expression analysis, carried out using RT-PCR, has revealed that IL-2, IL-6, IL-8, xCT and GCLM are increased in athletes in both months (p-value < 0.0001), while IL-10 and CHAC1 are increased only in September if compared to the controls (respectively, p-value 0.040 and p-value < 0.001). In conclusion, physical activity creates an adaptation of the systems involved in oxidative metabolism but without causing damage to the liver or kidney. This information could be of help to sports doctors for the prevention of injuries and illnesses in professional athletes for the construction of the athlete's passport.

How to? My first experience as a sports doctor (GOTS young academy presentation)

Non-typhoidal Salmonella (NTS) is the major cause of foodborne infections globally, with considerable morbidity and mortality. The accurate identification of Salmonella serovars is important in disease management and public health surveillance. However, traditional serotyping methods are laborious, time-consuming and may produce ambiguous results. In this study, we evaluated traditional serotyping and seven gene-based multilocus sequence typing (MLST) methods to determine the serogroups of Salmonella strains. This study analysis suggests that MLST based serotyping is accurate in serogroup identification and discrimination of Salmonella serovars compared to the traditional serotyping method and can be implemented in routine clinical practice.

Theory and methods of organizing group interaction of students in team sports

The article presents the theory and methodology of organizing group interaction of students in team sports. In order to increase the level of physical development of a person, physical fitness, and the state of health of education seekers, which has a clear tendency towards constant deterioration, it is necessary to instill a love for sports, carry out high-quality training of specialists and organize sports events even at school. And physical culture and sports activities allow solving these issues. In the process of sports events, when organizing group interaction of students in team sports, mental education of the participants is also carried out. There are two types of communication here: direct and indirect, which are disclosed in the article. In games and sports competitions, there are many opportunities for the formation of norms of collective behavior. The main issues of preparation and organization of sports events at school in general, and the organization of group interaction of students in team sports, in particular, have been clarified. The functions of teachers of physical culture and sports, organizers of competitions, and group interaction of students in team sports, sports referees and sports doctors, related to the organization and conduct of sports competitions, vary depending on the nature of the activities of these people. Sports competitions, where it is necessary to organize group interaction of students in team sports, are an incentive for systematic training and contribute to the growth of sports results if they are held regularly. During the organization of group interaction of students in team sports, the tasks set in physical culture and sports classes are improved, in order to improve the physical and theoretical training of the individual. The satisfaction from sports, bright, emotional spectacles arises as a result of the participation of the viewer in them. A sports competition must be properly and clearly organized. The success of the sports event depends on its competent construction.

Benzodiazepines in sport, an underestimated problem: Recommendations for sports medicine physicians' practice.

In the last years, only few studies in literature have focused on the use and abuse of benzodiazepines (BZDs) in sport. Benzodiazepine-related problems include misuse, addiction, driving impairments, and morbidity and mortality related to overdose and withdrawal. Two clinical cases regarding elite endurance athletes evidenced that they had started to use BZDs to counteract insomnia, to recover faster from training sessions and to manage muscle pain. One of the important points that emerged from their stories was that their sports doctors did not recognize the drugs' addictive properties, and did not intervene to gradually reduce the dosage. Experts have previously provided recommendations for BZD therapy management in clinical practice. In this article, we would like to address sports medicine physicians specifically and provide guidelines to help them manage situations involving BZD prescription, the recognition of addiction, and intervention strategies.

Potential danger of the negative impact of professional women’s sports on the reproductive function of sportswomen

The article is a review of modern achievements in the field of studying reproductive health problems among professional sportswomen. Long-term and intensive physical loads are used for professional female athletes in the training process in speed-strength sports at levels that were historically characteristic only for male athletes. Insufficient awareness of this problem among doctors, trainers, and athletes can be considered as an actual problem of the potential danger for the reproductive function of female athletes during professional sports. Specialists in the field of the impact of high physical exertion on the reproductive health of female athletes have to face a complex of problems. The medical problems include female athlete triad, relative lack of energy, disruption of endocrine regulation due to the use of doping and contraceptives, and hyperandrogenism. Pedagogical problems include contradiction between the desire to achieve high sports results and the conscious, even indifferent attitude of the coaching staff to the physiological characteristics of women and the lack of relevant knowledge on the part of female athletes and their parents.The well-known female athlete triad – amenorrhea, anorexia and the lack of energy syndrome – has a neuroendocrinology basis caused by genetic, physiological factors and high physical loads. These data should be brought to the attention of coaches, female athletes and their parents. It was proposed algorithm for the prevention of reproductive health of professional athletes.Conclusions. High performance sports pose an additional risk for women’s reproductive health. Doping, contraception and neglecting the peculiarities of the menstrual cycle are a threat to the future life and health of female athletes. The risk group consists of young athletes. An important approach to solving the problem is to inform of various specialties doctors, first of all obstetricians-gynecologists, endocrinologists, sports doctors, nutritionists, as well as trainers and athletes themselves, about the potential danger of the possible negative impact of professional women’s sports on their reproductive function and about the measures that are necessary to be carried out to prevent the development of this danger.

Clinical examination of the sprained knee

Abstract Introduction. Patients with knee injuries may be consulted in a first stage by specialists, such as the sports doctor, and in a second stage, depending on the severity of the injury and the therapeutic orientation, it may be necessary to consult an orthopedic surgeon and / or medical rehabilitation. Aim. Particularly important in the traumatic pathology of the knee is the physical examination. It must be rigorous and systematic, because, based on it, a correct diagnosis can be established, which also assesses the severity of the lesions. Only in this way the optimal therapeutic decision be made in order to establish an accurate initial diagnosis and to evaluate the severity of the sprain, depending on which medical or orthopedic-surgical treatment is decided. Methods. Complete and accurate physical examination in the knee sprain, begins with a meticulous anamnestic interview, followed by inspection and palpation. The examination ends with a series of maneuvers to test the various potentially damaged structures of the knee. Results. All the listed elements will allow us to establish the therapeutic management in the recent sprain of the knee and to differentiate the affected structures: sprain with the interest of the collateral ligaments or with the damage of the central pivot, represented by the cruciate ligaments. Conclusion. Although with the advent of imaging investigations methods, which provide particularly important information and the diagnosis becomes much simplified, the stage of the physical examination of the patient in the knee sprain should not be omitted, it is an accessible and extremely useful tool in the orientation toward diagnosis.

Assessment and monitoring of Achilles tendinopathy in clinical practice: a qualitative descriptive exploration of the barriers clinicians face

Our primary objective was to explore the barriers preventing clinicians from implementing what they think is ideal practice as it relates to using tools to aid diagnosis and monitor progress...