Author: Mokhtar

Diet and training go hand in hand if you want to achieve the best results. Most athletes know this, and many of them monitor their energy intake and training closely. However, a new study from the Department of Public Health at Aarhus University shows that the bodies of female athletes are negatively affected when the athletes consume too little energy through their diet compared to their training volume, explains PhD student Mikkel Oxfeldt. He and Associate Professor Mette Hansen are behind the research.

“We know that both top female athletes and active women sometimes, consciously or unconsciously, do not have an energy intake that matches their energy expenditure during training. The research shows that insufficient energy intake can have a negative effect on the ability of the muscles to respond to After just ten days of low energy intake, we started to see changes in the hormonal system, such as a decrease in metabolic hormone , followed by a decrease in metabolism.’

The research shows that it is important for women to be careful not to reduce their energy intake too much. In fact, they should actually increase their energy intake as they increase their training volume, says Mikkel Oxfeldt:

“If you don’t get enough energy from your diet, your body starts to slow down processes that require a lot of energy, much like a cell phone going into battery-saving mode. We know from previous studies that this can lead to menstruation. However, our results show that other processes in the body, such as the build-up of new muscle proteins, are also affected.”

We must confront the one-sided focus on weight

Thirty fit women aged between 18 and 30 took part in the study, which is part of the Novo Nordic-funded Team Denmark network called ‘competition preparation and training optimization’. All women started the study immediately after the start of their period and followed a highly controlled exercise and diet regimen for three weeks.

“Under the supervision of the researchers, the participants performed individual training programs aimed at increasing muscle mass, strength and overall fitness. We also provided the women’s meals. By monitoring their training regimen and their diet, we were able to see how much energy they expended and what they ate during the study,” says Mikkel Oxfeldt and continues:

“This is the first time such a well-controlled study has been conducted in this area, with both the diet and exercise of a group of fit women regulated to this extent. During the study, all participants drank double-labeled water. “, which is enriched with trace material. When we combine this tracer technique with the retrieval and subsequent analysis of muscle tissue samples, we can gain detailed insight into the response of the muscles to the experimental protocol,” explains Mikkel Oxfeldt.

Mikkel and the research group believe that it is necessary to confront the idea that weight loss leads to medals, when in fact weight loss can negatively impact a number of body systems, including the muscles.

“In recent years we have heard about public weigh-ins within some elite sports. They are part of promoting a culture where some women are constantly trying to lose weight. However, our results show that this focus on weight loss can have negative consequences on the short and possibly long term for women, both in relation to their health and training results. The research will hopefully give athletes and coaches a more nuanced picture of possible side effects.”

In collaboration with colleagues from the University of Copenhagen and the University of Southern Denmark, the researchers behind the study are now investigating how physical performance, the immune system and metabolism are affected by insufficient energy intake. They hope to one day be able to determine whether there is a difference between the way women’s and men’s bodies respond to insufficient energy intake.

Does headgear prevent sports-related concussions? A systematic review and meta-analysis of randomized controlled trials involving 6311 players and 173,383 exposure hours.

Al Attar WSA, Mahmoud H, Alfadel A, Faude O. Sports health. May 19, 2023: 19417381231174461. doi: 10.1177/19417381231174461. E-publishing prior to printing. PMID: 37204092.

Full text not freely available

Take home message

Headgear worn by young football or rugby players cannot reduce the incidence of sports-related concussions.

Background

Protective headgear reduces the risk of facial and dental injuries; However, there is inconsistent research supporting the rate at which they prevent sports-related concussions.

Study aim

In this systematic review, the authors identified and summarized findings from three randomized control trials evaluating whether headgear effectively reduces the incidence of sports-related concussions.

Methods

The authors systematically searched five databases to identify randomized control trials that evaluated the extent to which headgear prevented sports-related concussions. All control groups wore no headgear. The authors recorded exposure hours and number of players to calculate injury rates and document compliance.

Results

The 3 studies had an ‘average’ to ‘good’ methodological quality on the PEDro scale. The primary outcome assessed in each study was the rate of sports-related concussions per group (headgear vs. no headgear/control). The aggregated results include 6,311 players and 173,383 exposure hours. The authors found that headgear did not prevent concussions in football or rugby. Compliance was variable between studies (99.6%, 46% and not measured in one study).

Viewpoints

The authors of this systematic review concluded that the risk of sports-related concussion was virtually identical in the group with or without headgear. It should be noted that the rugby trials exclusively involved young men. While the football trials involved women, the study focused on 14- to 16-year-olds. Therefore, it is unclear how headgear performs among older athletes and female rugby players. The authors also found that compliance was quite variable. One football study had high adherence, while one rugby study had low adherence. It would be useful to understand whether differences in compliance are related to different strategies to promote compliance, differences in sport, or personal preferences for headgear styles. Understanding what worked in football but not in rugby could help identify strategies to promote good compliance.

Clinical implications

Medical professionals should not promote the wearing of headgear for football and rugby athletes to prevent concussion. Instead, medical professionals should promote concussion education on what can prevent a concussion, such as proper form (e.g., keeping head up while dribbling/being aware of surroundings) and proper tackling technique in rugby (e.g., not using head). .

Questions for discussion

Do you encourage headgear in sports such as football and rugby? Does this systematic review change your position? Why or why not?

related posts

1. Headgear can reduce concussion risk in high school lacrosse
2. Aftermarket helmet add-ons don’t add up
3. Women are not only at increased risk for concussions, but also for more severe concussions
4. A Closer Look at Concussions 2016-2020: Increasing Prevalence and Gender Differences

Written by Jane McDevitt
Reviewed by Jeffrey Driban

The findings – from emergency room visits at children’s hospitals in Canada and the United States – show that IQ and intelligence are not affected in a clinically meaningful way by pediatric concussions.

The study compares 566 children with concussions to 300 children with orthopedic injuries. The children range in age from eight to sixteen years and were recruited from two cohort studies. The Canadian cohort includes data collected from five children’s hospital emergency departments, including Alberta Children’s Hospital in Calgary, along with those in Vancouver, Edmonton, Ottawa and Montreal (CHU Sainte-Justine). In Canadian hospitals, patients completed IQ tests three months after injury.

The US cohort was conducted at two children’s hospitals in Ohio, where patients completed IQ tests three to 18 days after injury.

“There is clearly a lot of concern about the effects of concussion on children, and one of the biggest questions is whether or not it affects a child’s overall intellectual functioning,” says Dr. Keith Yeates, PhD, a professor at the University of Calgary. Psychology and senior author of the Pediatrics paper. Yeates is a renowned expert on the effects of brain disorders in children, including concussion and traumatic brain injury.

“The data on this is mixed and opinions within the medical community vary,” says Yeates. “It is difficult to collect large enough samples to confirm a negative finding. The absence of a difference in IQ after a concussion is more difficult to prove than the presence of a difference.”

Combining the Canadian and American cohorts yielded the Pediatrics studied an abundant sample and it allowed Yeates and his co-authors – from universities in Edmonton, Montreal, Vancouver, Ottawa, Atlanta, Utah and Ohio, along with Mount Royal University in Calgary – to study patients with a wide range of demographic characteristics to test and clinical characteristics.

“We looked at the patient’s socio-economic status, gender, severity of injuries, history of concussion and whether there was loss of consciousness at the time of injury,” says Yeates. “None of these factors made a difference. Across the board, concussion was not associated with lower IQ.”

The children with concussion were compared to children with orthopedic injuries other than concussion to control for other factors that might influence IQ, such as demographic background and the experience of trauma and pain. This allowed the researchers to determine whether the children’s IQs were different than expected, minus the concussion.

The study’s findings are important to share with parents, says Dr. Ashley Ware, PhD, professor at Georgia State University and lead author of the paper. While the Pediatrics research was underway, Ware was a Killam Postdoctoral Fellow at UCalgary, where Yeates was her supervisor.

“Understandably, there is a lot of fear among parents when it comes to their children’s concussions,” says Ware. “These new findings offer really good news, and we need to get the message across to parents.”

Dr. The paper’s co-author Stephen Freedman, PhD, professor of pediatrics and emergency medicine at the Cumming School of Medicine, agrees. “It’s something doctors can tell children who have suffered a concussion, and their parents, to help reduce their fears and concerns,” says Freedman. “It is certainly reassuring to know that concussions do not lead to changes in IQ or intelligence.”

Another power of the Pediatrics research is that includes the two cohort studies, one testing patients within days of their concussion and the other after three months.

“That makes our claim even stronger,” says Ware. “We can show that even in the first days and weeks after a concussion, when children show symptoms such as pain and slow processing speed, their IQ is not affected. Then it’s the same story three months later, when most children have recovered.” This study allows us to say that we consistently do not expect IQ to decline from the time children are symptomatic to the time they have recovered.”

She adds: “It’s a nice ‘rest in peace’ message for the parents.”

Effectiveness of injury prevention programs with core muscle strengthening exercises to reduce the incidence of hamstring injuries in football players: a systematic review and meta-analysis.

Al Attar WSA and Husain MA. Sports Health. 2023 [Epub Ahead of Print].

Full text freely available

Take home message

Injury prevention programs with core muscle strengthening exercises reduce the risk of hamstring injuries in football players.

Background

Football players are at risk for many lower limb injuries, especially hamstring injuries. Many researchers have shown that injury prevention programs, which often include core muscle strengthening exercises, can reduce the risk of lower extremity injuries. However, it remains unclear whether injury prevention programs that include core muscle strengthening exercises effectively reduce the risk of hamstring injuries.

Study aim

The researchers completed a systematic review and meta-analysis to investigate whether an injury prevention program, including core strengthening exercises, reduces the number of hamstring injuries.

Methods

Researchers conducted an extensive literature review of randomized clinical trials involving (1) injury prevention training programs that included core strengthening exercises, (2) an outcome measure for the number of hamstring injuries, (3) a control comparison, and (4) football players of any type. level. Two researchers evaluated the risk of bias among the included studies.

Results

The authors analyzed five studies. One study was a randomized controlled trial, while the others were cluster randomized controlled trials. Each trial included 209 to 1,892 participants, for a total of 4,485 participants across all studies. Participants completed the injury prevention programs for 10 weeks to 8 months and had compliance rates ranging from 21% to 91%. Three of the five studies were considered to be at low risk of bias. Across all studies, 171 hamstring injuries were recorded during 379,102 exposures. Overall, completing an injury prevention training program that included core strengthening exercises (e.g. FIFA 11+) resulted in a 47% reduction in hamstring injuries compared to the control group (typically a standard warm-up program).

Viewpoints

Overall, this study supports the implementation of an injury prevention program involving core muscle strengthening exercises to reduce the risk of hamstring injuries in football players. Although this finding is useful to many physicians, gaps remain. For example, the low number of studies that met the inclusion criteria limits our confidence in the results. For example, although we estimate that these prevention programs reduce the risk of hamstring injuries by 47%, we can only be confident that the actual risk reduction likely ranges from 2% to 72%. More studies and a larger sample size would help us better understand how effective these programs are in reducing the risk of hamstring injuries. The studies also did not use identical interventions. While this may frustrate some people because we can’t say we have to do this specific program, it can also reassure us that we may have some flexibility to customize programs for each team and still experience the benefits. Ultimately, injury prevention programs that include core strengthening exercises are low risk and low cost and can help reduce the risk of injuries, especially hamstring injuries.

Clinical implications

Clinicians should encourage football teams to use injury prevention training programs that include core muscle strengthening exercises. These programs are often low riskcheapand completed in less than 15 minutes.

Questions for discussion

What do you look for when evaluating injury prevention programs for implementation? Have you specifically looked for core strengthening in the past? Why or why not?

Written by Kyle Harris
Reviewed by Jeffrey Driban

related posts

Exercises that target specific hamstring muscle groups
Clinical Findings Triumph baseline MRI findings in predicting hamstring re-injury shortly after return to play
Another feather in the cap of the FIFA 11+ Injury Prevention Program
FIFA 11+ reduces the risk of injuries for football players

Through Mike Basten PT, DPT, MTC

Over the past two decades, more and more states have provided patients with pain with direct access to physical therapy without a physician referral. Although the state of Arizona has offered this type of access for several years, insurance companies have only recently begun paying for physical therapy without a doctor’s referral. Direct access is just one of many reasons why you should look into physical therapy first. There are many more.

There is increasing data showing that seeing a physical therapist first can reduce costs and improve the overall outcome of injury rehabilitation. The American Physical Therapy Association (APTA) just published a groundbreaking study: ‘The economic value of physical therapy in the United States,’ confirming that physical therapy (PT) can help Americans live better lives while saving the healthcare system millions of dollars annually.

Historically, the process from injury to recovery has involved seeing a doctor, trying medications, receiving diagnostic imaging, resting, and hoping for a resolution. If the problem was not resolved, the next step was to try physical therapy and perhaps some type of medical intervention such as injections or surgery. However, due to the rising costs of medical care, insurance companies and patients have started looking for methods to reduce the costs of rehabilitation. One of these methods is to first try PT for musculoskeletal problems.

Top three reasons to seek PT for pain first

1. Reduce or eliminate pain without drugs or opioids.

Physiotherapy offers the opportunity to reduce or eliminate pain through specific therapeutic exercises and hands-on manual therapy techniques. Additional treatments such as ultrasound, electrical stimulation, and taping techniques can also reduce pain during recovery.

Physiotherapy has come a long way in the past 20 to 25 years, as have the patients it helps. Due to costs and other factors, the goal now is to solve the problem as quickly as possible with as little use of health care as possible. PT allows the therapist to treat the cause of the pain early and begin rehabilitation by restoring the correct mechanisms that may be causing the pain.

A 2018 study analyzed 200,000 commercial and Medicare Advantage insurance beneficiaries seeking treatment for low back pain. It found that those who were initially referred by a physical therapist, chiropractor, or acupuncturist, compared to those who had an index visit by a primary care provider, reduced the likelihood of early opioid use by 85%-91% and long-term opioid use by 73% reduced. %-78%.

2. Savings on diagnostics

Being able to go straight to physiotherapy is cost-effective. For example, a patient avoids paying to see a doctor for a referral, and the doctor may order expensive diagnostic tests before determining that PT is the appropriate treatment method. A qualified therapist will work to avoid unnecessary diagnostics during your recovery, which can increase out-of-pocket costs and affect your long-term well-being. They will also work with your doctor to explore pre-surgery, post-surgery, and non-surgery options for a full recovery.

If physical therapy can address the reasons contributing to the pain, in many cases you can avoid surgery altogether. If you do need surgery, preoperative physical therapy can improve mobility and strength and help you get into better shape, allowing you to recover from surgery faster and with better results more easily with postoperative physical therapy.

When we look at patients who went to physical therapy first, there was an average savings of over $250 in one study and over $1,000 in another. Overall, there were significant savings across the board with less imaging, less medication, and even less treatment.

3. Improve mobility.

If you have difficulty standing, walking, or with transitions, such as moving from a sitting to a standing position, exercises to improve flexibility and strength can improve your ability to move more easily, making daily activities more enjoyable. Physical therapists can help you identify areas where you’re not moving correctly, predisposing you to future injuries, and correcting those movements to keep you injury-free. A PT can also instruct and fit you for an assistive device such as a cane, crutches, or other aids designed to improve your mobility.

PTs are also trained to recognize when physical therapy is needed not the correct or best first course of action and can point patients in the best direction. The physician-PT team is still the standard in treating musculoskeletal problems and guiding people with pain to a full recovery.

The search for full recovery is a journey without shortcuts and without a finish line. A journey that will lead to astonishing and satisfying results. At Foothills Sports Medicine Physical Therapy, our therapists embrace the journey. We take you, your pain and your full recovery seriously and do not believe that a good enough recovery is good enough. We strive to do everything we can to help you regain your full, healthy life.

If you have questions about immediate access to physical therapy, contact the Foothills Sports Medicine Physical Therapy clinic nearest you and schedule a free pain assessment.

The literature search was led by Dr. Kristian Goulet of the University of Ottawa’s Faculty of Medicine and the Children’s Hospital of Eastern Ontario (CHEO) calls on provincial and territorial governments to mandate schools – including those involved in school sports – and sports organizations to establish policies and protocols set, update and enforce to prevent concussions, with a sharp emphasis on body contact.

Currently, hockey organizations in Canada allow body contact in competitive and recreational leagues from the age of 13. But studies have shown that when body contact is initiated, injuries increase significantly, including concussions.

Nearly half of hockey injuries are caused by body checks, with injury rates four times higher for children and teens in leagues where body checks are allowed. Other studies have shown that concussions are reduced by more than 50% when body contact is eliminated. An estimated 200,000 concussions occur in Canada each year, mainly affecting children and youth. Ice hockey is the leading cause of all sports and recreation-related brain injuries in pediatric age groups, in both boys and girls.

Dr. Goulet is hopeful that this review will prompt Hockey Canada to forge a new path forward to strengthen our understanding of concussion and guidance for clinical management, especially as it relates to acute care, ongoing symptoms and prevention.

“Sports are incredibly important to the mental, physical, emotional and social health of our children. However, it is our duty as caregivers, parents, coaches, administrators and decision makers that we make every reasonable effort to make sports as safe as possible,” says Dr. Goulet, an assistant professor at the Ottawa School of Medicine and the medical director of the CHEO Concussion Clinic, the Eastern Ontario Concussion Clinic and the Pediatric Sports Medicine Clinic of Ottawa.