Understanding the first injury in athletics and its effect on dropout from sport: an online survey on 544 high-level youth and junior athletics (track and field) athletes.

Objective: To describe the first injury and to investigate whether it plays a role in altering athletics' sustainable practice. Methods: We conducted a cross-sectional study using an exploratory survey on the first injury and its consequences on athletics practice. In 2021, we asked all high-level athletes licensed with the French Federation of Athletics (FFA) under 18 years, under 20 years and under 23 years categories between 2007 and 2021. Results: Out of 6560 emails sent by FFA, 544 athletes responded, and 93.6% (n=510) reported experiencing at least one injury during their career. The first injury occurred at a mean age of 17.5±3.3 years after 6.1±4.1 years of athletics practice. The main locations of the first injury were the posterior thigh (28.9%), the ankle (16.5%) and the knee (12.6%), and the principal reported injury types were muscle (37.7%), tendon (17.5%) and ligament (15.5%). More than a third of injured athletes (36.7%) reported experiencing ongoing symptoms or sequelae after their first injury, and about half (48.5%) experienced recurrences. About 20% had stopped athletics at the time of the survey, with injury problems the primary cause of athletes dropping out (46.2%), including the first injury (9.4%). Conclusions: Injuries played an important role in altering sustainable athletics practice, with injury accounting for about 50% of all reported dropouts and the first injury accounting for about 10% of all reported causes. Our results provide evidence to target the prevention of the first injury, which could be considered the origin of the 'vicious circle' of injuries.

Hamstring Muscle Injuries and Hamstring Specific Training in Elite Athletics (Track and Field) Athletes.

OBJECTIVE: We aimed to describe hamstring muscle injury (HMI) history and hamstring specific training (HST) in elite athletes. A secondary aim was to analyse the potential factors associated with in-championships HMI. METHODS: We conducted a prospective cohort study to collect data before and during the 2018 European Athletics Championships. Injury and illness complaints during the month before the championship, HMI history during the entire career and the 2017-18 season, HST (strengthening, stretching, core stability, sprinting), and in-championship HMI were recorded. We calculated proportions of athletes with HMI history, we compared HST according to sex and disciplines with Chi2 tests or ANOVA, and analysed factors associated with in-championship HMI using simple model logistic regression. RESULTS: Among the 357 included athletes, 48% reported at least one HMI during their career and 24% during the 2017-18 season. Of this latter group, 30.6% reported reduced or no participation in athletics' training or competition at the start of the championship due to the hamstring injury. For HST, higher volumes of hamstring stretching and sprinting were reported for disciplines requiring higher running velocities (i.e., sprints, hurdles, jumps, combined events and middle distances). Five in-championship HMIs were recorded. The simple model analysis showed a lower risk of sustaining an in-championships HMI for athletes who performed more core (lumbo-pelvic) stability training (OR = 0.49 (95% CI: 0.25 to 0.89), p = 0.021). CONCLUSIONS: Our present study reports that HMI is a characteristic of the athletics athletes' career, especially in disciplines involving sprinting. In these disciplines, athletes were performing higher volumes of hamstring stretching and sprinting than in other disciplines. Further studies should be conducted to better understand if and how HST are protective approaches for HMI in order to improve HMI risk reduction strategies.

French Athletics Stakeholders' Perceptions of Relevance and Expectations on Injury Prevention.

This study aimed to explore how stakeholders in athletics perceive the relevance of injury prevention, determine their communication preferences, and describe their expectations regarding injury prevention. We conducted a cross-sectional study using an exploratory online survey with high-level athletes (i. e. listed by the French ministry of sports), non-high-level athletes (i. e. all competitive level except high-level athletes), coaches, and health professionals licensed with the French Federation of Athletics. The survey was composed of three parts regarding stakeholder's characteristics (4 questions), perceived relevance (2 questions), communication preferences and expectations (3 questions) towards injury prevention. There were 2,864 responders to the survey. Almost all responders found that injury prevention is relevant (97.7% [95% CI 97.0% to 98.2%]), without any significant differences in the distribution between stakeholders' age, experience and sex (p>0.05). About three-quarters of the stakeholders preferred to find injury prevention information on a website (77.4%) without significant differences between stakeholders' categories (p>0.05); other media to find injury prevention information was chosen by less than 50% of responders. Expectations about injury prevention were mainly explanations, advice and tips about injury knowledge, management and prevention, based on expert opinion and/or scientific research. In conclusion, these results confirm that injury prevention is a challenge shared by numerous stakeholders in athletics, within France, and provide some orientation on how and what information to disseminate to these stakeholders.

Correlation of Isokinetic Testing and ACL Failure With the Short Graft Tape Suspension Technique at Six Months.

Purpose: The objective of this study was to correlate the data of the 6-month postoperative isokinetic muscle evaluation before resuming sports activities with the occurrence of ACL reconstruction rerupture after semitendinosus short graft. Methods: From 2015 to 2018, all patients who were operated for an ACL reconstruction with a short semitendinosus autograft (TLS System) and who performed isokinetic tests on dynamometer at their 6th postoperative month were included in this study. The follow-up was prospective with the measurement of epidemiological, radiographic, and isokinetic parameters at 6 months of the ACL reconstruction. The cohort was divided into 2 groups: one group without an ACL reconstruction rerupture (Group 1) and the second group with a rerupture (Group 2). Results: One hundred and four patients were analyzed with an average follow-up of 42.3 months (Minimum: 24; Maximum: 63.5), of which 11 patients (10.6%) had an ACL reconstruction rerupture. Group 1 consisted of 93 patients with an average age of 26.5 ± 9.0 years old who did not have an ACL reconstruction rerupture with an average follow-up of 41.6 ± 12.1 months. Group 2 consisted of 11 patients with an average age of 22.7 ± 6.1 years old, who had an ACL reconstruction rerupture with an average follow-up of 44.8 ± 11.3 months. Concerning extension force recovery, the ratio between operated and healthy knee was 81.8% ± 32.0 for Group 1, and 53.4% ± 20.6 for Group 2 (P = .035). A statistically significant difference was also found (P = .0017) during 60°/s flexion isokinetic test between the two groups. Conclusions: This study revealed a significant link between muscle weakness in flexion and extension during 60°/s isokinetic test at 6 months of ACL reconstruction and semitendinosus autograft rerupture. Patients with an ACL reconstruction retear had inferior muscle dynamometric recovery results at 6 months before resuming sports activities. Level of Evidence: Level III, prognostic, retrospective cohort study.

The Athletics Injury Prevention Programme Can Help to Reduce the Occurrence at Short Term of Participation Restriction Injury Complaints in Athletics: A Prospective Cohort Study.

We aimed to determine whether an Athletics Injury Prevention Programme (AIPP), targeting the most common athletics injuries, can reduce the occurrence of injury complaints that lead to restrictions in athletics participation (participation restriction injury complaints) in the short (12 weeks) and long (40 weeks) terms. For our 40-week prospective cohort study (level of evidence 2), we invited inter-regional and national-level athletes to regularly perform the AIPP, which included 8 exercises addressing core stability, hamstring, leg and pelvic muscles strengthening and stretching, and balance exercises. A Cox regression was used to analyse the influence of AIPP on the occurrence of participation restriction injury complaint, adjusted to sex, age, height, body mass, discipline, and history of injury complaints during the preceding season, individual response rate, mean weekly training time, mean weekly number of competition, presented by hazard ratio (HR) with 95% confidence interval (95% CI). At 12 weeks (n = 62 athletes), the AIPP was significantly associated with a lower risk of participation restriction injury complaint HR = 0.36 (95%CI: 0.15 to 0.86), p = 0.02 and HR = 0.29 (95%CI: 0.12 to 0.73), p = 0.009, with cumulative weeks and cumulative training time as time scale, respectively, while at 40 weeks (n = 53 athletes) there was no significant association. An 8-exercise injury prevention programme can effectively help to reduce occurrence of injury complaints that would restrict an athlete's participation in athletics in the short term.

Ten Tips to Hurdle the Injuries and Illnesses During Major Athletics Championships: Practical Recommendations and Resources.

Participating or winning a medal in major track and field (athletics) competitions is the goal of every athlete. However, health problems can impair sports performance and affect this dream. Therefore, we present ten tips to help hurdle the challenges of illness/injury at major athletics championships: (1) Prepare for travel (medical checking, vaccine, time-zone, jet lag, culture, food habits…), (2) Respect athlete characteristics and discipline specificity (sex, endurance/explosive), (3) Educate athletes and their entourages regarding prevention, (4) Vigilance of painful symptoms and subclinical illness markers, (5) Avoid infection risk (washing hands, safe food and drink, avoid contact with sick people…), (6) Train appropriately and optimally (physical conditioning, technical training, load management, and psychological preparation), (7) Health status (history of previous injuries, well-being in the month before championships), (8) Lifestyle (good sleep, regular hydration and nutrition with safe water/food, regular fruits and vegetables, improve recovery strategies…), (9) Environmental considerations (heat, cold, air cleaning, changes or climatic conditions…), (10) Safety (equipment, rules, own-practice in athletics, and extra-sport activities). These ten tips "PREVATHLES" are based on our field experience in addition to existing epidemiological and experimental literature in athletics and other sports. Although there is currently no scientific evidence for their efficacy, sound judgement, and logical practice provide a strong basis, and given the low risk of using them in the benefit/risk balance, we suggest athletes and those around them follow these ten tips to limit the impact of injury/illness on championship performance.

Electronic data capture on athletes' pre-participation health and in-competition injury and illness at major sports championships: An extended usability study in Athletics.

This study set out to identify factors critical for the usability of electronic data collection in association with championships in individual sports. A qualitative analysis of electronic data collection system usability for collection of data on pre-participation health from athletes and in-competition injury and illness from team physicians was performed during the 2013 European Athletics Indoor Championships. A total of 15 athletes and team physicians participated. Athletes were found to experience few problems interacting with the electronic data collection system, but reported concerns about having to reflect on injury and illness before competitions and the medical terminology used. Team physicians encountered problems when first navigating through the module for clinical reporting, but they were not subjected to motivational problems. We conclude that athletes' motivation to self-report health data and the design of the human-computer interface for team physicians are key issues for the usability of electronic data collection systems in association with championships in individual sports.

Extending in-competition Athletics injury and illness surveillance with pre-participation risk factor screening: A pilot study.

OBJECTIVES: To explore the performance of retrospective health data collected from athletes before Athletics championships for the analysis of risk factors for in-competition injury and illness (I&I). METHODS: For the 2013 European Athletics Indoor Championships, a self-report questionnaire (PHQ) was developed to record the health status of 127 athletes during the 4 weeks prior to the championship. Physician-based surveillance of in-competition I&I among all 577 athletes registered to compete was pursued during the championships. RESULTS: 74 athletes (58.3%) from the sample submitted a complete PHQ. 21 (28%) of these athletes sustained at least one injury and/or illness during the championships. Training more than 12 h/week predisposed for sustaining an in-competition injury, and a recent health problem for in-competition illness. Among the 577 registered athletes, 60 injuries (104/1000 registered athletes) were reported. 31% of injuries were caused by the track, and 29% by overuse. 29 illnesses were reported (50/1000 registered athletes); upper respiratory tract infection and gastro-enteritis/diarrhoea were the most reported diagnoses. CONCLUSIONS: Pre-participation screening using athletes' self-report PHQ showed promising results with regard to identification of individuals at risk. Indoor injury types could be attributed to extrinsic factors, such as small track size, track inclination, and race tactics.

Analyses of Helsinki 2012 European Athletics Championships injury and illness surveillance to discuss elite athletes risk factors.

OBJECTIVE: To further analyze newly incurred injuries and illnesses (I&Is) during Athletics International Championships to discuss risk factors. DESIGN: Prospective recording of newly occurred injuries and illnesses. SETTING: The 2012 European Athletics (EA) Championships in Helsinki, Finland. PARTICIPANTS: National team and local organizing committee physicians and physiotherapists and 1342 registered athletes. MAIN OUTCOME MEASURES: Incidence and characteristics of new injuries and illnesses. RESULTS: Ninety-three percent of athletes were covered by medical teams, with a response rate of 91%. One hundred thirty-three injuries were reported (incidence of 98.4 injuries per 1000 registered athletes). Sixty-two injuries (47%) resulted in time loss from sport. The most common diagnosis was hamstring strain (11.4% of injuries and 21% of time-loss injuries). Injury risk was higher in males and increased with age. The highest incidences of injuries were found in combined events and middle- and long-distance events. Twenty-seven illnesses were reported (4.0 illnesses per 1000 athlete days). The most common diagnoses were upper respiratory tract infection (33.3%) and gastroenteritis/diarrhea (25.9%). CONCLUSIONS: During outdoor EA Championships, injury and illness incidences were slightly lower and injury characteristics were comparable with those during outdoor World Athletics Championships. During elite athletics Championships, gender (male), age (older than 30 years), finals, and some events (combined events and middle- and long-distance races) seem to be injury risk factors. Illness risk factors remain unclear. As in previous recommendations, preventive interventions should focus on overuse injuries, hamstring strains, and adequate rehabilitation of previous injuries, decreasing risk of infectious diseases transmission, appropriate event scheduling, sports clothes, and heat acclimatization.

Determination of future prevention strategies in elite track and field: analysis of Daegu 2011 IAAF Championships injuries and illnesses surveillance.

OBJECTIVE: To determine the incidence and characteristics of newly incurred injuries and illnesses during international Athletics Championships, by improving the medical surveillance coverage, in order to determine future prevention strategies. DESIGN: Prospective recording of newly occurred injuries and illnesses. SETTING: 13th International Association of Athletics Federations World Championships in Athletics 2011 in Daegu, Korea. PARTICIPANTS: National team and Local Organising Committee physicians; and 1851 registered athletes. MAIN OUTCOME MEASURES: Incidence and characteristics of newly incurred injuries and illnesses. RESULTS: 82% of athletes were covered by medical teams participating with a response rate of 94%. A total of 249 injuries were reported, representing an incidence of 134.5 injuries per 1000 registered athletes, and 119 (48%) resulted in time loss from sport. A total of 185 injuries affected the lower limb (74%). Hamstring strain was the main diagnosis and 67% resulted in absence from sport. Overuse (n=148; 59%) was the predominant cause. A total of 126 illnesses were reported, signifying an incidence of 68.1 per 1000 registered athletes. Upper respiratory tract infection was the most common reported diagnosis (18%), followed by exercise-induced dehydration (12%), and gastroenteritis/diarrhoea (10%). The highest incidences of injuries were found in combined events and middle and long-distance events, and of illness in race walking events. CONCLUSION: During elite Athletics World Championships, 135 injuries, 60 time-loss injuries and 68 illnesses per 1000 registered athletes were reported. Higher risks of injuries were found in combined events and long-distance runs. Preventive interventions should focus on overuse injuries and hamstring strains, decreasing the risk of transmission of infectious diseases, appropriate event scheduling and heat acclimatisation.

[What illegal substances are used by sportsmen? a study in Midi-Pyrénées Doping Preventing Medical Centre (AMPD-MP)]. / Consommation de substances interdites chez le sportif: étude à l'Antenne Médicale de Prévention du Dopage de Midi-Pyrénées (AMPD-MP).

OBJECTIVE: Doping Preventing Medical Centres (Antennes Médicales de Prévention du Dopage) were established in France in 2000 in order to help sportsmen using illegal substances. These services are also information centres on illegal substances (drugs or others) used in sport. The aim of the study was to analyze the characteristics of sportsmen outpatient clinics in Antenne Médicale de Prevention du Dopage Midi-Pyrénées (AMPD-MP). METHODS: We present the results of outpatient clinics in AMPD-MP from 2002 to 2008. A descriptive analysis of demographic data, substances used and sports practised were performed. RESULTS: During this 7 year-period, 35 outpatient clinics were performed [32 men, 3 women, mean age: 28 years (extreme values: 18-47; 10 patients ≥ 30 years)]. They were mainly involved in national (16), international (8) or regional (7) competitions. The main sports involved were rugby (9) followed by cycling (5), athletics (3) and body-building (3). The most frequently used illegal substances were cannabis (15) followed by glucocorticoïds (9), androgens (4), indirect sympathomimetics amphetaminics (4), beta 2 adrenergic agonists (2) and NSAIDs (2). Two veterinary substances (clenbuterol, boldone-veterinaire) were also found in body-builders. CONCLUSION: This study shows a clear under use of Doping Preventing Medical Centres by sportsmen and practitioners. It also indicates a relative high age for sportsmen referred to the centre. The main sports involved were rugby and cycling. Cannabis and glucocorticoïds were the drugs more often involved in doping behaviours.

Effects of Ramadan fasting on physical performance and metabolic, hormonal, and inflammatory parameters in middle-distance runners.

The Ramadan fasting (RF) period is associated with changes in sleep habits and increased sleepiness, which may affect physical performance in athletes, and may induce metabolic, hormonal, and inflammatory disturbances. In 8 middle-distance athletes (25.0 +/- 1.3 years), a maximal aerobic velocity (MAV) test was performed 5 days before RF (day -5), and on days 7 and 21 of RF. The same days, saliva samples were collected to determine cortisol and testosterone concentrations before and after the MAV test. Blood samples were collected before RF (P1), at the end of RF (P2), and 1 week post RF (P3). Plasma levels of interleukin (IL)-6, a mediator of sleepiness and energy availability, were determined. We also evaluated changes in metabolic and hormonal parameters, mood state, and nutritional and sleep profiles. During RF, mean body mass and body fat did not statistically change. Compared with day -5, MAV values decreased at days 7 and 21 (p < 0.05, respectively), while testosterone/cortisol ratio values did not change significantly. Nocturnal sleep time and energy intake were lower at day 21 than before RF (day 0/P1) (p < 0.05). At the end of RF (day 31), the fatigue score on the Profile of Mood States questionnaire was increased (p < 0.001). For P2 vs. P1, IL-6 was increased (1.19 +/- 0.25 vs. 0.51 +/- 0.13 pg.mL-1; p < 0.05), melatonin levels were decreased (p < 0.05), and adrenalin and noradrenalin were increased (p < 0.01 and p < 0.001, respectively). At 7 days post RF, all parameters recovered to pre-RF values. In conclusion, RF is accompanied by significant metabolic, hormonal, and inflammatory changes. Sleep disturbances, energy deficiency, and fatigue during RF may decrease physical performance in Muslim athletes who maintain training. Reduction of work load and (or) daytime napping may represent adequate strategies to counteract RF effects for Muslim athletes.

The use of dietary supplements by athletes.

Many athletes use dietary supplements as part of their regular training or competition routine, including about 85% of elite track and field athletes. Supplements commonly used include vitamins, minerals, protein, creatine, and various "ergogenic" compounds. These supplements are often used without a full understanding or evaluation of the potential benefits and risks associated with their use, and without consultation with a sports nutrition professional. A few supplements may be helpful to athletes in specific circumstances, especially where food intake or food choice is restricted. Vitamin and mineral supplements should be used only when a food-based solution is not available. Sports drinks, energy bars, and protein-carbohydrate shakes may all be useful and convenient at specific times. There are well-documented roles for creatine, caffeine, and alkalinizing agents in enhancing performance in high-intensity exercise, although much of the evidence does not relate to specific athletic events. There are potential costs associated with all dietary supplements, including the risk of a positive doping result as a consequence of the presence of prohibited substances that are not declared on the label.