Contemporary Issue: Health and Safety of Female Wrestlers.

ABSTRACT: Female wrestling has grown exponentially over the past decade. Within the United States, 46 states now recognize female high school wrestling, and 153 colleges have programs. It is on track to become an NCAA championship-level sport in 2026. A primary health and safety risk among this cohort pertains to rapid weight loss strategies. These can lead to intentional caloric restriction and decreased body fatness, with the perceived goal of attaining a competitive advantage. Low energy availability and low body fatness are associated with a number of health concerns including menstrual dysfunction and loss of bone mineral density in girls and women. The current recommendation of 12% as a minimum for percentage body fat is very likely too low, opening the door for health perturbations among this population. The minimum threshold might more appropriately fall within the range of 18% to 20%. Body fat assessment methods, primarily skinfold measures that are used to guide weight class selection, have not been adequately validated among this population and therefore should be an area of research focus, while also exploring alternative assessment techniques. Further, we recommend that weight cycling, restrictive energy intake, and intentional dehydration be avoided. Research should assess the effects of frequent weight cycling (to "make weight") and prolonged periods of low body fat on the reproductive and bone health of these athletes. Finally, research and clinical evaluations on female wrestlers are limited, and we offer a list of research priorities for future investigation into this contemporary issue.

Fellows' Perspective of Educational Changes in Medical Sports Medicine During the COVID-19 Pandemic.

Background As a result of the coronavirus disease 2019 (COVID-19) pandemic, graduate medical education, along with most of daily life, was disrupted. The goal of this study was to explore the experiences of fellows in primary care/medical sports medicine (MSM) and view the changes made to training programs through their eyes. Methodology A questionnaire was developed to collect qualitative and quantitative data regarding the fellow's experiences in training from March to June 2020. Fellows on the American Medical Society for Sports Medicine list of current Sports Medicine Fellows in the United States and Canada were invited to participate. Of the 329 invited, 90 (27.4%) fellows returned questionnaires. Results MSM fellows highlighted positive adaptations as well as losses to their educational programs related to the pandemic. The biggest gain reported was additional learning time, and the greatest loss was to sports and event coverage. Most fellows reported attending collaborative sessions, and they noted an increase in didactics compared to pre-pandemic levels. The largest losses were noted in event coverage and training room exposures, with smaller declines in ultrasounds, procedures, and research experiences. They also described challenges, including changing clinical roles, managing social isolation and boredom, and balancing work and family responsibilities. Conclusions Fellows identified gains, losses, and challenges due to pandemic-related changes to their fellowship programs. Fellowship directors and educators in different fields can use this understanding of the fellows' experiences to build on current resources, further develop collaborative efforts, create new educational opportunities, and provide additional support for fellow learning.