Eating Behavior Disorders and Disordered Eating Habits in Spanish High-Performance Women's Olympic Wrestling Athletes.

Eating disorders (EDs) are a significant health issue in combat sports. This study investigated the differences between the different types of female wrestlers and the frequency at which EDs occur in the elite population, and it also sought to establish which factors are predictors of EDs. This study was comprised of 22 elite, female wrestlers who were selected based on the following inclusion criteria: having previously been the Spanish champion, being part of the Spanish national team, participating in at least one international championship, and having a history of ED. Data collection involved five questionnaires: demographic data, the Eating Attitudes Test-26 (EAT-26), the Bulimic Investigatory Test, the Edinburgh (BITE), the Eating Disorders Inventory (EDI-3), and the Depression, Anxiety, and Stress Scale (DASS-21). The results revealed diverse levels of depression, anxiety, and stress, with BITE scores indicating abnormal eating patterns. Group comparisons exposed significant distinctions in eating behaviors based on competition and training experience. Regression analyses showed competition and training experience as predictors of bulimia severity and symptoms. The study revealed prevalent extreme weight-control practices, including fasting, diuretic and laxative use, and binge eating. This research emphasizes the importance of EDs in Olympic wrestling, urging a comprehensive approach involving education, support, and policy implementation by coaches, health professionals, and sports organizations to prioritize athletes' well-being and discourage unhealthy weight-control practices.

Nutritional and Training Strategies for Actual Competition in World-Class Japanese Female Wrestler: A Case Report.

Wrestlers have a risk of relative energy deficiency in sports because they believe that they can gain an advantage over their opponents by temporarily adopting weight-making strategies even women. However, precise methods of making weight and the effect of manipulating body mass (BM) on health and performance in female wrestlers have not been reported. Our study aimed to report a case of weight making in a world-class female wrestler, who won the world competition seven times in 5-y and had oligomenorrhea. We obtained the BM, blood, urine, and saliva samples, hand grip strength, subjective condition a month before the match (baseline), and 3-d before the match (day-3), and food and physical activity records during baseline and 10 d before the competition. The wrestler lost 4.7% of BM from baseline to day-3 and 7.6% of BM to the match by method to reduce energy intake and enhance dehydration. Hand grip strength did not change by weight loss. After weigh-in, the wrestler took the recovery food containing 4.9 g/kg BM of carbohydrate. Although these weight strategies may at least contribute to the success of wrestlers, the impact on health needs to be clarified in future studies.

Outcomes of Shoulder Instability Surgery in Competitive Wrestlers: Outcomes, Reoperations, and Return to Play at 5 Years' Mean Follow-up.

BACKGROUND: Wrestling is a physically demanding sport with young athletes prone to traumatic shoulder instability and a paucity of data evaluating the results of shoulder instability surgery (SIS). PURPOSE: To assess reoperation rates, patient-reported outcomes, and return to wrestling (RTW) after SIS in a cohort of competitive wrestlers. STUDY DESIGN: Case series; Level of evidence, 3. METHODS: All competitive wrestlers with a history of shoulder instability and subsequent surgery at a single institution between 1996 and 2020 were identified. All directions of shoulder instability (anterior shoulder instability [ASI], posterior shoulder instability [PSI], and traumatic multidirectional shoulder instability [TMDI]) were analyzed. Exclusions included revision SIS and <2 years of follow-up. Athletes were contacted for determination of complications, RTW, and Western Ontario Shoulder Instability Index scores. RESULTS: Ultimately, 104 wrestlers were included with a mean age at initial instability of 16.9 years (range, 12.0-22.7 years), mean age at surgery of 18.9 years (range, 14.0-29.0 years), and a mean follow-up of 5.2 years (range, 2.0-22.0 years). A total of 58 (55.8%) wrestlers were evaluated after a single shoulder instability event, while 46 (44.2%) sustained multiple events before evaluation. ASI was the most common direction (n = 79; 76.0%), followed by PSI (n = 14; 13.5%) and TMDI (n = 11; 10.6%). Surgical treatment was most commonly an arthroscopic soft tissue stabilization (n = 88; 84.6%), with open soft tissue repair (n = 13; 12.5%) and open bony augmentation (n = 3; 2.9%) performed less frequently. RTW occurred in 57.3% of wrestlers at a mean of 9.8 months. Recurrent instability was the most common complication, occurring in 18 (17.3%) wrestlers. Revision SIS was performed in 15 (14.4%) wrestlers. Across the entire cohort, survivorship rates free from recurrent instability and revision surgery were 90.4% and 92.5% at 2 years, 71.9% and 70.7% at 5 years, and 71.9% and 66.5% at 10 years, respectively. Preoperative recurrent instability was an independent risk factor for postoperative recurrent instability (hazard ratio, 3.8; 95% CI, 1.33-11.03; P = .012). CONCLUSION: Competitive wrestlers with multiple dislocations before initial clinical evaluation were 3.8 times more likely to experience postoperative recurrent instability. Patients should be counseled that despite SIS, only 57.3% returned to wrestling after surgery.

Collegiate women's wrestling body fat percentage and minimum wrestling weight values: time for revisiting minimal body fat percent?

BACKGROUND: The estimation of body fat percentage (BF%) in wrestling is used to determine the minimum wrestling weight (MWW) and lowest allowable weight class (MWC) in which wrestlers are eligible to compete. A 12% minimum threshold is currently used for women wrestlers, yet a potential increase for safety has been discussed. Because of the novelty of collegiate women's wrestling, there is a paucity of literature available on the body composition norms of this population. The purpose of this study was to provide a descriptive summary of BF% and MWW values of female wrestlers and how MWW values would change with the use of different BF% thresholds. METHODS: Data from the 2022-2023 collegiate season were retrospectively analyzed resulting in a sample of 1,683 collegiate women wrestlers from the National Association of Intercollegiate Athletics (NAIA, n = 868) and the National Collegiate Athletics Association (NCAA, n = 815). All wrestlers completed skinfold assessments for weight certification at the start of the competition season. The skinfold values were used to estimate BF% using the Slaughter skinfold prediction equation. Frequency statistics and descriptive analysis were performed to compute normative MWW and BF% profiles. BF% thresholds of 12% (12MWW) and the BF% value defined as the lowest 5th percentile, which would be considered unusually lean, were used to determine the resulting MWW and MWC for each method. The lowest recorded weight and weight class division throughout the season was also recorded for each wrestler. RESULTS: There was a positively skewed (0.94) and platykurtic (1.86) distribution of MWW values. The median ± interquartile range BF% for all wrestlers was 27.4 ± 10.22%, with 17% BF representing the 5th percentile. Only 354 out of 1,579 (22.4%) wrestlers competed in their lowest allowable weight class, based on the 12MWW. Of these 354 wrestlers, the mean BF% was 21.3 ± 5.2% at weight certification with only n = 17 being at or below 12% body fat and an average weight loss of 11.1 ± 8.8 lbs. from the time of weight certification. Throughout the season, wrestlers competed at weights that were, on average (mean ± SD), 19.4 ± 16.9 lbs. higher than their 12MWW (95% CI: 18.6, 20.2 lbs. p < 0.001; effect size [ES] = 1.1), 13.4 ± 19.0 lbs. higher than the 17MWW (p < 0.001; ES = 0.70), and 8.7 ± 8.3 lbs. lower than their weight at the certification (95% CI: 8.3, 9.1 lbs. p < 0.001; ES = 1.1). CONCLUSIONS: Nearly all BF% values were well above the 12% threshold used to determine MWW. Increasing the minimum BF% threshold from 12% to 17% would affect a small percentage of wrestlers, likely reduce the need for excessive weight cutting, and minimize the deleterious health effects of an athlete at such a low BF%.

Lateral preference in complex combat situations: Prevalence and relationship with general measures of hand and foot preference.

Laterality is considered relevant to performance in combat sports with particular emphasis being placed on fighters' handedness and combat stance. Such approach, however, may fall too short to understand the role of laterality in sports where fighters are allowed to use their hands and feet standing and on the ground. Here, we referred to grappling sports (i) to estimate lateral preferences in selected combat situations and (ii) to test for an association between those preferences and common measures of hand and foot preference. Based on the responses of 135 experienced grapplers who participated in an online questionnaire lateral preference, at the group-level, was revealed in 12 out of 18 combat situations. At an item-level, common measures of lateral preference and grappling-specific lateral preference were related in three out of 36 conditions (footedness only, not handedness). Across items, scores in a grappling-specific laterality index were positively related with foot but not with hand preference scores. Implications for the assessment of lateral preference in combat sports and the use of item-specific terminology in this context are discussed. On a broader scale, we also elaborate on potential consequences of our findings with regard to evolutionary explanations of the maintenance of left-handedness in humans.

Analysis of the effectiveness coefficient in greco-roman fighting athletes at different levels of competition / Análisis del coeficiente de eficacia en atletas de lucha griego-romana en distintos niveles de competición / Análise do coeficiente de efetividade em atletas de luta greco-romana em diferentes níveis de competição

ABSTRACT Introduction: Wrestling is an ancient combat sport, individual and of complex performance, which integrates high technical and tactical complexity, associated with a bioenergetic interaction and a high coordinative pattern. In Brazil, the number of competitors at different levels has increased significantly in the last years, evidencing the need to search for answers that can help coaches in the different situations of the competitive calendar. The prescription of the means and methods of training in Greco-Roman wrestling aims at the development of the technical effectiveness. However, there is no evidence of indicators of technical effectiveness, in Brazilian elite athletes of Greco-Roman wrestling, in national and international competitions. Objectives: The objective of the study was to verify and to compare the technical effectiveness of the wrestlers of Greco-Roman fight of the Brazilian selection, in two competitions: one in the national level and the other international. Methods: Seven athletes of the Brazilian wrestling team participated of the investigation (age: 25±5 years; stature: 175±12 cm; corporal mass: 80± 21kg). Analysis of the effective, not effective and total technique were accomplished. After identifying the normality of the data (SHAPIRO WILKS), the Student's t test was used to compare the variables, according to the moment evaluated, considering the significance level of 5%. Results: The results showed a significant decrease (p = 0.03) in the standing effective technique and in the total effective technique (p = 0.01), comparing the national competition with the international competition. Conclusion: Technical effectiveness of Brazilian wrestlers was found to be below the indices presented in studies with competitors from countries considered to have high world performance. In international competition, it presents a negative impact compared to national events. Level of Evidence IV; Therapeutic Studies - Investigation of Treatment Results.

RESUMEN Introducción: El Wrestling es una modalidad de combate milenaria, individual y de rendimiento complejo, que integra elevada complejidad técnico-táctica, asociada a una interacción bioenergética y un alto patrón coordinativo. En Brasil, el número de competidores en diferentes niveles aumentó significativamente en los últimos años, evidenciando la necesidad en la búsqueda de respuestas que auxilien a los entrenadores en las diferentes situaciones del calendario competitivo. La prescripción de los medios y métodos de entrenamiento en la lucha greco-romana tiene como objetivo el desarrollo de la efectividad técnica. Entre tanto, no hay evidencias de indicadores de efectividad técnica, en atletas de alto rendimiento brasileño en la lucha greco-romana, en competencias nacionales e internacionales. Objetivos: El objetivo de este estudio fue verificar y comparar la efectividad técnica de los atletas de lucha greco-romana de la selección brasileña, en dos competencias: una a nivel nacional y otra internacional. Métodos: Participaron de la investigación siete atletas de la selección brasileña de lucha greco-romana (edad: 25±5 años; estatura: 175±12 cm; masa corporal: 80± 21kg). Fueron realizados análisis de la técnica efectiva, no efectiva y total. Después de identificar la normalidad de los datos (SHAPIRO WILKS), fue utilizado el test de t de Student para la comparación de las variables, según el momento evaluado, considerando el nivel de significación de 5%. Resultados: Los resultados mostraron una disminución significativa (p = 0,03) en la técnica efectiva en pie y en la técnica efectiva total (p = 0,01), comparándose la competencia nacional con la internacional. Conclusión: Se concluyó que la eficacia técnica de los luchadores brasileños está por debajo de los índices presentados en estudios con competidores de países considerados de alto rendimiento mundial. En la competición internacional, presenta un impacto negativo en comparación con los eventos nacionales. Nivel de Evidencia IV; Estudios Terapéuticos - Investigación de Los Resultados Del Tratamiento.

RESUMO Introdução: O Wrestling é uma modalidade de combate milenar, individual e de rendimento complexo, que integra elevada complexidade técnico-táctica, associada a uma interação bioenergética e um alto padrão coordenativo. No Brasil, o número de competidores em diferentes níveis aumentou significativamente nos últimos anos, evidenciando a necessidade da busca de respostas que auxiliem os treinadores nas diferentes situações do calendário competitivo. A prescrição dos meios e métodos de treinamento na luta greco-romana visa o desenvolvimento da efetividade técnica. Entretanto, não há evidências de indicadores de efetividade técnica, em atletas de elite brasileira de luta greco-romana, em competições nacionais e internacionais. Objetivo: o objetivo do estudo foi verificar e comparar a efetividade técnica dos lutadores de luta greco-romana da seleção brasileira, em duas competições: uma no nível nacional e a outra internacional. Métodos: Participaram da investigação sete atletas da seleção brasileira de luta greco-romana (idade: 25±5 anos; estatura: 175±12 cm; massa corporal: 80± 21kg). Foram realizadas análises da técnica efetiva, não efetiva e total. Após identificar a normalidade dos dados (SHAPIRO WILKS), foi utilizado o teste t de Student para a comparação das variáveis, segundo o momento avaliado, considerando nível de significância de 5%. Resultados: Os resultados mostraram uma diminuição significativa (p = 0,03) na técnica efetiva em pé e na técnica efetiva total (p = 0,01), comparando-se a competição nacional com a internacional. Conclusão: Concluiu-se que a efetividade técnica dos lutadores brasileiros está abaixo dos índices apresentados em estudos com competidores de países considerados de alto desempenho mundial. Em competição internacional, apresenta um impacto negativo comparativamente a eventos nacionais. Nível de Evidência IV; Estudos Terapêuticos - Investigação dos Resultados do Tratamento.

Radiological Findings of the Lumbar Spine in High School and Collegiate Sumo Wrestlers.

Background: Sumo wrestling is a traditional sport in Japan and becoming popular worldwide. Risk factors for lower back injuries in sumo wrestlers are heavier weight and larger body mass index (BMI). The mawashi (loincloth belt) worn by sumo wrestlers has been shown to restrict motion of the lumbar spine. Purpose: To study the effects of sumo wrestling on the lumbar spine of high school and freshmen collegiate wrestlers, investigating the relationship between radiological findings, wearing of the mawashi during training, and lower back symptoms. Study Design: Case series; Level of evidence, 4. Methods: From 2001 to 2017, a total of 197 members of the Japanese Sumo Federation (55 high school and 142 college freshman students) underwent routine radiographic examination of their lumbar spines and answered a questionnaire regarding lumbar symptoms. Wrestlers were classified as symptomatic and asymptomatic based on responses to a custom questionnaire. We used the unpaired t test to evaluate patient demographics and the chi square test to analyze radiographic lumbar spine abnormalities between symptomatic and asymptomatic wrestlers. Results: The wrestlers' mean height, weight, BMI, and duration in the sport were 174.0 ± 6.7 cm, 107.1 ± 22.4 kg, 35.2 ± 6.4, and 8.0 ± 3.2 years, respectively. There were 91 participants in the symptomatic group (46.2%) and 106 (53.8%) in the asymptomatic group. Ten wrestlers (5.1%) had osteophyte formations in the lumbar body; 8 of the 11 osteophytes (72.7%) appeared in the upper lumbar spine. Of the total, 48 wrestlers (24.4%) had deformities (Schmorl nodules) in the lumbar body, and 23 of 50 (46.0%) and 10 of 16 (62.5%) deformities were found in the upper lumbar spine of collegiate and high school wrestlers, respectively. Five wrestlers of the total 197 athletes (2.5%) had disc space narrowing in the lumbar body, with 3 of the 5 cases of disc space narrowing (60.0%) found in the upper lumbar spine. Spondylolysis in the lumbar body was found in 25 wrestlers (12.7%); 19 of the 91 symptomatic wrestlers (20.9%) had spondylolysis, compared with 6 of the 106 (5.7%) asymptomatic wrestlers (P = .0028). Conclusion: Almost one-third of sumo wrestlers had ≥1 abnormal radiological finding in the lumbar spine. There was a significant relationship between symptomatic wrestlers and spondylolysis.

SARS-CoV-2 Infection in Wrestlers after International Tournaments, April 2021.

Epidemiologic and genomic investigation of SARS-CoV-2 infections in members of Japan's national wrestling team after participation in international tournaments in 2021 revealed multiple lineages of SARS-CoV-2 not reported in Japan. The attack rate among wrestlers was high. Results suggest possible transmission during matches. We recommend early case detection and response practices.

Validation of skinfold equations and alternative methods for the determination of fat-free mass in young athletes.

Intoduction: To cross-validate skinfold (SKF) equations, impedance devices, and air-displacement plethysmography (ADP) for the determination of fat-free mass (FFM). Methods: Male and female youth athletes were evaluated (n = 91[mean ± SD] age: 18.19 ± 2.37 year; height: 172.1 ± 9.8 cm; body mass: 68.9 ± 14.5 kg; BMI: 23.15 ± 3.2 kg m-2; body fat: 19.59 ± 6.9%) using underwater weighing (UWW), ADP, and SKF assessments. A 3-compartment (3C) model (i.e., UWW and total body water) served as the criterion, and alternate body density (Db) estimates from ADP and multiple SKF equations were obtained. Validity metrics were examined to establish each method's performance. Bioelectrical impedance analysis (BIA), bioimpedance spectroscopy (BIS), and the SKF equations of Devrim-Lanpir, Durnin and Womersley, Jackson and Pollock (7-site), Katch, Loftin, Lohman, Slaughter, and Thorland differed from criterion. Results: For females, Pearson's correlations between the 3C model and alternate methods ranged from 0.51 to 0.92, the Lin's concordance correlation coefficient (CCC) ranged from 0.41 to 0.89, with standard error of the estimate (SEE) ranges of 1.9-4.6 kg. For SKF, the Evans 7-site and J&P 3 Site equations performed best with CCC and SEE values of 0.82, 2.01 kg and 0.78, 2.21 kg, respectively. For males, Pearson's correlations between the 3C model and alternate methods ranged from 0.50 to 0.95, CCC ranges of 0.46-0.94, and SEE ranges of 3.3-7.6 kg. For SKF, the Evans 3-site equation performed best with a mean difference of 1.8 (3.56) kg and a CCC of 0.93. Discussion: The Evans 7-site and 3-site SKF equations performed best for female and male athletes, respectively. The field 3C model can provide an alternative measure of FFM when necessary.

Conservative Management of a Distal Humerus Spiral Fracture Sustained During Arm Wrestling: A Case Report and Literature Review.

Arm wrestling is a popular recreational activity that involves intense and repetitive muscular contractions of the upper extremity. Arm wrestling can result in various musculoskeletal injuries, including bone fractures. Humeral shaft fractures, particularly spiral fractures, are the most common fractures resulting from arm wrestling. Here, we present a case of a 25-year-old male patient who sustained a distal humerus spiral fracture during an arm-wrestling competition. The patient was managed conservatively with external reduction, cast stabilization, and physiotherapy with good outcomes. Despite initial angulation and rotation, the fracture healed well, and the patient regained full function of his arm within eight weeks. This case highlights the biomechanical aspects and risk factors of this type of fracture during arm wrestling and the value of protective measures such as proper technique, training, and protective equipment. It also highlights the potential for conservative management in such cases.

Headguard use in combat sports: position statement of the Association of Ringside Physicians.

Headguard use is appropriate during some combat sports activities where the risks of injury to the face and ears are elevated. Headguards are highly effective in reducing the incidence of facial lacerations in studies of amateur boxers and are just as effective in other striking sports. They should be used in scenarios - especially sparring prior to competitions - where avoidance of laceration and subsequent exposure to potential blood-borne pathogens is important. Headguards are appropriate where avoidance of auricular injury is deemed important; limited data show a marked reduction in incidence of auricular injury in wrestlers wearing headguards.Headguards should not be relied upon to reduce the risk of concussion or other traumatic brain injury. They have not been shown to prevent these types of injuries in combat sports or other sports, and human studies on the effect of headguards on concussive injury are lacking. While biomechanical studies suggest they reduce linear and rotational acceleration of the cranium, changes in athlete behavior to more risk-taking when wearing headguards may offset any risk reduction. In the absence of high-quality studies on headguard use, the Association of Ringside Physicians recommends that further research be conducted to clarify the role of headguards in all combat sports, at all ages of participation. Furthermore, in the absence of data on gender differences, policies should be standardized for men and women.

Gut microbiota and inflammation patterns for specialized athletes: a multi-cohort study across different types of sports.

Regular high-intensity exercise can cause changes in athletes' gut microbiota, and the extent and nature of these changes may be affected by the athletes' exercise patterns. However, it is still unclear to what extent different types of athletes have distinct gut microbiome profiles and whether we can effectively monitor an athlete's inflammatory risk based on their microbiota. To address these questions, we conducted a multi-cohort study of 543 fecal samples from athletes in three different sports: aerobics (n = 316), wrestling (n = 53), and rowing (n = 174). We sought to investigate how athletes' gut microbiota was specialized for different types of sports, and its associations with inflammation, diet, anthropometrics, and anaerobic measurements. We established a microbiota catalog of multi-cohort athletes and found that athletes have specialized gut microbiota specific to the type of sport they engaged in. Using latent Dirichlet allocation, we identified 10 microbial subgroups of athletes' gut microbiota, each of which had specific correlations with inflammation, diet, and anaerobic performance in different types of athletes. Notably, most inflammation indicators were associated with Prevotella-driven subgroup 7. Finally, we found that the effects of sport types and exercise intensity on the gut microbiota were sex-dependent. These findings shed light on the complex associations between physical factors, gut microbiota, and inflammation in athletes of different sports types and could have significant implications for monitoring potential inflammation risk and developing personalized exercise programs. IMPORTANCE This study is the first multi-cohort investigation of athletes across a range of sports, including aerobics, wrestling, and rowing, with the goal of establishing a multi-sport microbiota catalog. Our findings highlight that athletes' gut microbiota is sport-specific, indicating that exercise patterns may play a significant role in shaping the microbiome. Additionally, we observed distinct associations between gut microbiota and markers of inflammation, diet, and anaerobic performance in athletes of different sports. Moreover, we expanded our analysis to include a non-athlete cohort and found that exercise intensity had varying effects on the gut microbiota of participants, depending on sex.

Surgical Stabilization for Recurrent Patellar Instability in Competitive Wrestlers: Outcomes, Reoperations, and Return to Play at 6-Year Mean Follow-up.

BACKGROUND: The extent to which recurrent patellar instability (RPI) affects wrestlers has not been thoroughly examined. PURPOSE: To assess return to wrestling (RTW), patient-reported outcomes, and reoperation rates after patellofemoral stabilization surgery (PFSS) for RPI in a cohort of competitive wrestlers. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: All competitive wrestlers with a history of RPI and subsequent PFSS performed at a single institution between 2000 and 2020 were identified. Primary PFSS procedures included medial patellofemoral (MPFL) reconstruction (n = 31; 50%); MPFL repair (n = 22; 35.5%); or other PFSS (n = 9; 14.5%), such as tibial tubercle osteotomy, lateral retinacular release, and/or medial retinacular reefing. Exclusion criteria included revision PFSS or concomitant anterior cruciate ligament reconstruction or multiligament knee injury. Surgical failure was defined as subsequent patellar dislocation despite operative management or need for secondary PFSS. RESULTS: Ultimately, 62 knees in 56 wrestlers with a mean age of 17.0 years (range, 14.0-22.8 years) were included at a mean follow-up of 6.6 years (range, 2.0-18.8 years). RTW occurred in 55.3% of wrestlers at a mean ± SD 8.8 ± 6.7 months. Among PFSS types, no differences were observed in rates of RTW (P = .676), postoperative pain (P = .176), Tegner activity level (P = .801), International Knee Documentation Committee (P = .378), Lysholm (P = .402), or Kujala scores (P = .370). RPI was the most common postoperative complication (n = 13; 21.0%). MPFL reconstruction had the lowest rate of RPI (6.5% vs 27.3% [repair] vs 55.6% [other]; P = .005) and surgical failure (9.7% vs 31.8% [repair] vs 55.6% [other]; P = .008). Kaplan-Meier survivorship free from surgical failure of the entire cohort was 91.9% at 1 year, 77.7% at 5 years, and 65.7% at 15 years. MPFL reconstruction had the highest survivorship when compared with MPFL repair and other PFSS up to 10 years after the index surgery (90.3% vs 64.1% vs 27.8%; P = .048). CONCLUSION: RPI remains a concern for competitive wrestlers after PFSS. MPFL reconstruction may serve as a more durable surgical treatment option with lower rates of RPI and failure when compared with other PFSS procedures at up to 10 years after surgery.

Return to Sport After Knee Injuries in Collegiate Wrestling.

Background: Wrestling is known to be a sport of relatively high injury incidence, and knee injuries account for a large percentage of those injuries. Treatment of these injuries varies considerably depending on injury and wrestler characteristics, leading to variability in complete recovery and return to sport (RTS). The purpose of this study was to evaluate injury trends, treatment strategies, and RTS characteristics after knee injuries in competitive collegiate wrestling. Methods: NCAA Division I collegiate wrestlers who sustained knee injuries between January 2010 and May 2020 were identified using an institutional Sports Injury Management System (SIMS). Wrestling-related knee, meniscus, and patella injuries were identified, and treatment strategies were documented to investigate potential recurrent injury trends. Descriptive statistics were used to quantify the number of days, practices, and competitions missed, return to sport times, and recurrent injuries among wrestlers. Results: Overall, 184 knee injuries were identified. After excluding non-wrestling injuries (n=11), 173 injuries remained (77 wrestlers). The mean age at time of injury was 20.8 ± 1.4 years, and the mean BMI was 25.9 ± 3.8 kg/m2. There were 135 primary injuries (74 wrestlers), which consisted of 72 (53%) ligamentous injuries, 30 (22%) meniscus injuries, 14 patellar injuries (10%), and 19 other injuries (14%). The majority of ligamentous injuries (93%) and patellar injuries (79%) were treated non-operatively, while the majority of meniscus tears (60%) underwent surgery. Twenty-three wrestlers (22%) sustained recurrent knee injuries, of which 76% were treated non-operatively after their initial injury. Recurrent injuries consisted of 12 (32%) ligamentous injuries, 14 (37%) meniscus injuries, eight (21%) patellar injuries, and four (11%) other injuries. Fifty percent of recurrent injuries were treated operatively. When comparing recurrent injuries to primary injuries, recurrent injuries had a significantly longer return to sport time (Recurrent 68.3 ± 96.0 days vs. Primary 26.0 ± 56.4 days, p=0.01). Conclusion: The majority of NCAA Division I collegiate wrestlers who sustained knee injuries were initially treated non-operatively, and approximately one in five wrestlers sustained recurrent injuries. Return to sport time was significantly increased after a recurrent injury. Level of Evidence: IV.

Diagnostic Prospectives with Tau Protein and Imaging Techniques to Detect Development of Chronic Traumatic Encephalopathy.

Brain damage sustained from repeated blows in boxing, wrestling, and other combat sports has serious physical and mental health consequences. The degenerative brain disease, chronic traumatic encephalopathy (CTE), presents clinically with memory loss, aggression, difficulty in rational thinking and other cognitive problems. This spectrum, which mimics Alzheimer's disease, is diagnosed post-mortem through a brain biopsy in many professional athletes. However, little is known about the process of development and how to identify vulnerable individuals who may be on course for developing CTE. Boxing is a sport that has a severe toll on athletes' health, primarily on their brain health and function. This review addresses the concerns of brain injury, describes the pathologies that manifest in multiple scales, e.g., molecular and cognitive, and also proposes possible diagnostic and prognostic markers to characterize the early onset of CTE along with the aim to identify a starting point for future precautions and interventions.

Clinical Characteristics, Mechanism, and Outcome of Humeral Shaft Fractures Sustained during Arm Wrestling in Young Men: A Retrospective Study.

OBJECTIVE: Humeral fractures are common in arm wrestling and other sports and military activities requiring similar movements; however, the precise mechanism is poorly understood. Here, we present an overview of the characteristics, possible mechanisms, and treatment of humeral shaft fractures sustained during arm wrestling. METHODS: We reviewed 8 years (January 2013 to January 2021) of medical records and retrospectively analyzed data from 27 patients with humeral shaft fractures sustained during arm wrestling. The clinical data included sex, age, affected arm, alcohol consumption, muscle warm-up, history of competitive participation, opponents' characteristics, wrist position, and post-fracture radial nerve injuries. The fracture configurations were radiographically assessed and analyzed. Surgical management included single or dual plating. Scores on the Disability of the Arm, Shoulder, and Hand questionnaire (DASH) were evaluated preoperatively and postoperatively at the last follow-up visit. RESULTS: All fractures sustained during arm wrestling were spiral fractures of the distal third of the humerus. Of these, 11 were 12-A1 type and 16 were 12-B2 type with a wedge fragment. The two subtypes differed in the total fracture line length (12-A1: 0.18 ± 0.04; 12-B2: 0.23 ± 0.04; P < 0.001). The radial nerve injury rate was 0/11 (0%) in patients with 12-A1 type fractures and 7/16 (43.8%) in patients with 12-B2 type fractures (P = 0.011). Most patients were young men (mean age, ~25 years) with a history of competitively participating in arm wrestling for >2 years. Cold seasonal temperatures and a lack of warm-ups increased the risk of injury. All patients showed improved DASH scores at the last follow-up (12-A1:77.82 ± 5.14 to 10.25 [5.38]; 12-B2:78.91 ± 7.46 to 8.95 [3.17]; P < 0.001). No significant differences were observed among the different surgical treatments. CONCLUSIONS: Individuals who participated in arm wrestling were at risk of humeral shaft fractures (type 12-A1 or 12-B2). The 12-B2 type occurs with a wedge fragment and is frequently accompanied by radial nerve injuries. The characteristics of arm-wrestling fractures and the mechanism(s) underlying these fractures can help orthopedic surgeons understand the causes of these fractures and similar fractures sustained in traditional sports. This understanding will help surgeons choose more effective surgical treatments that will result in more desirable functional outcomes and a faster return to work.

Examining mindfulness and moral disengagement in doping: Perspective of Turkish wrestlers.

Introduction: Studies related to attitudes toward the use of prohibited substances in Turkish athletes are scarce. The World Anti-Doping Agency (WADA) has implemented anti-doping educational policies emphasizing doping-related education in studies conducted among Turkish wrestlers. However, it is still unclear the extent to which the wrestlers comply and adhere to these anti-doping policies. No research has previously examined the effect of anti-doping education on athletes' mindfulness and moral disengagement in doping (MDD). Therefore, the present study has a two-fold objective: first, to examine whether doping-related education (DRE) and the status of being a national athlete (NA) have an effect on athlete mindfulness and MDD. Second, to analyze the relationship between each sub-dimensions of athlete mindfulness: awareness (ASD), judgment (JSD), and refocus (RSD) with MDD. Methods: A total of 409 male wrestlers participated in this study. MANOVA analysis showed that NA and DRE alone have no effect on MDD but have a general effect on mindfulness. Results: The highest effect was on the ASD of being an NA ( η p 2 = 0.173). When the interaction effect of NA*DRE was examined, significant difference in MDD (F = 8.218, p = 0.004), ASD (F = 8.476, p = 0.004), JSD (F = 5.844, p = 0.016), and RSD (F = 11.476, p = 0.001) were found. MDD has a weak negative relationship with ASD (r = -0.126) and RSD (r = -0.041) and a weak positive relationship with the JSD sub-dimension (r = 0.140). Those results suggest that being a NA and having received anti-doping education affect moral disengagement in doping and athletes' mindfulness. Discussion: As a conclusion, it is recommended to increase awareness and anti-doping education among national-standard Turkish wrestlers to prevent them from engaging in doping behaviors.

Training Conditions and Psychological Health: Eating Behavior Disorders in Spanish High-Performance Women's Olympic Wrestling Athletes-A Qualitative Study.

(1) Background: the aim of this study was to determine the factors that affect the occurrence of behaviors related to possible eating disorders in Spanish high-performance Olympic wrestling athletes. (2) Methods: The sample consisted of 22 elite female wrestlers selected through purposive sampling with inclusion criteria of (i) having been a national champion, (ii) having been part of the Spanish team, and (iii) suffering or having suffered from an eating disorder. The semistructured interviews were conducted online and lasted between 20 and 40 min. A statistical analysis was performed with NVivo10 software. (3) Results: the athletes showed a series of issues grouped into three main themes, which were divided into the following categories-firstly, the reasons why wrestlers lose weight; secondly, the inadequate procedures they use; and, finally, the reference persons involved in the process. (4) Conclusions: The training conditions in high-performance sports have psychological and behavioral effects on wrestlers. Wrestlers have to move down to lower categories; however, they do not take into account how this practice influences their health when using inadequate procedures. Rapid and significant weight loss produces negative effects, especially in the female population, generating an incidence of eating disorders. The information obtained provided elements of interest for reflection on possible solutions to prevent existing eating disorders.

Disrupting arrhythmia in a professional male wrestler athlete after rapid weight loss and high-intensity training-Case report.

Introduction: Physiological heart adaptations may lead to increased susceptibility to arrhythmia in athletes. Furthermore, vigorous training and method like rapid weight loss (RWL) in combat sports could pose additional risks. This case represents how routine cardiovascular screening during high-risk methods like RWL and high-intensity training (HIT) reveal abrupt ventricular arrhythmias in a young athlete. Case report: We report a case of a 20-year-old male wrestler athlete who developed disrupting arrhythmia during RWL and HIT. The study included: a medical exam, 12 lead electrocardiograms (ECG), transthoracic echocardiogram (ECHO), and 24 h of continuous ECG monitoring in baseline, phase one (P1), (in which the athlete had to simulate RWL through vigorous training and dietary intervention and HIT) and phase two (P2), (with the same HIT protocol performed without the RWL procedure). Baseline laboratory analyses were without abnormalities, ECG showed sinus rhythm with one premature atrial contraction (PAC) and ECHO showed signs of concentric remodeling with preserved systolic, diastolic function, and global longitudinal strain. After P1 RWL simulation, he lost 5.15% of body weight in 3 days, which resulted in lower blood glucose levels, higher urea, creatinine, creatine kinase (CK), CK-MB levels, and slightly increased levels of NT pro-BNP, ECG revealed sinus rhythm with one ventricular premature beat (VPB), 24-h continuous electrocardiogram (ECG) revealed frequent ventricular premature beats (PVB) 2,150/ 24 h, with two couplets, and 8 PAC. After an advised 4-week period of de-training continuous 24 h, ECG monitoring was improved with only occasional PVB. The 24 h continuous ECG monitoring was repeated after HIT and revealed even more frequent PVB, 5% of all beats for 24 h, 4,205 in total, and almost all VPB were in bigeminy and trigeminy. The athlete was advised against RWL and extremely vigorous exercise and for regular, frequent checkups with occasional ECG monitoring during and after exercise. Conclusion: The short and long-term implication of abrupt ventricular arrhythmias provoked by intensive training and methods like RWL is unknown. We postulate that cardiovascular screening is necessitated, especially during high-risk methods like RWL and HIT, in helping us prevent adverse outcomes and come to individual-based clinical making decisions for each athlete.