A 'polypill' for acute tendon pain in athletes with tendinopathy?

Acute tendon pain in athletes is a condition that is difficult to manage. There are few treatment options that give adequate pain relief and have a theoretical basis for efficacy. We report the use of a novel “polypill” for tendon pain, and provide evidence for the basis for its use. We present it to stimulate discussion and research into a new area of tendinopathy.

Lost in translation? William Wardell's St John's College, Sydney and Convent and School, Kew

This paper considers two Colleges designed by the nineteenth century architect William Wardell (1823-99): St John’s College, within the University of Sydney (1858-59) and Convent and School, Kew, now known as Genazzano FCJ College Kew, Melbourne (1889). The approach of significant anniversaries for each of the Colleges has been the major impetus behind the current research. Both commissions demonstrate laudable aspirations; difficulty in comprehending and realising the design; partial completions and accretions over time which testify to changes in economic fortune and taste; inappropriate additions; and decades of neglect fuelled by a general misunderstanding of the 19th century for much of the 20th century. At the beginning of the 21st century conservation management plans were commissioned independently for both projects. Using the two Colleges as case studies, this paper examines tradition and its transformation, design and its translation, heritage and its significance.

An integrated approach to coaching athletes

This paper discusses an integrated approach to coaching athletes, which focuses on adapting coaching methods to individual learning style, and developing a tactical awareness of how to play the game alongside technique. An Integrated Coaching Model is proposed that links the cyclical model of experiential learning (Kolb, 1984), the 4MAT System (McCarthy, 1980), and TGfU (Bunker & Thorpe, 1982). Alternative approaches to teaching sport and physical education have been proposed; in particular, discussion in the coaching and physical education literature has debated the merits of tactical versus technical approaches, as opposite ends of a continuum. More recently, a number of authors have indicated that this argument is limited, as learning is complex and varied and should not be reduced to a linear model.

Key aspects of successful coaching are that the players have the ability to make successful decisions on the field and to increase a player’s self-awareness of both technical and tactical game aspects. This discussion of an integrated approach involves playing games, emphasises active involvement, considers player’s learning styles, and encourages democratic decision-making.

William Wardell's St John's College within the University of Sydney, 1858-59

Ursula wrote the essay for the catalogue of the Wardell Exhibition.

Quality of reporting of randomized clinical trials in abstracts of the 2005 annual meeting of the American College of Rheumatology.

Objective: To determine the quality of abstracts reporting randomized clinical trials (RCT) at the 2005 Annual Scientific Meeting of the American College of Rheumatology.

Methods: All 2005 abstracts including late-breaking abstracts were assessed. An abstract was deemed to be reporting an RCT if it indicated that participants were randomized in the title or body of the abstract. RCT were excluded if they included only pharmacokinetic data. The CONSORT checklist was applied and relevant data extracted. We defined manufacturer support as acknowledgment of industry support or industry employee as co-author.

Results: Of 2146 abstracts, 143 (6.7%) reported RCT. Of these, 78.3% were drug trials, and 63.6% indicated manufacturer support. Only 30.8% of abstracts used "randomized" in the title, 44.1% did not explicitly state whether blinding was undertaken, and only 7.0% clearly stated who was blinded. Thirty percent of studies did not give an explicit definition of eligibility criteria of participants. While 84.6% explicitly described the experimental intervention, only 37.1% explicitly described the comparator intervention. Only 21% explicitly stated that an intention to treat analysis was performed. Baseline demographic and clinical characteristics were reported in 48.3%. While most abstracts reported summary results for each treatment group, only 35.7% reported effect size with its precision.

Conclusion: The quality of reporting is suboptimal in many RCT abstracts. Abstracts reporting RCT would benefit from a structured approach that ensures more detailed reporting of eligibility criteria, active and comparator interventions, flow of participants, and adequate summary and precision of results.

Substrate utilization during exercise performed with and without glucose ingestion in female and male endurance trained athletes

Compared to males, females oxidize proportionately more fat and less carbohydrate during endurance exercise performed in the fasted state. This study was designed to test the hypothesis that there may also be gender differences in exogenous carbohydrate (CHOexo) oxidation during exercise. Healthy, young males (n = 7) and females (n = 7) each completed 2 exercise trials (90 min cycle ergometry at 60% VO[sub2peak]), 1 week apart. Females were eumenorrheic and were tested in the midfollicular phase of their menstrual cycle. Subjects drank intermittently either 8% CHOexo (1 g glucose ⋅ kg ⋅ h[sup-1]) enriched with U-13C glucose or an artificially sweetened placebo during the trial. Whole-body substrate oxidation was determined from PER, urinary urea excretion, and the ratio of 13C:12C in expired gas during the final 60 min of exercise. During the placebo trial, fat oxidation was higher in females than in males (0.42 ± 0.07 vs. 0.32 ± 0.09 g ⋅ min[sup-1] . kg LBM[sup-1] x 10[sup-2]) at 30 min of exercise (p < .05). When averaged over the final 60 min of exercise, the relative proportions of fat, total carbohydrate, and protein were similar between groups. During CHOexo ingestion, both the ratio of 13C: 12C in expired gas (p < .05) and the proportion of energy derived from CHOexo relative to LBM (p < .05) were higher in females compared to males at 75- and 90-min exercise. When averaged over the final 60 min of exercise, the percentage of CHOexo to the total energy contribution tended to be higher in females (14.3 + 1.2%) than in males (11.2 ± 1.2%; p = .09). The reduction in endogenous CHO oxidation with CHOexo intake was also greater in females (12.9 ± 3.1%) than in males (5.1 ± 2.0%; p = .05). Compared to males, females may oxidize a greater relative proportion of CHOexo during endurance exercise which, in turn, may spare more endogenous fuel. Based on these observations, ingested carbohydrate may be a particularly beneficial source of fuel during endurance exercise for females.

Functional dairy protein supplements for elite athletes

Elite athletes require a greater dietary protein intake than recreationally active people to maintain optimal muscular function. The timing of protein ingestion relative to exercise is critical to maximizing its physiological impact on skeletal muscles. Sports protein supplements provide a convenient means of supplying athletes with an adequate and timely source of quality dietary protein. There is now strong evidence that not all dietary proteins are equipotent in their effects on various aspects of athletic performance and specific protein isolates can provide benefits to athletes beyond simple supply of nutritional amino acids. Thus, there is an opportunity to develop new functional protein supplements to maximize athletic performance. This paper outlines the clinical evidence for the benefits of dairy proteins in sports performance and describes the development of new dairy protein supplements to build muscle strength, and to expedite recovery of strength following muscle-damaging eccentric exercise.

The relationship between monocarboxylate transporters 1 and 4 expression in skeletal muscle and endurance performance in athletes

The purpose of this study was to examine the relationship between skeletal muscle monocarboxylate transporters 1 and 4 (MCT1 and MCT4) expression, skeletal muscle oxidative capacity and endurance performance in trained cyclists. Ten well-trained cyclists (mean ± SD; age 24.4 ± 2.8 years, body mass 73.2 ± 8.3 kg, VO2max 58 ± 7 ml kg−1 min−1) completed three endurance performance tasks [incremental exercise test to exhaustion, 2 and 10 min time trial (TT)]. In addition, a muscle biopsy sample from the vastus lateralis muscle was analysed for MCT1 and MCT4 expression levels together with the activity of citrate synthase (CS) and 3-hydroxyacyl-CoA dehydrogenase (HAD). There was a tendency for VO2max and peak power output obtained in the incremental exercise test to be correlated with MCT1 (r = −0.71 to −0.74; P < 0.06), but not MCT4. The average power output (P average) in the 2 min TT was significantly correlated with MCT4 (r = −0.74; P < 0.05) and HAD (r = −0.92; P < 0.01). The P average in the 10 min TT was only correlated with CS activity (r = 0.68; P < 0.05). These results indicate the relationship between MCT1 and MCT4 as well as cycle TT performance may be influenced by the length and intensity of the task.

Injury and burnout in Australian athletes

The relationship between injury and burnout in a sample of 264 local to international Australian athletes (124 men and 140 women) was studied. Injury can be a stressful experience for athletes; coupled with the demands of rehabilitation, it could increase feelings of burnout. Experiencing more than one injury could have a cumulative effect on feelings of burnout. Alternatively, for some athletes the break from training or competing caused by an injury could alleviate burnout symptoms. Participants completed a demographic questionnaire and a modified version of the Maslach Burnout Inventory. Independent sample t tests indicated that currently injured athletes (n = 150) had significantly lower mean Burnout scores than currently uninjured athletes (n = 113). Small, but statistically significant, positive correlations were found between number of injuries and Burnout scores. Possible explanations are that injury provides a temporary break from intense sporting involvement and, thus, lower scores on Burnout, but multiple injuries might have a cumulative effect on burnout.