Pathology of chronic achilles-tendon injuries in athletes

Overuse tendon conditions have traditionally been considered to result from an inflammatory process and were treated as such. Microscopic examination of abnormal Achilles-tendon tissues, however, reveals a non-inflammatory degenerative process. The histopathology found in surgical specimens in patients with chronic overuse Achilles tendinopathy and those with Achilles-tendon rupture are reviewed. Seminal studies suggest that so-called tendinitis is a rare condition that might occur occasionally in the Achilles tendon in association with a primary tendinosis. These data have clinical implications and require a review of the traditional classification of pathologies seen in tendon conditions, The authors recommend that nomenclature be based on histopathological findings rather than traditional hypothesis.

Train without strain : health and amateur athletes

An exercise in historical sociology, this paper investigates the association between training and health made by amateur athletes between about 1860 and WWI. It examines the idea that while exercise benefited a person’s health and well-being, excessive exertion caused potentially life-threatening ‘strain’. The paper sets out the interpretation of contemporary scientific knowledge about the body–which the author terms the ‘physiology of strain’–that underpinned the advice given to those undergoing a training program for amateur competition. The point is made that the imputed effects of exercise on health were deduced from this scientific knowledge; it did not derive from bio-medical investigations specifically addressing these issues. Amateur athletes included people drawn from the professionally educated elite and medical practitioners figured significantly among them. Using insights from Bourdieu and Foucault, it is argued that their social power and professional connections served to legitimate their interpretation of the physiological effects of exercise (denying the value of the training practices of working class professional athletes) and cemented the physiology of strain as a ‘factual’ statement about exercise and health until well into the twentieth century. The data for the paper comes from training manuals, medical journals and other contemporary publications.

The ultrasound appearance of the patellar tendon attachment to the tibia in young athletes is conditional on gender and pubertal stage

This cross-sectional study investigated the imaging appearance of the previous termpatellarnext term tendon attachment to the tibia in young male and female tennis players of different ages and pubertal status. Forty-four competitive young players, who had been playing tennis at least for 2 years, were recruited from a tennis school and local tennis clubs. All subjects had bilateral ultrasound imaging of the previous termpatellarnext term tendon attachment to the tibia. Standard anthropometric measurements, pubertal status and injury history were recorded. Ultrasound appearance of the previous termpatellarnext term tendon attachment was categorised into three stages: cartilage attachment, insertional cartilage and mature attachment. Cartilage attachment was more prevalent in boys (32%) and extended further into puberty (until Tanner stage 4) compared to girls (6% and Tanner stage 1). Tendons with Osgood–Schlatter Disease symptoms (n = 3) did not have a cartilage attachment. Imaging appearance commonly seen in young active athletes, consistent with a clinical diagnosis of OSD, was more common in boys and in the pre- and peri-pubertal stages.

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.

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.

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.

Exercise dependence and elite Australian athletes

This thesis provides an examination of exercise dependence (EXD) among elite Australian athletes. The research identifies the main symptoms of EXD among elite athletes as excessive training, withdrawal, and continuance behaviours. EXD was found to be associated with irrational beliefs relating to training, low self esteem, and limited social support. The portfolio presents four case studies illustrating the use of solution focused brief counselling with athletes and drawing attention to the utility of a solution focused approach as an effective tool in sport psychology consultancy.

Monitoring voluntary food intake in female endurance athletes

Female athletes may demonstrate a poor ability to quantify portion sizes and educational sessions using food models do not always improve accuracy. Female cyclists with the highest body fat do not report the highest energy intakes during 70 days of training and racing. Training loads can influence reported daily energy intake.