Competitive and elite sport often challenges the balance between health and performance, especially when it involves youth athletes. As Lausanne was getting ready to host the 2020 winter Youth Olympic Games, we had the opportunity to reflect on these challenges and on what they mean for sports medicine practitioners. Elite sport pushes athletes to the limit, be it through their own intrinsic drive to achieve ever more, or through the pressures of the multiple stakeholders around sport.
Concentric and eccentric muscle work is characterized through different biochemical activating cascades. Concentric contraction is characterized by an ATP O2 coupling dependent interaction of the myofibril proteins Aktin and Myosin. In eccentric contraction, according to the Winding-filament hypothesis, a rotation movement around the thin filament is caused which is ATP independent. In addition, the processes of motor anticipation vary greatly between the two. This leads to the aim of the study: What are the differences in concentric versus eccentric muscle work concerning anticipation, perception and execution.
Objectives: The objectives of this study were to observe the developmental trajectories of motivation types among young children from 8 to 12 years using a more comprehensive scale of physical education motivation. We also tested the relations between these trajectories and objective physical activity during this period.
The Youth Olympic Games were introduced in 2010 with the aim to bring young athletes not only an experience of competition on the world stage, but also to help them learn about the Olympic values, explore other cultures and develop the skills to become true ambassadors. The Lausanne 2020 Games provided an excellent opportunity to develop innovative concepts for health promotion and sports-related prevention. The enthusiasm across various sectors of society (political, academic and economy) empowered us to bring together multiple skills to materialize the IOC’s pledge.
This interview was conducted by Dr Boris Gojanovic after the Lausanne 2020 Youth Olympic Games.
Richard, can you please introduce yourself, as a medical doctor and an athlete.
I am the medical and scientific director for the IOC and I started off in life as a rower. As an athlete, I had the privilege to compete in the 1984 Olympic Games in Los Angeles, and I won a gold medal there.
Background: The development of Mountain Ultra Marathon (MUM) raises several questions to health professionals, regarding the short or long-term consequences on the health of participants.
Objective: to present the main acute and long-term effects of MUM on the main health issues usually studied among runners.
Methods: Pragmatic review of the literature, including grey literature from the medical staff of the races, notably the Ultra-trail du Mont Blanc.
This observational study used field tests to investigate the association between physiological parameters and rowing performance in athletes during ergometer and on-water Swiss national competitions. 25 Participants between 15 and 35 years who compete at national level were recruited among different clubs. We assessed anthropometric parameters such as weight, height, aerobic capacity during an incremental test on a rowing ergometer, anaerobic capacity during an on rowing ergometer Wingate test and lower limb strength and power during countermovement- and squat jumps.
Back pain is common among elite cyclists. Experiences of athletes and observations of coaches show that it may influence training quality and sometimes even limit performance during competition. Therefore the following study questions were investigated: 1) How many athletes of the Swiss cycling national teams suffer back pain during training or competition? 2) How good is athletes’ core strength? 3) What correlation exists between back pain and core strength? 4) Does an intensified core strength training reduce back pain?
A total of 111 elite cyclists, 45 athletes (38 m, 7f; 19.6 ± 3.5y) of technical disciplines (BMX, Trial, Downhill, 4X) and 66 athletes (39 m, 27f; 19.5 ± 5.8y) of endurance disciplines (road, MTB, Cyclo-cross) all members of Swiss cycling national teams, took part in in the study.
This article described the clinical examination of the lower extremity during a pre-participation screening in regard of sports ability, presence of injuries and musculoskeletal disorders as well as predisposing risk factors for injuries and prevention. It divided into global static and dynamic testing but also isolated analysis of joint function.
L’attribution des Jeux Olympiques de la Jeunesse (JOJ) à Lausanne a déclenché dans toute la Romandie un engouement extraordinaire pour la préparation des Jeux, avec la volonté affirmée de faire des Jeux pour les jeunes, avec les jeunes et par les jeunes. En tant qu’étudiant-e-s en médecine, nous avons eu le privilège de participer aux JOJ du 4 au 24 janvier 2020; un groupe de 20 étudiant-e-s en 6e année ont eu l’occasion d’effectuer un stage de médecine du sport, validé dans le catalogue de l’année à option, dans le cadre de la troisième édition hivernale des Jeux Olympiques de la Jeunesse à Lausanne, plus connus sous l’appellation Lausanne 2020.
A common complaint in the musculoskeletal system is the anterior knee pain (AKP) or the so called patellofemoral pain syndrome (PFPS). The large number of contributing factors that lead to the symptoms make a proper diagnosis and targeted physiotherapeutic treatment management difficult. With regard to symptom-complex-oriented physiotherapeutic care, the question arises as to which therapy methods should be used for individuals with AKP. In order to be able to identify adequate physical therapy methods, an understanding of the clinical condition and the chosen treatment method is essential. This article aims to present a heuristic model of objectives and situational physiotherapeutic treatment methods.
Die Änderungen des öffentlichen Lebens, Isolation, Quarantäne und damit verbundene weitere Einschränkungen der gewohnten Routine sowie Ängste und Sorgen sind nur einige Beispiele für die psychischen Belastungen durch die COVID-19-Pandemie (1). Nicht nur die Normalbevölkerung, sondern auch bzw. vor allem Leistungssportler sind diesen Belastungen ausgesetzt, und Leistungssport ist in Zeiten von COVID-19 nur noch stark eingeschränkt denkbar. Von einem Tag auf den anderen änderten sich für Sportler über Jahre und Jahrzehnte etablierte Tagesstrukturen und Gewohnheiten.
Patients with a patellofemoral pain are either in an acute state after a patellofemoral dislocation or are suffering from a chronic anterior knee pain (AKP), whereas AKP might be accompanied by patellar instability without dislocation. Whereas the acute state after a dislocation is mostly clear and its examination limited, the examination of a AKP is much more complex. A profound knowledge of the anatomy, the painful structures and patellofemoral biomechanics is essential in order to find the underlying pathology within the heterogeneous and diverse etiologies. Furthermore, a meticulous and precise examination is key to find the adequate treatment for AKP.
Physical inactivity is a known risk factor for stroke. The interaction between exercise and risk of stroke is complex. Physical activity has a beneficial effect on most risk factors for stroke, which may show reciprocal potentiation (e.g. obesity, sleep apnea, atrial fibrillation). Advice on physical activity is of importance in primary prevention of stroke. Hereby, type, amount and intensity of physical activity may be distinguished and adjusted according to comorbidities (e.g. in case of heart failure).
Exercise testing in athletes and patients is an important and valuable diagnostic tool in the hand of the physician and sport scientist. A close collaboration between sport scientist and sport physician creates a win-win-win-situation for athletes and patients and professionals equally. According to the demands of the sport an incremental lactate threshold test (determination of the anaerobic threshold), testing of VO2max and performance at VO2max, and a testing of aerobic capacity (performance at competitional level) are the tests of choice. All tests need to be valid, reliable and sport specific. Sport specificity in testing is for practical purposes the most important.
Myocarditis is defined as an inflammation of the heart muscle and its presentation, especially in athletes, is heterogeneous. Underlying causes include in most of the cases viruses, and less often bacteria, toxins, vasculitic diseases or pharmaceutical agents. Cardiac magnetic resonance (CMR) imaging is the primary imaging tool to diagnose myocarditis following laboratory test, electrocardiogram and echocardiography. In certain cases, endomyocardial biopsy is required, especially in unclear cases with reduced systolic left ventricular ejection fraction.
Meniscal Ramp lesions are frequently associated with Anterior Cruciate Ligament ruptures. It has been reported to play a key role in the anterior tibial translation the knee joint. Ramp lesions are difficult to diagnose in imaging modality and are under-recognized when using standard anterolateral and anteromedial arthroscopic portals even with probe test.
Iron deficiency is frequent among athletes. All types of iron deficiency may affect physical performance and should be treated. The main mechanisms by which sport leads to iron deficiency are an increased iron demand, an elevated iron loss and a blockage of iron absorption due to hepcidin bursts. As a baseline set of blood tests, haemoglobin, haematocrit, mean cellular volume (MCV), mean cellular haemoglobin (MCH) and serum ferritin levels are the important parameters to monitor iron deficiency. In healthy male and female athletes >15 years, ferritin values <15µg/l are equivalent to empty, values from 15 to 30µg/l to low iron stores. Therefore a cut-off of 30µg/l is appropriate.
The restorative qualities of sleep are fundamentally the basis of the individual athlete’s ability to recover and perform, and to optimally be able to challenge and control the effects of exercise regimes in high performance sport. Research consistently shows that a large percentage of the population fails to obtain the recommended 7–9 hours of sleep per night . Moreover, recent years’ research has found that athletes have a high prevalence of poor sleep quality . Given its implications on the recovery process, sleep affects the quality of the athlete’s training and outcome of competitions.
There seems to be a lack of consensus among medical associations, professional sports bodies and medical professionals about when pre-participation evaluations (PPE) are indicated and how they should be designed. Although it is generally accepted that the primary purpose of the PPE is the identification of cardiovascular disease and risk factors for sudden cardiac death in competitive athletes, there is an ongoing debate on which methods are most apt in the screening process. Furthermore, the need of PPE has been questioned all together in leisure or hobby athletes.