The incidence of injuries in elite junior figure skaters

BACKGROUND: There has been rapid growth in the technical and physiologic demands made on skaters who perform more and more difficult jumps, spins, lifts, throws, and free skating movements. PURPOSE: To investigate the frequency of injuries and overuse syndromes in elite junior skaters. STUDY DESIGN: Questionnaire. METHODS: During four consecutive Junior World Figure Skating Championships and the Croatia Cup, we interviewed 236 female and 233 male skaters by questionnaire to determine the frequency of injuries and overuse syndromes. RESULTS: Fifty-nine of the female skaters (25%) and 65 of the male skaters (27.9%) reported sustaining acute injuries; 101 female (42.8%) and 106 male (45.5%) skaters reported overuse syndromes. Low back pain was reported by 19 female and 23 male skaters. The most frequent acute injury was ankle sprain. In singles female skaters, the most frequent overuse injury was stress fracture (19.8%), followed by jumper's knee (14.9%). In singles male skaters, jumper's knee (16.1%) was the most frequent injury, followed by Osgood-Schlatter disease (14.2%). More than 50% of injuries in young singles figure skaters involved overuse syndromes. Pairs skaters and ice dance skaters had a higher risk of acute injury than overuse syndrome because of falls from lifts and throw jumps. CONCLUSIONS: Programs to improve postural alignment, flexibility, and strength, especially during the asynchronous period of bone and soft tissue development, should be instituted to prevent and reduce overuse syndromes.     

Strength capabilities of knee extensor muscles in junior speed skaters

BACKGROUND: The present study aimed to investigate the gender- and age-related profiles of junior speed skaters in strength capabilities during both single and repetitive maximal contractions. METHODS: The subjects were 19 male (age = 17.1 +/- 0.2 years, X +/- SE) and 13 female skaters (16.9 +/- 0.2 years). Isokinetic knee extension torque (T) developed concentrically in a single contraction at three constant velocities of 1.05, 3.14 and 5.24 rad/sec and 50 repetitive maximal contractions at 3.14 rad/sec was measured using an isokinetic dynamometer. In addition, a B-mode ultrasound apparatus was used to determine the cross-sectional area (CSA) of the quadriceps femoris muscle at mid-thigh. RESULTS: For the junior skaters, T values at three velocities of 1.05, 3.14 and 5.24 rad/sec and the mean value of isokinetic torque (MT) for every five consecutive trials in the first 25 maximal contractions were similar in both genders when they were expressed relative to the product of the cross-sectional area (CSA) of the quadriceps femoris muscle and lower limb length, T/CSAL and MT/CSAL, respectively. However, the males showed significantly higher MT/CSAL values than the females in the last 25 repetitions of the endurance test. In the comparisons between junior and reference senior skaters, T/CSAL for both genders and MT/CSAL for the females showed little age-related difference. For the males, however, MT/CSAL values in the first 15 repetitions of the endurance test were significantly lower in the junior skaters than in the senior ones. CONCLUSIONS: The present results indicate that the strength capabilities of junior speed skaters in a single maximal contraction will be similar in both genders when the difference in muscle size is normalized. However, the junior male skaters may be less fatiguable than the junior female ones in repetitive maximal contractions. Moreover, the comparison between junior and senior skaters suggests that, in postadolescence, males might be more trainable than females to improve torque output during short-term repetitive maximal contractions beyond that achieved during adolescence.     

Hemoglobin levels and athletic performance in elite speed skaters during the olympic season 2006.

OBJECTIVE: To test the hypotheses that the hemoglobin (Hb) distribution curve in elite male and female long track speed skaters is not normally distributed and that there is a positive relationship between competitive success and Hb concentration. DESIGN: A venous blood sample was taken before the events from all skaters. The Hb concentration distribution curves of all ranked from 1 to 30 were tested for normality. In addition, individual Hb concentrations were plotted against ranking in the matching events. SETTING: 2006 major championships and Olympic winter games. PARTICIPANTS: All elite male and female speed skaters (217 men and 200 women) competing in major international championships in 2006 and in the Olympic winter games 2006. MAIN OUTCOME MEASUREMENTS: Hb concentration and individual ranking in the matching event. RESULTS: The mean Hb levels in men and women were 15.7 +/- 0.8 g/dL and 14.0 +/- 0.7 g/dL, respectively. The distribution curve in men would meet the criteria for normal distribution when 4 values from 2 skaters with naturally high Hb levels were neglected. In the women, the distribution curve did not meet the criteria for normality because of low frequency in the right side of the distribution curve and a high frequency at the left side. The curve failed to have a steep drop off at the right side. When plotting Hb concentration against ranking, there is no correlation and relationship between Hb concentration and competitive success. CONCLUSIONS: The Hb concentrations are within the normal range for endurance athletes, and there is no indication that the values are titrated toward the upper allowed limit. In addition, there is no relationship between Hb concentration and competitive success in elite speed skaters.     

Injuries in elite pair skaters and ice dancers

Figure skating coaches have become concerned about the increasing number of injuries among competitive skaters, particularly pair skaters. This study prospectively examines the incidence, severity, and cause of injuries sustained by a group of elite pair skaters and ice dancers. Thirty-three serious injuries, causing the skater to alter training significantly or to cease training completely for at least 7 consecutive days, were recorded over a 9 month period. Female senior pair skaters reported an average of 1.4 serious injuries, and other groups averaged greater than 0.5 serious injury per skater. The lower extremities were injured most frequently, and 7 of the 33 serious injuries were directly related to the skating boot. Eleven serious injuries were caused by lifts. Few of the serious injuries appeared preventable. Changes in boot design and the training for lifting maneuvers should be initiated and studied prospectively to attempt to reduce the unacceptably high injury rate among elite pair skaters and ice dancers.     

Hemoglobin level in elite speed skaters from 2000 up to 2005, and its relationship with competitive results

We studied the mean hemoglobin (Hb) concentration in elite male and female long track junior and senior speed skaters from 2000 to 2005. In addition, the number of abnormal hematological findings observed over this period of time was investigated. We also studied whether there were differences in Hb concentration between top ranked and lower ranked skaters, and whether a relationship between Hb concentration and competitive results could be observed. The present study shows that the mean Hb level in male and female junior and senior long track speed skaters remained fairly stable and did not change from 2000 through 2005. The number and percentage of abnormal hematological findings were found to vary between 0 and 2 %, and failed to show a clear pattern or trend over the years. There was no difference in mean Hb levels between top ranked and lower ranked skaters, and no meaningful relationship between Hb concentration and ranking could be found.     

Kinanthropometric differences between 1997 World championship junior elite and 2011 national junior elite triathletes

ObjectivesIn 1997, anthropometry measures were made to determine the body size and shapes of both senior and junior elite triathletes. Since then, the junior event distance has changed and the optimal morphology of participants may have evolved. Thus the objective of this study was to compare the morphology of 1997 World championship junior elite triathlon competitors with junior elite competitors in 2011.DesignComparative study of junior elite triathlete kinanthropometry.MethodsTwenty-nine males and 20 females junior elite competitors in the 1997 Triathlon World Championships underwent 26 anthropometric measurements. Results were compared with 28 male and 14 female junior elite triathletes who competed in the 2011 Australian National Junior Series, as qualifying for 2011 Triathlon World Championships. Comparisons were made on the raw scores, as well as somatotype, and body proportional scores.ResultsBoth male and female junior elite triathletes in the 2011 group were significantly more ectomorphic than their 1997 counterparts. The 2011 triathletes were also proportionally lighter, with significantly smaller flexed arm and thigh girths, and femur breadths. The 2011 males recorded significantly longer segmental lengths and lower endomorphy values than the 1997 junior males.ConclusionsJunior elite triathlete morphology has evolved during the past 14 years possibly as a result of changing race distance and race tactics, highlighting the importance of continually monitoring and updating such anthropometric data.     

Exercise-induced bronchospasm among healthy elite cross country skiers and non-athletic students

Regular exercise in cold, dry air is believed to be a predisposing factor for exercise-induced bronchospasm (EIB). The aim of this study was to compare the occurrence of EIB among previously healthy elite cross country skiers and their non-athletic control subjects. Twenty healthy elite cross country skiers and 18 non-asthmatic controls were challenged by a standardized free exercise test. Thereafter, subjects' respiratory function was followed by flow-volume spirometry up to 30 min. EIB was defined in the post-exercise spirometry as at least one of the following: a >or=10% decrease in forced expiratory volume in 1 s (FEV1), a >or=20% decrease in mean maximal expiratory flow (MMEF) or a >or=25% decrease in peak expiratory flow rate (PEF). EIB was found in two skiers and one control according to FEV1, for seven skiers and two controls according to MMEF. Two skiers and one control had exercise-induced asthma (EIA) according to both parameters. The largest decrease in PEF was 13%, that did not result in additional diagnoses. All nine of the subjects with a positive test result reported asthma-like symptoms (dyspnea, cough or increased mucus excretion) after the exercise challenge. Accordingly, seven previously healthy skiers (35%) and two controls (11%) were diagnosed as having EIB. In addition, three skiers of the original cohort were excluded because of an earlier asthma diagnosis, making the total asthma prevalence 10/23 (42%) among the elite skiers. It was concluded that EIB is more common in elite cross country skiers than in non-athletic controls. The bronchoconstriction induced by exercise is usually mild or moderate, and flow-volume spirometry with sensitive flow parameters is needed for it to be diagnosed. Even a mild asthma decreases minute ventilation and maximal performance of winter sport athletes. Therefore, skiers with long-term respiratory symptoms or decreased performance should be studied for EIA and treated adequately.     

The effect of sports training on the age-related changes of body composition and isokinetic peak torque in knee extensors of junior speed skaters

To elucidate the effect of sports training on age-related changes of body composition and isokinetic peak torque (IPT) in knee extensors, junior speed skaters were tested in comparison with relatively sedentary age-matched controls. Subjects consisted of 132 male and 71 female junior speed skaters (SSs; aged 10-18 years). Two-hundred and thirty-six males and 265 females between the ages of 10 to 18 in the same geographic area were also tested as controls (Cs). Lean Body Mass (LBM) and relative body fat (%) were estimated from skinfolds, using the equations for preadolescent boys and girls. An isokinetic dynamometer (Cybex II) was used to measure IPT (Nm) produced at angular velocities corresponding to 0, 30, 180, 300 deg.sec-1 during maximal knee extensions. SSs were heavier in body weight and LBM from age 13 for males and from age 16 for females than the Cs, and there were significant differences in LBM between SSs and Cs after age 16 regardless of sex. The female Cs showed a gradual increase in relative body fat (%) after age 14, however, such a trend was absent in female SSs. IPT increased in any angular velocity with age from 10-18 years in the male Cs, and from 10-15 years in the female Cs. On the other hand, male SSs tended to be stronger after age 13 and female SSs stronger after age 16. Significant differences between the two groups were obtained only at lower angular velocities from 16 years of age in both sexes.(ABSTRACT TRUNCATED AT 250 WORDS)     

Skin conditions in figure skaters, ice-hockey players and speed skaters: part I - mechanical dermatoses

Figure skaters, ice-hockey players and speed skaters experience a range of dermatologic conditions and tissue-related injuries on account of mechanical trauma, infectious pathogens, inflammatory processes and environmental factors related to these competitive pursuits. Sports medicine practitioners, family physicians, dermatologists and coaches should be familiar with these skin conditions to ensure timely and accurate diagnosis and management of affected athletes. This review is Part I of a subsequent companion review and provides a comprehensive review of mechanical dermatoses experienced by ice-skating athletes, including skater's nodules and its variants, pump bumps, piezogenic pedal papules, talon noir, skate/lace bite, friction bullae, corns and calluses, onychocryptosis, skater's toe and skate blade-induced lacerations. These injuries result from friction, shear forces, chronic pressure and collisions with surfaces that occur when athletes endure repetitive jump landings, accelerated starts and stops and other manoeuvres during rigorous training and competition. Ill-fitting skates, improper lacing techniques and insufficient lubrication or protective padding of the foot and ankle often contribute to the development of skin conditions that result from these physical and mechanical stresses. As we will explain, simple measures can frequently prevent the development of these conditions. The treatment of skater's nodules involves reduction in chronic stimulation of the malleoli, and the use of keratolytics and intralesional steroid injections; if malleolar bursitis develops, bursa aspirations may be required. Pump bumps, which result from repetitive friction posteriorly, can be prevented by wearing skates that fit correctly at the heel. Piezogenic pedal papules may be treated conservatively by using heel cups, compressive stockings and by reducing prolonged standing. Talon noir usually resolves without intervention within several weeks. The treatment of skate bite is centred on reducing compression by the skate tongue of the extensor tendons of the anterior ankle, which can be accomplished by use of proper lacing techniques, increasing pliability of the skate tongue and using protective padding, such as Bunga Pads?. Anti-inflammatory medications and cold compresses can also help reduce inflammation. Friction bullae are best managed by careful lancing of painful blisters and application of petrolatum or protective dressings to accelerate healing; preventative measures include the use of well fitting skates, proper lacing techniques and moisture-wicking socks. Corns and calluses are similarly best prevented by the use of well fitted skates and orthotic devices. Symptomatic, debridement reduces the irritant effect of the thick epidermis, and can be accomplished by soaking the area in warm water followed by paring. Application of creams with high concentrations of urea or salicylic acid can also soften callosities. Cases of onychocryptosis benefit from warm soaks, antibiotic ointments and topical steroids to reduce inflammation, but sometimes chemical or surgical matricectomies are required. Preventative measures of both onychocryptosis and skater's toe include cutting toenails straight across to allow for a more equal distribution of forces within the toe box. Finally, the prevention and treatment of lacerations, which constitute a potentially fatal type of mechanical injury, require special protective gear and acute surgical intervention with appropriate suturing. The subsequent companion review of skin conditions in ice skaters will discuss infectious, inflammatory and cold-induced dermatoses, with continued emphasis on clinical presentation, diagnosis, treatment and prevention.     

Bone density,microarchitecture and strength in elite figure skaters is discipline dependent

ObjectivesIn elite figure skaters, to determine if there was a difference in volumetric bone mineral density and bone strength between 1) figure skaters and population-based normative data, 2) single or pair skaters and ice dancers, and 3) the landing and takeoff legs.DesignCross-sectional.MethodsFigure skaters had their non-dominant distal radius and bilateral tibia scanned using high-resolution peripheral quantitative computed tomography. Volumetric bone mineral density was determined at the total, cortical and trabecular compartments, and finite element analysis estimated bone strength. Normative data was used to compare the total bone mineral density of figure skaters to a population-based cohort. Independent t-tests compared differences between skating discipline, and paired t-tests compared skeletal parameters for the landing and takeoff leg.ResultsTwenty elite skaters (mean age 22 ± 6.2; female = 11, male = 9) completed scans. Compared with the general population, the mean percentile rank for skaters' total volumetric bone mineral density was below normal at the radius (27th percentile) and normal at the tibia (54th percentile). Single or pair skaters had more robust bone in the landing compared with their takeoff leg. Specifically, the landing leg had higher total bone mineral density (2.8%) and trabecular bone mineral density (6.5%), and superior bone strength (8.5%) than the takeoff leg (p < 0.05).ConclusionsVolumetric bone mineral density and strength differences in figure skaters were discipline dependent. Side-to-side differences were observed in single and pair skaters where the landing leg is denser, larger and stronger than the takeoff leg.     

Anthropometric characteristics of elite male junior rowers

During the 1997 Fédération Internationale des Sociétés d'Aviron World Junior Rowing Championships, anthropometric data on 383 male junior rowers were assessed. With 430 participating athletes, the sample represented 89% of the population. In addition to age, 27 dimensions were measured: body mass, six heights or lengths, four breadths, 10 girths, and six skinfolds. The elite male junior rowers were tall (187.4 (5.8) cm; mean (SD)) and heavy (82.2 (7.4) kg), with larger length, breadth, and girth dimensions than a nationally representative sample of Belgian boys of the same chronological age. A rowing specific anthropometric profile chart with norms was constructed. The stature of the junior rowers is similar to that of adult heavyweight elite rowers, except that the junior rowers are lighter. Compared with non-finalists, finalists are heavier (but still lighter than the adult heavyweight elite rower) and taller, with greater length, breadth (except for the bicristal diameter), and girth dimensions.

Key Words: anthropometry; body size; males; junior; rowers

     

Shoulder functional ratio in elite junior tennis players

ObjectiveTo evaluate shoulder rotation strength and compare the functional ratio between shoulders of elite junior tennis players.DesignThis cross-sectional study evaluated muscular rotation performance of 40 junior tennis players (26 male and 14 female) with an isokinetic dynamometer.Main outcome measuresStrength variables of external (ER) and internal rotators (IR) in concentric and eccentric modes were considered. For the peak torque functional ratio, the eccentric strength of the ER and the concentric strength of the IR were calculated.ResultsAll variables related to IR were significantly higher on the dominant compared to the non-dominant side in males and females (p < 0.05), but only boys exhibited this dominance effect in ER (p < 0.05 and p < 0.001). Regarding functional ratios, they were significantly lower for the dominant shoulder (p < 0.001) and below 1.00 for both groups, indicating that the eccentric strength of the ER was not greater than the concentric strength of the IR.ConclusionElite junior tennis players without shoulder injury have shoulder rotation muscle strength imbalances that alter the normal functional ratio between rotator cuff muscles. Although these differences do not seem to affect the athletic performance, detection and prevention with exercise programs at an early age are recommended.     

Acute hormonal responses in elite junior weightlifters.

To date, no published studies have demonstrated resistance exercise-induced increases in serum testosterone in adolescent males. Furthermore, few data are available on the effects of training experience and lifting performance on acute hormonal responses to weightlifting in young males. Twenty-eight junior elite male Olympic-style weightlifters (17.3 +/- 1.4 yrs) volunteered for the study. An acute weightlifting exercise protocol using moderate to high intensity loads and low volume, characteristic of many weightlifting training sessions, was examined. The exercise protocol was directed toward the training associated with the snatch lift weightlifting exercise. Blood samples were obtained from a superficial arm vein at 7 a.m. (for baseline measurements), and again at pre-exercise, 5 min post-, and 15 min post-exercise time points for determination of serum testosterone, cortisol, growth hormone, plasma beta-endorphin, and whole blood lactate. The exercise protocol elicited significant (p less than or equal to 0.05) increases in each of the hormones and whole blood lactate compared to pre-exercise measures. While not being significantly older, subsequent analysis revealed that subjects with greater than 2 years training experience exhibited significant exercise-induced increases in serum testosterone from pre-exercise to 5 min post-exercise (16.2 +/- 6.2 to 21.4 +/- 7.9 nmol.l-1), while those with less than or equal to 2 years training showed no significant serum testosterone differences. None of the other hormones or whole blood lactate appear to be influenced by training experience.(ABSTRACT TRUNCATED AT 250 WORDS)     

Anthropometric and physiological characteristics of junior elite volleyball players

Objectives

To investigate the anthropometric and physiological characteristics of junior elite volleyball players.

Method

Twenty five national level volleyball players (mean (SD) age 17.5 (0.5) years) were assessed on a number of physiological and anthropometric variables. Somatotype was assessed using the Heath‐Carter method, body composition (% body fat, % muscle mass) was assessed using surface anthropometry, leg strength was assessed using a leg and back dynamometer, low back and hamstring flexibility was assessed using the sit and reach test, and the vertical jump was used as a measure of lower body power. Maximal oxygen uptake was predicted using the 20 m multistage fitness test.

Results

Setters were more ectomorphic (p<0.05) and less mesomorphic (p<0.01) than centres. Mean (SD) of somatotype (endomorphy, mesomorphy, ectomorphy) for setters and centres was 2.6 (0.9), 1.9 (1.1), 5.3 (1.2) and 2.2 (0.8), 3.9 (1.1), 3.6 (0.7) respectively. Hitters had significantly greater low back and hamstring flexibility than opposites. Mean (SD) for sit and reach was 19.3 (8.3) cm for opposites and 37 (10.7) cm for hitters. There were no other significant differences in physiological and anthropometric variables across playing positions (all p>0.05).

Conclusion

Setters tend to be endomorphic ectomorphs, hitters and opposites tend to be balanced ectomorphs, whereas centres tend to be ectomorphic mesomorphs. These results indicate the need for sports scientists and conditioning professionals to take the body type of volleyball players into account when designing individualised position specific training programmes.     

Cardiac MRI of elite junior Olympic weight lifters

Cardiac magnetic resonance imaging was performed on 14 junior elite Olympic weight lifters and 14 controls (means +/- Se, age = 18.4 +/- 0.5 and 17.8 +/- 0.4 years, weight = 76.5 +/- 3.6 and 78.8 +/- 3.3 kg, % fat = 6.5% +/- 0.8% and 11.5% +/- 1.7%, respectively). Controls were individually matched to the lifters to within 2 years of age and 2.5 kg of body weight. Systolic (S) and diastolic (D) left posterior wall thickness (LPW), left ventricular short axis (LSA), left ventricular transverse long axis (LLA), spetal wall thickness (SW), right ventricular wall thickness (RWT), and right ventricular short axis (RSA) were determined. Variables were examined in absolute (mm), relative to body surface area (BSA, mm/m2), total body weight (BW, mm/kg), and lean body mass (LBM, mm/kg) terms. In absolute terms S LPW (21.1 +/- 1.7 vs 13.3 +/- 0.5 mm), S SW (15.3 +/- 1.3 vs 11.7 +/- 0.6 mm), and D LLA (75.2 +/- 1.6 vs 69.1 +/- 2.4 mm) were significantly greater and S LSA (23.4 +/- 2.4 vs 36.7 +/- 2.3 mm) and S LLA (46.5 +/- 3.7 vs 58.2 +/- 3.8 mm) were significantly less in the lifters vs the controls. S LPW/BW, S LPW/BSA, S LPW/LBM, S SW/BW, S SW/BSA, S SW/LBM, D LSA/BSA, and D LLA/BSA were significantly greater and S LSA/BW, B LSA/BSA, S LSA/LBM, S LLA/BSA, S LLA/LBM, and D SW/LBM were significantly less in the lifters than the controls.(ABSTRACT TRUNCATED AT 250 WORDS)     

Skin conditions in figure skaters, ice-hockey players and speed skaters: part II - cold-induced, infectious and inflammatory dermatoses

Participation in ice-skating sports, particularly figure skating, ice hockey and speed skating, has increased in recent years. Competitive athletes in these sports experience a range of dermatological injuries related to mechanical factors: exposure to cold temperatures, infectious agents and inflammation. Part I of this two part review discussed the mechanical dermatoses affecting ice-skating athletes that result from friction, pressure, and chronic irritation related to athletic equipment and contact with surfaces. Here, in Part II, we review the cold-induced, infectious and inflammatory skin conditions observed in ice-skating athletes. Cold-induced dermatoses experienced by ice-skating athletes result from specific physiological effects of cold exposure on the skin. These conditions include physiological livedo reticularis, chilblains (pernio), Raynaud phenomenon, cold panniculitis, frostnip and frostbite. Frostbite, that is the literal freezing of tissue, occurs with specific symptoms that progress in a stepwise fashion, starting with frostnip. Treatment involves gradual forms of rewarming and the use of friction massages and pain medications as needed. Calcium channel blockers, including nifedipine, are the mainstay of pharmacological therapy for the major nonfreezing cold-induced dermatoses including chilblains and Raynaud phenomenon. Raynaud phenomenon, a vasculopathy involving recurrent vasospasm of the fingers and toes in response to cold, is especially common in figure skaters. Protective clothing and insulation, avoidance of smoking and vasoconstrictive medications, maintaining a dry environment around the skin, cold avoidance when possible as well as certain physical manoeuvres that promote vasodilation are useful preventative measures. Infectious conditions most often seen in ice-skating athletes include tinea pedis, onychomycosis, pitted keratolysis, warts and folliculitis. Awareness, prompt treatment and the use of preventative measures are particularly important in managing such dermatoses that are easily spread from person to person in training facilities. The use of well ventilated footgear and synthetic substances to keep feet dry, as well as wearing sandals in shared facilities and maintaining good personal hygiene are very helpful in preventing transmission. Inflammatory conditions that may be seen in ice-skating athletes include allergic contact dermatitis, palmoplantar eccrine hidradenitis, exercise-induced purpuric eruptions and urticaria. Several materials commonly used in ice hockey and figure skating cause contact dermatitis. Identification of the allergen is essential and patch testing may be required. Exercise-induced purpuric eruptions often occur after exercise, are rarely indicative of a chronic venous disorder or other haematological abnormality and the lesions typically resolve spontaneously. The subtypes of urticaria most commonly seen in athletes are acute forms induced by physical stimuli, such as exercise, temperature, sunlight, water or particular levels of external pressure. Cholinergic urticaria is the most common type of physical urticaria seen in athletes aged 30 years and under. Occasionally, skaters may develop eating disorders and other related behaviours some of which have skin manifestations that are discussed herein. We hope that this comprehensive review will aid sports medicine practitioners, dermatologists and other physicians in the diagnosis and treatment of these dermatoses.     

Electrocardiographic changes in 1000 highly trained junior elite athletes

OBJECTIVES: To evaluate the spectrum of electrocardiographic (ECG) changes in 1000 junior (18 or under) elite athletes. METHODS: A total of 1000 (73% male) junior elite athletes (mean (SD) age 15.7 (1.4) years (range 14-18); mean (SD) body surface area 1.73 (0.17) m2 (range 1.09-2.25)) and 300 non-athletic controls matched for gender, age, and body surface area had a 12 lead ECG examination. RESULTS: Athletes had a significantly higher prevalence of sinus bradycardia (80% v 19%; p<0.0001) and sinus arrhythmia (52% v 9%; p<0.0001) than non-athletes. The PR interval, QRS, and QT duration were more prolonged in athletes than non-athletes (153 (20) v 140 (18) milliseconds (p<0.0001), 92 (12) v 89 (7) milliseconds (p<0.0001), and 391 (27) v 379 (29) milliseconds (p = 0.002) respectively). The Sokolow voltage criterion for left ventricular hypertrophy (LVH) and the Romhilt-Estes points score for LVH was more common in athletes (45% v 23% (p<0.0001) and 10% v 0% (p<0.0001) respectively), as were criteria for left and right atrial enlargement (14% v 1.2% and 16% v 2% respectively). None of the athletes with voltage criteria for LVH had left axis deviation, ST segment depression, deep T wave inversion, or pathological Q waves. ST segment elevation was more common in athletes than non-athletes (43% v 24%; p<0.0001). Minor T wave inversion (less than -0.2 mV) in V2 and V3 was present in 4% of athletes and non-athletes. Minor T wave inversion elsewhere was absent in non-athletes and present in 0.4% of athletes. CONCLUSIONS: ECG changes in junior elite athletes are not dissimilar to those in senior athletes. Isolated Sokolow voltage criterion for LVH is common; however, associated abnormalities that indicate pathological hypertrophy are absent. Minor T wave inversions in leads other than V2 and V3 may be present in athletes and non-athletes less than 16 but should be an indication for further investigation in older athletes.