Cardiovascular health in former elite male athletes

To increase our knowledge on the effects of previous and current physical activity on cardiovascular health, we studied a group of Finnish male former elite athletes (endurance, n = 49; power, n = 50) and their 49 age and area‐matched controls, aged 64–89 years. Body mass index (BMI), fasting serum glucose, lipids, blood pressure, and ultrasonography of cardiac and carotid artery structure and function were measured. Former endurance athletes smoked less, had lower prevalence of hypertension, and had higher intensity and volume of leisure time physical activity (LTPA) than the controls. No difference was detected in cardiac or carotid artery structure and function between these groups. Former athletes performing high‐intensity LTPA were slightly younger (possible selection bias), had lower BMI and waist circumference, lower use of antihypertensives, lower prevalence of diabetes, lower pulse wave velocity, and higher carotid artery elasticity than former athletes not performing high‐intensity LTPA. In conclusion, former athletes had a higher intensity and volume of LTPA than the controls. Athletes performing vigorous LTPA had more elastic arteries than athletes performing moderately or no LTPA. Vigorous LTPA through the whole lifetime associates with good cardiovascular health, although the previous medical history may play an important role.     

Intensive training in young athletes.

An increasing number of children take part in organized sporting activities, undergoing intensive training and high level competition from an early age. Although intensive training in children may foster health benefits, many are injured as a result of training, often quite seriously. This paper reviews some of the areas of research dealing with intensively trained young athletes, and focuses on physical, cardiovascular and muscular effects, sports injuries and psychological effects of intensive training. It is concluded that measures should be taken to modify present training and competition schemes to avoid the deleterious effects of intensive physical activity on these children.     

Prevalence of smoking among Israeli male athletes.

A survey of smoking habits was carried out on 2447 males age 14-40 years. The subjects were athletes trained in a wide variety of sports. Overall 15.5% of the athlete population were smokers. When broken down into training groups, the highest smoking prevalence was reported by subjects not engaged in specific training, while the lowest prevalence was reported by endurance trained athletes. When divided into specific sports, the highest percent of group smoking was found in soccer players. Smoking prevalence increased with increasing age. No significant differences in smoking prevalence existed between groups of varying ethnic origin. This study provides data on groups of athletes to target in smoking intervention programs.     

Spinal deformity in young athletes

Young athletes may have a spinal deformity incidentally or potentially related to their sport. These athletes should be encouraged to continue sports participation in many instances. Brace wear is commonly used for kyphotic and scoliosis deformities. Many sports can be played in the brace. Even with sports that cannot practically be played in the brace, most bracing protocols have enough time out of brace during the day for the athlete to continue participation. However, good physical therapy for flexibility and strengthening of the spine should be continued. Even sports that potentially aggravate the deformity may be continued in these circumstances.     

Head and neck injuries in young taekwondo athletes.

BACKGROUND: To investigate the location, type, situation and mechanism of head and neck injuries in young taekwondo athletes. METHODS: Experimental design: Prospective. Setting: National and international taekwondo tournaments. Participants: 3,341 boys and 917 girls, aged 6 to 16 years. Measures: Injury rates per 1,000 athlete-exposures (A-E) for total number of head and neck injuries, location, type, situation, and mechanism of injury. RESULTS: There was a significant difference between young male and female taekwondo athletes in total head and neck injury rate (p < 0.001) with the boys (21.42/1,000 A-E) recording a higher rate than the girls (16.91/1,000 A-E). The head was the most often injured body part (6.10/1,000 A-E and 4.55/1,000 A-E for boys and girls, respectively). The contusion was the most often occurring injury type for both boys (8.41/1,000 A-E) and girls (7.80/1,000 A-E). The cerebral concussion ranked second in both boys (5.11/1,000 A-E) and girls (4.55/1,000 A-E). The unblocked attack was the major injury situation for both boys (19.78/1,000 A-E) and girls (14.96/1,000 A-E). As a consequence, the major injury mechanism was receiving a blow (20.93/1,000 A-E and 16.25/1,000 A-E for boys and girls, respectively). Only the boys (0.66/1,000 A-E) incurred the most serious head and neck injuries that resulted in > or = 21 days away from participation. CONCLUSIONS: The national and international taekwondo governing bodies should review their current injury prevention measures. Given the potentially debilitating nature of these injuries, implications for any diagnostic capabilities on site should be carefully reviewed.     

Postactivation potentiation in endurance-trained male athletes

PURPOSE: The purpose of the study was to determine whether postactivation potentiation (PAP) was enhanced in the trained muscles of male endurance athletes. METHODS: Triathletes (TRI), distance runners (RUN), active controls (AC), and sedentary control subjects (SED) (N = 10 per group) performed 10-s maximal isometric contractions (MVC) of the elbow extensor and ankle plantarflexor muscles. Maximal twitch contractions were evoked (percutaneous stimulation) before and during a 5-min period after the MVC. PAP was measured as the percentage change in peak twitch torque post-MVC. RESULTS: TRI, who train both upper and lower limb muscles, had enhanced (relative to SED) PAP in both elbow extensor and plantarflexor muscles. In RUN, who train only the lower limbs, enhanced PAP was restricted to the plantarflexors. AC, whose main activity was upper and lower limb weight training, also had enhanced PAP in both muscle groups, although the enhancement in the plantarflexors was not as great as in TRI and RUN. CONCLUSION: PAP is enhanced in endurance athletes. Enhanced PAP may counteract fatigue during endurance exercise. The mechanism(s) responsible for the enhanced PAP remain to be determined.     

Low back pain in young athletes. A practical approach.

Lumbar spine pain accounts for 5 to 8% of athletic injuries. Although back pain is not the most common injury, it is one of the most challenging for the sports physician to diagnose and treat. Factors predisposing the young athlete to back injury include the growth spurt, abrupt increases in training intensity or frequency, improper technique, unsuitable sports equipment, and leg-length inequality. Poor strength of the back extensor and abdominal musculature, and inflexibility of the lumbar spine, hamstrings and hip flexor muscles may contribute to chronic low back pain. Excessive lifting and twisting may produce sprains and strains, the most common cause of low back pain in adolescents. Blows to the spine may create contusions or fractures. Fractures in adolescents from severe trauma include compression fracture, comminuted fracture, fracture of the growth plate at the vertebral end plate, lumbar transverse process fracture, and a fracture of the spinous process. Athletes who participate in sports involving repeated and forceful hyperextension of the spine may suffer from lumbar facet syndrome, spondylolysis, or spondylolisthesis. The large sacroiliac joint is also prone to irritation. The signs and symptoms of disc herniation in adolescents may be more subtle than in adults. Disorders simulating athletic injury include tumours and inflammatory connective tissue disease. Often, however, a specific diagnosis cannot be made in the young athlete with a low back injury due to the lack of pain localisation and the anatomic complexity of the lumbar spine. A thorough history and physical examination are usually more productive in determining a diagnosis and guiding treatment than imaging techniques. Diagnostic tests may be considered, though, for the adolescent athlete whose back pain is severe, was caused by acute trauma, or fails to improve with conservative therapy after several weeks. Radiographs, bone scanning, computed tomography, and magnetic resonance imaging may help identify, or exclude serious pathology. Fortunately, the majority of cases of low back pain in adolescents respond to conservative therapy. Immediate treatment of an acute injury, such as a sprain or strain, includes cryotherapy, electrogalvanic stimulation, anti-inflammatory medications and gentle exercises. Prolonged bed rest should be avoided since atrophy may occur rapidly. Strong analgesics are also usually contraindicated, except for sleep, since they mask pain and may allow overvigorous activity. Early strengthening exercises include the Williams flexion exercises and/or McKenzie extension exercises. Both exercise motions may often be prescribed. Athletes with an acute disc herniation, however, should only perform extension exercises initially. Athletes with spondylolysis, spondylolisthesis and facet joint irritation should initially be limited to flexion exercises.(ABSTRACT TRUNCATED AT 400 WORDS)     

Body composition in paraplegic male athletes

The body composition and anthropometric characteristics of male paraplegic athletes (PARA, N = 22) were contrasted to an able-bodied ectomorphic (N = 22) and mesomorphic (N = 31) comparison group of moderately and highly trained male subjects. The validity of 12 body composition [density (Db)] prediction equations reported in the literature, 4 generalized, were determined (tested) on this special group of athletes (PARA). On the whole, the prediction equations over-predicted Db in PARA by 0.0039 to 0.0166 g X cm-3 (under-predicted relative fat by 1.8 to 7.4%). Five diameter, 11 circumference, and 7 skinfold measures were used in a SAS-STEPWISE multiple regression procedure with hydrostatically determined Db to develop several suitable Db prediction equations for the paraplegic athlete. Diameters were poor predictors (r = 0.60, SEE = 0.0164), while skinfolds, circumferences, or a combination of measures were acceptable, with the combined equation being best (r = 0.95, SEE = 0.0064). The findings of this study suggest that even generalized equations do not adequately predict Db in PARA and that paraplegic specific equations are presently best suited for predicting Db in paraplegic athletes. The results further indicate that although these equations meet many of the criteria of Lohman, the SEE and total error values are unusually high and make prediction of body composition using anthropometry in a heterogeneous group of PARA athletes slightly unreliable.     

Modifications of the Dmax method in comparison to the maximal lactate steady state in young male athletes

Objective: To investigate the influence of different approaches for first-rise determination on the accuracy of Dmax as an estimate of the maximal lactate steady state (MLSS).

Methods: Seventeen male cyclists and 18 male runners with different levels of endurance performance completed graded exercise tests either on a cycle ergometer or treadmill to determine Dmax, calculated by the final data point and five modifications of the first rise in blood lactate concentration. Two or more constant load tests over 30 min were performed to determine MLSS. Differences between the modifications of the first rise in blood lactate concentration as well as the corresponding Dmax variants and MLSS were tested, using one-way repeated measure ANOVA with Bonferroni post-hoc tests, and illustrated, using the Bland–Altman method. The absolute agreement was observed, using intra-class correlation coefficients, based on a single measure, absolute agreement, 2-way mixed effects model.

Results: The peak power output/running velocity of the groups averaged 275 ± 43 W and 4.3 ± 0.4 m · s^?1, respectively. The mean power output/running velocity at MLSS was 229 ± 38 W and 3.77 ± 0.38 m · s^?1. For both running and cycling the original Dmax described by Cheng et al. was significantly lower than MLSS (p < 0.01). All modifications showed good agreement with MLSS (ICC ≥0.75). According to the Bland–Altman method the mean differences of the modifications compared to MLSS in cycling ranged from ?7 (43) to 2 (41) W. In running the mean differences ranged from ?0.12 (0.34) to ?0.08 (0.35) m· s^?1.

Conclusion: We suggest using the first rise in blood lactate concentration for calculating Dmax instead of the first data point of a lactate curve as originally described. The approach of first rise determination has no substantial influence on the accuracy of Dmax compared to MLSS in cycling and running.     

Physiological considerations in training young athletes

Healthy children evidence smaller values of cardiorespiratory function than adults, but these are in proportion to the smaller body size. At birth, the distribution of muscle fibres and the activity of enzymes in muscle are different from in adults, but these differences disappear at about age 6. On the other hand, muscle fibre thickness increases from birth to about 18 years of age and this is concurrent with increases in muscular strength. The increase in maximal oxygen consumption (VO2max) that accompanies growth and maturation in the human has been attributed in the main to appreciating muscle mass. During exercise, heart rate and cardiac output increase in the child as in the adult, but the heart rate in the child is greater and the stroke volume smaller. Furthermore, the arteriovenous difference in oxygen is greater in the exercising child than in the adult. Children also evidence a diminished blood pressure response to exercise. It seems that control of ventilation at exercise is the same in children as in adults, but exercise ventilation has been reported to be less efficient in the child. The young are less capable of regulating core temperature at exercise than adults and are more readily dehydrated. Very limited data suggest that muscle energy substrate storage and utilisation in children are such that they are less capable of anaerobic metabolism than adults. Generally, children respond to aerobic training as do adults, but such training in the first decade of life has been reported to have negligible effects. Blood lipid levels in children seem to be favourably influenced by persistent endurance activity. Ventilatory efficiency of children at exercise is augmented by aerobic training. Maximal values of ventilation and breathing frequency are increased in children and youth by endurance training. Conflicting data exist regarding the influence of training upon the child's vital capacity. Pulmonary diffusion capacity in well trained children has been seen to be greater than in untrained youngsters and many workers have reported increased VO2max as an outcome of endurance training. Limited data indicate that the nature of training may alter muscle fibre distribution in youthful athletes, and that muscle fibre hypertrophy can be induced in the young by means of strength and power training.(ABSTRACT TRUNCATED AT 400 WORDS)     

Former male elite athletes have better metabolic health in late life than their controls

Elite‐class athletes have longer life expectancy and lower risk for chronic noncommunicable diseases possibly because of physically active and healthier lifestyle. In this study, we assessed former male Finnish elite‐class athletes’ (n = 392) and their matched controls’ (n = 207) body composition, and risk for the metabolic syndrome (MS) and nonalcoholic fatty liver disease (NAFLD) in later life. Compared with the controls, the former athletes had lower body fat percentage (24.8% vs 26.0%, P = 0.021), lower risk for MS [odds ratio (OR) 0.57, 95% confidence interval (CI) 0.40–0.81], and NAFLD (OR 0.61, 95% CI 0.42–0.88). High volume of current leisure‐time physical activity (LTPA) was associated with lower body fat percentage (P for trend < 0.001). When current volume of LTPA increased 1 MET h/week, the risk of MS and NAFLD decreased (OR 0.99, 95% CI 0.98–0.99 and OR 0.97, 95% CI 0.96–0.98, respectively). Although a career as an elite‐class athlete during young adulthood may help to protect from developing metabolic syndrome, present exercise levels and volume of LTPA seem equally important as well.     

Intensive training in young athletes. The orthopaedic surgeon's viewpoint

A young athlete's musculoskeletal system is unique, in that it is not only growing, but is giving support to the growing soft tissues as well. With this in mind, it is easily understood that the fastest growing areas of children skeletal system are at greater risk of injury. No controlled longitudinal studies have yet been performed about the long term effects of injuries occurring in intensively trained young athletes. During the growth spurt, a dissociation between bone matrix formation and bone mineralisation occurs, thus leaving the child with the risks of chronic moderate-to-high overloading, sudden great overload, and diminished bone strength. This may account for both acute and overuse bone injuries in this age group. Epiphyseal plate injuries can have disastrous consequences. About 10% of all skeletal trauma in children involves the epiphysis, but few long-lasting effects have been reported. It is not clear whether intensively trained young athletes are at greater risk of injury than children engaged in free-play activities. It is worrying, though, that about 20% of injuries in sports children require internal fixation. Few studies have addressed injuries to tendons, ligaments and the enthesis in young athletes. It seems that tendon injuries are mild, not requiring surgery, and with a low recurrence rate, but no prospective studies have been performed. Avulsion of the ligamentous insertion occurs more frequently than ligament ruptures in this age group, even though they seem on the increase. Osteochondritis dissecans affects weightbearing joints such as the hip, the knee and the ankle, but elbow lesions in gymnasts and throwers are also relatively frequent. If it occurs before epiphyseal fusion, long term effects are scarce. The centre of growth or ossification where a major tendon is attached may undergo chronic inflammation and avulsion of cartilage and bone, due to the stresses transmitted to it. Typical areas are the inferior pole of the patella, the tibial tubercle and the calcaneal apophysis. Sports activity contributes to the disease by excessive traction at the tendinous and fascial insertion, or as a result of direct pressure. The lumbar spine is subjected to enormous forces in some sports. The true incidence of lumbar disc lesions in sporting children is not known, but it seems that acute trauma may play a major role. With the increase of the intensity and duration of training programmes, degenerative changes may play an adjuvant role.(ABSTRACT TRUNCATED AT 400 WORDS)