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Guevara SA, Crunkhorn ML, Drew M, Waddington G, Périard JD, Etxebarria N, Toohey LA, Charlton P. Injury and illness in short-course triathletes: A systematic review. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:172-185. [PMID: 36898525 PMCID: PMC10980869 DOI: 10.1016/j.jshs.2023.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/04/2022] [Accepted: 01/11/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of prevention strategies. This study synthesizes the existing evidence on the incidence and prevalence of injury and illness and summarizes reported injury or illness etiology and risk factors affecting short-course triathletes. METHODS This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting health problems (injury and illness) in triathletes (all sexes, ages, and experience levels) training and/or competing in short-course distances were included. Six electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, Embase, APA PsychINFO, Web of Science Core Collection, and SPORTDiscus) were searched. Risk of bias was independently assessed by 2 reviewers using the Newcastle-Ottawa Quality Assessment Scale. Two authors independently completed data extraction. RESULTS The search yielded 7998 studies, with 42 studies eligible for inclusion. Twenty-three studies investigated injuries, 24 studies investigated illnesses, and 5 studies investigated both injuries and illnesses. The injury incidence rate ranged 15.7-24.3 per 1000 athlete exposures, and the illness incidence rate ranged 1.8-13.1 per 1000 athlete days. Injury and illness prevalence ranged between 2%-15% and 6%-84%, respectively. Most injuries reported occurred during running (45%-92%), and the most frequently reported illnesses affected the gastrointestinal (7%-70%), cardiovascular (14%-59%), and respiratory systems (5%-60%). CONCLUSION The most frequently reported health problems in short-course triathletes were: overuse and lower limb injuries associated with running; gastrointestinal illnesses and altered cardiac function, primarily attributable to environmental factors; and respiratory illness mostly caused by infection.
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Affiliation(s)
- Sara A Guevara
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia; New South Wales Institute of Sport, Sydney, NSW 2127, Australia
| | - Melissa L Crunkhorn
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia; Queensland Academy of Sport, Brisbane, QLD 4111, Australia; Triathlon Australia, Gold Coast, QLD 4227, Australia.
| | - Michael Drew
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia
| | - Gordon Waddington
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia; Australian Institute of Sport, Bruce, ACT 2617, Australia
| | - Julien D Périard
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia
| | - Naroa Etxebarria
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia
| | - Liam A Toohey
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia; Australian Institute of Sport, Bruce, ACT 2617, Australia
| | - Paula Charlton
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia; Triathlon Australia, Gold Coast, QLD 4227, Australia
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Crunkhorn ML, Toohey LA, Charlton P, Drew M, Watson K, Etxebarria N. Injury incidence and prevalence in elite short-course triathletes: a 4-year prospective study. Br J Sports Med 2024:bjsports-2023-107327. [PMID: 38331566 DOI: 10.1136/bjsports-2023-107327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To characterise the prevalence, incidence rate (IR) and burden of injuries in elite short-course triathletes over a 4-year training and competition period. METHODS Fifty elite Australian triathletes were prospectively monitored for injury during four consecutive seasons (2018-2021). Injuries requiring medical attention were prospectively recorded and further subcategorised according to time loss. The IR and burden (injury IR×mean injury severity) were calculated per 365 athlete days, with sex differences in IR compared using IR ratios (IRR) from negative binomial regression models. RESULTS Two hundred and sixty-six injuries were reported in 46 (92.0%) athletes, of which 67.3% resulted in time loss. The injury IR was 1.87 injuries per 365 athlete days (95% CI 1.70 to 2.80), and comparable between sexes (IRR 0.82, 95% CI 0.64 to 1.04, p=0.109). Most injuries (70.7%) were training related. The most frequently injured body sites were the ankle (15.8%), foot (12.4%) and lower leg (12.0%). Bone stress injuries (BSIs) were the most burdensome injury type with 31.38 days of time loss per 365 days (95% CI 24.42 to 38.34). Twenty athletes (40.0%) reported at least one bone stress injury (BSI) (range 0-3). The rate of BSIs in female athletes was three times greater compared with male athletes (IRR 2.99, 95% CI 1.26 to 7.07, p=0.013). CONCLUSION Two-thirds of injuries reported in elite short-course triathletes resulted in time loss, with the majority occurring during training activities. Foot, ankle and other lower leg injuries had the highest incidence, with BSIs carrying the highest injury burden. The considerably higher rate of BSI observed in female athletes warrants consideration for future prevention strategies in female triathletes.
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Affiliation(s)
- Melissa Leith Crunkhorn
- University of Canberra Research Institute for Sport and Exercise, Canberra, Australian Capital Territory, Australia
- Queensland Academy of Sport, Nathan, Queensland, Australia
| | - Liam Anthony Toohey
- University of Canberra Research Institute for Sport and Exercise, Canberra, Australian Capital Territory, Australia
- AIS Performance, Australian Institute of Sport, Bruce, Australian Capital Territory, Australia
| | - Paula Charlton
- University of Canberra Research Institute for Sport and Exercise, Canberra, Australian Capital Territory, Australia
- Triathlon Australia, Gold Coast, Queensland, Australia
| | - Michael Drew
- University of Canberra Research Institute for Sport and Exercise, Canberra, Australian Capital Territory, Australia
| | - Kate Watson
- Performance Health, Queensland Academy of Sport, Nathan, Queensland, Australia
| | - Naroa Etxebarria
- University of Canberra Research Institute for Sport and Exercise, Canberra, Australian Capital Territory, Australia
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Neupert E, Gupta L, Holder T, Jobson SA. Athlete monitoring practices in elite sport in the United Kingdom. J Sports Sci 2022; 40:1450-1457. [PMID: 35694788 DOI: 10.1080/02640414.2022.2085435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Athlete monitoring systems (AMS) aid performance optimisation and support illness/injury prevention. Nonetheless, limited information exists on how AMS are employed across elite sports in the United Kingdom. This study explored how athlete monitoring (AM) data, in particular athlete self-report measures, were collected, analysed and disseminated within elite sports. Thirty elite sports practitioners representing 599 athletes responded to a survey on their AM methodologies. The majority, 83%, (n = 25) utilised an AMS, and a further 84% (n = 21) stated the collection of their AMS data was underpinned by a scientific rationale. Athlete self-report measures (ASRM) were the most commonly employed tool, with muscle soreness, sleep and energy levels amongst the most frequently collected measures. The ubiquitous use of custom single-item ASRM resulted in considerable variability in the questionnaires employed, thus potentially impacting questionnaire validity. Feedback processes were largely felt to be ineffective, with 44% (n = 11) respondents indicating that athletes did not receive sufficient feedback. Some respondents indicated that AMS data was never discussed with athletes and/or coaches. Overall, significant disparities exist in the use of athlete monitoring systems between research and elite sports practice, and the athlete, coach and practitioner experience of monitoring risks being poor if these disparities are not addressed.
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Affiliation(s)
- Emma Neupert
- School of Sport, Health & Exercise Science, University of Portsmouth, Portsmouth, UK.,School of Sport, Health & Community, University of Winchester, Winchester, UK
| | | | - Tim Holder
- School of Sport, Health & Community, University of Winchester, Winchester, UK
| | - Simon A Jobson
- Faculty of Health & Wellbeing, University of Winchester, Winchester UK
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Feletti F, Saini G, Naldi S, Casadio C, Mellini L, Feliciani G, Zamprogno E. Injuries in Medium to Long-Distance Triathlon: A Retrospective Analysis of Medical Conditions Treated in Three Editions of the Ironman Competition. J Sports Sci Med 2022; 21:58-67. [PMID: 35250334 PMCID: PMC8851118 DOI: 10.52082/jssm.2022.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 12/07/2021] [Indexed: 06/14/2023]
Abstract
Triathlon's popularity is rapidly increasing, and epidemiological data relating to its related medical conditions is crucial to the development of proper medical plans and safety guidelines for it. This study examined the data from the medical reports collected during three consecutive editions of Ironman Italy, from 2017 to 2019. Out of 10,653 race-starters, 3.3% required medical attention sustaining 472 medical conditions. A significantly higher injury risk was found for females versus males (χ2 = 9.78, p = 0.02) and in long-distance (IR: 4.09/1,000hours) rather than in Olympic/middle distance races (IR: 1.75/1,000hours). Most (68.4%) conditions (including muscular exhaustion, hypothermia, and dehydration) were systemic, whilst only 10.2% were acute traumatic injuries. Of a total of 357 triathletes requiring medical assistance, 8.1% were a candidate for hospitalisation. The equipment and personnel that are required for the medical assistance in future triathlon events were estimated based on Maurer's algorithm, and ten practical recommendations for triathlon medical support were formulated.
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Affiliation(s)
- Francesco Feletti
- Department of Diagnostic Imaging, Ausl Romagna, S. Maria delle Croci Hospital, Ravenna Italy
| | - Gaia Saini
- Department of Emergency, Ausl Romagna, S. Maria delle Croci Hospital, Ravenna, Italy
| | - Stefano Naldi
- Department of Surgery, Unit of Emergency Surgery, S. Maria delle Croci Hospital, Ravenna, Italy
| | - Carlo Casadio
- Associazione dietetica e nutrizione clinica italiana, Rome, Italy
- Comitato di Ravenna, Croce Rossa Italiana, Ravenna, Italy
| | - Lorenzo Mellini
- Department of Diagnostic Imaging, Ausl Romagna, S. Maria delle Croci Hospital, Ravenna Italy
| | - Giacomo Feliciani
- Istituto Scientifico Romagnolo per lo studio e la cura dei tumori - IRCCS, Meldola (FC), Italy
| | - Emanuela Zamprogno
- Critical Care Team I-Help BSO
- Confederazione Nazionale Misericordie d'Italia
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Abstract
The distribution of injuries affecting long-distance triathletes is yet to be fully understood. A systematic review was performed of the clinical literature to determine the epidemiology of musculoskeletal injuries affecting long-distance triathletes. Searched databases in Feb 2020 were PubMed, Medline, EMBASE, EMCARE, and CINHAL databases. Published observational research articles related to the incidence or prevalence of musculoskeletal injuries in long-distance triathletes (competing at “Ironman” full distance or greater), written in the English language and not restricted by age or gender or date were eligible. Of the 975 studies identified on the initial search, six studies met the inclusion criteria for analysis. The mean age (SD) of the long-distance triathletes in these studies was 35.1 (2.7) and the range was 21-68 years. Overuse injuries were most frequent with the incidence range of 37-91%, and acute injury incidence range was 24-27%. The knee and spine were the most frequent location of injury. Running and cycling were the most frequently affected disciplines. Elite athletes had a lower incidence of overuse injury (37%). The highest acute injury incidence (27%) was recorded in non-elite athletes. The quality of the studies was relatively poor with only one study satisfying >50% of the quality assessment tool questions and only two studies were prospective, the rest were retrospective cross-sectional studies. Overall, there is a lack of literature reporting on musculoskeletal injuries in long-distance triathletes. Overuse injuries, particularly in the knee, are the most frequently reported, running and cycling are the most frequent disciplines associated. Long-distance triathletes may have a lower incidence of both overuse and acute injuries.
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Abstract
Triathlon is an increasingly popular sport that includes swimming, cycling, followed by running. The triathlete should not be seen merely as a cyclist who also swims and runs. Notable differences are seen in the type of bike used, training patterns, lower extremity demands, and cumulative nature of the sport. Injury prevention and treatment strategies need to take into account the triathlon distance, the type of bike used, athletic experience, prior injuries, risk factors, and a thorough understanding of the demands placed on the body through all 3 disciplines (swim, bike, and run).
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Affiliation(s)
- Daniel M Cushman
- Division of Physical Medicine and Rehabilitation, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.
| | - Nathan Dowling
- Department of Physical Therapy, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Meredith Ehn
- Division of Physical Medicine and Rehabilitation, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA
| | - Dana H Kotler
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
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Gimigliano F, Resmini G, Moretti A, Aulicino M, Gargiulo F, Gimigliano A, Liguori S, Paoletta M, Iolascon G. Epidemiology of Musculoskeletal Injuries in Adult Athletes: A Scoping Review. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57101118. [PMID: 34684155 PMCID: PMC8539527 DOI: 10.3390/medicina57101118] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/06/2021] [Accepted: 10/14/2021] [Indexed: 02/05/2023]
Abstract
Background and Objectives: Sport-related musculoskeletal injuries (MSK-Is) are a common health issue in athletes that can lead to reduced performance. The aim of this scoping review was to synthetize available evidence on injury incidence rates (IIRs), types, and sites that affect the musculoskeletal (MSK) system of adult athletes. Materials and Methods: We performed a scoping review on the Pubmed database limiting our search to 33 Olympic sports. Results: We identified a total of 1022 papers, and of these 162 were examined in full for the purpose of this review. Archery was the sport with the highest risk of injuries to the upper extremities, marathons for the lower extremities, and triathlon and weightlifting for the body bust. In the majority of the sports examined, muscle/tendon strain and ligament sprain were the most common MSK-Is diagnoses, while athletics, karate, and football were the sports with the highest IIRs, depending on the methods used for their calculations. Conclusions: Our scoping review highlighted the general lack and dishomogeneity in the collection of data on MSK-Is in athletes.
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Affiliation(s)
- Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, 81100 Naples, Italy;
| | - Giuseppina Resmini
- Centre for the Study of Osteoporosis and Metabolic Bone Disease, Section of Orthopaedic and Traumatology, Treviglio-Caravaggio Hospital, 24047 Bergamo, Italy;
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.A.); (F.G.); (S.L.); (M.P.); (G.I.)
- Correspondence: ; Tel.: +39-081-566-5537
| | - Milena Aulicino
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.A.); (F.G.); (S.L.); (M.P.); (G.I.)
| | - Fiorinda Gargiulo
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.A.); (F.G.); (S.L.); (M.P.); (G.I.)
| | | | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.A.); (F.G.); (S.L.); (M.P.); (G.I.)
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.A.); (F.G.); (S.L.); (M.P.); (G.I.)
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.A.); (F.G.); (S.L.); (M.P.); (G.I.)
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8
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Jacques T, Bini R, Arndt A. Bilateral in vivo neuromechanical properties of the triceps surae and Achilles tendon in runners and triathletes. J Biomech 2021; 123:110493. [PMID: 34000645 DOI: 10.1016/j.jbiomech.2021.110493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 11/17/2022]
Abstract
Inter-limb differences in Achilles tendon mechanical, material and morphological properties have previously been described in non-athletes and attributed to the preferential use of a given limb. Achilles tendon overuse tendon injury generally initiate unilaterally and alters triceps surae activation and Achilles tendon properties. The investigation of inter-limb differences in muscle activation and tendon properties may provide directions for injury prevention in habitual runners. In this study triceps surae and Achilles tendon properties were investigated bilaterally in habitual runners during unilateral maximal isometric contractions. Morphological, mechanical and material Achilles tendon properties were assessed using isokinetic dynamometry, motion capture and ultrasonography while triceps surae activation strategies were assessed using electromyography. Lower limb preference was assessed for inter-limb comparisons using the Waterloo questionnaire. Zero and one-dimensional statistical analysis and Cohen's d were employed to investigate possible inter-limb differences. Inter-limb associations in Achilles tendon properties and intra-limb associations between triceps surae activations were assessed using Pearson's correlation coefficients. No differences were observed between the preferred and non-preferred limb in terms of triceps surae muscle activation amplitude and Achilles tendon properties. However, intra-limb association among triceps surae activation ratios were not identical between limbs. Runners and triathletes present similar Achilles tendons properties between limbs, and thus initial observations of unilateral changes in the Achilles tendon properties might be used as a strategy to prevent the onset of overuse tendon injury. The non-similar associations within activation ratios between limbs should be further explored since triceps surae activation strategies may alter loading of the Achilles tendon.
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Affiliation(s)
- Tiago Jacques
- The Swedish School of Sport and Health Sciences, Lidingovägen 1, 114 33 Stockholm, Sweden.
| | - Rodrigo Bini
- La Trobe Rural Health School, Edwards Rd, Flora Hill, VIC 3552, Bendigo, Australia
| | - Anton Arndt
- The Swedish School of Sport and Health Sciences, Lidingovägen 1, 114 33 Stockholm, Sweden; Karolinska Institute, Alfred Nobels Allé 8, 11486 Stockholm, Sweden
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Jacques T, Bini R, Arndt A. Running after cycling induces inter-limb differences in muscle activation but not in kinetics or kinematics. J Sports Sci 2020; 39:154-160. [PMID: 32814515 DOI: 10.1080/02640414.2020.1809176] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Overuse injuries are a common problem to triathletes' population. Overuse injuries may arise from inter-limb biomechanical differences during running, but the literature lacks information regarding inter-limb differences in triathletes. In this study inter-limb differences were investigated in injury-free triathletes during the running portion of a simulated cycle-run transition. Thirteen triathletes performed a 5 km run preceded by a 20 min cycling trial at 70% of maximal power output. During the Start, Mid and End stages of running, kinetic, kinematic and muscle activation variables were compared between the preferred and non-preferred limbs across the stance phase. A statistical parametric mapping analysis showed no differences between limbs when considering kinetic and kinematic variables (p > 0.05, ES<0.60). A lower soleus activation was observed in the preferred limb (p < 0.05, ES>0.60) from 53.40-75.9% of the stance phase at the End stage of running. In conclusion, inter-limb differences in kinetic or kinematic variables may not represent a risk for overloading in triathletes. However, inter-limb differences in triceps surae activation during running after cycling may represent one potential factor leading to overuse injuries in triathletes and should be further investigated.
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Affiliation(s)
- Tiago Jacques
- The Swedish School of Sport and Health Sciences , Stockholm, Sweden
| | - Rodrigo Bini
- La Trobe Rural Health School , Bendigo, Australia
| | - Anton Arndt
- The Swedish School of Sport and Health Sciences , Stockholm, Sweden.,Karolinska Institute , Stockholm, Sweden
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Chenaut P, Ménard M, Vaucher P, Lancelot L, Bideau B, Bourgin M. Biomechanical analysis of the lumbar-pelvic-femoral complex during the one-sided tilt test: a pilot study in triathletes. Comput Methods Biomech Biomed Engin 2020. [DOI: 10.1080/10255842.2020.1714921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- P. Chenaut
- Institut d’Ostéopathie de Rennes, Bruz, France
| | - M. Ménard
- Institut d’Ostéopathie de Rennes, Bruz, France
- Univ Rennes, Rennes, France
| | - P. Vaucher
- Unit of Research in Mobility & Musculoskeletal Care, School of Health Sciences Fribourg, University of Applied Sciences and Arts Western Switzerland (HES-SO), Delémont, Switzerland
| | - L. Lancelot
- Institut d’Ostéopathie de Rennes, Bruz, France
| | | | - M. Bourgin
- Institut d’Ostéopathie de Rennes, Bruz, France
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Nunes G, Sprada de Menezes F, Karloh M, Neis Machado C, Prado Barbosa M, Laurentino A. Recovery sector of the Ironman triathlon race: Pain profile of triathletes and sector organization. Sci Sports 2019. [DOI: 10.1016/j.scispo.2019.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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12
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Wiegand K, Mercer JA, Navalta JW, Pharr J, Tandy R, Freedman Silvernail J. Running status and history: A self-report study. Phys Ther Sport 2019; 39:8-15. [PMID: 31202143 DOI: 10.1016/j.ptsp.2019.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/01/2019] [Accepted: 06/01/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The purpose of the current study was to compare injury and running history among current and former runners who consider themselves either injured or uninjured. DESIGN Cross-sectional survey. SETTING Online survey, available to any individuals over the age of 18 who currently run (runners) or who once ran regularly but are no longer running (former runners). PARTICIPANTS 312 participants (age 38 ± 12 years, 219 males, 89 females, 4 did not disclose) completed the survey. MAIN OUTCOME MEASURES This study assessed injury incidence, consequences of injury such as time off, and reported injury diagnoses and treatments. Chi-square and frequency analyses were calculated to describe running status, injury counts, and response to injury. RESULTS Most participants (80%) reported 1 + running injury. 775 total injuries were reported. The four most common injuries were iliotibial band syndrome (34%), plantar fasciitis (30%), strained thigh/hip muscle (25%), and medial tibial stress syndrome (22%). About 40% of participants continued to run with these injuries. CONCLUSIONS Injury frequencies (80%) agreed with those reported in the literature. The results of this study also support the notion that running injuries exist on a continuum of severity and that the individual response to injury is complex and determined by various factors.
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13
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Menard M, Domalain M, Decatoire A, Lacouture P. Influence of saddle setback on knee joint forces in cycling. Sports Biomech 2018; 19:245-257. [DOI: 10.1080/14763141.2018.1466906] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Mathieu Menard
- Research Department, Rennes Institute of Osteopathy, Bruz, France
- Prime Institute and Sport Sciences Department, University of Poitiers, Poitiers, France
| | - Mathieu Domalain
- Prime Institute and Sport Sciences Department, University of Poitiers, Poitiers, France
| | - Arnaud Decatoire
- Prime Institute and Sport Sciences Department, University of Poitiers, Poitiers, France
| | - Patrick Lacouture
- Prime Institute and Sport Sciences Department, University of Poitiers, Poitiers, France
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14
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Schorn D, Vogler T, Gosheger G, Schneider K, Klingebiel S, Rickert C, Andreou D, Liem D. Risk factors for acute injuries and overuse syndromes of the shoulder in amateur triathletes - A retrospective analysis. PLoS One 2018; 13:e0198168. [PMID: 29856780 PMCID: PMC5983428 DOI: 10.1371/journal.pone.0198168] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 05/15/2018] [Indexed: 12/20/2022] Open
Abstract
Objectives To investigate the prevalence of shoulder-related acute and overuse injuries in triathletes and examine the role of possible risk factors, in order to identify potential preventive measures. Methods We performed a retrospective epidemiologic study of 193 amateur triathletes between June and August 2013 and evaluated their competition and training habits, as well as the presence of acute and overuse injuries of the shoulder sustained during the past 12 months. Contingency tables were analyzed using Pearson’s chi-squared test. Normally distributed data were compared with the independent samples t-test, while non-parametric analyses were performed with the Mann-Whitney U test. Binary logistic regression was used to identify important predictors of injuries. Results 12 participants (6%) sustained acute injuries and 36 athletes experienced an overuse injury. The acute injury rate amounted to 0.11 per 1000 hours of training and the overuse injury rate to 0.33 per 1000 hours of training. There was no association between athletes’ age, height, weight, BMI, a history of shoulder complaints or triathlon experience in years and acute or overuse injuries. Male athletes had a trend for sustaining more acute injuries then female athletes (8% vs. 2%, p = 0.079). Athletes with acute injuries spent a significantly higher amount of time per week doing weight training (p = 0.007) and had a trend for a higher weekly duration of cycling training (p = 0.088). Athletes with overuse injuries participated in a significantly higher number of races compared to athletes without overuse injuries (p = 0.005). The regular use of paddles was associated with a significantly higher rate of overuse injuries (24% vs. 10%, p = 0.014). Conclusion The regular use of paddles during swimming training appears to be a risk factor for the development of overuse injuries, while an increased duration of weight and cycling training seems to be associated with a higher rate of acute injuries.
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Affiliation(s)
- Dominik Schorn
- Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Münster, Germany
| | - Tim Vogler
- Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Münster, Germany
| | - Georg Gosheger
- Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Münster, Germany
| | - Kristian Schneider
- Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Münster, Germany
| | - Sebastian Klingebiel
- Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Münster, Germany
| | - Carolin Rickert
- Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Münster, Germany
| | - Dimosthenis Andreou
- Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Münster, Germany
| | - Dennis Liem
- Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Münster, Germany
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Turris SA, Lund A, Bowles RR, Camporese M, Green T. Patient Presentations and Medical Logistics at Full and Half Ironman Distance Triathlons. Curr Sports Med Rep 2017; 16:137-143. [DOI: 10.1249/jsr.0000000000000367] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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16
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Nunes GS, Bender PU, de Menezes FS, Yamashitafuji I, Vargas VZ, Wageck B. Massage therapy decreases pain and perceived fatigue after long-distance Ironman triathlon: a randomised trial. J Physiother 2016; 62:83-7. [PMID: 27025688 DOI: 10.1016/j.jphys.2016.02.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 02/03/2016] [Accepted: 02/16/2016] [Indexed: 10/22/2022] Open
Abstract
QUESTION Can massage therapy reduce pain and perceived fatigue in the quadriceps of athletes after a long-distance triathlon race (Ironman)? DESIGN Randomised, controlled trial with concealed allocation, intention-to-treat analysis and blinded outcome assessors. PARTICIPANTS Seventy-four triathlon athletes who completed an entire Ironman triathlon race and whose main complaint was pain in the anterior portion of the thigh. INTERVENTION The experimental group received massage to the quadriceps, which was aimed at recovery after competition, and the control group rested in sitting. OUTCOME MEASURES The outcomes were pain and perceived fatigue, which were reported using a visual analogue scale, and pressure pain threshold at three points over the quadriceps muscle, which was assessed using digital pressure algometry. RESULTS The experimental group had significantly lower scores than the control group on the visual analogue scale for pain (MD -7 mm, 95% CI -13 to -1) and for perceived fatigue (MD -15 mm, 95% CI -21 to -9). There were no significant between-group differences for the pressure pain threshold at any of the assessment points. CONCLUSION Massage therapy was more effective than no intervention on the post-race recovery from pain and perceived fatigue in long-distance triathlon athletes. TRIAL REGISTRATION Brazilian Registry of Clinical Trials, RBR-4n2sxr.
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Affiliation(s)
- Guilherme S Nunes
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis
| | - Paula Urio Bender
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis
| | | | - Igor Yamashitafuji
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis
| | - Valentine Zimermann Vargas
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis; Department of Physiology, São Paulo Federal University, São Paulo, Brazil
| | - Bruna Wageck
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis
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Abstract
Although the sport of triathlon provides an opportunity to research the effect of multi-disciplinary exercise on health across the lifespan, much remains to be done. The literature has failed to consistently or adequately report subject age group, sex, ability level, and/or event-distance specialization. The demands of training and racing are relatively unquantified. Multiple definitions and reporting methods for injury and illness have been implemented. In general, risk factors for maladaptation have not been well-described. The data thus far collected indicate that the sport of triathlon is relatively safe for the well-prepared, well-supplied athlete. Most injuries 'causing cessation or reduction of training or seeking of medical aid' are not serious. However, as the extent to which they recur may be high and is undocumented, injury outcome is unclear. The sudden death rate for competition is 1.5 (0.9-2.5) [mostly swim-related] occurrences for every 100,000 participations. The sudden death rate is unknown for training, although stroke risk may be increased, in the long-term, in genetically susceptible athletes. During heavy training and up to 5 days post-competition, host protection against pathogens may also be compromised. The incidence of illness seems low, but its outcome is unclear. More prospective investigation of the immunological, oxidative stress-related and cardiovascular effects of triathlon training and competition is warranted. Training diaries may prove to be a promising method of monitoring negative adaptation and its potential risk factors. More longitudinal, medical-tent-based studies of the aetiology and treatment demands of race-related injury and illness are needed.
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Affiliation(s)
- Veronica Vleck
- CIPER, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, Cruz Quebrada-Dafundo, 1499-002, Portugal,
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Winslow J. Treatment of lateral knee pain using soft tissue mobilization in four female triathletes. Int J Ther Massage Bodywork 2014; 7:25-31. [PMID: 25184012 PMCID: PMC4145001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
STUDY DESIGN Prospective case series. BACKGROUND These case reports present results of the treatment of lateral knee pain in four female amateur triathletes. The athletes were referred to the author's clinic with either a diagnosis of iliotibial band friction syndrome or patellofemoral pain syndrome, all four having symptoms for longer than seven months. Changes in training routines were identified as the possible cause of the overuse injuries that eventually developed into chronic conditions. INTERVENTION Treatment involved soft tissue mobilization of the musculotendinous structures on the lateral aspect of the knee. RESULTS At four weeks, three of the athletes improved 9 to 19 points on the Lower Extremity Functional Scale, 3 to 5 points on the Global Rating of Change Scale, and demonstrated improvement in hamstring and iliotibial band flexibility. At eight weeks the Global Rating of Change for these three athletes was a 7 ("a very great deal better") and they had returned to triathlon training with no complaints of lateral knee pain. One athlete did not respond to treatment and eventually underwent arthroscopic surgery for debridement of a lateral meniscus tear. CONCLUSIONS After ruling out common causes for lateral knee pain such as lateral meniscus tear, lateral collateral ligament sprain, patellofemoral dysfunction, osteochondral injury, biceps femoris tendonitis, iliotibial band friction syndrome or osteoarthritis, soft tissue restriction should be considered a potential source of dysfunction. In some cases soft tissue restriction is overlooked; athletes go undiagnosed and are limited from sports participation.
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Affiliation(s)
- John Winslow
- Corresponding author: John Winslow, DPT, OCS, MTC, ATC, Department of Physical Therapy, Ithaca College, 953 Danby Rd., Ithaca, NY 14850, USA.
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Chalmers S, Magarey ME, Scase E. Junior Australian football injury research: Are we moving forward? Phys Ther Sport 2013; 14:175-82. [DOI: 10.1016/j.ptsp.2013.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 05/17/2013] [Accepted: 06/04/2013] [Indexed: 10/26/2022]
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Andersen CA, Clarsen B, Johansen TV, Engebretsen L. High prevalence of overuse injury among iron-distance triathletes. Br J Sports Med 2013; 47:857-61. [DOI: 10.1136/bjsports-2013-092397] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Abstract
OBJECTIVE To explore stakeholder perceptions of triathlon competition safety and injury risk. DESIGN Qualitative focus group study. SETTING Triathlon stakeholders from Melbourne, Australia. PARTICIPANTS Competition organizers, coaches, and competitors of various skill levels, age, gender, and experience (n = 18). INTERVENTIONS Focus groups were conducted, recorded, and transcribed for analysis. MAIN OUTCOME MEASURES Key themes were identified using content analysis. RESULTS The perceived risk of serious injury was highest for cycling. Running was most commonly linked to minor injuries. Physical and environmental factors, including course turning points, funneling of competitors into narrow sections, and the weather, were perceived as contributing to injury. Experience, skill level, feelings of vulnerability, personal awareness, club culture, and gender issues were perceived as the competitor-related factors potentially contributing to injury. The cycling mount/dismount area, cycling, and swim legs were the race sections perceived as the riskiest for competitors. Competition organizers were considered to generally have the competitors' best interest as a priority. Triathlons were acknowledged as risky activities and individual competitors accepted this risk. CONCLUSIONS This study has highlighted the main risks and concerns perceived by triathlon competitors, coaches, and competition organizers, which will help identify potential, context-relevant intervention strategies to reduce injury risk.
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Health professionals' perceptions of musculoskeletal injury and injury risk factors in Australian triathletes: a factor analysis. Phys Ther Sport 2012. [PMID: 23177357 DOI: 10.1016/j.ptsp.2012.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study investigated health professional perceptions of triathlon-related injury risk factors and injury prevention strategies, to inform prospective cohort studies investigating injury in triathletes. DESIGN Exploratory factor analysis. METHODS A questionnaire was developed and distributed to Australian sports medicine health professionals (n = 504). Information was collected about their perceptions of factors contributing to injury and injury prevention strategies relating to Sprint/Olympic (S/O) and Ironman/Long Course (I/LC) athletes. Factor analysis was performed to identify the number and nature of the constructs (factors) underlying the responses to the questions, and to ascertain whether these factors were similar for S/O and I/LC athletes. RESULTS The response rate was 22.4% (n = 113). Five factors were extracted for injury risk accounting for 53% (S/O) and 56% (I/LC) of the variance. The factors were common across S/O and I/LC groups; biomechanics and technique, training factors, demographics, injury prevention and personal factors. Three common factors accounted for 54% (S/O) and 55% (I/LC) of the variance for injury prevention strategies; designated training regimes, health and medical monitoring and preparation of the triathlete. CONCLUSIONS These results indicate that future studies into triathlon injuries should include, at a minimum, detailed training load and demographic factors to test their impact as injury risk factors in triathlete populations.
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Luna NMS, Alonso AC, Brech GC, Mochizuki L, Nakano EY, Greve JMD. Isokinetic analysis of ankle and ground reaction forces in runners and triathletes. Clinics (Sao Paulo) 2012; 67:1023-8. [PMID: 23018298 PMCID: PMC3438241 DOI: 10.6061/clinics/2012(09)07] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 05/07/2012] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To analyze and compare the vertical component of ground reaction forces and isokinetic muscle parameters for plantar flexion and dorsiflexion of the ankle between long-distance runners, triathletes, and nonathletes. METHODS Seventy-five males with a mean age of 30.26 (±6.5) years were divided into three groups: a triathlete group (n=26), a long-distance runner group (n = 23), and a non-athlete control group. The kinetic parameters were measured during running using a force platform, and the isokinetic parameters were measured using an isokinetic dynamometer. RESULTS The non-athlete control group and the triathlete group exhibited smaller vertical forces, a greater ground contact time, and a greater application of force during maximum vertical acceleration than the long-distance runner group. The total work (180º/s) was greater in eccentric dorsiflexion and concentric plantar flexion for the non-athlete control group and the triathlete group than the long-distance runner group. The peak torque (60º/s) was greater in eccentric plantar flexion and concentric dorsiflexion for the control group than the athlete groups. CONCLUSIONS The athlete groups exhibited less muscle strength and resistance than the control group, and the triathletes exhibited less impact and better endurance performance than the runners.
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Affiliation(s)
- Natália Mariana Silva Luna
- Department of Orthopedics and Traumatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
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Jakeman J, Adamson S, Babraj J. Extremely short duration high-intensity training substantially improves endurance performance in triathletes. Appl Physiol Nutr Metab 2012; 37:976-81. [PMID: 22857018 DOI: 10.1139/h2012-083] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
High-intensity training (HIT) involving 30-s sprints is an effective training regimen to improve aerobic performance. We tested whether 6-s HITs can improve aerobic performance in triathletes. Six subelite triathletes (age, 40 ± 9 years; weight, 86 ± 11 kg; body mass index, 26 ± 3 kg·m⁻²) took part in cycle HIT and 6 endurance-trained subelite athletes (age, 36 ± 9 years; weight, 82 ± 11 kg; BMI, 26 ± 3 kg·m⁻²) maintained their normal training routine. Before and after 2 weeks of HIT, involving 10 × 6-s sprints or normal activity, participants performed a self-paced 10-km time trial and a time to exhaustion test on a cycle ergometer. Finger prick blood samples were taken throughout the time to exhaustion test to determine blood lactate concentration. Two weeks of HIT resulted in a 10% decrease in self-paced 10-km time trial (p = 0.03) but no significant change in time to exhaustion. The time taken to reach onset of blood lactate accumulation (OBLA, defined as the point where blood lactate reaches 4 mmol·L⁻¹) was significantly increased following 2 weeks of HIT (p = 0.003). The change in time trial performance was correlated to the change in time taken to reach OBLA (R² = 0.63; p = 0.001). We concluded that a very short duration HIT is a very effective training regimen to improve aerobic performance in subelite triathletes and this is associated with a delay in blood lactate build-up.
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Affiliation(s)
- John Jakeman
- Department of Sport and Health Sciences, Oxford Brookes University, Oxford OX3 0BP, England
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26
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De Bernardo N, Barrios C, Vera P, Laíz C, Hadala M. Incidence and risk for traumatic and overuse injuries in top-level road cyclists. J Sports Sci 2012; 30:1047-53. [DOI: 10.1080/02640414.2012.687112] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bini RR, Hume PA, Croft J. Cyclists and triathletes have different body positions on the bicycle. Eur J Sport Sci 2012; 14 Suppl 1:S109-15. [PMID: 24444194 DOI: 10.1080/17461391.2011.654269] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Our study evaluated differences in body position on the bicycle for recreational cyclists, competitive cyclists and triathletes. Thirty-six recreational cyclists, 17 competitive road cyclists and 18 competitive triathletes were assessed for body position on their bicycles on a cycle trainer. Images were taken of cyclists/triathletes in static poses with the crank at the 3 o'clock and 6 o'clock positions. Trunk, pelvis, hip, knee and ankle angles, anterior-posterior and medio-lateral positions of the knees in relation to the pedal axis and frontal projected area were measured using ImageJ. Comparison of body position between groups (recreational, competitive road cyclists and competitive triathletes) was conducted using effects sizes (ES). The greatest differences between groups in the measured variables were observed between the triathletes and the other two groups. Smaller differences were observed between competitive and recreational cyclists. Competitive triathletes had greater body forward projection (10% greater trunk flexion and 66% knee anterior position, ES = 2.5 and 1.2, respectively) and less frontal projected area (17%, ES = 1.3) than competitive road cyclists for body position on the bicycle. Both recreational and competitive cyclists sat on their bicycles with their trunks in a more vertical position compared to triathletes. Guidelines for bicycle configuration for triathletes and road cyclists need to consider the body positions during events.
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Affiliation(s)
- Rodrigo Rico Bini
- a Sport Performance Research Institute New Zealand , Auckland University of Technology , Auckland , New Zealand
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28
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Galera O, Gleizes-Cervera S, Pillard F, Riviere D. Prevalence of injuries in triathletes from a French league. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.apunts.2011.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Injuries in triathletes are common and are mostly overuse injuries. Rotator cuff tendinitis is the most common complaint from swimming, but the incidence of tendinopathy and rotator cuff tears on magnetic resonance imaging is comparable in triathletes without and with shoulder pain. Cycling injuries are mainly to the knee, including patellar tendinosis, iliotibial band syndrome, and patellofemoral stress syndrome, and to the Achilles tendon and the cervical and lumbar spine. Running is associated with most injuries in triathletes, during both training and racing, causing the athlete to discontinue the triathlon. In addition to knee injuries from running, triathletes may also develop foot and ankle, lower leg, and hip injuries similar to single-sport distance runners. Some injuries in triathletes may be mainly symptomatic during one of the three sports but are exacerbated by one or both of the other disciplines.
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Affiliation(s)
- Michael J Tuite
- Musculoskeletal Division, Department of Radiology, University of Wisconsin Medical School/UW Health, 600 Highland Avenue, Madison, WI 53792, USA.
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30
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Bonacci J, Blanch P, Chapman AR, Vicenzino B. Altered movement patterns but not muscle recruitment in moderately trained triathletes during running after cycling. J Sports Sci 2010; 28:1477-87. [DOI: 10.1080/02640414.2010.514279] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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31
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Machado CN, Gevaerd MDS, Goldfeder RT, Carvalho TD. Efeito do exercício nas concentrações séricas de creatina cinase em triatletas de ultradistância. REV BRAS MED ESPORTE 2010. [DOI: 10.1590/s1517-86922010000500012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O triatlo é um esporte de destaque e ampla participação mundial. Incorpora três diferentes modalidades de endurance - natação, ciclismo e corrida - dentro de um único evento. Há uma variedade de distâncias sobre as quais os eventos de triatlo são realizados, sendo a prova de ultradistância (ironman) a mais extensa. Autores diversos já relataram a ocorrência de lesões após esforço intenso, seja diretamente, através de alterações histológicas no sarcômero, ou indiretamente, pela quantificação da concentração de proteínas musculares específicas (biomarcadoras de lesão) no plasma. Entre esses marcadores de lesão muscular destacam-se a mioglobina e a creatina cinase. Efetivamente, a creatina cinase é o indicador bioquímico mais utilizado na literatura como indicador da ocorrência de lesão muscular. Dentro desse contexto justifica-se o objetivo do presente trabalho que visa verificar o efeito do exercício nas concentrações séricas de creatina cinase em triatletas de ultradistância frente a um período de competição. Para tanto, foram avaliados os dados das concentrações séricas de CK de 10 atletas que participaram da prova do Ironman Brasil de 2007. As análises sanguíneas foram realizadas em cinco períodos distintos: 19 dias antes da prova do ironman (CK1), 48 horas antes da prova (CK2), imediatamente após (CK3), cinco dias após (CK4) e 12 dias depois da prova (CK5). Os resultados apontaram aumento significativo nas concentrações de CK nos períodos 3 e 4 em relação aos demais períodos avaliados. Estas alterações evidenciam a influência do exercício exaustivo sobre as concentrações de CK, revelando a possibilidade de desenvolvimento de lesões musculares durante essa competição. Este fato reforça a importância do monitoramento de biomarcadores, como a CK, que permite a treinadores e atletas ajustarem suas cargas de treinamento para aumentar os benefícios do treinamento e para evitar o supertreinamento, melhorando o desempenho, a saúde e a qualidade de vida do atleta.
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Gosling CM, Forbes AB, McGivern J, Gabbe BJ. A profile of injuries in athletes seeking treatment during a triathlon race series. Am J Sports Med 2010; 38:1007-14. [PMID: 20436054 DOI: 10.1177/0363546509356979] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Triathlon combines swimming, cycling, and running into a single event. With increasing popularity of this sport, there has been a rise in the number of participants, particularly in shorter distance races. However, the risks of participating in short-distance races have not been reported. PURPOSE To describe the rate and profile of injuries seen for medical assistance during a triathlon race series. STUDY DESIGN Descriptive epidemiology study. METHODS A standardized injury reporting form was used to collect information from race entrants seeking medical aid at each of the races comprising a combination of Sprint, Olympic, and Fun race distances in a triathlon series in Victoria, Australia over the 2006-2007 race season. Injury rates and risk factors were assessed via regression analysis. RESULTS There were 10,197 individual starters who took part. There were 235 presentations for medical assistance (n = 322 injuries) over the series. The presentation rate was 20.1 per 1000 hours of competition (2.3% of total race starts). Injuries were predominantly sustained during the run (38.4%) and cycle (14.3%) legs. Lower limb injuries (59.5%) and abrasions (28.6%) were the most common site and nature of injury, respectively. There were 9 severe injuries: 5 fractures, 3 probable heat stroke cases, and 1 deep laceration. Elite/Junior Elite, Olympic distance, and 12- to 19-year-old competitors were at higher risk of injury, especially during running and cycling. CONCLUSION The level and age of triathlon competitors, and the race distance, influenced the risk of injury over a race series. These results provide timely information for triathlon race event organizers and could be incorporated into a review of practices for the provision of medical services to triathlon events, especially the common sprint distance competitions. CLINICAL RELEVANCE Shorter distance triathlons have lower injury rates and relatively minor injuries, but medical teams and race organizers should be prepared for serious injuries.
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Affiliation(s)
- Cameron M Gosling
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Chapman AR, Hodges PW, Briggs AM, Stapley PJ, Vicenzino B. Neuromuscular control and exercise-related leg pain in triathletes. Med Sci Sports Exerc 2010; 42:233-43. [PMID: 19927036 DOI: 10.1249/mss.0b013e3181b07e91] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
UNLABELLED Previous studies have shown that cycling can directly influence neuromuscular control during subsequent running in some highly trained triathletes. A relationship between this altered neuromuscular control of running and musculoskeletal pain and injury has been proposed; however, this link has not been investigated. PURPOSE This study aimed to evaluate the influence of cycling on neuromuscular control during subsequent running in highly trained triathletes with and without exercise-related leg pain (ERLP). METHODS Participants were 34 highly trained triathletes: 10 triathletes with a history of ERLP and 24 training-matched control triathletes with no history of ERLP. Knee and ankle kinematics and leg muscle recruitment were compared between a baseline run (no prior exercise) and a transition run (preceded by cycling; i.e., run vs cycle run). RESULTS Knee and ankle joint kinematics were not different between baseline and transition runs for any triathletes: absolute mean difference (+/-95% confidence interval) was 1.49 degrees +/- 0.17 degrees. However, muscle recruitment was different between baseline and transition runs, defined by absolute mean difference in EMG amplitude > or = 10%, in 5 of 24 control triathletes (11/130 muscles exhibited altered recruitment) and in 5 of 10 triathletes with a history of ERLP (12/50 muscles exhibited altered recruitment). This represents a relative risk of 2.40 (0.89-6.50; P = 0.089) when defined by athletes and 2.62 (1.34-6.01; P < 0.01) when defined by muscles. The magnitude of change in muscle recruitment between baseline and transition runs was not different between control (14.10% +/- 2.34%) and ERLP triathletes (16.31% +/- 3.64%; P = 0.41). CONCLUSIONS This study demonstrates an association between ERLP in triathletes and their neuromuscular control when running off the bike.
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Affiliation(s)
- Andrew R Chapman
- Division of Physiotherapy, The University of Queensland, Brisbane, Australia.
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Bonacci J, Chapman A, Blanch P, Vicenzino B. Neuromuscular adaptations to training, injury and passive interventions: implications for running economy. Sports Med 2010; 39:903-21. [PMID: 19827859 DOI: 10.2165/11317850-000000000-00000] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Performance in endurance sports such as running, cycling and triathlon has long been investigated from a physiological perspective. A strong relationship between running economy and distance running performance is well established in the literature. From this established base, improvements in running economy have traditionally been achieved through endurance training. More recently, research has demonstrated short-term resistance and plyometric training has resulted in enhanced running economy. This improvement in running economy has been hypothesized to be a result of enhanced neuromuscular characteristics such as improved muscle power development and more efficient use of stored elastic energy during running. Changes in indirect measures of neuromuscular control (i.e. stance phase contact times, maximal forward jumps) have been used to support this hypothesis. These results suggest that neuromuscular adaptations in response to training (i.e. neuromuscular learning effects) are an important contributor to enhancements in running economy. However, there is no direct evidence to suggest that these adaptations translate into more efficient muscle recruitment patterns during running. Optimization of training and run performance may be facilitated through direct investigation of muscle recruitment patterns before and after training interventions. There is emerging evidence that demonstrates neuromuscular adaptations during running and cycling vary with training status. Highly trained runners and cyclists display more refined patterns of muscle recruitment than their novice counterparts. In contrast, interference with motor learning and neuromuscular adaptation may occur as a result of ongoing multidiscipline training (e.g. triathlon). In the sport of triathlon, impairments in running economy are frequently observed after cycling. This impairment is related mainly to physiological stress, but an alteration in lower limb muscle coordination during running after cycling has also been observed. Muscle activity during running after cycling has yet to be fully investigated, and to date, the effect of alterations in muscle coordination on running economy is largely unknown. Stretching, which is another mode of training, may induce acute neuromuscular effects but does not appear to alter running economy. There are also factors other than training structure that may influence running economy and neuromuscular adaptations. For example, passive interventions such as shoes and in-shoe orthoses, as well as the presence of musculoskeletal injury, may be considered important modulators of neuromuscular control and run performance. Alterations in muscle activity and running economy have been reported with different shoes and in-shoe orthoses; however, these changes appear to be subject-specific and non-systematic. Musculoskeletal injury has been associated with modifications in lower limb neuromuscular control, which may persist well after an athlete has returned to activity. The influence of changes in neuromuscular control as a result of injury on running economy has yet to be examined thoroughly, and should be considered in future experimental design and training analysis.
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Affiliation(s)
- Jason Bonacci
- Musculoskeletal Pain and Injury Research Unit, University of Queensland, Brisbane, Queensland, Australia
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Effect of short-term creatine supplementation on markers of skeletal muscle damage after strenuous contractile activity. Eur J Appl Physiol 2009; 108:945-55. [DOI: 10.1007/s00421-009-1305-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2009] [Indexed: 10/20/2022]
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36
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Galera O, Gleizes-Cervera S, Pillard F, Rivière D. Prévalence des lésions traumatologiques dans un échantillon de triathlètes amateurs. Sci Sports 2009. [DOI: 10.1016/j.scispo.2009.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Chapman AR, Vicenzino B, Hodges PW, Blanch P, Hahn AG, Milner TE. A protocol for measuring the direct effect of cycling on neuromuscular control of running in triathletes. J Sports Sci 2009; 27:767-82. [PMID: 19437184 DOI: 10.1080/02640410902859100] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The direct effects of cycling on movement and muscle recruitment patterns (neuromuscular control) during running are unknown but critical to success in triathlon. We outline and test a new protocol for investigating the direct influence of cycling on neuromuscular control during running. Leg movement (three-dimensional kinematics) and muscle recruitment (surface electromyography, EMG) were compared between a control run (no prior exercise) and a 30-min transition run that was preceded by 20 min of cycling. We conducted three experiments investigating: (a) the repeatability (between-day reliability) of the protocol; (b) the ability of the protocol to investigate, in highly trained national or international triathletes, the direct influence of cycling on neuromuscular control during running independent of neuromuscular fatigue; and (c) the ability of the protocol to provide a control, or baseline, measure of neuromuscular control (determined using a measure of stability) without causing fatigue. Kinematic and EMG measures of neuromuscular control during running showed moderate to high repeatability: mean coefficients of multiple correlation for repeatability of EMG and kinematics were 0.816 +/- 0.014 and 0.911 +/- 0.031, respectively. The protocol provided a robust baseline measure of neuromuscular control during running without causing neuromuscular fatigue (coefficients of multiple correlation for stability of EMG and kinematics were 0.827 +/- 0.023 and 0.862 +/- 0.054), while EMG and force data provided no evidence of fatigue. The protocol outlined here is repeatable and can be used to measure any direct influence of cycling on neuromuscular control during running.
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Affiliation(s)
- Andrew R Chapman
- Division of Physiotherapy, The University of Queensland, Brisbane, Australia.
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Bentley DJ, Bishop D. Science and medicine of triathlon. J Sci Med Sport 2008; 11:361-2. [DOI: 10.1016/j.jsams.2008.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Revised: 01/10/2008] [Accepted: 01/10/2008] [Indexed: 10/22/2022]
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