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Thornton JS, Hewitt C, Khan K, Speechley M, Ambrose A, Reilly K, Mountjoy ML, Gouttebarge V, Crossley K. Hang up your cleats and hope for the best? A cross-sectional study of five health domains in retired elite female rugby players. BMJ Open Sport Exerc Med 2024; 10:e001999. [PMID: 39286323 PMCID: PMC11404255 DOI: 10.1136/bmjsem-2024-001999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2024] [Indexed: 09/19/2024] Open
Abstract
ABSTRACT Objectives To investigate retired elite female rugby players' health outcomes (and their relationships) in five key areas (musculoskeletal, cognitive, mental, reproductive/endocrinological and cardiovascular) and how those compare with the general population. Methods Female rugby players aged ≥18 years old and retired from elite competition ≥2 years were recruited via email or social media to complete a 179-item online questionnaire and neurocognitive assessment. Data from general population controls (matched for age and sex) were obtained where available. Results 159 participants responded (average age 43 (±5) years). 156 (98%) reported a hip/groin, knee, foot/ankle or lower back injury during their career, of which 104 (67%) reported ongoing pain. Participants reported worse hip and knee outcomes compared with the general population (p<0.0001). 146 (92%) reported sustaining one or more concussions. History of concussion was associated with lower-than-average scores on neurocognitive assessment. Compared with general population data, retired female rugby players reported less anxiety (OR=0.079 (95% CI 0.03 to 0.19)), depression (OR=0.67 (95% CI 0.57 to 0.78)) and distress (OR=0.17 (95% CI 0.15 to 0.19)). Amenorrhoea rates were higher compared with matched controls, and the age at menopause was younger. The prevalence of hypertension was higher. The rugby players perceived that their health decreased in retirement and cited a lack of physical activity as a main contributor. Conclusion Our findings point to the potential value of screening and monitoring, and identifying preventative measures during sporting careers to promote health and long-term quality of life for athletes.
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Affiliation(s)
- Jane S Thornton
- West Coast University-Ontario Campus, Ontario, California, USA
| | - Chloe Hewitt
- Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Karim Khan
- The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Mark Speechley
- Departments of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Ashley Ambrose
- Fowler Kennedy Sport Medicine Clinic, London, Ontario, Canada
| | | | | | - Vincent Gouttebarge
- Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Meibergdreef 9, Amsterdam, Netherlands
- Amsterdam Collaboration for Health & Safety in Sports (ACHSS), IOC Research Center, Amsterdam, Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Sports, Amsterdam, Netherlands
- Section Sports Medicine, University of Pretoria, Pretoria, South Africa
| | - Kay Crossley
- La Trobe University, Melbourne, Victoria, Australia
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Edouard P, Mosser C, Chapon J, Depiesse F, Palmer D. Understanding the first injury in athletics and its effect on dropout from sport: an online survey on 544 high-level youth and junior athletics (track and field) athletes. BMJ Open Sport Exerc Med 2024; 10:e001767. [PMID: 38288271 PMCID: PMC10824051 DOI: 10.1136/bmjsem-2023-001767] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2024] [Indexed: 01/31/2024] Open
Abstract
Objective To describe the first injury and to investigate whether it plays a role in altering athletics' sustainable practice. Methods We conducted a cross-sectional study using an exploratory survey on the first injury and its consequences on athletics practice. In 2021, we asked all high-level athletes licensed with the French Federation of Athletics (FFA) under 18 years, under 20 years and under 23 years categories between 2007 and 2021. Results Out of 6560 emails sent by FFA, 544 athletes responded, and 93.6% (n=510) reported experiencing at least one injury during their career. The first injury occurred at a mean age of 17.5±3.3 years after 6.1±4.1 years of athletics practice. The main locations of the first injury were the posterior thigh (28.9%), the ankle (16.5%) and the knee (12.6%), and the principal reported injury types were muscle (37.7%), tendon (17.5%) and ligament (15.5%). More than a third of injured athletes (36.7%) reported experiencing ongoing symptoms or sequelae after their first injury, and about half (48.5%) experienced recurrences. About 20% had stopped athletics at the time of the survey, with injury problems the primary cause of athletes dropping out (46.2%), including the first injury (9.4%). Conclusions Injuries played an important role in altering sustainable athletics practice, with injury accounting for about 50% of all reported dropouts and the first injury accounting for about 10% of all reported causes. Our results provide evidence to target the prevention of the first injury, which could be considered the origin of the 'vicious circle' of injuries.
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Affiliation(s)
- Pascal Edouard
- Inter-university Laboratory of Human Movement Biology (EA 7424), Université Jean Monnet, Lyon 1, Université Savoie Mont-Blanc, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France
| | - Constance Mosser
- Inter-university Laboratory of Human Movement Biology (EA 7424), Université Jean Monnet, Lyon 1, Université Savoie Mont-Blanc, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France
| | - Joris Chapon
- Inter-university Laboratory of Human Movement Biology (EA 7424), Université Jean Monnet, Lyon 1, Université Savoie Mont-Blanc, Saint-Etienne, France
| | - Frédéric Depiesse
- CH Chalons en Champagne et Institut Mutualiste de Montsouris, Paris, France
| | - Debbie Palmer
- Edinburgh Sports Medicine Research Network & UK Collaborating Centre on Injury and Illness Prevention in Sport, Institute for Sport, PE and Health Sciences, The University of Edinburgh, Edinburgh, UK
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Brent M, Brent MB. Sports Participation and Osteoarthritis in Females: A Systematic Review. Sports (Basel) 2023; 12:15. [PMID: 38251289 PMCID: PMC10819498 DOI: 10.3390/sports12010015] [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: 11/29/2023] [Revised: 12/22/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024] Open
Abstract
Sports participation and the risk of osteoarthritis (OA) have been a concern for decades. Few research efforts have been dedicated to clarify this issue for females, although they are considered at greater risk of developing OA than males. In contrast, several reviews have established an association between sports participation and OA for males. The aim of the systematic review was to assess the association between OA and participation in popular sports for females. PubMed, Embase, and Google Scholar were searched and yielded 578 articles. Nine eligible studies were included and covered ballet (age range: 19-54 years), running or tennis (age range: 40-65 years), Olympic sports (age range: not specified), volleyball (age range: 16.0 ± 0.8 to 46.8 ± 5.1 years), and cross-country skiing (age range: 15 to ≥60 years). For females, participating in sports at an elite level was associated with a higher risk of OA and an increased need for surgical treatment. At non-elite level, it was associated with a higher risk of OA, but it did not materialize to an increased risk for surgical treatment. Few studies compared females and males, and these studies suggested that sex did not affect the risk of developing OA from participating in sports. Nevertheless, to isolate the precise effect of sports participation on the development of OA remains difficult as injuries are common among athletes and are independently associated with an increased risk of OA.
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Affiliation(s)
- Magnus Brent
- Department of Health Science and Technology, Aalborg University, 9200 Aalborg Øst, Denmark
| | - Mikkel Bo Brent
- Department of Biomedicine, Health, Aarhus University, 8000 Aarhus, Denmark
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Yousufy U, Chimera NJ. Is There an Association Between Injury History and Lower Extremity Joint Injury During Canada Games Competition? Int J Sports Phys Ther 2023; 18:1308-1319. [PMID: 38050547 PMCID: PMC10693481 DOI: 10.26603/001c.89273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/12/2023] [Indexed: 12/06/2023] Open
Abstract
Background Injuries during elite level competition like the Canada Games, occur frequently and injury history is one of the strongest predictors of future injury; however, this association is unknown in the Canada Games. Purpose To determine the association between injury history and incidence of lower extremity joint injury during Canada Games competition. Methods Data from the 2009 - 2019 Canada Games (8710 male and 8391 female athletes) competitions were de-identified by the Canada Games Council for analysis. Injury data were cleaned and categorized for previous injury and injury type and location. Injury history was self-reported and included concussion, major surgical procedure, neck and back, trauma to joint or bone, and trauma to ligament or tendon. Injury from the Canada Games competitions were categorized to include ankle, knee, hip, and patellofemoral joint injuries. Chi-Square (χ2 ) test of independence determined association between injury history and incidence of lower extremity joint injury during Canada Games competition. IBM SPSS (Version 26) was used for statistical analysis (p-value < 0.05). Results Four hundred and seventy-five ankle, 503 knee, 253 hip, and 106 patellofemoral joint injuries were reported during 10 years of Canada Games competitions. There were significant associations between history of neck and back injuries with ankle injuries and knee injuries, history of trauma and overuse of ligament or tendon with hip injuries and history of trauma or overuse of joint or bone with patellofemoral joint injuries. Conclusion These findings support previous literature suggesting that injury history is associated with future injury. Level of Evidence 3.
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Affiliation(s)
- Umar Yousufy
- Faculty of Applied Health Science Brock University
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Thornton J, Rosen C, Davenport M, Mountjoy ML, Dorian P, Gouttebarge V, Breau B, Pila E, Reilly K, Yuan J, Mok K, Di Ciacca S, Speechley M, Crossley K. Beyond the medals: a cross-sectional study exploring retired elite female athletes' health. BMJ Open Sport Exerc Med 2023; 9:e001479. [PMID: 36643408 PMCID: PMC9835950 DOI: 10.1136/bmjsem-2022-001479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 01/13/2023] Open
Abstract
Objectives Little is known about the impact of elite sport participation on long-term athlete health. We aimed to: (1) describe musculoskeletal, mental health, reproductive/endocrine and cardiovascular characteristics in retired elite female athletes and compare to the general population and (2) explore athletes' perceptions of their elite sport participation and its impact on health. Methods A 136-item online questionnaire was disseminated to Canadian elite female rowing and rugby athletes >18 years old, >2 years retired from elite competition. Matched general population data were obtained from Statistics Canada when available. Results Seventy-four (24% response rate) athletes (average age 45 (±9) years; retired 15 (±9) years) completed the questionnaire (30 rowing, 44 rugby athletes). During their career, 63 athletes (85%) experienced a hip/groin, knee, foot/ankle injury, or low back pain, with 42 (67%) reporting ongoing symptoms. Athletes 35-54 years reported worse knee symptoms and quality of life compared with the general population (symptom: p=0.197; d=1.15 [0.66, 1.63]; quality of life: p=0.312 d=1.03 [0.54, 1.51]) while other hip, knee and foot/ankle outcome scores were similar. Retired athletes had lower odds of anxiety (OR=0.155 [95% CI0.062 to 0.384]), greater lifetime/ever odds of amenorrhea (OR=6.10 [95%CI 2.67 to 13.96]) and gave birth when older (p<0.05). Fifty-nine (79%) recalled witnessing or experiencing at least one form of harassment/abuse during their career. Sixty athletes (81%) rated their current health as above average or excellent and 61 (82%) would compete at the same level again if given the choice. Conclusion These novel insights can inform future preventative efforts to promote positive elite sport-related outcomes for current, former and future female athletes.
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Affiliation(s)
- Jane Thornton
- Department of Family Medicine, Western University, London, Ontario, Canada
| | - Casey Rosen
- Return to Health and Performance Lab, Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Margie Davenport
- Faculty of Kinesiology, University of Alberta, Edmonton, Alberta, Canada
| | | | - Paul Dorian
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vincent Gouttebarge
- Orthopaedic Surgery, Amsterdam University Medical Centres, Duivendrecht, The Netherlands
| | - Becky Breau
- Return to Health and Performance Lab, Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Eva Pila
- Return to Health and Performance Lab, Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Kristen Reilly
- Return to Health and Performance Lab, Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Jane Yuan
- Departments of Epidemiology & Biostatistics, Western University, London, Ontario, Canada
| | - Kelly Mok
- Return to Health and Performance Lab, Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Steve Di Ciacca
- Return to Health and Performance Lab, Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Mark Speechley
- Departments of Epidemiology & Biostatistics, Western University, London, Ontario, Canada
| | - Kay Crossley
- La Trobe Sport and Exercise Research Centre, La Trobe University, Melbourne, Victoria, Australia
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Soligard T, Palmer D, Steffen K, Lopes AD, Grek N, Onishi K, Shimakawa T, Grant ME, Mountjoy M, Budgett R, Engebretsen L. New sports, COVID-19 and the heat: sports injuries and illnesses in the Tokyo 2020 Summer Olympics. Br J Sports Med 2022; 57:bjsports-2022-106155. [PMID: 36588430 DOI: 10.1136/bjsports-2022-106155] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To describe the incidence of injuries and illnesses sustained during the Tokyo Summer Olympic Games from 23 July to 8 August 2021. METHODS We recorded the daily number of athlete injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the Tokyo 2020 medical staff. RESULTS In total, 11 315 athletes (5423 women, 48%; 5892 men, 52%) from 206 NOCs were followed up prospectively for the occurrence of injury and illness. NOC and Tokyo 2020 medical staff reported 1035 injuries and 438 illnesses, equalling 9.1 injuries and 3.9 illnesses per 100 athletes over the 17-day period. Altogether, 9% of the athletes incurred at least one injury and 4% at least one illness. The incidence of injury was highest in boxing (27%), BMX racing (27%), BMX freestyle (22%), skateboarding (21%), karate (19%) and handball (18%), of which both BMX freestyle and skateboarding were new events, and lowest in diving, road cycling, rowing, marathon swimming and shooting (1-2%). Marathon and artistic swimming presented the highest illness incidences (both 8%), followed by skateboarding and karate (both 7%). In the study period, COVID-19 affected 18 athletes, accounting for 4% of all illnesses and 0.16% of all athletes. Exertional heat illness affected 78 athletes (18% of all illnesses, 0.7% of all athletes), the majority (88%) resulting in no time lost from sport. CONCLUSION Overall, 9% of the athletes incurred an injury and 4% an illness during the Games. Comprehensive countermeasures helped mitigate both COVID-19 and exertional heat illnesses.
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Affiliation(s)
- Torbjørn Soligard
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Debbie Palmer
- Edinburgh Sports Medicine Research Network, University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, UK
- Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Kathrin Steffen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo Sports Trauma Research Center, Oslo, Norway
| | - Alexandre Dias Lopes
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA
| | | | - Kentaro Onishi
- Department of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Tomoyuki Shimakawa
- Department of Orthopaedic Surgery, Yaesekai Doujin Hospital, Okinawa, Japan
| | - Marie-Elaine Grant
- Institute of Sport and Health, University College Dublin, Dublin, Ireland
| | - Margo Mountjoy
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo Sports Trauma Research Center, Oslo, Norway
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7
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Palmer D, Cooper D, Whittaker JL, Emery C, Batt ME, Engebretsen L, Schamasch P, Shroff M, Soligard T, Steffen K, Budgett R. Prevalence of and factors associated with osteoarthritis and pain in retired Olympians compared with the general population: part 2 - the spine and upper limb. Br J Sports Med 2022; 56:bjsports-2021-104978. [PMID: 35961762 DOI: 10.1136/bjsports-2021-104978] [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: 07/05/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES (1) To determine the prevalence of spine and upper limb osteoarthritis (OA) and pain in retired Olympians; (2) identify risk factors associated with their occurrence and (3) compare with a sample of the general population. METHODS 3357 retired Olympians (44.7 years) and 1735 general population controls (40.5 years) completed a cross-sectional survey. The survey captured demographics, general health, self-reported physician-diagnosed OA, current joint/region pain and significant injury (lasting ≥1 month). Adjusted ORs (aORs) compared retired Olympians and the general population. RESULTS Overall, 40% of retired Olympians reported experiencing current joint pain. The prevalence of lumbar spine pain was 19.3% and shoulder pain 7.4%, with lumbar spine and shoulder OA 5.7% and 2.4%, respectively. Injury was associated with increased odds (aOR, 95% CI) of OA and pain at the lumbar spine (OA=5.59, 4.01 to 7.78; pain=4.90, 3.97 to 6.05), cervical spine (OA=17.83, 1.02 to 31.14; pain=9.41, 6.32 to 14.01) and shoulder (OA=4.91, 3.03 to 7.96; pain=6.04, 4.55 to 8.03) in retired Olympians. While the odds of OA did not differ between Olympians and the general population, the odds of lumbar spine pain (1.44, 1.20 to 1.73), the odds of shoulder OA after prior shoulder injury (2.64, 1.01 to 6.90) and the odds of cervical spine OA in female Olympians (2.02, 1.06 to 3.87) were all higher for Olympians compared with controls. CONCLUSIONS One in five retired Olympians reported experiencing current lumbar spine pain. Injury was associated with lumbar spine, cervical spine and shoulder OA and pain for Olympians. Although overall OA odds did not differ, after adjustment for recognised risk factors, Olympians were more likely to have lumbar spine pain and shoulder OA after shoulder injury, than the general population.
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Affiliation(s)
- Debbie Palmer
- Edinburgh Sports Medicine Research Network, Institute for Sport PE and Health Sciences, The University of Edinburgh, Edinburgh, UK
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Dale Cooper
- School of Allied Health Professions, Keele University, Keele, UK
| | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Centre Of Canada, Richmond, British Columbia, Canada
| | - Carolyn Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology and Departments of Paediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Mark E Batt
- Nottingham University Hospitals NHS Trust, Nottingham, UK
- Centre for Sport, Exercise and Osteoarthritis Versus Arthritis, Queen's Medical Centre, Nottingham, UK
| | - Lars Engebretsen
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Patrick Schamasch
- Medical Committee, World Olympians Association, Lausanne, Switzerland
| | - Malav Shroff
- Medical Committee, World Olympians Association, Lausanne, Switzerland
| | - Torbjørn Soligard
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Kathrin Steffen
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
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Prevalence and factors associated with low back pain in retired Great Britain’s Olympians: A cross‐sectional study. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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