OBJECTIVE: To investigate the training and development process of a multiple-Grand-Slam finalist.
METHODS: A mixed-methods case-study design was used to capture the quantitative and qualitative aspects related to the training and successful development process. We used a 3-step data-collection process and pragmatic analyses of (1) training history based on logs, plans, and questionnaires; (2) in-depth semistructured interviews with the player\'s head coach/father, physical coach, and team administrator/mother; and (3) systematic quality assurance through negotiation among researchers and all key informants, including the player.
RESULTS: The player\'s exceptional performance level was achieved by a progressive, nonlinear increase in annual training load during childhood and early youth, stabilizing at 800 sessions and 1250 to 1300 hours per year at the age of 19. The annual tennis-specific training plateaued at ∼750 hours from the age of 15, and 60 to 80 matches were played in most of the analyzed years. Point-play accounted for approximately 50% of the total amount of specific tennis training, clearly ahead of ground strokes (∼30%), serve/return (∼15%), and smash/volley (∼5%). Physical-conditioning hours increased 5-fold from 12 to 19 years, before stabilizing at ∼500 hours at senior age. Key success factors included the athlete\'s multidimensional sports talent, discipline, and inner drive; a highly dedicated father and tennis-enthusiastic family; and strong support from a complementary and interdisciplinary performance team.
CONCLUSIONS: This study provides novel information regarding the training and development process for a world-leading tennis player, providing a point of departure for the development of future talents.

UNASSIGNED: Load management is a sports science concept describing the execution of well-established training principles to measure athletic workloads and enhance performance. The term \'load management\' has become common in sports media to refer to a much wider range of scenarios, including the idea that by limiting regular season workload for athletes, their health and playoff performance will improve. Varying links between load and performance have been demonstrated in baseball and soccer. The purpose of this study was to objectively assess the impact of regular season workload on postseason performance among National Hockey League (NHL) goalies.
UNASSIGNED: NHL goalies with lighter regular season workloads will perform better in postseason appearances.
UNASSIGNED: Retrospective cohort.
UNASSIGNED: Level 3.
UNASSIGNED: NHL goalies with a minimum of 20 regular season games played and 3 playoff game appearances in the same season since 2013-2014 were eligible for inclusion. All regular season and postseason workload and performance metrics were collected from publicly available statistical databases. Workload outcomes included games started, minutes played, and shots faced. Performance outcomes included goals against average, save percentage, goals saved above average, and quality start percentage. Multivariable linear regression was used to determine whether regular season workload predicted postseason performance, when controlling for age and injury status.
UNASSIGNED: A total of 51 goalies contributed 111 goalie-seasons to the analysis. The results of the primary model indicated that regular season workload explained only 6.8% of the variance in postseason performance, and that this relationship was not significant (R2 = 0.068; F(5,92) = 1.335; P = 0.26).
UNASSIGNED: Based on data from 6 full seasons, there is no evidence to support a specific regular season game limit among NHL goalies with the aim of improved performance.
UNASSIGNED: Individualized workload plans may be more appropriate than a single league-wide standard.

BACKGROUND: The benefits of oral caffeine intake to enhance several aspects of physical performance, such as aerobic endurance, strength, power, and muscle endurance performance, are well supported. However, how the physical performance benefits of caffeine supplementation are translated into better specific actions in intermittent sports during real or simulated competition has been the topic of fewer investigations, and their results need to be appropriately reviewed and meta-analyzed.
OBJECTIVE: The aim of the study was to investigate the effects of acute caffeine intake on specific actions in intermittent sports involving decision making and high-intensity efforts (eg, team, racket, and combat sports) during real or simulated competitions.
METHODS: All studies included had blinded and crossover experimental designs, and we conducted a risk-of-bias analysis. In total, we included 24 studies. A meta-analysis was performed using the random-effects model to calculate the standardized mean difference (SMD) estimated by Hedges g and 95% CIs.
RESULTS: Caffeine ingestion increased high-intensity sport-specific actions during competition, such as the number of sprints (SMD: 0.48; 95% CI, 0.23-0.74), body impacts (SMD: 0.28; 95% CI, 0.08-0.49), accelerations (SMD: 0.35; 95% CI, 0.06-0.63), decelerations (SMD: 0.63; 95% CI, 0.12-1.14), and high-intensity offensive efforts (SMD: 0.36; 95% CI, 0.11-0.61). Additionally, caffeine ingestion induced a higher positive or success rate of actions during real or simulated competition (SMD: 0.44; 95% CI, 0.19-0.69).
CONCLUSIONS: The current meta-analysis provides evidence of caffeine supplementation in increasing high-intensity efforts and the success rate of sport-specific actions during real or simulated competition.

UNASSIGNED: To compare performance progression and variety in race distances of comparable lengths (timewise) between pool swimming and track running. Quality of within-sport variety was determined as the performance differences between individual athletes\' main and secondary race distances across (top-) elite and (highly-) trained swimmers and runners.
UNASSIGNED: A total of 3,827,947 race times were used to calculate performance points (race times relative to the world record) for freestyle swimmers (n = 12,588 males and n = 7,561 females) and track runners (n = 9,230 males and n = 5,841 females). Athletes were ranked based on their personal best at peak performance age, then annual best times were retrospectively traced throughout adolescence.
UNASSIGNED: Performance of world-class swimmers differentiates at an earlier age from their lower ranked peers (15-16 vs. 17-20 year age categories, P < 0.05), but also plateaus earlier towards senior age compared to runners (19-20 vs. 23 + year age category, P < 0.05), respectively. Performance development of swimmers shows a logarithmic pattern, while runners develop linearly. While swimmers compete in more secondary race distances (larger within-sport variety), runners specialize in either sprint, middle- or long-distance early in their career and compete in only 2, 4 or 3 other race distances, respectively. In both sports, sprinters specialize the most (P < 0.05). Distance-variety of middle-distance swimmers covers more longer rather than sprint race distances. Therefore, at peak performance age, (top-) elite female 200 m swimmers show significantly slower sprint performances, i.e., 50 m (P < 0.001) and 100 m (P < 0.001), but not long-distance performances, i.e., 800 m (P = 0.99) and 1,500 m (P = 0.99). In contrast, (top-) elite female 800 m middle-distance runners show significantly slower performances in all their secondary race distances (P < 0.001). (Top-) elite female athletes specialize more than (highly-) trained athletes in both sports (P < 0.05).
UNASSIGNED: The comparison to track running and lower ranked swimmers, the early performance plateau towards senior age, and the maintenance of a large within-sport distance variety indicates that (top-) elite sprint swimmers benefit from greater within-sport specialization.

OBJECTIVE: This study documents the efficacy and safety of using a Ligament Augmentation and Reconstruction System (LARS) ligament graft to augment extra-articular knee ligament reconstructions in elite athletes by reporting return-to-play (RTP) rates and levels, career longevity and complications.
METHODS: A consecutive series of all extra-articular knee ligament reconstructions augmented by LARS ligaments in elite athletes undertaken by three specialist sports knee surgeons between 2013 and 2020 were reviewed. Seventy-six elite athletes, aged over 16 years old, and more than 2 years postsurgery were included. RTP was defined as competing at professional level or national/international level in amateur sport.
RESULTS: There were 64 medial collateral ligament (MCL) and 12 posterolateral corner (PLC) reconstructions. Fifty-two (68.4%) underwent concomitant autograft cruciate ligament(s) reconstruction. The mean age was 25.1 years (SD ± 4.5). Most were football (35, 46.1%) or rugby players (35, 46.1%). Sixty-seven athletes (88.2%) RTP with 65 (97.0%) of these playing at the same or higher Tegner level. Fifty-six (83.6%) of the athletes that RTP were still playing at 2 years postsurgery. Twenty (57.1%) of those who had RTP and were more than 5 years postsurgery were still playing at 5 years. Six (7.9%) players required further surgery relating to the LARS/metalwork. One case had soft tissue inflammation adjacent to the proximal end of the synthetic graft, but it is unknown if this was mechanical irritation or a biological reaction. One MCL reruptured 4 years after RTP.
CONCLUSIONS: Utilising LARS to augment extra-articular knee ligament reconstructions allows 88.2% of athletes with a variety of knee ligament injuries to return to elite sport. The low morbidity rates coupled with 57% of athletes still playing 5 years postsurgery demonstrates that the LARS is safe and effective in these cases. Although there are reports of LARS ligaments being used in MCL and PLC reconstructions, there is very little evidence investigating if they are safe and effective. This study demonstrates that LARS synthetic grafts can be safely used for MCL and PLC reconstructions in elite athletes and they permit a high RTP with a low risk of complications.
METHODS: Level IV.

Previous literature has reported increased rates of gambling problems in athletes compared to non-athletes. More liberal gambling-related attitudes have been suggested as a reason, although this rarely has been researched. The present study aimed to examine gambling experience, gambling problems, and gambling-related attitudes and parental gambling experience in high school students, comparing student-athletes to students at conventional schools. This is a cross-sectional web survey study in high school students (N = 473, 53% at sports high schools, 57% male) at eleven schools in the Skåne region, Sweden, who answered a web survey addressed gambling experiences, parental gambling and gambling-related attitudes, and included validated screening instruments for gambling problems and psychological distress. A history of any gambling was common and increased with age. Problem gambling was detected in 10% (13% of males and 5% of females, p < .001), and was associated with paternal and maternal gambling but not with psychological distress. Sports high school students were not more likely (9%) than other students (10%) to endorse gambling problems and history of each gambling type. However, paternal (but not maternal) gambling was more commonly reported in athletes, who also had more positive attitudes to gambling\'s effects on society and gambling availability. In contrast to other studies, this study did not demonstrate higher prevalence of gambling or gambling problems among young athletes than among other students, but liberal attitudes towards gambling, and experience of parental gambling on the father\'s side, were more common among athletes than among non-athletes. Gambling attitudes in adolescents may need to be targeted in future preventive efforts in young athletes and others.

For athletes, sleep is essential for recovery and performance. Yet, up to two-thirds of athletes report poor sleep quality. Comprehensive data across all sports disciplines on the underlying causes of sleep problems are missing. We reanalyzed a data set of N = 1004 Swiss top athletes across an extensive array of 88 sports to gain knowledge on the specific deficits in sleep health with respect to gender, sport classes, sport-related factors, and well-being. We found that 18% of athletes were affected by at least two out of five high-risk sleep factors: 9% of athletes slept less than 6 h per day, 30% were dissatisfied with their sleep, 17% showed problems falling asleep within 30 min, 18% of athletes reported difficulty maintaining sleep more than three times a week, and 6% of athletes used sleeping pills more than once a week. We found sleep health strongly linked to overall well-being and mental health (22% showed at least moderate symptoms of either depression or anxiety). Therefore, screening and treating sleep disorders might effectively improve mental health and general well-being as well as performance among athletes around the globe.

UNASSIGNED: There is little evidence to guide elite athletes who desire returning to competition after giving birth to a child. Ultimately, this can result in decreased performance and increased risk of injury. This paper addresses aspects that must be considered when building and monitoring a return to running program for a postpartum elite or subelite athlete, including pelvic floor and core stability, progressive reloading of the musculoskeletal system, monitoring of nutritional parameters, and considerations for lactation.
UNASSIGNED: PubMed and CINAHL (Cumulative Index for Nursing and Allied Health Literature) were searched with the following search strategy: (extreme sports OR elite athletes OR running OR exercise) AND (breastfeeding OR lactation OR bone density OR fetal weight OR gestational weight gain OR postpartum or post-partum OR postnatal OR post-natal OR pregnancy OR childbirth). The following information is based on best available evidence and clinical experience.
UNASSIGNED: Clinical review.
UNASSIGNED: Level 4.
UNASSIGNED: Due to the interplay between cardiovascular fitness, postpartum nutrition, lactation, and progressive reloading of the muscular and skeletal system, we propose a multimodal, multidisciplinary approach to safely and successfully allow an athlete to return to an elite level of competition.
UNASSIGNED: Return to running in the postpartum period is a highly individualized process that benefits from multidisciplinary, individualized care. This includes monitoring of nutrition, core and pelvic floor function, bone reloading, muscle and tendon reloading, and breastfeeding care when applicable.
UNASSIGNED: C.

暂无摘要。

OBJECTIVE: Management of meniscal injuries in the elite athlete is a difficult problem secondary to the high demands of athletic competition, the need for a timely return to sport, and the desire to maximize performance over time. The purpose of this review is to provide an up-to-date summary on the current literature and trends regarding the management of meniscus injuries with a special consideration for elite athletes.
RESULTS: Historically, partial meniscectomy has been the primary treatment option for meniscus injuries. However, in recent years there has been an increased emphasis on meniscus preservation due to the increased risk of cartilage degeneration over time. Moreover, while partial meniscectomy still provides a quicker return to sport (RTS), recent literature has demonstrated similar rates of RTS and return to pre-injury levels between partial meniscectomy and meniscus repair. In the setting of symptomatic meniscal deficiency, meniscus allograft transplantation has become an increasingly utilized salvage procedure with promising yet variable outcomes on the ability to withstand elite competition. Currently, there is no uniform approach to treating meniscal injuries in elite athletes. Therefore, an individualized approach is required with consideration of the meniscus tear type, location, concomitant injuries, athlete expectations, rehabilitation timeline, and desire to prevent or delay knee osteoarthritis. In athletes with anatomically repairable tears, meniscus repair should be performed given the ability to restore native anatomy, provide high rates of RTS, and mitigate long-term chondral damage. However, partial meniscectomy can be indicated for unrepairable tears.