Pathophysiology and classification of iliotibial friction injuries

As a result of the frequent endurance sports that are being practiced nowadays, many techniques have been introduced to this field with favorable outcomes regarding to the management approaches of the different injuries. However, no previous investigations have adequately discussed the pathophysiology of iliotibial band friction syndrome (ITBS) based on recent evidence from the current studies in the literature. In the present investigation, we have discussed the pathophysiology and related classification of iliotibial band friction injuries based on the current studies in the literature. The current evidence about the pathophysiology of the condition is still controversial, although epidemiological investigations indicate that ITBS is becoming a more prevalent condition among runners and other endurance athletes. Furthermore, many factors can attribute to the development of the condition and have been reported to take essential roles in the pathophysiology of the disease. Some of these factors include gender, iliotibial band tightness, rearfoot eversion and weak hip abductors. Further investigations are still needed to completely understand the pathophysiology of the disease to help clinicians aim to achieve better interventions to enhance the outcome of practicing endurance and excessive exercises.

High Endurance Elite Athletes Show Age-dependent Lower Levels of Circulating Complements Compared to Low/Moderate Endurance Elite Athletes

Introduction: Aerobic exercise activates the complement system in the peripheral blood. However, the effect of age and high intensity endurance training on the levels of circulating complements and sassociated inflammatory cytokines, oxidative stress markers and cellular aging remains unknown.Methods: In this study, serum samples from 79 elite athletes who belong to high (n = 48) and low/moderate (n = 31) endurance sports and two age groups (below 30 years old, n = 53, and above 30 years old, n = 26) were profiled for 14 complements. Linear models were used to assess differences in complements levels between sport and age groups. Spearmann’s correlation was used to assess the relationship among detected complements and proinflammatory cytokines, oxidative stress markers and telomere lengths.Results: High endurance elite athletes exhibited significantly lower levels of circulating C2, C3b/iC3b and adipsin complements than their age-matched low/moderate endurance counterparts. Levels of C2, adipsin and C3b/iC3b were positively correlated with most detected complements, the pro-inflammatory cytokines TNF-alpha and IL-22 and the anti-oxidant enzyme catalase. However, they were negatively correlated with telomere length only in younger elite athletes regardless of their sport groups. Furthermore, high endurance elite athletes showed significantly lower concentrations of C3b/iC3b, C4b, C5, C5a, C1q, C3, C4, factor H and properdin in younger athletes compared to their older counterparts.Conclusion: Our novel data suggest that high endurance elite athletes exhibit age-independent lower levels of circulating C2, C3b/iC3b and adipsin, associated with lower inflammatory, oxidative stress and cellular aging, as well as lower levels of 10 other complements in younger athletes compared to older counterparts. Assessing the effect of various levels of endurance sports on complements-based immune response provides a better understanding of exercise physiology and pathophysiology of elite athletes.

Citius, Altius, Fortius: Managers’ quest for heroic leader identities

In this paper, we draw on Foucault’s concept “governmentality” to show how a cohort of middle-aged senior managers who engaged in competitive endurance sports fabricated (avowed) “heroic” leader identities drawing on this repertoire of discursive resources. Neoliberalism constitutes a form of governmentality which encourages people to regard themselves as autonomous and to aspire to personal fulfillment by investing entrepreneurially in themselves as “human capital.” Healthism, which requires individuals be responsible for their own health and wellbeing, is one program by which this is accomplished. We analyze managers’ talk about themselves as people who self-examined, and sought continually to transform (improve) themselves, to avow identities as superior (heroic) leaders. Our study contributes to the literature on governmentality by showing how in neoliberalism “healthism” constructs managers as enterprising selves.

The effects of dietary nitrate supplementation on endurance exercise performance and cardiorespiratory measures in healthy adults: a systematic review and meta-analysis

Background Nitrate supplementation is thought to improve performance in endurance sports. Objective To meta-analyze studies evaluating the effect of nitrate supplementation on endurance sports performance among adults. Data sources We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Web of Science and CINAHL without language restrictions. Methods We included studies that: 1) compared nitrate supplementation with placebo; 2) enrolled adults engaging in an endurance-based activity; and 3) reported a performance measure or surrogate physiologic outcome. We evaluated risk of bias using the Cochrane Collaboration tool and pooled data with a random-effects model. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to evaluate confidence in estimates. Results We included 73 studies (n = 1061). Nitrate supplementation improved power output (MD 4.6 watts, P < 0.0001), time to exhaustion (MD 25.3 s, P < 0.00001), and distance travelled (MD 163.7 m, P = 0.03). We found no significant difference on perceived exertion, time trial performance and work done. Nitrate supplementation decreased VO2 (MD − 0.04 L/min, P < 0.00001) but had no significant effect on VO2max or blood lactate levels. Conclusion The available evidence suggests that dietary nitrate supplementation benefits performance-related outcomes for endurance sports.

Cardiac remodeling induced by exercise in male master athletes

Aims: To describe cardiac remodeling in a population of male master athletes evaluated by transthoracic echocardiography and to analyse its relationship with several exercise-related characteristics.Methods and results: A total of 105 male master athletes aged ≥40 years old, mostly involved in endurance sports (81.0%) with a median training-volume of 66 [44; 103] METs/h/week, were studied. Left ventricular end-diastolic and end-systolic volumes were above the references in 84.8% and 75.8% athletes, decreasing in frequency when adjusted for BSA (26.3% and 23.2%). LV geometry was changed in more than half of the athletes (eccentric hypertrophy 28.3%, concentric remodelling 15.2% and concentric hypertrophy 8.1%) and several right ventricular (RV) dimensions were increased. Left atrium was dilated in 53.5% and right atrium in 37.4% athletes; only one athlete had a dilated aorta. Mean LV ejection fraction was 61±7% and global longitudinal strain -18.3±2.0%. Changes in LV geometry were more common in high intensity sports; LV dilation in athletes exercising >10 hours/week and in high intensity sports; RV dilation in athletes exercising >66 MET-hour/week and in endurance sports. In multivariate analysis high intensity sports remained an independent predictor of changes in LV geometry. There was a significant correlation between volume of exercise and cardiac structural adaptations.Conclusions: Cardiac structural adaptations were frequent in male master athletes, more pronounced in those involved in endurance sports, with high intensity and high volume of exercise. This data reinforces the concept that the characteristics of exercise are major determinants of cardiac remodeling and should be considered during athletes’ evaluation.

Diet Quality, Nutritional Status, and Haemoglobin Level of Female Adolescent Athletes in Endurance and Non Endurance Sports

Background: Based on the duration and intensity of the exercise, sports can b classified into two types: endurance and non endurance (strength and power). Endurance sports is a high risk sport with low diet quality, nutritional status (body mass index (BMI) and body fat percentage), and haemoglobin level. Objectives: The aimed of this study is to analyze the differences of diet quality, nutritionl status, and haemoglobin level of female adolescent athletes in endurance and non endurance sports. Methods: An observational study with a cross-sectional design was conducted on 23 endurance athletes and 21 non endurance athletes in BBLOP Central Java, UNNES swimming and athletic sports club, and Salatiga atlhetic sports club. Subjects were selected by purposive sampling. BMI and body was measured by Bioelectrical Impedance Analysis (Tanita DC-360). Haemoglobin level was assessed by cyanmethemoglobin method. Diet quality was measured by semi quantitative food frequency questionnaire (SQ-FFQ) and diet quality index-international (DQI-I) form. Data was analyzed by independent t-test and Mann-Whitney. Results: The majority of nutritional status based on BMI and perventage body fat in endurance and non endurance athlete were normal. About 9,5% of non endurance athlete had anemia. There were significant difference in diet quality (p=0,029) and variety of protein source, iron, vitamin C, and empty calorie foods intake (p<0,001; p=0,028; p=0,045; p<0,001) of endurance and non endurance athletes, but no significant difference in body fat percentage (p=0,573) and haemoglobin level (p=0,714). Conclusion: There were significant difference on diet quality, variety of protein source, iron, vitamin C, and empty calorie foods intake between endurance and non endurance athletes.

The Influence of Exercise Modality on Training Load Management

Purpose: To provide novel insight regarding the influence of exercise modality on training load management by (1) providing a theoretical framework for the impact of physiological and biomechanical mechanisms associated with different exercise modalities on training load management in endurance exercise and (2) comparing effort-matched low-intensity training sessions performed by top-level athletes in endurance sports with similar energy demands. Practical Applications and Conclusions: The ability to perform endurance training with manageable muscular loads and low injury risks in different exercise modalities is influenced both by mechanical factors and by muscular state and coordination, which interrelate in optimizing power production while reducing friction and/or drag. Consequently, the choice of exercise modality in endurance training influences effort beyond commonly used external and internal load measurements and should be considered alongside duration, frequency, and intensity when managing training load. By comparing effort-matched low- to moderate-intensity sessions performed by top-level athletes in endurance sports, this study exemplifies how endurance exercise with varying modalities leads to different tolerable volumes. For example, the weight-bearing exercise and high-impact forces in long-distance running put high loads on muscles and tendons, leading to relatively low training volume tolerance. In speed skating, the flexed knee and hip position required for effective speed skating leads to occlusion of thighs and low volume tolerance. In contrast, the non-weight-bearing, low-contraction exercises in cycling or swimming allow for large volumes in the specific exercise modalities. Overall, these differences have major implications on training load management in sports.