The global intensity of modern sports has pushed youth athletes into competitions originally designed for fully mature adults. Recent Olympic Games have included athletes as young as 11, with 337 athletes aged 16 and under competing in summer or winter Olympic Games between London 2012 and Beijing 2022.
During adolescence, the human body is still...]]>
We need to define some baseline standards in prevention, treatment and organisation, and having defined the baseline, we can then seek improvement and raise standards—Macauley, BJSM, 1997.
Almost 30 years ago, Macauley
At the Summer and Winter Paralympic Games, this should be realised through robust, well-governed medical provision. Preparatory frameworks such as the Paris 2024
A sports pharmacist is a highly trained clinician specialising at the intersection of pharmacy and athlete care.
To evaluate the incidence of bone stress injuries (BSIs) in college athletes from the USA by sport, sex and location.
Deidentified injury data for US collegiate athletes were collected from the 2016–2022 seasons using the Pac-12 Health Analytics Program from 33 sports. Included injuries were labelled as ‘bone stress injury,’ ‘stress fracture’ or ‘stress reaction’ and grouped together as BSIs. Incidence rates and incidence proportions were calculated and analysed by sport, sex and location. Rate ratios (RRs) were calculated comparing matched sports.
There were 1443 BSIs in 33 190 athlete years of participation, 695 female (63%) and 415 male (37%). BSIs occurred most commonly in the lower extremity (n=1165 times, 81%), followed by axial (n=246, 17%) and upper extremity (n=32, 2%). New injuries accounted for 81% of BSIs, while 19% were recurrent. The overall incidence proportion (average annual risk) of a BSI was 4% but risk varied by sport with women’s cross country (14.6%), men’s cross country (10.2%), women’s gymnastics (9.4%), women’s track and field (8.4%), women’s basketball (8.1%) and women’s rowing (8.0%) having the highest risk. Incidence rates were similar. In sex-matched sports, a higher rate of BSI occurred in women in gymnastics (RR 2.72, 95% CI (1.26 to 7.01)), softball/baseball (RR 2.12, 95% CI (1.23 to 3.67)), basketball (RR 2.10, 95% CI (1.41 to 3.17)), track and field (RR 1.71, 95% CI (1.35 to 2.17)), rowing (RR 1.62, 95% CI (1.13 to 2.39)) and cross country (RR 1.45, 95% CI (1.11 to 1.92)). Most sports had predominantly lower extremity BSIs; however, men’s baseball, men’s/women’s diving, men’s golf, men’s/women’s rowing and men’s/women’s swimming had primarily axial BSIs.
Women college athletes are at greatest risk of BSI with lower extremity injury most prevalent. Understanding sport-specific patterns and incidence rates of BSIs provides critical insight for shaping future injury prevention strategies.
Evaluate the effect of supported implementation on a co-created injury prevention programme (Prep-to-Play) use and injury incidence and evaluate the dose response relationship between adherence and injury incidence.
In this hybrid implementation-effectiveness stepped wedge cluster randomised trial, 165 women’s/girls’ Australian Football teams (2481 players) were randomly allocated to transition from unsupported to supported implementation at one of five time points during 2021/2022. Supported implementation included in-person workshops and support visits for coaches/team leaders. Unsupported implementation was access to online resources. Prep-to-Play includes warm-up, contact and strength activities. Primary (Prep-to-Play use) and secondary (concussion, anterior cruciate ligament (ACL)) outcomes were reported weekly. Weekly Prep-to-Play use (yes/no) was defined as using ≥75% of programme elements, ≥two-thirds of sessions each week. Analyses compared outcomes between supported and unsupported phases, adjusted for clustering, period, age group, competition level and region.
Average weekly Prep-to-Play use by teams was 13.1% (95% CI 11.5% to 14.9%) in the unsupported and 29.7% (95% CI 27.6% to 31.9%) in supported phase (OR 3.7 95% CI 2.4 to 5.7). The concussion and ACL injury incidence (per 1000 game hours) was 6.80 (95% CI 5.75 to 8.05) and 1.36 (95% CI 0.98 to 1.89) in unsupported, and 3.50 (95% CI 2.72 to 4.52) and 0.69 (95% CI 0.44 to 1.15) in supported, respectively, but the effect of supported implementation on injury incidence was unclear (concussion: incidence rate ratios (IRR) 1.36; 95% CI 0.74 to 2.49; ACL: IRR 2.27 (0.56 to 9.12). Higher Prep-to-Play adherence was associated with fewer total injuries (IRR: 0.95 95% CI 0.92 to 0.99).
Supported implementation via in-person workshops and support visits was associated with greater Prep-to-Play use compared with unsupported implementation, and greater adherence was associated with fewer injuries.
The purpose of this study was to (1) rigorously evaluate the Sport Concussion Assessment Tool (SCAT) 22-item symptom list and improve the area under the curve (AUC), sensitivity and specificity by creating the mini Symptom Index Tool (mSIT) and (2) identify the added utility of other examinations to include with the mSIT.
Prospective cohort study, with nested subsets, of collegiate athletics and military service academies. 59 901 athletes and cadets were enrolled in the National Collegiate Athletic Association-Department of Defense Concussion Assessment Research and Education (CARE) Consortium; 5075 diagnosed with a concussion. These analyses used the SCAT symptom survey, Standardised Assessment of Concussion, modified Balance Error Scoring System, modified Vestibular/Ocular Motor Screening (mVOMS), Immediate Post-Concussion Assessment and Cognitive Testing, King-Devick, Clinical Reaction Time and numerous neuropsychological tests in concussed versus non-concussed individuals within 48 hours of injury.
Individual symptoms in the symptom survey demonstrated a variety of Cohen’s d effect sizes, the largest being pressure in head (d=2.59), do not feel right (d=2.51) and headache (d=2.85). The largest effect sizes of the examinations were Symptom Severity Score (d=2.09) and mVOMS (d=3.41). The proposed mSIT is the sum of the 7-point Likert symptom scores for headache, pressure in head, do not feel right, sensitivity to light, dizziness and sensitivity to noise (range 0–36). The AUC/sensitivity/specificity of SCAT symptom severity index was 0.88/85 %/76%, whereas mSIT was 0.94/87 %/88%. The only concussion test/examination which added utility to mSIT was mVOMS with an AUC/sensitivity/specificity of 0.94/88 %/92% when used in combination. The proposed clinical cut-off score is ≥2 for mSIT and ≥2 for mVOMS. All other examinations in CARE were non-additive in acute concussion identification.
For a shorter concussion evaluation, the 6-question mSIT is recommended, improving the AUC from 0.88 to 0.94 with 2% better sensitivity and 12% better specificity compared with the 22-item SCAT Symptom Severity Score. Adding mVOMS further marginally enhances these metrics and can be completed within 2–3 min (mSIT Plus).
To quantify the incidence of concussions identified through clinical assessments or diagnostic protocols in rugby union (RU) (sevens and XVs) and rugby league (RL) over the past decade and analyse differences by sex, playing level, match versus training exposure and concussion assessment protocols (Head Injury Assessment (HIA) vs non-HIA).
Systematic review and meta-analysis.
PubMed, Web of Science, Scopus, Embase, SPORTDiscus, PsycINFO and CINAHL were searched in February 2025 for studies published between 2014 and 2025.
Studies were eligible if they reported concussions identified through clinical assessment or diagnostic protocols in rugby with extractable exposure data (match-player-hours and/or training-player-hours) and incidence rates per 1000 player-hours.
98 studies, comprising 10 591 concussions across 3 275 130 player-hours, met the inclusion criteria. Studies included data from 2003 to 2023. The pooled overall concussion incidence was 9.74 per 1000 player-hours (95% CI 8.54 to 10.95) in RU and 9.20 (95% CI 7.38 to 11.02) in RL, with no significant difference between codes (p=0.891). When analysed by subgroups, no statistically significant overall sex-based differences in concussion incidence were observed in either RU or RL; however, post hoc analyses identified higher concussion incidence among female youth players (<18 years) compared with males. Match play showed a markedly higher incidence than training (RU: 10.98 per 1000 match-player-hours vs 0.34 per 1000 training-player-hours; RL: 10.45 per 1000 match-player-hours vs 0.32 per 1000 training-player-hours; p<0.001). Studies using HIA protocols reported nearly double the incidence compared with non-HIA protocols (RU: 15.35 vs 7.72; rate ratio=1.83; p<0.001). Concussion trends reflected external factors, including COVID-19 disruptions and policy changes.
Concussion incidence in rugby appears to be strongly influenced by match intensity and assessment protocol. Structured diagnostic approaches, such as the HIA protocol, are associated with higher reported concussion incidence, likely reflecting improved detection.
CRD42023480774.
In 2022, I experienced an assault that had lasting emotional and physical impacts, including persistent lower back pain that followed. I lived with the physical pain, being in a whirl of denial and hope that I would just get better with time. After reinjuring my back at the gym, I could no longer ignore it. What initially felt like the end of my weightlifting career became a turning point for me instead.
For 6 months, my lower back pain held a constant presence in my day-to-day life. I experienced pain with sitting, pain with walking and pain with laughing. My symptoms followed me everywhere I went. I eventually decided to see a physician, one who unfortunately advised that I stop lifting weights. I could not accept that as the final answer; I was not ready to step away from lifting. I left the...]]>
My PhD research had two main aims. First, it investigated the acute changes and time course of recovery in muscle performance following a simulated half-marathon protocol on a treadmill. Second, it examined post-run changes in landing strategies, proprioception and joint mechanics as well as their recovery in recreational runners following the same protocol (
Half-marathon participation has increased worldwide, with a high prevalence of running-related musculoskeletal injuries
Volunteering is central to service-focused healthcare professions, offering opportunities to support communities through meaningful action. In 2025, British Broadcasting Corporation (BBC) Children in Need’s Challenge Yourself appeal called for collective effort to help ‘make life lighter’ for children and young people facing significant challenges, emphasising unity, inclusivity and the power of movement to bring people together.
The BBC Children in Need Thousand Mile Challenge invited 40 BBC local radio stations to each complete 25 miles of three-legged walking over 2 days. Each station was represented by two members of BBC Radio staff, tethered...]]>