The author, Pamela Venning, name has been corrected online only.
]]>Reference 57 has been corrected.
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Following publication of this article, constructive methodological concerns were raised by the scientific community. In the interest of full transparency, the authors of this study initiated this correction. The main conclusions and key messages remain unchanged.
Removal of three studies: Ceolin et al. 2024 and Van Caenegem et al. 2013 were removed because, upon re-examination, both studies included exclusively pre-GAHT participants. The eligibility criteria specified inclusion of studies assessing outcomes following exposure to GAHT when comparisons were intended to reflect post-hormonal physiological status. While these studies were initially retained, a closer reassessment of participant characteristics confirmed that no post-GAHT data were...]]>
The WHO defines health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".
In 2023, the International Olympic Committee (IOC) published its Mental Health Action Plan (MHAP), reaffirming that 'there is no health without mental health'.
Non-contact ACL injury risk can be reduced by up to 64% in female athletes aged 12–19.
Injury surveillance in cycling has historically focused on injury incidence, diagnostic classification and time-loss outcomes at the individual-athlete level.
In this context, ‘incidents’ refer to any race-related event recorded during competition, including crashes with multiple riders, solo collisions or other occurrences affecting rider participation or safety, irrespective of whether medical contact occurred. This paper proposes an incident-level severity framework for surveillance purposes, recognising that these recommendations are conceptual rather than confirmatory and require validation.
The recent development of an incident-based injury surveillance log within the Union Cycliste Internationale (UCI) World Tour incident surveillance programme enables systematic capture of race incidents irrespective of injury outcome.
This editorial aims to explore both risks and opportunities of social media use and exposure while highlighting potential directions for research and practice.
Social media is acknowledged to be both an extraordinary platform for connection and a documented contributor to a range of negative mental health...]]>
An anterior cruciate ligament (ACL) injury carries one of the highest injury burdens in sport
There has been a substantial focus on return-to-sport testing practices.
To assess safeguarding structures and organisational readiness to respond to interpersonal violence within 20 European National Olympic Committees (NOCs) and identify system gaps with implications for response and referral.
A cross-sectional online survey was completed by safeguarding personnel from 20 NOCs in the Safe Harbour project. The survey assessed safeguarding officer roles and capacity, policies, reporting mechanisms, case management, organisational needs and facilitators. Quantitative data were summarised descriptively, and open responses analysed using qualitative content analysis to identify recurring challenges.
All 20 NOCs returned surveys (100% response rate). Safeguarding officers were appointed in 19/20 NOCs, although most combined safeguarding with other duties. 11 NOCs (55%) had a safeguarding policy, with variation in content and implementation. 15 (75%) reported a (partly) implemented reporting mechanism, while 5 relied on ad hoc routes. Among NOCs with reporting systems (n=15), confidentiality (87%) and reporting on behalf of others (80%) were common, but guidance on escalation to authorities was rare (27%). Referral pathways were inconsistent (60% present). Reported barriers included limited staff capacity, legal uncertainty and variable leadership support. Facilitators included strengthening organisational infrastructure, clearer collaboration with external authorities, targeted training and access to practical tools such as classification and response frameworks.
Safeguarding systems across European NOCs are developing but remain uneven and incomplete. Gaps in capacity, policy maturity, reporting, referral and case triage may delay recognition of harm. Strengthening safeguarding as part of the athlete health system, with shared tools and sustainable resources, may improve readiness to respond.
To identify factors associated with return-to-sport (RTS) outcomes following confirmed acute respiratory infections (ARinf) in athletes.
This prospective cohort study included 114 confirmed ARinf cases among athletic individuals. Causative pathogens were identified using multiplex PCR testing, and illness severity was classified per International Olympic Committee consensus (mild, moderate and severe). RTS outcomes included time (days) to return-to-training (RTT), return-to-full-training (RTFT) and return-to-full-performance (RTFP). Cox regression models (HRs) assessed associations between RTS outcomes and demographics, sport participation, pathogen groups and illness severity.
The median (IQR) days to RTT were 3.5 (0–7), RTFT 8 (6–11) and RTFP 11 (7–14). Amateur athletes had prolonged RTS outcomes (HR range=0.51–0.59; p≤0.03) compared with professional athletes. RTS outcomes differed between the most common pathogen groups: influenza and SARS-CoV-2 had longer RTS than rhinovirus (HR range=0.11–0.23; p≤0.003). Severe illness was associated with prolonged RTS outcomes compared with mild and moderate illnesses (HR range=0.17–0.31; p<0.0001). Pathogen-related differences in RTS persisted within each severity group. Within mild/moderate illnesses, the influenza/SARS-CoV-2 subgroup had longer RTS than rhinovirus (HRs: RTT=0.35; RTFT=0.05; RTFP=0.06; p<0.05) and within severe illnesses (HRs: RTT=0.23; RTFT=0.21; RTFP=0.13; p≤0.01).
Factors associated with RTS outcomes following ARinf in athletes are level of sport participation, illness severity at presentation and the causative pathogen. Clinical assessment of illness severity remains valuable in RTS decision-making, particularly in low-resource settings. However, identifying the causative pathogen may provide additional predictive value and refine RTS clinical decision-making.
To describe the epidemiology of injuries and illnesses at the Paris 2024 Paralympic Games.
Injuries and illnesses were recorded daily via a web-based injury and illness surveillance system and local organising committee medical facilities. Adjusted incidences (injuries/illnesses per 1000 athlete days; 95% CIs), injury prevalence (IP; %) and injury burden (days lost per 1000 athlete days; 95% CIs) are reported.
In total, 4450 athletes (1978 female; 2472 male) from 163 National Paralympic Committees were monitored prospectively during the 14-day Games period (62300 athlete days). A total of 535 injuries (IP=10.9%) were reported in 485 athletes, with an incidence of 8.6 (7.9–9.4). Taekwondo (27.3 (20.7–35.8)), football 5-a-side (22.3 (14.4–37.7)) and sitting volleyball (19.9 (14.8–26.7)) showed higher incidences of injury compared to other sports (p<0.001). Injury burden was 8.5 (6.5–11.1) and 19.1% of injuries resulting in time loss from training/competition. The highest burden was observed in taekwondo (64.3 (35.9–115.2)) and football 5-a-side (23.4 (6.2–88.3)). A total of 520 illnesses were reported in 467 athletes (IP=10.5%), with an incidence of 8.3 (7.6–9.1). Illness incidence for female athletes (10.6 (9.4–11.9)) was higher than recorded for male athletes (6.6 (5.7–7.5)); p<0.001 and higher in triathlon (18.2 (12.6–26.7)) compared to other sports (p<0.05).
The incidence and burden of injury in taekwondo and football 5-a-side were significantly higher compared with other sports at the Paris 2024 Paralympic Games. The highest incidence of illness was observed in triathlon and female athletes had a higher illness incidence than male athletes.
Sudden cardiac arrest (SCA) remains the leading cause of sport-related death worldwide, yet survival outcomes in Africa are critically poor. We conducted a formative assessment of the knowledge, attitudes and practices of professional football stakeholders in Cameroon as a model for identifying system-level gaps in SCA preparedness in low-resource sport settings.
We conducted a cross-sectional survey during the 2024/2025 season across five pre-competition medical centres in Cameroon. Eligible participants were players, referees, coaches and physiotherapists from Elite 1, Elite 2 and the Female Super League who had two or more seasons of professional experience. A validated questionnaire, adapted from international guidelines, was used to assess sociodemographic data, knowledge, attitudes and practices. Data were analysed descriptively with subgroup comparisons using SPSS V.20.
A total of 745 participants were enrolled: 536 players, 90 referees, 84 coaches and 35 physiotherapists. Most (66.4%) demonstrated poor knowledge of SCA, only 12% reported confidence in cardiopulmonary resuscitation (CPR) or automated external defibrillator (AED) use and referees showed the lowest preparedness scores despite their critical first-responder role. While one-third expressed positive attitudes, self-reported barriers to providing CPR included fear of harm (66.3%) and legal concerns (78.3%). Only 33.4% reported good practices, with significant gaps in AED access, CPR training and emergency action plan awareness.
This assessment identified critical gaps in SCA preparedness in Cameroonian football, exposing gaps that likely extend across Africa and similar environments. Compulsory CPR/AED training, AED availability and enforceable emergency action plans are urgently needed to align African football with international best practice and strengthen the survival chain.
To estimate the prevalence of eating disorders (EDs) and disordered eating (DE) among athletes across training levels and assessment methods and to identify moderators associated with prevalence estimates.
Systematic review, meta-analysis and meta-regression conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
PubMed/MEDLINE, Scopus, Web of Science and SportDiscus were searched from inception to December 2024.
Studies were eligible if they included active athletes of any sex, age, sport discipline or training level and reported the prevalence of ED and/or DE using standardised assessments, including clinical diagnoses or structured diagnostic interviews for ED, and self-report instruments with established cut-off values for DE. Studies were excluded if they involved retired athletes, participants with pre-existing ED diagnoses, included fewer than 25 participants, reused data or were non-peer-reviewed.
From 1582 identified records, 190 studies (58 335 athletes, 34 628 women) were included in the systematic review and 127 high-quality studies (43 006 athletes) in the meta-analysis. The pooled prevalence of ED/DE was 20.0% (95% CI 17.0% to 23.0%). Subgroup analyses showed no significant differences according to training level or screening method (clinical interview or diagnosis vs self-reported instruments). However, prevalence varied significantly by instrument: Eating Disorder Examination yielded the lowest prevalence estimates (11.9%), whereas Eating Disorder Inventory yielded the highest (28.3%). Meta-regression showed that a higher proportion of women and more recent publication years were associated with higher prevalence estimates.
Approximately one in five athletes experience ED or DE, underscoring the magnitude of this issue in sport. These findings highlight the need for validated, athlete-specific screening instruments and tailored prevention and intervention strategies.
While laboratory-based biomechanical studies provide valuable insights into muscle-tendon behaviour, they are limited in their ability to replicate the dynamic, high-speed and unpredictable conditions of real-world injury situations. In this context, video analysis has emerged as a powerful tool for investigating injury-inciting situations directly...]]>
My skating story began at the age of six after being inspired by 'Dancing on Ice'. Quickly, I fell in love with everything, except the sparkles. I never felt I fit in with skating’s aesthetic. I was muscly and powerful. I wanted people to watch me jump, not comment on my hair or the dress I was wearing. The sparkles of skating were an aspect that I did not identify with, and it took me a long time to figure out how to make it my own. I now compete in catsuits instead of sparkly dresses (
The main purpose of my PhD work was to explore the responses of the neuromuscular and musculotendinous system in vivo, under different heat stress conditions. My PhD work followed a three-step experimental approach, inducing thermal stress through exposure in an environmental chamber and focusing on gastrocnemius medialis muscle-tendon unit. The first study aimed to determine the effects of passive heat exposure on muscle-tendon unit properties. Then, the second study investigated the acute effects of heat exposure on muscle-tendon interactions and fascicle dynamics in active participants (ie, during running). Finally, the third study measured the impact of active heat acclimation on muscle-tendon unit properties.
Athletes are exposed to high environmental temperatures, a challenge that is and will be exacerbated by climatic changes.