International Olympic Committee

Patients with an osteochondral lesion of the talus (OLT) often present with deep ankle pain, but the direct relationship between structural damage and the perceived pain remains unclear. The aim of this study was therefore to determine whether pain is associated with demographic and radiologic (computed tomography [CT]-only) lesion characteristics. This cross-sectional study was conducted in patients with symptomatic OLTs at a tertiary referral academic hospital. The primary outcome was the Pain subscale of the Foot and Ankle Outcome Score (FAOS). Secondary outcomes included the Numeric Rating Scale (NRS) for pain at rest and during walking, as well as the other FAOS subscales. Associations with patient demographics, lesion size, morphology, and location were assessed using univariate linear regression, followed by multivariate linear regression with backward selection. A total of 310 patients were included. In the final multivariate model for the FAOS Pain subscale, higher age (β = -0.18, P = .04) and smoking (β = -8.70, P < .001) were significantly associated with worse pain scores. Lesion morphology characterized by the presence of an osteochondral fragment was associated with lower NRS pain scores during walking. For NRS pain at rest, worse scores were significantly associated with female sex, higher body mass index, smoking, non-primary lesion nature, and greater lesion depth. No association was found between CT-based radiologic lesion characteristics and patient-reported pain as measured by the FAOS Pain subscale. In secondary analyses, some lesion characteristics showed associations, but these were limited and directionally inconsistent. These findings suggest structural damage alone does not seem to fully explain the patient's pain. Given the CT‑only approach and other design constraints, further research is warranted.

Objective : This study explored the experiences of female athletes performing heavy resistance exercise during pregnancy and postpartum (REX group) and reflected these against experiences of physically active women not engaging in heavy resistance exercise (REF group). Design : Secondary outcomes from a prospective, longitudinal study following two exercising groups of pregnant women through pregnancy and up to 12 months postpartum. Data were collected via questionnaires and analyzed using inductive content analysis. Results : Thirty-two women were included in the REX group and 17 were in the REF group. Of all participants, 35% reported receiving warnings against their usual training—most often from midwives. Although REX participants typically faced concerns related to heavy resistance exercise, REF participants also reported warnings, particularly about high-intensity exercise. Three key themes emerged from pregnancy responses: “training for two: joy, strength, and sanity through exercise”; “between warnings and worries: pregnant women’s struggle for reliable advice”; and “strength over strain: why resistance training works in pregnancy.” Two themes were identified postpartum: “new priorities, new physique” and “when experts fall silent.” Conclusion : Women training beyond standard health recommendations often encounter concerns from healthcare providers and others. Although the female athletes rely on personal experience, many express doubt and frustration due to the lack of tailored, evidence-based advice. Exercise, especially resistance exercise, was seen as vital for both mental and physical health, particularly when other forms of movement were limited by pregnancy or postpartum symptoms.

The aim of this study was to explore how socio-cultural norms and values influence female rowers’ experiences and perceptions of the menstrual cycle in sport. Individual semistructured interviews were conducted with 18 menstruating female rowers (29.2±11 years) from Ireland and the USA. Data were audio-recorded, transcribed verbatim, and analysed using a reflexive thematic analysis.Five themes were identified: (1) normalisation of abnormal periods: the majority of athletes described experiencing menstrual cycle irregularities. These irregularities were viewed as ‘normal’ or even valorised within rowing subcultures, precluding athletes from seeking help; (2) ‘Is she faking it?’ The delegitimisation of menstrual cycle pain and symptoms: pain was viewed as part and parcel of rowing culture, leading to athletes silencing or suppressing their pain as well as seeking medical interventions to ‘manage away’ their symptoms; (3) stigma and fear of leakages: athletes expressed a profound fear of leakages, which was amplified by patriarchal ideals and stigmatising notions surrounding bleeding bodies; (4) gendered norms and issues of non-disclosure: the interpersonal dynamics surrounding gendered norms create and perpetuate cultures of non-disclosure; (5) period power: emergence of alternative sociocultural norms that challenge dominant ideals and expand perceptions of how the menstrual cycle is experienced and managed within sport settings. Heeding calls for more research on the menstrual cycle within sports medicine, this study extends the literature by highlighting how sociocultural influences can perpetuate harmful discourses and practices that have implications for athletes’ menstrual health and well-being. Moreover, the findings illustrate how these sociocultural norms create contexts of concealment and taboo, ultimately limiting progression towards best practice management for female rowers.

Female, woman and/or girl athletes’ sport participation rates are rising and associated with high injury rates and burden. Using best-practice consensus methodology, we developed recommendations to guide injury prevention for female/woman/girl athletes. The Female/woman/girl Athlete Injury pRevention (FAIR) International Olympic Committee Consensus meeting was held from 31 March to 2 April 2025 (Lausanne, Switzerland).The FAIR Consensus followed an eight-step hybrid method. 109 authors from six continents conducted: (1) systematic reviews synthesising evidence on injury prevention strategies and modifiable risk factors for lower-extremity and upper-extremity injuries, concussions and spine/chest/abdominal/pelvic injuries/pain, (2) a scoping review synthesising dissemination and implementation (D&I) approaches; and (3) a concept mapping project generating knowledge on gender/sex-related factors for injury prevention. These projects underpinned draft recommendations subsequently voted on by a steering committee (n=24) and an external advisory committee chair over two anonymous survey rounds. Recommendations, Round 1 voting results and suggestions/dissenting comments were discussed between Round 1 and 2 voting. Consensus was defined as ‘critical to include’ (≥70% scored recommendation as 7–9 (9-point Likert scale, 1=not important; 9=critically important) AND ≤15% scored recommendation as 1–3).The 56 FAIR recommendations address: primary injury prevention (n=16) (policy/rules/laws=6; personal protective equipment=8; training=2); secondary injury prevention (n=4); modifiable risk factors (n=12); approaches to D&I (n=14); and promoting gender/sex-supportive environments (n=10).The FAIR Consensus informs evidence-based best practices and policy for injury prevention, approaches to implementation and creation of supportive environments for female/woman/girl athletes. Every person at all levels of sport can, and should, take responsibility for actions that positively influence female/woman/girl athlete health and safety.

The Youth Olympic Games (YOG) combines competition with educational initiatives for elite youth athletes. Despite the benefits of sport participation, young athletes face risks related to health and interpersonal violence (IV). The 'Mind, Body & Me' initiative at the 2024 Gangwon YOG was designed to promote holistic athlete health and safe sport. This study assessed youth athletes' understanding of health-related rights, perceptions of safe sport and awareness of safeguarding services. A cross-sectional survey was conducted among 1211 YOG athletes. Data were analysed using descriptive statistics and χ2 tests to identify differences based on sex, continent, sport and language. Content analysis was performed for qualitative responses. Most athletes felt that their health-related rights were respected; however, they reported discomfort seeking mental health support. Athletes described healthy sport as 'fun,' 'safe' and 'good,' while unhealthy sport was linked to 'bad,' 'bullying' and 'negative,' with regional variations. Bullying was the most widely recognised form of IV, particularly in female athletes, who were more aware of IV than males. Male athletes and those from Europe and Oceania expressed greater discomfort with reporting IV. While 74% were aware of the International Olympic Committee's safeguarding services, knowledge gaps existed among female athletes and non-English speakers. Athletes asked for more interactive tools, mental health programmes and improved accessibility to resources. Our findings highlight the importance of a holistic, athlete-centred approach, the need to improve access to health support services, the value of culturally tailored safeguarding strategies and the imperative of integrating safeguarding into broader health policies in youth sport.

The accurate estimation of daily energy requirements is important to inform athletes about their caloric needs and to prevent long-term low energy availability. Such estimations are often done by estimating energy expenditure. Recent data, including from a 200+ athlete cohort, show systematic underprediction of resting metabolic rate (RMR). Here, we tested this specifically in elite male volleyball players, who represent an underrepresented sport and a body morphology that is lacking in the literature. The purpose of this investigation is to compare the estimates of currently recommended predictive RMR equations for athletes (Harris-Benedict, Cunningham, Freire, Ten Haaf, and Tinsley) against measured RMR using high-resolution indirect calorimetry in volleyball players. Using a cross-sectional design, 22 international (tier 4) elite male volleyball players underwent evaluations of body composition, RMR, and bloodwork and completed the three-factor eating questionnaire-R18. Participants had a body mass of 93.3 ± 8.7 kg, fat-free mass of 77.5 ± 7.7 kg, and %body fat of 17.0 ± 2.2%. Our main findings were 1) the Ten Haaf [-134.9 ± 151 kcal (95% CI)], Freire [-181.4 ± 156 kcal (95% CI)], Harris-Benedict [-256.4 ± 152 kcal (95% CI)], and Cunningham [-299.8 ± 150 kcal (95% CI)] equations under predicted RMR compared with indirect calorimetry (P < 0.05), 2) the Tinsley equation was the most accurate [-126.8 ± 150 kcal (95% CI)], but moderately reliable (intraclass correlation coefficient = 0.59), at estimating RMR compared with indirect calorimetry, and 3) due to proportional bias toward heavier players, the RMR ratio < 0.90 with the Tinsley equation was not reliable to detect individual volleyball players at greater energy deficit. Future work should explore novel metabolic assessment protocols that will reliably assess energy needs of athletes high in absolute fat-free mass.NEW & NOTEWORTHY The most recently recommended predictive resting metabolic rate equations for athletes are unsuitable for heavier elite male volleyball athletes with higher FFM.

Chronic inflammation has emerged as a crucial component in cancer biology, influencing various aspects of tumor progression, immune evasion, and resistance to therapeutic interventions. This review explores the molecular underpinnings of inflammation-driven oncogenesis, with a focus on key inflammatory pathways such as NF-κB, STAT3, and inflammasomes. These pathways not only regulate tumor cell survival and proliferation but also alter the tumor microenvironment (TME), enhancing cancer cell adaptability to treatments. Furthermore, the review discusses how these inflammatory processes contribute to resistance mechanisms in conventional, targeted, and immunotherapies, while highlighting emerging strategies for integrating inflammation-targeting therapies into precision oncology.