United Kingdom Sport

Purpose Narratives help people to make sense of illness and trauma experiences. Exposure to a breadth of narratives is proposed to offer validation, reassurance and support well-being. Previous research constructed five narratives from people with major lower limb amputation (MLLA). However, efforts to bridge the research-practice gap, and meet clinical priorities by translating the narratives into resources, remained. This study aimed to illustrate an immersive co-design process and develop narrative resources for healthcare professionals working within, and people undergoing MLLA rehabilitation. Methods Commissioned by a National Health Service (NHS) MLLA rehabilitation centre, a 27-month rigorous co-design process was undertaken. An immersive, iterative three-stage process involving multiple end-user groups (e.g. patients, therapists, managers) and co-design activities (e.g. immersion, workshops) was used. Results Two co-design workstreams were undertaken, one to develop resources for people with MLLA and one for new allied healthcare professionals (AHPs). Outcomes included perceptions of the narratives (e.g. authentic, awareness raising), content and format priorities (e.g. visual, novel), and factors likely to influence implementation and engagement (e.g. readiness, existing knowledge). Conclusions Two narrative resource packages were co-designed for use in MLLA rehabilitation. The importance of context, and the dilemmas of sharing regressive narratives in clinical practice are discussed.

Abstract Background There is a need to continue to understand, nutrition, and overall health and wellbeing of athletes during pregnancy and postpartum. This study aimed to explore nutritional perceptions, needs, preferences, and concerns of female athletes in the United Kingdom (UK) and Republic of Ireland (ROI) during pregnancy and postpartum. An exploratory cross-sectional online survey was conducted between April and May 2024 among athletes ≥ 18 years who had experienced a pregnancy while competing (or retiring due to pregnancy) within the last eight years. Descriptive analyses were conducted for the full sample and stratified by pregnancy status and athlete level. Group differences were assessed using chi-square and McNemar’s test. Results 287 athletes (34.7 ± 3.8years) from 48 different primary sporting types and activities completed the survey. 44% were elite and 56% active non-elite. Only 21.6% of athletes received nutrition advice during pregnancy and 10.8% during postpartum, with no significant differences between levels (pregnancy: p = 0.61; postpartum: p = 0.81). Most advice focused on general healthy eating and supplementation, while athletes expressed a strong preference for specific nutrition for athletes during pregnancy or postpartum, supplement use, and return-to-sport nutrition, ideally delivered by registered dietitians/nutritionists or sporting organisations in addition to general and sport healthcare providers. Conclusion Pregnant and postpartum athletes in the UK and ROI receive limited nutrition support that did not meet the demands of training, recovery or return to sport. There is a clear need for athlete-specific nutrition education and coordinated care pathways between maternity and sport performance systems.

Topical menthol application improves thermal perception and enhances performance but reduces sweat production in hot environments. In the aquatic environment, where sweat evaporation is of limited thermoregulatory benefit (ie,minimal evaporation) and leads to dehydration and cardiovascular strain, downregulating thermoregulatory sweating may have little consequence. However, it may preserve hydration status and improve subsequent performance, especially in air (ie,after first transition in triathlon); we tested this hypothesis. Eight trained triathletes (age 36 [5]y; height 1.77 [0.1]m; mass 73.9 [8.0]kg) completed 2 experimental conditions with prior whole-body application of menthol GEL (40g, 3.5% menthol) contrasted to NO-GEL. The protocol comprised 30 minutes ofswimming (at 85% of400-m personal best) in tropical water (29 °C) followed by a 20-km self-paced cycling time trial. Measures were deep body temperature (gastrointestinal pill), skin temperature, sweat production, rating of perceived exertion, thermal sensation, and thermal comfort. Paired t test and analysis of variance compared the data (.05 alpha level). Wet-bulb globe temperature equated to "red flag" conditions-heat-injury potential for all participants. Terminal gastrointestinal temperature was 38.8 °C (0.3 °C) and 38.8 °C (0.7 °C)and time-trial performance was 39:36 (04:31) and 40:53 (05:53) minutes in the GEL and NO-GEL conditions, respectively (P = .340; 95% CI, -222 to 88s; d = -0.22). Sweat production increased in the GEL condition (1140 [257]mL) compared to the NO-GEL condition (961 [202]mL) (t = 2.482, P = .042; 95% CI, 08 to 349mL; d = 0.77). Menthol improved perception but increased thermoregulatory sweating and did not enhance performance (partial hypothesis support).

This study aimed to compare three methods of predicting ovulation day: (1) a positive urinary luteinising hormone test (LH), (2) a sustained rise in salivary progesterone above critical difference (SP), and (3) a countback regression equation (CB), to determine variability in the menstrual cycle (MC) lengths and reproductive hormone concentrations of professional female soccer players. Eight players provided daily morning saliva samples for three consecutive cycles. Samples were analysed for oestradiol and progesterone concentrations. Each MC was separated into the follicular (FP) and luteal (LP) phases relative to the day of ovulation, using the three different methods. MC length ranged from 24 to 32days (28.3±2.4days); intra-assay coefficient of variation (7.5%) exceeded inter-assay coefficient of variation (4.6%). Ovulation estimated using SP (15.4±3.0days) occurred later than LH (13.3±2.0days) (P=0.017). The CB method (14.1±1.8days) did not differ from SP (P=0.102) or LH (P=0.262). Oestradiol and progesterone levels varied significantly between sub-phases (P<0.001). Inter-variability surpassed intra-variability for both hormones. Differences in methods for predicting ovulation indicate the need for standardised protocols. Individual variation in MC length and hormone concentrations challenges the narrative for group-level MC recommendations, emphasising the need for individualised hormone monitoring across multiple cycles.

Martín-Miguel, I, Torrontegi-Ronco, E, Martínez-Ortega, JdD, Moreno-Martín, A, and Montalvo-Zenarruzabeitia, Z. Relative values of maximal isometric strength in lower limbs across different sports disciplines in high-performance athletes. J Strength Cond Res 39(8): e982-e990, 2025-This study aimed to establish reference values for relative strength in lower limb dynamometry among high-performance athletes across various sports disciplines and to compare the differences in relative strength between these disciplines. In total, 297 elite athletes (female athletes:155; male athletes:142) from 26 different sports participated, grouped into categories such as team sports, gymnastics, combat sports, racket sports, endurance, power track and field, weightlifting, and other. Relative strength was measured using a dynamometer through maximal isometric contractions. Knee extension and ankle plantar flexion were the tests with the highest strength application in both sexes, while external hip rotation and hip abduction showed the least force application. Analysis of variance revealed differences based on the test and sports discipline ( p < 0.05). Female athletes showed differences in hip abduction, hip extension, hip flexion, knee extension, knee flexion, and ankle plantar flexion, with gymnastic sports demonstrating greater strength, particularly compared with team sports and endurance. In male athletes ( p < 0.05), endurance sports showed lower strength in external hip rotation compared with racket sports, and in hip abduction compared with combat sports. The agonist-antagonist ratio indicated greater strength in internal hip rotation, hip flexion, knee extension, and ankle plantar flexion in both sexes, and hip abduction in female athletes and hip adduction in male athletes, compared with their antagonists. Significant differences were found in the hip adduction-abduction and ankle plantar-dorsal flexion ratio in gymnastics compared with the rest of sports. These findings can be used to assess athletes' physical condition, prevent injuries, and facilitate rehabilitation to optimize performance.

The concept of periodised nutrition is well-established within performance nutrition support to appropriately fuel elite athletes while maximising the adaptative response from training. Despite this, there may still be little planning and integration of training prescription and nutrition between the performance nutritionist and multi-disciplinary team. Consequently, the aim of this case study was to (1) propose a ‘Periodised Nutrition System’ which can be utilised by performance nutrition practitioners when working with athletes, through amalgamating previously published literature, tools, and approaches in the literature; (2) discuss how this can be administered in practice, collaborating with the coach, multidisciplinary team and athlete; (3) present a case study of the proposed ‘Periodised Nutrition System’ and its utilisation with a world class swimmer leading into the 2024 Paris Summer Olympic Games. The ‘Periodised Nutrition System’ presents different ‘performance plates’, quantities of different foods to fit into the ‘performance plates’ to aid recipe development, and how they may practically fit into an athlete’s training periodisation alongside theoretical rationale. The case study demonstrates a ‘real world’ scenario of its utilisation with an elite swimmer, transitioning through three separate performance goals while reducing body mass by 1.9 kg, sum of eight skinfolds by 20.1 mm, predicted fat mass by 2.6 kg and an increase in predicted lean mass by 0.6 kg over a six-week mesocycle. The study highlights that the ‘Periodised Nutrition System’ enables the practitioner to develop a structure to their support, aligning nutritional strategies with the training periodisation of the athlete, allowing for an individualised approach, specific to the athlete’s performance goal(s) and the desired adaptation of a training session.

BackgroundData on upper limb injuries in elite female rugby athletes are limited. This study aims to describe the incidence, severity and burden of upper limb injuries over five seasons in elite women’s rugby at both the club and international levels in training and matches.MethodsA longitudinal cohort study was conducted from the 2017/2018 to 2021/2022 seasons, involving female players from the English club top tier and international team. Data on upper limb injuries were reported by team medical staff, capturing injury type, location, severity and mechanism. Injury incidence was calculated per 1000 hours of match/training exposure, and burden was measured by multiplying incidence by severity.ResultsA total of 190 upper limb injuries were recorded, with shoulder injuries the most common, representing 43% of all injuries. Median severity (mid-range of injury severity within the data) in international settings was lower than in club settings (Club matches 38 days, IQR 65, international matches 15 days, IQR 55). Injury burden (which is derived from injury mean severity and injury incidence) was significantly higher at international level (club matches, 265 days/1000 hours, 95% CI 213 to 328; club training 6 days/1000 hours, 95% CI 6 to 8; international matches 2638 days/1000 hours, 95% CI 2000 to 3481; international training 51 days/1000 hours, 95% CI 30 to 88).ConclusionsThe current study data highlight a low injury severity at an international level. Although the international injury severity rate is higher than club injury incidence and burden. Hand injuries were more common within club training settings, and the shoulder was more prevalent in all other settings.

Changes to the variability within biomechanical signals may reflect a change in the health of the human system. However, for running gait variability measures calculated from wearable device data, it is unknown whether a between-day difference reflects a shift in system dynamics reflective of a change in human health or is a result of poor between-day reliability of the measurement device or the biomechanical signal. This study investigated the reliability of stride time and sacral acceleration variability measures calculated from inertial measurement units (IMUs). Nineteen runners completed six treadmill running trials on two occasions seven days apart. Stride time and sacral acceleration signals were obtained using IMUs. Stride time variability and complexity were calculated using the coefficient of variation (CV) and detrended fluctuation analysis (DFA), respectively. Sacral acceleration regularity was quantified using sample entropy with a range of input parameters m (vector length) and r (similarity threshold). Between-day reliability was assessed using the intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimum detectable change. Stride time CV displayed moderate relative reliability (ICC = 0.672), but with a large absolute minimum detectable change=0.525%, whilst stride time DFA-α displayed poor relative reliability (ICC = 0.457) and yielded large minimum detectable changes (≥ 0.208). Sample entropy displayed good relative reliability in mediolateral and resultant sacral acceleration signals for certain combinations of the parameters m and r, although again with large minimum detectable changes. Researchers should be cognisant of these reliability metrics when interpreting changes in running gait variability measures in clinical contexts.