Stress, control, and coping in elite athletes

The main object of this study was to explore different dimensions of the stress experience and the following coping efforts among elite athletes. Sixty-nine Norwegina Winte Olympic athletes, competing in the Lillehammer Games in 1994 participated in the study. Recall of the most stressfull experiences was reported through open-ended questions following the Olympic Games, and the actual time of the experience with the following coping efforts were measured with the COPE inventory (19). The stress was mainly experienced during the time period prior to the competition. External distractions and expectations were the most frequently reported stress experiences. The coach was viewed as a major source of stress by some athletes, with a subsequent lack of control and low satisfaction with performance. Type of stress more than the time of the experience seemed to have a deterimental effect on performance. Problem-focused coping strategies were employed at all times, while cognitive defense strategies were employed more days before (time phase 1) and after the competition (time phase 4).     

A prospective cohort study on symptoms of common mental disorders among Dutch elite athletes

Objective: Scientific knowledge about symptoms of common mental disorders in elite sports is scarce. Consequently, the objectives of the study were to (i) establish the 12-month incidence of symptoms of common mental disorders (CMD; distress, anxiety/depression, sleep disturbance, adverse alcohol use, eating disorders) among Dutch elite athletes and (ii) explore their potential association with several stressors (being injured, recent life events, career dissatisfaction).

Methods: A prospective cohort study with a 12-month follow-up period was conducted. The study used validated questionnaires to assess symptoms of common mental disorders (thus not clinically diagnosed) as well as several stressors; an electronic questionnaire was set up and repeatedly distributed.

Results: A total of 203 elite athletes gave their written informed consent to participate in the study, from which 143 completed the 12-month follow-up period (follow-up rate of 70%). Incidence of symptoms of CMD ranged from 6% for adverse alcohol use to 57% for symptoms of anxiety/depression. Over the follow-up period, around 17% of the participants reported two simultaneous symptoms of CMD, and around 19% reported three simultaneous symptoms of CMD. Inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant.

Conclusions: Substantial 12-month incidence rates of symptoms of CMD (self-reported and not clinically diagnosed) were found among Dutch elite athletes (especially for anxiety/depression), appearing similar to the ones found among athletes from other sports disciplines and the Dutch general population. Also, inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant. Supportive and preventive measures directed towards symptoms of CMD should be developed to improve awareness and psychological resilience of athletes, which would likely improve their performance and quality-of-life.     

Metabolic profiling of elite athletes with different cardiovascular demand

Intensive exercise of elite athletes can lead to physiological alterations in the cardiovascular system in response to increased stroke volume and blood pressure, known collectively as cardiovascular demand (CD). This study aimed to compare metabolic differences in elite athletes with high vs low/moderate CD and to reveal their underlying metabolic pathways as potential biomarker signatures for assessing health, performance, and recovery of elite athletes. Metabolic profiling of serum samples from 495 elite athletes from different sport disciplines (118 high CD and 377 low/moderate CD athletes) was conducted using non‐targeted metabolomics‐based mass spectroscopy combined with ultra‐high‐performance liquid chromatography. Results show that DAGs containing arachidonic were enriched in high CD together with branched‐chain amino acids, plasminogens, phosphatidylcholines, and phosphatidylethanolamines, potentially indicating increased risk of cardiovascular disease in the high CD group. Gamma‐glutamyl amino acids and glutathione metabolism were increased in low/moderate CD group, suggesting more efficient oxidative stress scavenging mechanisms than the high CD group. This first most comprehensive metabolic profiling of elite athletes provides an evidence that athletes with different CD show a unique metabolic signature that reflects energy generation and oxidative stress and potentially places the high CD group at a higher risk of cardiovascular disease. Further studies are warranted for confirmation and validation of findings in other sport groups in light of potential confounders related to limited available information about participants.     

Goal orientations, beliefs about success, and performance improvement among young elite Dutch soccer players

Extending past work testing goal perspective theory in sport, one purpose of this study was to examine, via a longitudinal design, the relationship of goal orientations to the beliefs about the causes of success in the case of elite male Dutch soccer players. A second purpose was to determine the relationship of goals and beliefs to ratings of performance. Seventy-five male pupils representing five teams from an internationally renowned soccer school in The Netherlands completed the TEOSQ and a measure of their perceptions of the determinants of success in soccer at the onset and conclusion of one season. Assessments of the coaches' appraisal and athletes' self-reported performance in soccer were carried out at the same time. In line with other studies, a positive association between ego orientation and the belief that ability or innate talent are determinants of success was revealed. Task orientation was linked to the beliefs that effort, team play, and parental support contribute to achievement in soccer. An increase in skilled performance over the season (as appraised by the coach) corresponded to a stronger task orientation and the beliefs that soccer success stems from hard work and having supportive parents.     

Effect of long haul travel on maximal sprint performance and diurnal variations in elite skeleton athletes

Objective

To quantify the impact of eastward long haul travel on diurnal variations in cortisol, psychological sensations and daily measurements of physical performance.

Methods

Five elite Australian skeleton athletes undertook a long haul eastward flight from Australia to Canada (LH_travel), while seven elite Canadian skeleton athletes did not travel (NO_travel). Salivary cortisol was measured on awakening, 60 min and 120 min after awakening. Psychological sensations were measured with a questionnaire, and maximal 30 m sprints were performed once a day between 09:30 and 11:00 h local time.

Results

Compared with baseline, average (SD) resting salivary cortisol decreased by 67% immediately after long haul travel (23.43 (5.71) nMol/l) (mean±90% confidence interval) in the LH_travel group (p = 0.03), while no changes were found in the NO_travel group (p = 0.74). There were no significant differences in 30 m sprint time between baseline and post‐flight tests in the LH_travel group (p>0.05). The LH_travel group perceived themselves as “jet lagged” for up to 2 days after the flight (p = 0.01 for both midday lunch and evening dinner).

Conclusions

Despite a distinct phase change in salivary cortisol rhythmicity and the athletes perceiving themselves as “jet lagged”, minimal disturbances in “one‐off” maximal sprinting ability between 09:30 and 11:00 h local time were seen in a group of elite skeleton athletes after long haul eastward travel from Australia to Canada.     

Increased mortality rate and suicide in Swedish former elite male athletes in power sports

Physical training has been shown to reduce mortality in normal subjects, and athletes have a healthier lifestyle after their active career as compared with normal subjects. Since the 1950s, the use of anabolic androgenic steroids (AAS) has been frequent, especially in power sports. The aim of the present study was to investigate mortality, including causes of death, in former Swedish male elite athletes, active 1960–1979, in wrestling, powerlifting, Olympic lifting, and the throwing events in track and field when the suspicion of former AAS use was high. Results indicate that, during the age period of 20–50 years, there was an excess mortality of around 45%. However, when analyzing the total study period, the mortality was not increased. Mortality from suicide was increased 2–4 times among the former athletes during the period of 30–50 years of age compared with the general population of men. Mortality rate from malignancy was lower among the athletes. As the use of AAS was marked between 1960 and 1979 and was not doping‐listed until 1975, it seems probable that the effect of AAS use might play a part in the observed increased mortality and suicide rate. The otherwise healthy lifestyle among the athletes might explain the low malignancy rates.     

Poor sleep is related to lower general health,increased stress and increased confusion in elite Gaelic athletes

Objectives: Persistent poor sleep is associated with a range of adverse health outcomes. Sleep is considered the main method of recovery in athletes; however, studies report that a significant number of athletes are getting insufficient sleep. The purpose of this study was to assess the sleep profiles of elite Gaelic athletes and to compare wellbeing in those with poor sleep and those with good sleep.

Methods: 69 elite Gaelic athletes completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Subjective Health Complaints Inventory (SHC), Nordic Musculoskeletal Questionnaire (NMQ), stress subscale of the Depression Anxiety Stress Scale (DASS), the tension-anxiety, anger-hostility and confusion-bewilderment subscales of the Profile of Mood States (POMS) as well as the catastrophising subscale of the Coping Strategies Questionnaire (CSQ). Participants were categorised into poor sleepers (PSQI ≥5) and good sleepers (PSQI <5) and outcome measures of health and wellbeing were analysed between the two groups.

Results: 47.8% of athletes were poor sleepers. Self-reported sleep duration was 7.5 ± 0.6 h per night. 63.7% of poor sleepers took >30 min to fall asleep, compared to 5.6% of good sleepers. Poor sleepers had significantly lower general health (SHC) (p = 0.029), increased stress (DASS) (p = 0.035) and increased confusion (POMS-subscale) (p = 0.005). There was no significant difference between groups for number of painful body parts (NMQ) (p = 0.052), catastrophising (CSQ) (p = 0.287), overall mood (POMS) (p = 0.059), or POMS subscales of anger (p = 0.346) or tension (p = 0.593).

Conclusion: Nearly 50% of elite Gaelic athletes report poor sleep. There is a significant relationship between poor sleep and lower general health, increased stress and increased confusion, and these factors may interact with each other. Monitoring of and interventions to enhance sleep may be required to improve athletes’ wellbeing.     

Mobility and muscle strength in male former elite endurance and power athletes aged 66−91 years

The aim of this cross‐sectional study was to compare mobility and muscle strength in male former elite endurance and power athletes aged 66?91 years (n = 150; 50 men in both former elite athlete groups and in their control group). Agility, dynamic balance, walking speed, chair stand, self‐rated balance confidence (ABC‐scale), jumping height, and handgrip strength were assessed. Former elite power athletes had better agility performance time than the controls (age‐ and body mass index, BMI‐adjusted mean difference ?3.6 s; 95% CI ?6.3, ?0.8). Adjustment for current leisure time physical activity (LTPA) and prevalence of diseases made this difference non‐significant (P = 0.214). The subjects in the power sports group jumped higher than the men in the control group (age‐ and BMI‐adjusted mean differences for vertical squat jump, VSJ 4.4 cm; 95% CI 2.0, 6.8; for countermovement jump, CMJ 4.0 cm; 95% CI 1.7, 6.4). Taking current LTPA and chronic diseases for adjusting process did not improve explorative power of the model. No significant differences between the groups were found in the performances evaluating dynamic balance, walking speed, chair stand, ABC‐scale, or handgrip strength. In conclusion, power athletes among the aged former elite sportsmen had greater explosive force production in their lower extremities than the men in the control group.     

Substantial injuries influence ranking position in young elite athletes of athletics,cross‐country skiing and orienteering

The relationship between injury and performance in young athletes is scarcely studied. The aim of this study was therefore to explore the association between injury prevalence and ranking position among adolescent elite athletes. One hundred and sixty‐two male and female adolescent elite athletes (age range 15‐19), competing in athletics (n = 59), cross‐country skiing (n = 66), and orienteering (n = 37), were monitored weekly over 22‐47 weeks using a web‐based injury questionnaire. Ranking lists were collected. A significant (P  = .003) difference was found in the seasonal substantial injury prevalence across the ranked athletes over the season, where the top‐ranked (median 3.6%, 25‐75th percentiles 0%‐14.3%) and middle‐ranked athletes (median 2.3%, 25‐75th percentiles 0%‐10.0%) had a lower substantial injury prevalence compared to the low‐ranked athletes (median 11.3%, 25‐75th percentiles 2.5%‐27.1%), during both preseason (P  = .002) and competitive season (P  = .031). Athletes who improved their ranking position (51%, n = 51) reported a lower substantial injury prevalence (median 0%, 25‐75th percentiles 0%‐10.0%) compared to those who decreased (49%, n = 49) their ranking position (md 6.7%, 25‐75th percentiles 0%‐22.5%). In the top‐ranked group, no athlete reported substantial injury more than 40% of all data collection time points compared to 9.6% (n = 5) in the middle‐ranked, and 17.3% (n = 9) in the low‐ranked group. Our results provide supporting evidence that substantial injuries, such as acute and overuse injuries leading to moderate or severe reductions in training or sports performance, influence ranking position in adolescent elite athletes. The findings are crucial to stakeholders involved in adolescent elite sports and support the value of designing effective preventive interventions for substantial injuries.     

Examining the effects of rational emotive behavior therapy on performance outcomes in elite paralympic athletes

Traditionally a psychotherapeutic intervention, rational emotive behavior therapy (REBT ) is receiving increasing attention within the extant literature as an intervention to enhance the athletic performance and psychological well‐being of competitive athletes. Whilst the benefits of REBT on psychological health are established, less is understood about the effects on athletic performance. This study aimed to examine the immediate and maintained effects of REBT on physiological, psychological, and performance outcomes with elite Paralympic athletes. Using a single‐case research design, eight athletes recruited from the same Paralympic sport (M =40.12, SD= 12.99) received five, one‐to‐one REBT sessions. Measures of irrational beliefs were collected weekly, whereas the remaining psychological and physiological measures were collected at a pre‐, post‐, and at a 9‐month follow‐up time point. Visual and statistical analyzes of the data indicates reductions in irrational beliefs were coupled with reductions in systolic blood pressure indicative of an adaptive physiological response, improved athletic performance during competition simulations, and reductions in avoidance goals. Furthermore, social validation data indicated greater self‐awareness, emotional control, and enhanced focus during competition as a result of the REBT intervention. This study contributes to growing literature supporting the efficacy of REBT as an intervention that not only facilitates psychological health but also enhances athletic performance. Results are discussed with reference to theory, limitations, and future recommendations.     

Young elite athletes and social support: coping with competitive and organizational stress in “Olympic” competition

Elite adolescent sport is a relatively unexplored research field. The purpose of this investigation was to examine how the Norwegian Olympic Youth Team (N=29) experienced competitive and organizational stress during the European Youth Olympic Festival in July 2007 and how they coped with the stressors. Participants were aged 14–17 and competed in handball, track and field, swimming, and judo. We used a qualitative methodology with interviews and open‐ended questionnaires. Qualitative content analyses revealed that the athletes experienced competitive stressors because of the size and importance of the competition, and organizational stressors (e.g., housing, lining up for food, and transportation) exacerbated by the extreme heat during the Festival. The elite competitive experience was novel to all and overwhelming for some of the more “inexperienced” athletes. The athletes used cognitive coping strategies to some extent in addition to relying on different types of social support. The findings revealed the need for social support for adolescent athletes, and underlined the importance of a good coach–athlete relationship in order to perform well and enjoy the competitive experience.     

Survival estimates for elite male and female Olympic athletes and tennis championship competitors

In this paper, we report survival estimates for male and female Olympic medal winners and for male and female finalists at the British and U S national tennis championships. We find a consistent longevity advantage of Olympic medal‐winning female athletes over Olympic medal‐winning male athletes competing separately in the same events since 1900 and for female finalists over male finalists competing separately in the finals of the national tennis championships of Britain and of the United States since the 1880s. This is the case for sample mean comparisons, for Kaplan–Meier survival function estimates, including life expectancy, and for Cox proportional hazard estimates, which show statistically significant lower hazard rates for women with birth year and other variables constant. The female longevity advantage over males is similar in the early period samples (birth years before1920) and in the full period samples, and is 5–7 years.     

辽宁省特殊教育学校学生口腔健康状况的调查比较

目的探讨具有智力障碍、肢体障碍、聋哑盲人群的对口腔健康知识知晓情况、口腔保健行为执行情况,以及龋病、牙周疾病等发生情况,指导该类人群口腔预防保健。方法通过对辽宁省特殊教育学校202名学生(A组)和沈阳市广全中学同龄202名学生(B组)发放调查问卷,并对口腔健康状况进行检查,了解两组调查对象口腔健康知识和行为的状况,比较其龋病、牙龈炎和牙结石的发病率。结果 A组学生的龋病、牙龈炎、牙结石患病率分别为61.4%、53.0%、31.4%,与B组比较,差异有统计学意义(P<0.01)。结论辽宁省特殊教育学校学生的口腔健康状况不佳,需要加强对他们的口腔宣传教育和预防保健,提高其口腔健康水平。     

Acute effects of static and dynamic stretching on leg flexor and extensor isokinetic strength in elite women athletes

The aim of this study was to explore the effects of static and dynamic stretching of the leg flexors and extensors on concentric and eccentric peak torque (PT) and electromyography (EMG) amplitude of the leg extensors and flexors in women athletes. Ten elite women athletes completed the following intervention protocol in a randomized order on separate days: (a) non‐stretching (control), (b) static stretching, and (c) dynamic stretching. Stretched muscles were the quadriceps and hamstring muscles. Before and after the stretching or control intervention, concentric and eccentric isokinetic PT and EMG activity of the leg extensors and flexors were measured at 60 and 180°/s. Concentric and eccentric quadriceps and hamstring muscle strength at both test speeds displayed a significant decrease following static stretching (P<0.01–0.001). In contrast, a significant increase was observed after dynamic stretching for these strength parameters (P<0.05–0.001). Parallel to this, normalized EMG amplitude parameters exhibited significant decreases following static (P<0.05–0.001) and significant increases following dynamic stretching (P<0.05–0.001) during quadriceps and hamstring muscle actions at both concentric and eccentric testing modes. Our findings suggest that dynamic stretching, as opposed to static or no stretching, may be an effective technique for enhancing muscle performance during the pre‐competition warm‐up routine in elite women athletes.     

Exploring attitudes toward eating disorders among elite athlete support personnel

To date, little is known about the beliefs, attitudes, and experiences of athlete support personnel (ASP) working in elite sport toward disordered eating (DE) and eating disorders (EDs). This study seeks to explore this area of mental health, employing an attribution model of stigma as a conceptual lens. Interviews were undertaken with 14 service providers (seven males and seven females) working in high‐performance sport in Ireland. In contrast to previous research in the general population, findings revealed that sport‐based personnel, in the main, did not hold the individual responsible for the development of their eating disorder. The predominant emotional response of those who had worked with an athlete with a known or suspected eating disorder was anxiety and worry. In line with the findings of previous studies with other health professionals, negative views on the prognosis of those with EDs were expressed by the ASP. Furthermore, confidentiality was found to be a significant barrier to bringing athletes' disclosure of problematic eating or exercise behavior to the fore. The findings of this study add to the limited research exploring attitudes toward EDs in sport and highlights the importance of greater education and openness toward this particular mental health problem.     

Too little sleep and an unhealthy diet could increase the risk of sustaining a new injury in adolescent elite athletes

Little is known about health variables and if these variables could increase the risk of injuries among adolescent elite athletes. The primary aim was to present overall data on self‐perceived stress, nutrition intake, self‐esteem, and sleep, as well as gender and age differences, on two occasions among adolescent elite athletes. A secondary aim was to study these health variables as potential risk factors on injury incidence. A questionnaire was e‐mailed to 340 adolescent elite athletes on two occasions during a single school year: autumn semester and spring semester. The results show that during autumn semester, the recommended intake of fruits, vegetables, and fish was not met for 20%, 39%, and 43% of the adolescent elite athletes, respectively. The recommended amount of sleep during weekdays was not obtained by 19%. Multiple logistic regression showed that athletes sleeping more than 8 h of sleep during weekdays reduced the odds of injury with 61% (OR, 0.39; 95% CI, 0.16–0.99) and athletes reaching the recommended nutrition intake reduced the odds with 64% (OR, 0.36; 95% CI, 0.14–0.91). Our findings suggest that nutrition intake and sleep volume are of importance in understanding injury incidence.     

Impressive anaerobic adaptations in elite karate athletes due to few intensive intermittent sessions added to regular karate training

The aim of this study was to investigate the effects of adding a high-intensity intermittent session twice a week during a 7-week karate training (KT) on markers of aerobic and anaerobic metabolisms in elite class karate athletes. Two groups were studied: a KT group ( n =8, age 20.1±0.9 years, 70.0±8.8 kg) that followed traditional KT, and a group that followed combined traditional karate and a high-intensity intermittent training (HIT group, n =9, age 24.4±3.1 years, 67.0±7.8 kg). The subjects undertook a supramaximal exercise and a maximal oxygen uptake test before and after the training. Blood lactate, pH and plasma ammonia were determined at rest, immediately at the end of the supramaximal exercise and during the recovery period at 2, 4, 6, 8, 10 and 15 min. After the training period, no changes occurred in the KT group. However, in the HIT group, the time to exhaustion, MAOD and     in the maximal oxygen uptake test were significantly improved by 23.6%, 10.3% and 4.6%, respectively. A clear-cut discrepancy was observed in the time course of lactate and pH in the supramaximal test after the training in the HIT group. We observed a significantly higher peak for lactate and a lower extreme value for pH with a shorter delay of appearance. At the end of the test, the lactate concentration increased significantly (+53.7%) and pH declined significantly, when compared with the values obtained after the same test before the training period. Ammonia was not influenced. The addition of high-intensity intermittent sessions twice per week during the period of KT induced beneficial physiological adaptations in athletes, allowing improvement in the duration of intense physical exercise before a state of fatigue is reached.     

The prevalence and severity of health problems in youth elite sports: A 6‐month prospective cohort study of 320 athletes

Little is known regarding the overall health of youth elite athletes. Our aim was to describe the prevalence and severity of health problems in a cohort of youth elite athletes representing a variety of endurance, team, and technical sports. Elite sport athletes (N = 260, 16.2 years) from different Sport Academy High Schools in Norway, and a group of their teammates (N = 60, 16.4 years) attending regular high schools, were included in the study. The Oslo Sports Trauma Research Centre (OSTRC ) questionnaire on health problems was used to self‐report injuries and illnesses for 26 weeks. At any given time, an average of 43% [95% CI : 37%‐49%] of the elite sport athletes had some form of health problem and 25% [20%‐31%] had substantial health problems. The prevalence of health problems was similar between the elite team sport athletes and their teammates, except for substantial injuries (22% [16%‐30%] vs 10% [5%‐20%]). Endurance sport athletes reported more illnesses (23% [15%‐35%]) than technical and team sport athletes (10% [5%‐20%] and 8% [4%‐14%]). In contrast, technical and team sport athletes reported more injuries (36% [95% CI : 25‐48] and 37% [95% CI 29‐45]) compared to endurance sport athletes (15% [8%‐25%]). The total impact of health problems was roughly split in thirds between overuse injuries (37%), acute injuries (34%), and illnesses (30%). This is the first prospective study to present self‐reported injury and illness data in a large heterogeneous group of youth elite athletes, documenting a substantial impact of both injuries and illnesses on the health of this population.     

Ultrasound characteristics of the patellar and quadriceps tendons among young elite athletes

Tendons adapt in response to sports‐specific loading, but sometimes develop tendinopathy. If the presence of ultrasound changes like hypoechoic areas and neovascularization in asymptomatic tendons precede (and predict) future tendon problems is unknown. The aim of this prospective cohort study was to investigate the relationship between the development of ultrasound changes in the patellar and quadriceps tendons and symptoms of jumper's knee, as well to examine the medium‐term effects of intensive training on tendon thickness among adolescent athletes. Elite junior volleyball athletes were followed with semi‐annual ultrasound and clinical examinations (average follow‐up: 1.7 years). Of the 141 asymptomatic athletes included, 22 athletes (35 patellar tendons) developed jumper's knee. In a multivariate logistic regression analysis, a baseline finding of a hypoechoic tendon area (odds ratio 3.3, 95% confidence interval 1.1 to 9.2) increased the risk of developing symptoms of jumper's knee. Patellar tendon thickness among healthy athletes did not change (Wilk's lambda, P = 0.07) while quadriceps tendon thickness increased (P = 0.001). In conclusion, ultrasound changes at baseline were risk factors for developing symptoms of jumper's knee. Also, among healthy athletes, we observed a 7–11% increase in quadriceps tendon thickness, while there was no increase in patellar tendon thickness.     

Training volume and body composition as risk factors for developing jumper's knee among young elite volleyball players

Training volume and body composition have been suggested as risk factors for jumper's knee among athletic youth, but research is lacking. The aim of this 4‐year prospective cohort study was to examine the relationship between training and competition load, body composition, and risk for developing jumper's knee. Participants are elite volleyball players, aged 16–18 years. Training and competition load was recorded continuously and body composition semiannually. Jumper's knee was diagnosed on a standardized clinical examination. We recruited 141 healthy students (69 males and 72 females), and 28 developed jumper's knee (22 boys and six girls). In a multivariate analyses, boys had three to four times higher risk compared with girls. Volleyball training had an odds ratio (OR) 1.72 (1.18–2.53) for every extra hour trained, and match exposure was the strongest sports‐related predictor for developing jumper's knee with an OR of 3.88 (1.80–8.40) for every extra set played per week. We did not detect any significant differences between the groups in body composition at the time of inclusion or in the change of body composition during the study period. Conclusion, male gender, a high volume of volleyball training and match exposure were risk factors for developing jumper's knee.