Inflammation and Oral Contraceptive Use in Female Athletes Before the Rio Olympic Games
- Larsen, Brianna, Cox, Amanda, Colbey, Candice, Drew, Michael, McGuire, Helen, Fazekas de St Groth, Barbara, Hughes, David, Vlahovich, Nicole, Waddington, Gordon, Burke, Louise, Lundy, Bronwen, West, Nicholas, Minahan, Clare
- Authors: Larsen, Brianna , Cox, Amanda , Colbey, Candice , Drew, Michael , McGuire, Helen , Fazekas de St Groth, Barbara , Hughes, David , Vlahovich, Nicole , Waddington, Gordon , Burke, Louise , Lundy, Bronwen , West, Nicholas , Minahan, Clare
- Date: 2020
- Type: Text , Journal article
- Relation: Frontiers in Physiology Vol. 11, no. (2020), p.
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- Description: This study investigated the association between synthetic ovarian hormone use [i.e., the oral contraceptive (OC) pill] and basal C-reactive protein (CRP), peripheral blood immune cell subsets, and circulating pro- and anti-inflammatory cytokine concentrations in elite female athletes. Elite female athletes (n = 53) selected in Rio Summer Olympic squads participated in this study; 25 were taking an OC (AthletesOC) and 28 were naturally hormonally cycling (AthletesNC). Venous blood samples were collected at rest for the determination of sex hormones, cortisol, CRP, peripheral blood mononuclear memory and naïve CD4+ T-cells, CD8+ T-cells and natural killer cells, as well as pro- and anti-inflammatory cytokine concentrations. C-reactive protein concentrations were elevated (p < 0.001) in AthletesOC (median = 2.02, IQR = 3.15) compared to AthletesNC (median = 0.57, IQR = 1.07). No differences were reported for cortisol, cytokines, or PBMC immune cell subsets, although there was a trend (p = 0.062) for higher IL-6 concentrations in AthletesNC. Female Olympians had substantially higher CRP concentrations, a marker of inflammation and tissue damage, before the Rio Olympic Games if they used an OC. Future research should examine the potential consequences for athlete performance/recovery so that, if necessary, practitioners can implement prevention programs. © Copyright © 2020 Larsen, Cox, Colbey, Drew, McGuire, Fazekas de St Groth, Hughes, Vlahovich, Waddington, Burke, Lundy, West and Minahan.
- Authors: Larsen, Brianna , Cox, Amanda , Colbey, Candice , Drew, Michael , McGuire, Helen , Fazekas de St Groth, Barbara , Hughes, David , Vlahovich, Nicole , Waddington, Gordon , Burke, Louise , Lundy, Bronwen , West, Nicholas , Minahan, Clare
- Date: 2020
- Type: Text , Journal article
- Relation: Frontiers in Physiology Vol. 11, no. (2020), p.
- Full Text:
- Reviewed:
- Description: This study investigated the association between synthetic ovarian hormone use [i.e., the oral contraceptive (OC) pill] and basal C-reactive protein (CRP), peripheral blood immune cell subsets, and circulating pro- and anti-inflammatory cytokine concentrations in elite female athletes. Elite female athletes (n = 53) selected in Rio Summer Olympic squads participated in this study; 25 were taking an OC (AthletesOC) and 28 were naturally hormonally cycling (AthletesNC). Venous blood samples were collected at rest for the determination of sex hormones, cortisol, CRP, peripheral blood mononuclear memory and naïve CD4+ T-cells, CD8+ T-cells and natural killer cells, as well as pro- and anti-inflammatory cytokine concentrations. C-reactive protein concentrations were elevated (p < 0.001) in AthletesOC (median = 2.02, IQR = 3.15) compared to AthletesNC (median = 0.57, IQR = 1.07). No differences were reported for cortisol, cytokines, or PBMC immune cell subsets, although there was a trend (p = 0.062) for higher IL-6 concentrations in AthletesNC. Female Olympians had substantially higher CRP concentrations, a marker of inflammation and tissue damage, before the Rio Olympic Games if they used an OC. Future research should examine the potential consequences for athlete performance/recovery so that, if necessary, practitioners can implement prevention programs. © Copyright © 2020 Larsen, Cox, Colbey, Drew, McGuire, Fazekas de St Groth, Hughes, Vlahovich, Waddington, Burke, Lundy, West and Minahan.
How much is enough in rehabilitation? High running workloads following lower limb muscle injury delay return to play but protect against subsequent injury
- Stares, Jordan, Dawson, Brian, Peeling, Peter, Drew, Michael, Heasman, Jarryd, Rogalski, Brent, Colby, Marcus
- Authors: Stares, Jordan , Dawson, Brian , Peeling, Peter , Drew, Michael , Heasman, Jarryd , Rogalski, Brent , Colby, Marcus
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 21, no. 10 (2018), p. 1019-1024
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- Description: Objectives: Examine the influence of rehabilitation training loads on return to play (RTP) time and subsequent injury in elite Australian footballers. Design: Prospective cohort study. Methods: Internal (sessional rating of perceived exertion: sRPE) and external (distance, sprint distance) workload and lower limb non-contact muscle injury data was collected from 58 players over 5 seasons. Rehabilitation periods were analysed for running workloads and time spent in 3 rehabilitation stages (1: off-legs training, 2: non-football running, 3: group football training) was calculated. Multi-level survival analyses with random effects accounting for player and season were performed. Hazard ratios (HR) and 95% confidence intervals (CI) for each variable were produced for RTP time and time to subsequent injury. Results: Of 85 lower limb muscle injuries, 70 were rehabilitated to RTP, with 30 cases of subsequent injury recorded (recurrence rate = 11.8%, new site injury rate = 31.4%). Completion of high rehabilitation workloads delayed RTP (distance: >49,775 m [reference: 34,613–49,775 m]: HR 0.12, 95%CI 0.04–0.36, sRPE: >1266 AU [reference: 852–1266 AU]: HR 0.09, 95%CI 0.03–0.32). Return to running within 4 days increased subsequent injury risk (3–4 days [reference: 5–6 days]: HR 25.88, 95%CI 2.06–324.4). Attaining moderate-high sprint distance (427–710 m) was protective against subsequent injury (154–426 m: [reference: 427–710 m]: HR 37.41, 95%CI 2.70–518.64). Conclusions: Training load monitoring can inform player rehabilitation programs. Higher rehabilitation training loads delayed RTP; however, moderate-high sprint running loads can protect against subsequent injury. Shared-decision making regarding RTP should include accumulated training loads and consider the trade-off between expedited RTP and lower subsequent injury risk.
- Authors: Stares, Jordan , Dawson, Brian , Peeling, Peter , Drew, Michael , Heasman, Jarryd , Rogalski, Brent , Colby, Marcus
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 21, no. 10 (2018), p. 1019-1024
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- Description: Objectives: Examine the influence of rehabilitation training loads on return to play (RTP) time and subsequent injury in elite Australian footballers. Design: Prospective cohort study. Methods: Internal (sessional rating of perceived exertion: sRPE) and external (distance, sprint distance) workload and lower limb non-contact muscle injury data was collected from 58 players over 5 seasons. Rehabilitation periods were analysed for running workloads and time spent in 3 rehabilitation stages (1: off-legs training, 2: non-football running, 3: group football training) was calculated. Multi-level survival analyses with random effects accounting for player and season were performed. Hazard ratios (HR) and 95% confidence intervals (CI) for each variable were produced for RTP time and time to subsequent injury. Results: Of 85 lower limb muscle injuries, 70 were rehabilitated to RTP, with 30 cases of subsequent injury recorded (recurrence rate = 11.8%, new site injury rate = 31.4%). Completion of high rehabilitation workloads delayed RTP (distance: >49,775 m [reference: 34,613–49,775 m]: HR 0.12, 95%CI 0.04–0.36, sRPE: >1266 AU [reference: 852–1266 AU]: HR 0.09, 95%CI 0.03–0.32). Return to running within 4 days increased subsequent injury risk (3–4 days [reference: 5–6 days]: HR 25.88, 95%CI 2.06–324.4). Attaining moderate-high sprint distance (427–710 m) was protective against subsequent injury (154–426 m: [reference: 427–710 m]: HR 37.41, 95%CI 2.70–518.64). Conclusions: Training load monitoring can inform player rehabilitation programs. Higher rehabilitation training loads delayed RTP; however, moderate-high sprint running loads can protect against subsequent injury. Shared-decision making regarding RTP should include accumulated training loads and consider the trade-off between expedited RTP and lower subsequent injury risk.
Multivariate modelling of subjective and objective monitoring data improve the detection of non-contact injury risk in elite Australian footballers
- Colby, Marcus, Dawson, Brian, Peeling, Peter, Heasman, Jarryd, Rogalski, Brent, Drew, Michael, Stares, Jordan, Zouhal, Hassane, Lester, Leanne
- Authors: Colby, Marcus , Dawson, Brian , Peeling, Peter , Heasman, Jarryd , Rogalski, Brent , Drew, Michael , Stares, Jordan , Zouhal, Hassane , Lester, Leanne
- Date: 2017
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 20, no. 12 (2017), p. 1068-1074
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- Description: Objectives: To assess the association between workload, subjective wellness, musculoskeletal screening measures and non-contact injury risk in elite Australian footballers. Design: Prospective cohort study. Methods: Across 4 seasons in 70 players from one club, cumulative weekly workloads (acute; 1 week, chronic; 2-, 3-, 4-week) and acute:chronic workload ratio’s (ACWR: 1-week load/average 4-weekly load) for session-Rating of Perceived Exertion (sRPE) and GPS-derived distance and sprint distance were calculated. Wellness, screening and non-contact injury data were also documented. Univariate and multivariate regression models determined injury incidence rate ratios (IRR) while accounting for interaction/moderating effects. Receiver operating characteristics determined model predictive accuracy (area under curve: AUC). Results: Very low cumulative chronic (2-, 3-, 4- week) workloads were associated with the greatest injury risk (univariate IRR = 1.71–2.16, 95% CI = 1.10–4.52) in the subsequent week. In multivariate analysis, the interaction between a low chronic load and a very high distance (adj-IRR = 2.60, 95% CI = 1.07–6.34) or low sRPE ACWR (adj-IRR = 2.52, 95% CI = 1.01–6.29) was associated with increased injury risk. Subjectively reporting “yes” (vs. “no”) for old lower limb pain and heavy non-football activity in the previous 7 days (multivariate adj-IRR = 2.01–2.25, 95% CI = 1.02–4.95) and playing experience (>9 years) (multivariate adj- IRR = 2.05, 95% CI = 1.03–4.06) was also associated with increased injury risk, but screening data were not. Predictive capacity of multivariate models was significantly better than univariate (AUCmultivariate = 0.70, 95% CI 0.64–0.75; AUCunivariate range = 0.51–0.60). Conclusions: Chronic load is an important moderating factor in the workload–injury relationship. Low chronic loads coupled with low or very high ACWR are associated with increased injury risk.
- Description: Objectives: To assess the association between workload, subjective
- Authors: Colby, Marcus , Dawson, Brian , Peeling, Peter , Heasman, Jarryd , Rogalski, Brent , Drew, Michael , Stares, Jordan , Zouhal, Hassane , Lester, Leanne
- Date: 2017
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 20, no. 12 (2017), p. 1068-1074
- Full Text:
- Reviewed:
- Description: Objectives: To assess the association between workload, subjective wellness, musculoskeletal screening measures and non-contact injury risk in elite Australian footballers. Design: Prospective cohort study. Methods: Across 4 seasons in 70 players from one club, cumulative weekly workloads (acute; 1 week, chronic; 2-, 3-, 4-week) and acute:chronic workload ratio’s (ACWR: 1-week load/average 4-weekly load) for session-Rating of Perceived Exertion (sRPE) and GPS-derived distance and sprint distance were calculated. Wellness, screening and non-contact injury data were also documented. Univariate and multivariate regression models determined injury incidence rate ratios (IRR) while accounting for interaction/moderating effects. Receiver operating characteristics determined model predictive accuracy (area under curve: AUC). Results: Very low cumulative chronic (2-, 3-, 4- week) workloads were associated with the greatest injury risk (univariate IRR = 1.71–2.16, 95% CI = 1.10–4.52) in the subsequent week. In multivariate analysis, the interaction between a low chronic load and a very high distance (adj-IRR = 2.60, 95% CI = 1.07–6.34) or low sRPE ACWR (adj-IRR = 2.52, 95% CI = 1.01–6.29) was associated with increased injury risk. Subjectively reporting “yes” (vs. “no”) for old lower limb pain and heavy non-football activity in the previous 7 days (multivariate adj-IRR = 2.01–2.25, 95% CI = 1.02–4.95) and playing experience (>9 years) (multivariate adj- IRR = 2.05, 95% CI = 1.03–4.06) was also associated with increased injury risk, but screening data were not. Predictive capacity of multivariate models was significantly better than univariate (AUCmultivariate = 0.70, 95% CI 0.64–0.75; AUCunivariate range = 0.51–0.60). Conclusions: Chronic load is an important moderating factor in the workload–injury relationship. Low chronic loads coupled with low or very high ACWR are associated with increased injury risk.
- Description: Objectives: To assess the association between workload, subjective
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