Sports Med
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Delayed onset muscle soreness (DOMS) is a familiar experience for the elite or novice athlete. Symptoms can range from muscle tenderness to severe debilitating pain. The mechanisms, treatment strategies, and impact on athletic performance remain uncertain, despite the high incidence of DOMS. ⋯ Alternatively, exercises targeting less affected body parts should be encouraged in order to allow the most affected muscle groups to recover. Eccentric exercises or novel activities should be introduced progressively over a period of 1 or 2 weeks at the beginning of, or during, the sporting season in order to reduce the level of physical impairment and/or training disruption. There are still many unanswered questions relating to DOMS, and many potential areas for future research.
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This article reviews the potential effects of the female steroid hormone fluctuations during the menstrual cycle on exercise performance. The measurement of estrogen and progesterone concentration to verify menstrual cycle phase is a major consideration in this review. However, even when hormone concentrations are measured, the combination of differences in timing of testing, the high inter- and intra-individual variability in estrogen and progesterone concentration, the pulsatile nature of their secretion and their interaction, may easily obscure possible effects of the menstrual cycle on exercise performance. ⋯ Thus, the mid-luteal phase has a potential negative effect on prolonged exercise performance through elevated body temperature and potentially increased cardiovascular strain. Practical implications for female endurance athletes may be the adjustment of competition schedules to their menstrual cycle, especially in hot, humid conditions. The small scope of the current research and its methodological limitations warrant further investigation of the effect of the menstrual cycle on prolonged exercise performance.
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Orbital fractures represent a small proportion of sports-related injuries in the US and abroad. However, the significant functional and cosmetic sequelae of such fractures warrant a comprehensive evaluation of any athlete sustaining facial trauma. Initial evaluation is directed at excluding neurological impairment or the presence of vision-threatening injury. ⋯ Orbital fracture mandates referral to an ophthalmologist or oculoplastic surgeon; initial management is dictated by the severity of functional symptoms, and may necessitate early surgical intervention. Those patients who are managed conservatively should return for frequent follow-up, as progressive diplopia, enophthalmos, or gaze limitation are indications for late operative repair. The majority of patients who sustain orbital fractures are able to return to sport, however, persistent diplopia is not uncommon, and may persist despite optimal treatment.