Sports Med
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There are few data on youth marathon runners and the most commonly asked questions of "can children run marathons?" and "what are the health consequences?" remain unanswered. Expert opinion is split with regard to running this distance at a young age. There have been many thousands of finishers <18 years old at the Los Angeles Marathon in an organised programme for youth running and nearly 300 finishers in at the Twin Cities Marathon. ⋯ There has not been any significant medical injury at these events. Children who choose of their own accord to participate in marathon training should be allowed to do so as long as their social, academic, psychological and physiological development is not disrupted. Follow-up studies of these young runners would help evaluate the long-term health consequences of long distance running and shape future recommendations.
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Exertional heat stroke (EHS) during or following a marathon race can be fatal if not promptly recognised and treated. EHS is a true medical emergency and immediate cooling markedly improves the outcomes. It is critical to recognise EHS and stop the cell damage before the cascade of heat-induced tissue changes becomes irreversible. ⋯ The field treatment of EHS is immediate, total-body cooling with ice-water tub immersion or rapidly rotating ice-water towels to the trunk, extremities and head, combined with ice packing of the neck, axillae and groin. Any combination of delayed recognition or cooling increases the potential for morbidity and mortality. For optimal outcomes, it is best to treat immediately with on-site whole-body cooling if cardiorespiratory status is 'stable' and then to transfer the runner for additional evaluation and care.
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The quality of vegetarian diets to meet nutritional needs and support peak performance among athletes continues to be questioned. Appropriately planned vegetarian diets can provide sufficient energy and an appropriate range of carbohydrate, fat and protein intakes to support performance and health. The acceptable macronutrient distribution ranges for carbohydrate, fat and protein of 45-65%, 20-35% and 10-35%, respectively, are appropriate for vegetarian and non-vegetarian athletes alike, especially those who perform endurance events. ⋯ The main sources of these nutrients are animal products; however, they can be found in many food sources suitable for vegetarians, including fortified soy milk and whole grain cereals. Vegetarians have higher antioxidant status for vitamin C (ascorbic acid), vitamin E (tocopherol), and beta-carotene than omnivores, which might help reduce exercise-induced oxidative stress. Research is needed comparing antioxidant defences in vegetarian and non-vegetarian athletes.
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Recurrent peroneal tendon subluxation is an uncommon sports-related injury. The retrofibular groove is formed not by the concavity of the fibula itself, but by a relatively pronounced ridge of collagenous soft tissue blended with the periosteum that extends along the posterolateral lip of the distal fibula. The shape of the groove is primarily determined by this thick fibrocartilagenous periosteal cushion, and not by the bone itself. ⋯ If an anatomical approach to treating the pathology is utilised, reattachment of the superior retinaculum seems a most appropriate technique. Randomised controlled trials may be the way forward in determining the best surgical management method. However, the relative rarity of the condition and the large number of techniques described make such study difficult.
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Regular weight-bearing physical activity has been widely recommended for adult women and may be beneficial in preserving bone mineral density (BMD). However, there is conflicting evidence regarding the effects of resistance training on BMD in premenopausal women. Novel systematic review and meta-analysis evidence is presented on the effects of progressive high-intensity resistance training on BMD in premenopausal women. ⋯ The methodological quality score of all included studies was low and no study presented a valid intention-to-treat accounting for participant drop-out (attrition). As such, the modest overall treatment effects for resistance training on BMD among premenopausal women observed in this review may be biased and should be interpreted with caution. It is concluded that further RCTs of resistance training of sufficiently long duration and providing optimum type, intensity and volume of loading, with intention-to-treat analysis are now required.