Background: Relative energy deficiency in sport (REDs) is a condition that is associated with negative health and performance outcomes in athletes. Insufficient energy intake relative to exercise energy expenditure, resulting in low energy availability, is the underlying cause, which triggers numerous adverse physiological consequences including several associated with musculoskeletal (MSK) health and neuromuscular performance. Purpose: This commentary aims to (1) discuss the health and performance implications of REDs on the skeletal and neuromuscular systems and (2) examine the role that MSK training (ie, strength and plyometric training) during treatment and return to performance following REDs might have on health and performance in athletes, with practical guidelines provided. Conclusions: REDs is associated with decreases in markers of bone health, lean body mass, maximal and explosive strength, and muscle work capacity. Restoration of optimal energy availability, mainly through an increase in energy intake, is the primary goal during the initial treatment of REDs with a return to performance managed by a multidisciplinary team of specialists. MSK training is an effective nonpharmacological component of treatment for REDs, which offers multiple long-term health and performance benefits, assuming the energy needs of athletes are met as part of their recovery. Supervised, prescribed, and gradually progressive MSK training should include a combination of resistance training and high-impact plyometric-based exercise to promote MSK adaptations, with an initial focus on achieving movement competency. Progressing MSK training exercises to higher intensities will have the greatest effects on bone health and strength performance in the long term.
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The Role of Musculoskeletal Training During Return to Performance Following Relative Energy Deficiency in Sport
Richard C. Blagrove, Katherine Brooke-Wavell, Carolyn R. Plateau, Carolyn Nahman, Amal Hassan, and Trent Stellingwerff
Volume 19 (2024): Issue 6 (Jun 2024)
A Biopsychosocial Framework for Sport Science: “A Jack of All Trades Is Oftentimes Better Than a Master of One”
Kerry McGawley
Effects of Different Conditioning Activities on the Sprint Performance of Elite Sprinters: A Systematic Review With Meta-Analysis
Irineu Loturco, Lucas A. Pereira, Túlio B.M.A. Moura, Michael R. McGuigan, and Daniel Boullosa
Purpose: Postactivation performance enhancement (PAPE), which refers to the phenomena associated with the attainment of enhanced performance in sport-specific tasks after a conditioning activity, is an important objective of warming-up practices in many sports. This is even more relevant for sprinters, as potential increases in sprinting speed will directly influence their competitive results. This systematic review with meta-analysis evaluated the effects of different PAPE protocols (ie, using plyometrics, strength-power exercises, and resisted/assisted sprints) on the sprinting performance (ie, sprint time or sprint speed) of competitive sprinters. Methods: Initially, 1205 records published until last December 18 were identified, using the following databases: PubMed/MEDLINE, Scopus, and Clarivate Web of Science. After removing duplicates and screening titles and abstracts, 14 high-quality studies met the inclusion criteria for the meta-analysis. Results: Overall, there were no significant changes in sprint performance after implementing various types of conditioning activities (standardized mean difference [SMD] = 0.16 [95% CI, −0.02 to 0.33]; Z = 1.78; P = .08; I 2 = 0%). In addition, when comparing prechanges and postchanges between experimental, control, and other conditions, no significant differences were found in sprint speed or time across all studies (SMD = 0.09 [95% CI, −0.10 to 0.28]; Z = 0.92; P = .36; I = 0%). Conclusions: Results revealed that different types of conditioning activities may not be capable of acutely enhancing the sprint speed of competitive sprinters. This aligns with previous observations indicating that sprinting is a highly stable physical capacity, a phenomenon that is even more consistent among elite sprinters. Coaches and sport scientists should collaborate to develop more efficient PAPE protocols for these highly specialized athletes, with special attention to study design and individualization, while considering their effects on acceleration versus top speed.
Velocity–Load Jump Testing Predicts Acceleration Performance in Elite Speed Skaters: But Does Movement Specificity Matter?
Matthew Zukowski, Walter Herzog, and Matthew J. Jordan
Purpose: In this study, we compared the influence of movement specificity during velocity–load jump testing to predict on-ice acceleration performance in elite speed skaters. Methods: Elite long-track speed skaters (N = 27) performed velocity–load testing with 3 external loads during unilateral horizontal jumping, lateral jumping, and bilateral vertical countermovement jumping. For the unilateral tests, external load conditions were set to 10 N, 7.5% and 15% of external load relative to body weight. For the countermovement jumping, load conditions were body weight and 30% and 60% of external load relative to body weight. On-ice performance measures were obtained during maximal 50-m accelerations from a standing start, including maximal skating speed, maximal acceleration capacity, and maximum horizontal power. The 100-m split time from a 500-m race was also obtained. Regularized regression models were used to identify the most important predictors of on-ice acceleration performance. In addition to regularized regression coefficients, Pearson correlation coefficients (r) were calculated for all variables retained by the model to assess interrelationships between single predictors and on-ice performance measures. Results: The countermovement jump with 30% of body mass demonstrated the strongest association with maximal skating speed, maximum horizontal power, and 100-m time (regularized regression coefficient = .16−.49, r = .84−.97, P < .001). Horizontal jump with 15% of body mass was the strongest predictor of maximal acceleration capacity performance (regularized regression coefficient = .08, r = .83, P < .001). Conclusions: The findings of this study suggest that mechanical specificity rather than movement specificity was more relevant for predicting on-ice acceleration performance.
Comparative Effects of Advanced Footwear Technology in Track Spikes and Road-Racing Shoes on Running Economy
Dustin P. Joubert, Garrett M. Oehlert, Eric J. Jones, and Geoffrey T. Burns
Purpose: Determine the effects of advanced footwear technology (AFT) in track spikes and road-racing shoes on running economy (RE). Methods: Four racing shoes (3 AFT and 1 control) and 3 track spikes (2 AFT and 1 control) were tested in 9 male distance runners on 2 visits. Shoes were tested in a random sequence over 5-minute trials on visit 1 (7 trials at 16 km·h−1; 5-min rest between trials) and in the reverse/mirrored order on visit 2. Metabolic data were collected and averaged across visits. Results: There were significant differences across footwear conditions for oxygen consumption (F = 13.046; P < .001) and energy expenditure (F = 14.710; P < .001). Oxygen consumption (in milliliters per kilogram per minute) in both the first AFT spike (49.1 [1.7]; P < .001; d z = 2.1) and the other AFT spike (49.3 [1.7]; P < .001; d z = 1.7) was significantly lower than the control spike (50.2 [1.6]), which represented a 2.1% (1.0%) and 1.8% (1.0%) improvement in RE, respectively, for the AFT spikes. When comparing the subjects’ most economic shoe by oxygen consumption (49.0 [1.5]) against their most economic spike (49.0 [1.8]), there were no statistical differences (P = .82). Similar statistical conclusions were made when comparing energy expenditure (in watts per kilogram). Conclusions: AFT track spikes improved RE ∼2% relative to a traditional spike. Despite their heavier mass, AFT shoes resulted in similar RE as AFT spikes. This could make the AFT shoe an attractive option for longer track races, particularly in National Collegiate Athletic Association and high school athletics, where there are no stack-height rules.
Pacing Strategies in Elite Individual-Medley Swimmers: A Decision-Tree Approach
Chin-Kuei Yang, Yu-Chia Hsu, and Chen-Kang Chang
Purpose: This study aimed to examine pacing strategies and identify the stroke that has the most significant impact on overall performance in men’s and women’s 200-m and 400-m individual-medley events from 2000 to 2021. Methods: The time in each lap and overall race was retrieved from the World Aquatics website. The standardized time for each stroke in individual medley was calculated by dividing the actual time by a reference time specific to each stroke. The reference time was derived from the respective laps in single-stroke finals in the 2017 World Swimming Championships. The decision-tree method was used for analysis. The dependent variables were qualified or nonqualified in heats and semifinals, and winning medals in finals. The independent variables were the ratio of standardized time in each stroke to the sum of standardized time in all 4 strokes. Results: Swimmers who spent a higher ratio of standardized time in the butterfly stroke (>0.236–0.245) are associated with a higher likelihood of winning medals or qualifying for the next stage in most men’s and women’s 200-m and 400-m individual medley. Butterfly exhibited the highest normalized importance that distinguished medalists from nonmedalists in the finals. The front-crawl stroke is the second most important determinant in medalists in men’s and women’s 200-m individual medley, whereas backstroke and breaststroke were the second most important in men’s and women’s 400-m individual medley, respectively. Conclusion: Individual-medley swimmers who were excellent in butterfly and conserved energy in butterfly had a higher likelihood of success.
The Autoregulation Rest-Redistribution Training Method Mitigates Sex Differences in Neuromuscular and Perceived Fatigue During Resistance Training
Antonio Dello Iacono, Kevin Watson, and Ivan Jukic
Purpose: To examine the sex differences in performance and perceived fatigue during resistance training prescribed using traditional (TRA) and autoregulation rest-redistribution training (ARRT) approaches. Methods: Twelve resistance-trained men and 12 women completed 2 sessions including the bench-press exercise matched for load (75% of 1-repetition maximum), volume (24 repetitions), and total rest (240 s). Sessions were performed in a counterbalanced randomized design with TRA consisting of 3 sets of 8 repetitions with 120-second interset rest and ARRT employing a personalized combination of clusters, repetitions per cluster, and between-clusters rest regulated with a 20% velocity-loss threshold. The effects of TRA and ARRT on velocity loss, unilateral isometric peak force, and rating of fatigue (ROF) were compared between sexes. Results: The velocity loss was generally lower during ARRT compared with TRA (−0.47% [0.11%]), with velocity loss being mitigated by ARRT to a greater extent among males compared with females (−0.37% [0.15%]). A smaller unilateral isometric peak force decline was observed after ARRT than TRA among males compared with females (−38.4 [8.4] N). Lower ROF after ARRT than TRA was found among males compared to females (−1.97 [0.55] AU). Additionally, males reported greater ROF than females across both conditions (1.92 [0.53] AU), and ARRT resulted in lower ROF than TRA overall (−0.83 [0.39] AU). Conclusions: The ARRT approach resulted in decreased velocity loss, peak force impairment, and ROF compared with TRA in both sexes. However, male subjects exhibited more pronounced acute within-session benefits from the ARRT method.
Subjective and Objective Monitoring Markers: Are They Related to Game Performance Indicators in Elite Female Volleyball Players?
André Rebelo, Diogo V. Martinho, Inês G. Pires, Inês Arrais, Ricardo Lima, João Valente-dos-Santos, and João R. Pereira
Purpose: This cohort study aimed to investigate the relationship between subjective (wellness and internal training load [ITL]) and objective (neuromuscular fatigue) monitoring markers and performance aspects (reception quality [RQ] and attack efficiency [AE]) in professional female volleyball players. Methods: The study was conducted over an 8-week period during the final mesocycle of the competitive phase. A total of 24 training sessions and 10 matches were included in the analysis. Subjective measures of wellness and ITL were assessed, and neuromuscular fatigue was evaluated using countermovement-jump (CMJ) height. RQ and AE were determined based on game statistics. Results: The study found a positive relationship between wellness and RQ, particularly affecting outside hitters and liberos. ITL showed a positive association with AE, primarily impacting outside hitters, opposite hitters, and middle blockers. Additionally, ITL demonstrated a negative correlation with RQ, mainly affecting outside hitters and liberos. CMJ performance was associated with AE, where a decrease in CMJ height was linked to reduced AE. Conclusions: The findings highlight the importance of considering players’ wellness scores in training and match strategies for different positions. Careful management of training loads, considering both physical and technical demands, is crucial for optimizing performance outcomes. Monitoring neuromuscular fatigue, as indicated by CMJ performance, is particularly relevant for outside hitters, opposite hitters, and middle blockers involved in attack actions. Coaches, trainers, and sports practitioners can use these insights to develop position-specific training protocols and implement effective strategies for maintaining or improving performance metrics under various stressors.
Cadence Paradox in Cycling—Part 2: Theory and Simulation of Maximal Lactate Steady State and Carbohydrate Utilization Dependent on Cycling Cadence
Ralph Beneke and Renate M. Leithäuser
Purpose: To develop and evaluate a theory on the frequent observation that cyclists prefer cadences (RPMs) higher than those considered most economical at submaximal exercise intensities via modeling and simulation of its mathematical description. Methods: The theory combines the parabolic power-to-velocity (v) relationship, where v is defined by crank length, RPM-dependent ankle velocity, and gear ratio, RPM effects on the maximal lactate steady state (MLSS), and lactate-dependent carbohydrate oxidation (CHO). It was tested against recent experimental results of 12 healthy male recreational cyclists determining the v-dependent peak oxygen uptake (VO 2PEAKv ), MLSS (MLSS v ), corresponding power output (P MLSSv ), oxygen uptake at P MLSSv (VO 2MLSSv ), and CHO MLSSv -management at 100 versus 50 per minute, respectively. Maximum RPM (RPM MAX ) attained at minimized pedal torque was measured. RPM-specific maximum sprint power output (P MAXv ) was estimated at RPMs of 100 and 50, respectively. Results: Modeling identified that MLSS v and P MLSSv related to P MAXv (IP MLSSv ) promote CHO and that VO 2MLSSv related to VO 2PEAKv inhibits CHO. It shows that cycling at higher RPM reduces IP MLSSv . It suggests that high cycling RPMs minimize differences in the reliance on CHO at MLSS v between athletes with high versus low RPM MAX . Conclusions : The present theory-guided modeling approach is exclusively based on data routinely measured in high-performance testing. It implies a higher performance reserve above IP MLSSv at higher RPM. Cyclists may prefer high cycling RPMs because they appear to minimize differences in the reliance on CHO at MLSS v between athletes with high versus low RPM MAX .
