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Michael Kellmann, Maurizio Bertollo, Laurent Bosquet, Michel Brink, Aaron J. Coutts, Rob Duffield, Daniel Erlacher, Shona L. Halson, Anne Hecksteden, Jahan Heidari, K. Wolfgang Kallus, Romain Meeusen, Iñigo Mujika, Claudio Robazza, Sabrina Skorski, Ranel Venter and Jürgen Beckmann

Definition of Central Terms Recovery is regarded as a multifaceted (eg, physiological, psychological) restorative process relative to time. In case an individual’s recovery status (ie, his or her biopsychosocial balance) is disturbed by external or internal factors, fatigue as a condition of

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Eric S. Rawson, Mary P. Miles and D. Enette Larson-Meyer

to exercise, improving brain performance, decreasing delayed onset muscle soreness or pain, reducing injury severity, enhancing recovery from injury, reducing gastrointestinal problems, and decreasing respiratory tract infection illness load. For the most part, these effects are not ergogenic, but

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Corey P. Ochs, Melissa C. Kay and Johna K. Register-Mihalik

resulting time out of play and the potential athletic consequences following this time loss. Concussions in professional sports, such as football and ice hockey, are unique due to players’ job security relying on their ability to perform. Typically, initial clinical recovery occurs within 7 to 10 days 3

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Steven Nagib and Shelley W. Linens

Clinical Scenario Although headache is the most commonly reported symptom associated with concussion, dizziness comes in at a close second with report rates between 66% and 77%. 1 This statistic is concerning as dizziness may be a predictor of prolonged recovery. 1 Any patient, who has symptoms

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Landon Lempke, Abbis Jaffri and Nicholas Erdman

is necessary to prevent a protracted recovery. 1 For the past several decades, physical rest has been prescribed as a mainstay for SRC management. 1 More recently, rest has been divided into cognitive and physical components. Cognitive rest may include restricting daily living activities, such as

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Stephan R. Fisher, Justin H. Rigby, Joni A. Mettler and Kevin W. McCurdy

regulatory factors, and increases the formation of new red blood cells locally. 2 These effects make PBMT a valuable treatment option for muscle recovery; however, PBMT has not become a mainstream tool for muscle recovery in clinical practice. For decades, cryotherapy has been a popular modality for

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Mary Lynn Manduca and Stephen J. Straub

normal concentration of platelets in an injured area to promote healing and decrease recovery time. 3 Despite the proposed benefits, the effect of PRP on hamstring injuries is unclear. Focused Clinical Question Does the combination of PRP injection and rehabilitation decreased recovery time of acute

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Robin T. Thorpe, Anthony J. Strudwick, Martin Buchheit, Greg Atkinson, Barry Drust and Warren Gregson

Purpose:

To determine the sensitivity of a range of potential fatigue measures to daily training load accumulated over the previous 2, 3, and 4 d during a short in-season competitive period in elite senior soccer players (N = 10).

Methods:

Total highspeed-running distance, perceived ratings of wellness (fatigue, muscle soreness, sleep quality), countermovement-jump height (CMJ), submaximal heart rate (HRex), postexercise heart-rate recovery (HRR), and heart-rate variability (HRV: Ln rMSSD) were analyzed during an in-season competitive period (17 d). General linear models were used to evaluate the influence of 2-, 3-, and 4-d total high-speed-running-distance accumulation on fatigue measures.

Results:

Fluctuations in perceived ratings of fatigue were correlated with fluctuations in total high-speed-running-distance accumulation covered on the previous 2 d (r = –.31; small), 3 d (r = –.42; moderate), and 4 d (r = –.28; small) (P < .05). Changes in HRex (r = .28; small; P = .02) were correlated with changes in 4-d total high-speed-running-distance accumulation only. Correlations between variability in muscle soreness, sleep quality, CMJ, HRR%, and HRV and total high-speed-running distance were negligible and not statistically significant for all accumulation training loads.

Conclusions:

Perceived ratings of fatigue and HRex were sensitive to fluctuations in acute total high-speed-running-distance accumulation, although sensitivity was not systematically influenced by the number of previous days over which the training load was accumulated. The present findings indicate that the sensitivity of morning-measured fatigue variables to changes in training load is generally not improved when compared with training loads beyond the previous day’s training.

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Ian McGinnis, Justin Cobb, Ryan Tierney and Anne Russ

recovery from concussion, both in athletic and general populations. 4 – 6 The vestibular system’s regulation of balance, spatial orientation, and gaze stability plays a key role in athletic tasks and many activities of daily living. Disruption of the vestibular system can exacerbate other symptoms of

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Alireza Esmaeili, Andrew M. Stewart, William G. Hopkins, George P. Elias and Robert J. Aughey

Purpose:

Detrimental changes in tendon structure increase the risk of tendinopathies. The aim of this study was to investigate the influence of individual internal and external training loads and leg dominance on changes in the Achilles and patellar tendon structure.

Methods:

The internal structure of the Achilles and patellar tendons of both limbs of 26 elite Australian footballers was assessed using ultrasound tissue characterization at the beginning and the end of an 18-wk preseason. Linear-regression analysis was used to estimate the effects of training load on changes in the proportion of aligned and intact tendon bundles for each side. Standardization and magnitude-based inferences were used to interpret the findings.

Results:

Possibly to very likely small increases in the proportion of aligned and intact tendon bundles occurred in the dominant Achilles (initial value 81.1%; change, ±90% confidence limits 1.6%, ±1.0%), nondominant Achilles (80.8%; 0.9%, ±1.0%), dominant patellar (75.8%; 1.5%, ±1.5%), and nondominant patellar (76.8%; 2.7%, ±1.4%) tendons. Measures of training load had inconsistent effects on changes in tendon structure; eg, there were possibly to likely small positive effects on the structure of the nondominant Achilles tendon, likely small negative effects on the dominant Achilles tendon, and predominantly no clear effects on the patellar tendons.

Conclusion:

The small and inconsistent effects of training load are indicative of the role of recovery between tendon-overloading (training) sessions and the multivariate nature of the tendon response to load, with leg dominance a possible influencing factor.