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Jordan Milsom, Paulo Barreira, Darren J. Burgess, Zafar Iqbal and James P. Morton

The onset of injury and subsequent period of immobilization and disuse present major challenges to maintenance of skeletal muscle mass and function. Although the characteristics of immobilization-induced muscle atrophy are well documented in laboratory studies, comparable data from elite athletes in free-living conditions are not readily available. We present a 6-month case-study account from a professional soccer player of the English Premier League characterizing rates of muscle atrophy and hypertrophy (as assessed by DXA) during immobilization and rehabilitation after ACL injury. During 8 weeks of inactivity and immobilization, where the athlete adhered to a low carbohydrate-high protein diet, total body mass decreased by 5 kg attributable to 5.8 kg loss and 0.8 kg gain in lean and fat mass, respectively. Changes in whole-body lean mass was attributable to comparable relative decreases in the trunk (12%, 3.8 kg) and immobilized limb (13%, 1.4 kg) whereas the nonimmobilized limb exhibited smaller declines (7%, 0.8 kg). In Weeks 8 to 24, the athlete adhered to a moderate carbohydrate-high protein diet combined with structured resistance and field based training for both the lower and upper-body that resulted in whole-body muscle hypertrophy (varying from 0.5 to 1 kg per week). Regional hypertrophy was particularly pronounced in the trunk and nonimmobilized limb during weeks 8 to 12 (2.6 kg) and 13 to 16 (1.3 kg), respectively, whereas the previously immobilized limb exhibited slower but progressive increases in lean mass from Week 12 to 24 (1.2 kg). The athlete presented after the totality of the injured period with an improved anthropometrical and physical profile.

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Liam Anderson, Patrick Orme, Rocco Di Michele, Graeme L. Close, Jordan Milsom, Ryland Morgans, Barry Drust and James P. Morton

Purpose:

To quantify the accumulative training and match load during an annual season in English Premier League soccer players classified as starters (n = 8, started ≥60% of games), fringe players (n = 7, started 30–60% of games) and nonstarters (n = 4, started <30% of games).

Methods

Players were monitored during all training sessions and games completed in the 2013–14 season with load quantified using global positioning system and Prozone technology, respectively.

Results:

When including both training and matches, total duration of activity (10,678 ± 916, 9955 ± 947, 10,136 ± 847 min; P = .50) and distance covered (816.2 ± 92.5, 733.8 ± 99.4, 691.2 ± 71.5 km; P = .16) were not different between starters, fringe players, and nonstarters, respectively. However, starters completed more (all P < .01) distance running at 14.4–19.8 km/h (91.8 ± 16.3 vs 58.0 ± 3.9 km; effect size [ES] = 2.5), high-speed running at 19.9–25.1 km/h (35.0 ± 8.2 vs 18.6 ± 4.3 km; ES = 2.3), and sprinting at >25.2 km/h (11.2 ± 4.2 vs 2.9 ± 1.2 km; ES = 2.3) than nonstarters. In addition, starters also completed more sprinting (P < .01, ES = 2.0) than fringe players, who accumulated 4.5 ± 1.8 km. Such differences in total high-intensity physical work done were reflective of differences in actual game time between playing groups as opposed to differences in high-intensity loading patterns during training sessions.

Conclusions

Unlike total seasonal volume of training (ie, total distance and duration), seasonal high-intensity loading patterns are dependent on players’ match starting status, thereby having potential implications for training program design.

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Liam Anderson, Graeme L. Close, Matt Konopinski, David Rydings, Jordan Milsom, Catherine Hambly, John Roger Speakman, Barry Drust and James P. Morton

Maintaining muscle mass and function during rehabilitation from anterior cruciate ligament injury is complicated by the challenge of accurately prescribing daily energy intakes aligned to energy expenditure. Accordingly, we present a 38-week case study characterizing whole body and regional rates of muscle atrophy and hypertrophy (as inferred by assessments of fat-free mass from dual-energy X-ray absorptiometry) in a professional male soccer player from the English Premier League. In addition, in Week 6, we also quantified energy intake (via the remote food photographic method) and energy expenditure using the doubly labeled water method. Mean daily energy intake (CHO: 1.9–3.2, protein: 1.7–3.3, and fat: 1.4–2.7 g/kg) and energy expenditure were 2,765 ± 474 and 3,178 kcal/day, respectively. In accordance with an apparent energy deficit, total body mass decreased by 1.9 kg during Weeks 1–6 where fat-free mass loss in the injured and noninjured limb was 0.9 and 0.6 kg, respectively, yet, trunk fat-free mass increased by 0.7 kg. In Weeks 7–28, the athlete was advised to increase daily CHO intake (4–6 g/kg) to facilitate an increased daily energy intake. Throughout this period, total body mass increased by 3.6 kg (attributable to a 2.9 and 0.7 kg increase in fat free and fat mass, respectively). Our data suggest it may be advantageous to avoid excessive reductions in energy intake during the initial 6–8 weeks post anterior cruciate ligament surgery so as to limit muscle atrophy.

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Liam Anderson, Patrick Orme, Robert J. Naughton, Graeme L. Close, Jordan Milsom, David Rydings, Andy O’Boyle, Rocco Di Michele, Julien Louis, Catherine Hambly, John Roger Speakman, Ryland Morgans, Barry Drust and James P. Morton

In an attempt to better identify and inform the energy requirements of elite soccer players, we quantified the energy expenditure (EE) of players from the English Premier League (n = 6) via the doubly labeled water method (DLW) over a 7-day in-season period. Energy intake (EI) was also assessed using food diaries, supported by the remote food photographic method and 24 hr recalls. The 7-day period consisted of 5 training days (TD) and 2 match days (MD). Although mean daily EI (3186 ± 367 kcals) was not different from (p > .05) daily EE (3566 ± 585 kcals), EI was greater (p < .05) on MD (3789 ± 532 kcal; 61.1 ± 11.4 kcal.kg-1 LBM) compared with TD (2956 ± 374 kcal; 45.2 ± 9.3 kcal.kg-1 LBM, respectively). Differences in EI were reflective of greater (p < .05) daily CHO intake on MD (6.4 ± 2.2 g.kg-1) compared with TD (4.2 ± 1.4 g.kg-1). Exogenous CHO intake was also different (p < .01) during training sessions (3.1 ± 4.4 g.h-1) versus matches (32.3 ± 21.9 g.h-1). In contrast, daily protein (205 ± 30 g.kg-1, p = .29) and fat intake (101 ± 20 g, p = .16) did not display any evidence of daily periodization as opposed to g.kg-1, Although players readily achieve current guidelines for daily protein and fat intake, data suggest that CHO intake on the day before and in recovery from match play was not in accordance with guidelines to promote muscle glycogen storage.