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Armand E.O. Bettonviel, Naomi Y.J. Brinkmans, Kris Russcher, Floris C. Wardenaar and Oliver C. Witard

The nutritional status of elite soccer players across match, postmatch, training and rest days has not been defined. Recent evidence suggests the pattern of dietary protein intake impacts the daytime turnover of muscle proteins and, as such, influences muscle recovery. We assessed the nutritional status and daytime pattern of protein intake in senior professional and elite youth soccer players and compared findings against published recommendations. Fourteen senior professional (SP) and 15 youth elite (YP) soccer players from the Dutch premier division completed nutritional assessments using a 24-hr web-based recall method. Recall days consisted of a match, postmatch, rest, and training day. Daily energy intake over the 4-day period was similar between SP (2988 ± 583 kcal/day) and YP (2938 ± 465 kcal/day; p = .800). Carbohydrate intake over the combined 4-day period was lower in SP (4.7 ± 0.7 g·kg-1 BM·day-1) vs. YP (6.0 ± 1.5 g·kg-1 BM·day-1, p = .006) and SP failed to meet recommended carbohydrate intakes on match and training days. Conversely, recommended protein intakes were met for SP (1.9 ± 0.3 g·kg-1 BM·day-1) and YP (1.7 ± 0.4 g·kg-1 BM·day-1), with no differences between groups (p = .286). Accordingly, both groups met or exceeded recommended daily protein intakes on individual match, postmatch, rest and training days. A similar “balanced” daytime pattern of protein intake was observed in SP and YP. To conclude, SP increased protein intake on match and training days to a greater extent than YP, however at the expense of carbohydrate intake. The daytime distribution of protein intake for YP and SP aligned with current recommendations of a balanced protein meal pattern.

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Jay R. Ebert, Anne Smith, Peter K. Edwards and Timothy R. Ackland


Matrix-induced autologous chondrocyte implantation (MACI) is an established technique for the repair of knee chondral defects. Despite the reported clinical improvement in knee pain and symptoms, little is known on the recovery of knee strength and its return to an appropriate level compared with the unaffected limb.


To investigate the progression of isokinetic knee strength and limb symmetry after MACI.


Prospective cohort.


Private functional rehabilitation facility.


58 patients treated with MACI for full-thickness cartilage defects to the femoral condyles.


MACI and a standardized rehabilitation protocol.

Main Outcome Measures:

Preoperatively and at 1, 2, and 5 y postsurgery, patients underwent a 3-repetition-maximum straight-leg raise test, as well as assessment of isokinetic knee-flexor and -extensor torque and hamstring:quadriceps (H:Q) ratios. Correlation analysis investigated the association between strength and pain, demographics, defect, and surgery characteristics. Linear-regression analysis estimated differences in strength measures between the operated and nonoperated limbs, as well as Limb Symmetry Indexes (LSI) over time.


Peak knee-extension torque improved significantly over time for both limbs but was significantly lower on the operated limb preoperatively and at 1, 2, and 5 y. Mean LSIs of 77.0%, 83.0%, and 86.5% were observed at 1, 2, and 5 y, respectively, while 53.4–72.4% of patients demonstrated an LSI ≤ 90% across the postoperative timeline. Peak knee-flexion torque was significantly lower on the operated limb preoperatively and at 1 year. H:Q ratios were significantly higher on the operated limb at all time points.


While peak knee-flexion and hip-flexor strength were within normal limits, the majority of patients in this study still demonstrated an LSI for peak knee-extensor strength ≤ 90%, even at 5 y. It is unknown how this prolonged knee-extensor deficit may affect long-term graft outcome and risk of reinjury after return to activity.

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


To quantify the mean daily changes in training and match load and any parallel changes in indicators of morningmeasured fatigue across in-season training weeks in elite soccer players.


After each training session and match (TL), session ratings of perceived exertion (s-RPE) were recorded to calculate overall session load (RPE-TL) in 29 English Premier League players from the same team. Morning ratings of fatigue, sleep quality, and delayed-onset muscle soreness (DOMS), as well as submaximal exercise heart rate (HRex), postexercise heart-rate recovery (HRR%), and heart-rate variability (HRV) were recorded before match day and 1, 2, and 4 d postmatch. Data were collected for a median duration of 3 wk (range 1–13) and reduced to a typical weekly cycle including no midweek match and a weekend match day. Data were analyzed using withinsubject linear mixed models.


RPE-TL was approximately 600 arbitrary units (AU) (95% confidence interval 546–644) higher on match day than following day (P < .001). RPE-TL progressively decreased by »60 AU per day over the 3 days before a match (P < .05). Morning-measured fatigue, sleep quality, and DOMS tracked the changes in RPE-TL, being 35–40% worse on postmatch day vs prematch day (P < .001). Perceived fatigue, sleep quality, and DOMS improved by 17–26% from postmatch day to 3 d postmatch, with further smaller (7%–14%) improvements occurring between 4 d postmatch and prematch day (P < .01). There were no substantial or statistically significant changes in HRex, HRR%, or HRV over the weekly cycle (P > .05).


Morning-measured ratings of fatigue, sleep quality, and DOMS are clearly more sensitive than HR-derived indices to the daily fluctuations in session load experienced by elite soccer players in a standard in-season week.

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Benita J. Lalor, Shona L. Halson, Jacqueline Tran, Justin G. Kemp and Stuart J. Cormack

Australian Football (AF) is an intermittent team sport involving rapid accelerations and decelerations, collisions, and large distances covered at a high intensity. 1 The competitive season can produce high levels of fatigue, and optimizing recovery in order to maximize performance is critical. 1

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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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Corall S. Hjert and Cynthia J. Wright

after FR application. Characteristics of the included studies are presented in Table  1 . Table 1 Characteristics of Included Studies Authors Characteristics MacDonald et al. 2 Pearcey et al. 3 Fleckenstein et al. 9 Laffaye et al. 13 Study title Foam Rolling as a Recovery Tool after an Intense Bout of

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Brett S. Pexa, Eric D. Ryan, Elizabeth E. Hibberd, Elizabeth Teel, Terri Jo Rucinski and Joseph B. Myers

’s posterior shoulder to a high amount of eccentric muscle activity and causes significant trauma to the musculoskeletal system. Despite acute changes in CSA, 19 , 22 range of motion, 7 – 9 and glenohumeral strength, 23 there is still limited evidence defining the time to recovery of these variables

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Gavriil G. Arsoniadis, Gregory C. Bogdanis, Gerasimos Terzis and Argyris G. Toubekis

exhaustion was reduced over a week of concurrent strength and endurance training, but the energy cost of submaximal exercise was unchanged 9 hours after the strength training sessions. 11 Strength training characteristics and subsequent endurance training intensity as well as the recovery period may be

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Ned Brophy-Williams, Matthew W. Driller, Cecilia M. Kitic, James W. Fell and Shona L. Halson


To determine the effect of wearing compression socks between repeated running bouts on perceptual, physiological, and performance-based parameters.


Twelve well-trained male runners (mean ± SD 5-km time 19:24 ± 1:19 [min:s]) recorded their perceptions of the efficacy of compression socks for recovery before completion of 2 experimental sessions. Each session consisted of two 5-km running time trials (TT1 and TT2) on a treadmill, with a 1-h recovery period between. In a randomized crossover design, 1 session required participants to wear compression socks during the recovery period, and no compression socks were worn between TTs in the other session (control).


Running performance between TT1 and TT2 for runners wearing compression socks was similar between TTs (mean Δ 5.3 ± 20.7 s, d = 0.07, P = .20), whereas for control runners, performance significantly decreased in the second TT (mean Δ 15.9 ± 13.3 s, d = 0.19, P < .01). When grouped by perception of efficacy for compression socks, participants with strong beliefs (n = 7) experienced improved subsequent running performance with compression socks (mean Δ –3.6 ± 19.2 s, d = 0.05, P = .32) compared with those with neutral or negative perceptions (n = 5; mean Δ 17.9 ± 17.0 s, d = 0.19, P = .04). Cross-sectional area of the calf and muscle soreness were significantly reduced during the recovery period with the use of compression socks (P < .01), whereas ratings of fatigue showed no difference between conditions.


Wearing compression socks between repeated running bouts can aid recovery and subsequent performance. Furthermore, subsequent exercise performance may be even further enhanced when athletes believe in the efficacy of compression socks to assist in recovery between exercise bouts.

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Benjamin G. Serpell, Barry G. Horgan, Carmen M.E. Colomer, Byron Field, Shona L. Halson and Christian J. Cook

Sleep is regarded as one of the best recovery strategies available to elite athletes, with sleep playing an important role in performance, cognitive function, mood, illness, and metabolism. 1 Evidence suggests that athletes may have poorer sleep quality and quantity than the general population, 2