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Dean Ritchie, Will G. Hopkins, Martin Buchheit, Justin Cordy and Jonathan D. Bartlett

Context:

Training volume, intensity, and distribution are important factors during periods of return to play.

Purpose:

To quantify the effect of injury on training load (TL) before and after return to play (RTP) in professional Australian Rules football.

Methods:

Perceived training load (RPE-TL) for 44 players was obtained for all indoor and outdoor training sessions, while field-based training was monitored via GPS (total distance, high-speed running, mean speed). When a player sustained a competition time-loss injury, weekly TL was quantified for 3 wk before and after RTP. General linear mixed models, with inference about magnitudes standardized by between-players SDs, were used to quantify effects of lower- and upper-body injury on TL compared with the team.

Results:

While total RPE-TL was similar to the team 2 wk before RTP, training distribution was different, whereby skills RPE-TL was likely and most likely lower for upper- and lower-body injury, respectively, and most likely replaced with small to very large increases in running and other conditioning load. Weekly total distance and high-speed running were most likely moderately to largely reduced for lower- and upper-body injury until after RTP, at which point total RPE-TL, training distribution, total distance, and high-speed running were similar to the team. Mean speed of field-based training was similar before and after RTP compared with the team.

Conclusions:

Despite injured athletes’ obtaining comparable TLs to uninjured players, training distribution is different until after RTP, indicating the importance of monitoring all types of training that athletes complete.

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Courtney W. Hess, Stacy L. Gnacinski and Barbara B. Meyer

theory the lone-physician approach to injury rehabilitation is considered inferior to approaches aligned with the biopsychosocial model, it is still commonly used in practice as evidenced by continual reports of return-to-play decisions based only on physical measures of healing ( Creighton et al., 2010

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Iñigo Mujika, Juanma Santisteban, Paco Angulo and Sabino Padilla

A 7-week, 10-session individual training program was implemented with a youth elite football (soccer) player who had been underperforming because of poor aerobic fitness. The intervention focused on developing aerobic power and high lactate production and contributed to a 32.3% improvement in a football-specific performance test. The player was able to return to play and exceed expected performance levels during competitive match play.

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Nicole Reams, Rodney A. Hayward, Jeffrey S. Kutcher and James F. Burke

Purpose:

Lingering neurologic injury after concussion may expose athletes to increased risk if return to play is premature. The authors explored whether on-field performance after concussion is a marker of lingering neurologic injury.

Design:

Retrospective cohort study on 1882 skill-position players who played in the National Football League (NFL) during 2007–2010.

Methods:

Players with concussion based on the weekly injury report were compared with players with other head and neck injuries (controls) on measures of on-field performance using Football Outsiders’ calculation of defense-adjusted yards above replacement (DYAR), a measure of a player’s contribution controlling for game context. Changes in performance, relative to a player’s baseline level of performance, were estimated before and after injury using fixed-effects models.

Results:

The study included 140 concussed players and 57 controls. Players with concussion performed no better or worse than their baseline on return to play. However, a decline in DYAR relative to their prior performance was noted 2 wk and 1 wk before appearing on the injury report. Concussed players performed slightly better than controls in situations where they returned to play the same week as appearing on the injury report.

Conclusions:

On return, concussed NFL players performed at their baseline level of performance, suggesting that players have recovered from concussion. Decline in performance noted 2 wk and 1 wk before appearing on the injury report may suggest that concussion diagnosis was delayed or that concussion can be a multihit phenomenon. Athletic performance may be a novel tool for assessing concussion injury and recovery.

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Martin Buchheit and Ben Michael Simpson

With the ongoing development of microtechnology, player tracking has become one of the most important components of load monitoring in team sports. The 3 main objectives of player tracking are better understanding of practice (provide an objective, a posteriori evaluation of external load and locomotor demands of any given session or match), optimization of training-load patterns at the team level, and decision making on individual players’ training programs to improve performance and prevent injuries (eg, top-up training vs unloading sequences, return to play progression). This paper discusses the basics of a simple tracking approach and the need to integrate multiple systems. The limitations of some of the most used variables in the field (including metabolic-power measures) are debated, and innovative and potentially new powerful variables are presented. The foundations of a successful player-monitoring system are probably laid on the pitch first, in the way practitioners collect their own tracking data, given the limitations of each variable, and how they report and use all this information, rather than in the technology and the variables per se. Overall, the decision to use any tracking technology or new variable should always be considered with a cost/benefit approach (ie, cost, ease of use, portability, manpower/ability to affect the training program).

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Bradford Strand, Shannon David, Katie J. Lyman and Jay M. Albrecht

The purpose of this original research was to survey high school coaches in four states in the Midwest region of the United States regarding their knowledge of first aid, cardiopulmonary resuscitation (CPR), and use of an Automated External Defibrillator (AED) as well as confidence in managing/treating emergency situations. Responses to general knowledge inquiries revealed that coaches were able to accurately answer questions related to return to play, level of consciousness, external bleeding, and cardiac arrest. However, coaches were unable to correctly answer questions specific to rest, ice, compression, and elevation (RICE) and also misidentified information related to pediatric AED use. Because sudden cardiac death is the leading cause of death and has been linked to lack of bystander intervention, the results of this project should be considered by coaches and administrators to implement certification and continuing education for high school coaches. Finally, coaches who were certified in first aid, CPR, and AED were more confident in treating an individual who required care compared with coaches not certified. Therefore, individuals who coach at all levels of sport and recreational activities should consider formal training and certification.

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Bart Roelands and Kevin De Pauw

the overtraining syndrome 2 ; or recovery strategies or manipulations designed to optimize recovery 3 or accelerate the return to play. One of the emerging topics in sport science is technology. For healthy athletes, newly developed state-of-the-art equipment or monitoring tools are technological

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Hugh H.K. Fullagar, Robert McCunn and Andrew Murray

this time to the present day. These include injury prevention, 3 , 4 concussion, 5 return-to-play injury characteristics, 6 , 7 analysis of strength and conditioning, 8 – 11 overall health 12 and wellbeing, and, most recently, the objective quantification of training and games. 13 – 15 Despite the

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Mathieu Lacome, Ben M. Simpson, Yannick Cholley and Martin Buchheit

consumption (VO 2 ), 10 the floater role may be used to decrease overall external load (both locomotor and mechanical) while maintaining internal loading and thus aerobic stimulus. It is noteworthy that some players returning to play as floaters after injury were also included in this study, which might have

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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

Anterior cruciate ligament (ACL) injury is a troublesome and potentially serious injury in soccer that often requires surgical reconstruction ( Brophy et al., 2012 ). After ACL reconstruction, an athlete’s return-to-play time is reported to range from 16 to 52 weeks ( Zaffagnini et al., 2014