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Mark T. Suffolk

The sport of competitive bodybuilding is strongly associated with muscle dysmorphia, a body-image-related psychological disorder. This theoretical article draws on existing concepts, namely stereotyping, prejudice, and positive deviance in sport, to explicate the notion that competitive bodybuilding and body-image disturbance may be mistakenly conflated. The perspective offered here goes beyond the countercultural physique to argue that a negative social perception of competitive bodybuilders obscures the pragmatic necessity to develop a hypermesomorphic physique. Competitive bodybuilders (CBs) and athletes in mainstream competitive sport exhibit congruent psychobehavioral tendencies. In a competitive-sport context, behavior among CBs perceived as pathological may primarily represent a response to the ideological sporting ethic of “win at all costs,” not extreme body-image disturbance. Analyzing the psychobehavioral characteristics of CBs within a sporting rather than a pathological framework, allows for a contextual assessment of behaviors to then determine the clinical significance relative to the research population under investigation.

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Ryan S. McCann, Kyle B. Kosik, Masafumi Terada and Phillip A. Gribble

that patients with lower age, greater height, mass, and body mass index (BMI), as well as more severe impairments and activity limitations at RTP would have greater odds of sustaining a recurrent ankle sprain during the same competitive sport season. Methods Participants Sixty-five patients (female: 18

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Gary Robinson and Mark Freeston

A growing body of research has provided evidence for intolerance of uncertainty (IU)—a dispositional characteristic resulting from negative beliefs about uncertainty and its implications—as a possible transdiagnostic maintaining factor across a range of anxiety disorders. No studies have yet examined IU in performance anxiety in sport. The purpose of the present investigation, therefore, was to investigate the relationship between IU and performance anxiety in sport. Participants included 160 university athletes (51% female) who completed measures of IU, performance anxiety, and robustness of sport confidence. Regression analyses revealed that the inhibitory dimension of IU and robustness of sport confidence were significant predictors of performance anxiety. A simple mediation model was also tested and suggested indirect and direct effects of inhibitory IU on performance anxiety symptoms through robustness of sport confidence. Implications of these findings for researchers and practitioners and directions for future research are discussed.

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J.D. DeFreese and Alan L. Smith

), 258 – 265 . doi: 10.1016/j.psychsport.2012.10.009 DeFreese , J.D. , & Smith , A.L. ( 2014 ). Athlete social support, negative social interactions, and psychological health across a competitive sport season . Journal of Sport & Exercise Psychology, 36 ( 6 ), 619 – 630 . PubMed ID: 25602144

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Gavin Breslin, Stephen Shannon, Kyle Ferguson, Shauna Devlin, Tandy Haughey and Garry Prentice

groups ( Ahmedani, 2011 ), one sub-population receiving increasingly more research attention is those individuals participating in competitive sport (for a recent review see Breslin, Shannon, Haughey, Donnelly, & Leavey, 2017 ). Participation in sport can contribute to mental well-being. For example

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Urban Johnson

The rehabilitation of 77 competitive athletes with long-term injuries was followed for 2–3 years from the time of the injury with the aim of identifying potential risk factors in rehabilitation. Seven athletes not returning to competitive sport despite favorable physical records were compared with 5 athletes who returned despite unfavorable records and with 65 athletes whose rehabilitation met expectations. Twelve tests were employed on four different occasions. The results suggested that being younger, being female, and having had no previous experience with injury characterized the nonreturning athlete. An insufficient mental plan for rehabilitation and a predominantly negative attitude toward it, as well as restricted social contacts with fellow athletes and a low mood level, appeared to accompany a problematic and prolonged rehabilitation. It was concluded that the nonreturning, long-term injured athlete can be identified as early as the beginning of the rehabilitation process.

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Eric Emmanuel Coris, Stephen Walz, Jeff Konin and Michele Pescasio


Heat illness is the third leading cause of death in athletics and a leading cause of morbidity and mortality in exercising athletes. Once faced with a case of heat related illness, severe or mild, the health care professional is often faced with the question of when to reactivate the athlete for competitive sport. Resuming activity without modifying risk factors could lead to recurrence of heat related illness of similar or greater severity. Also, having had heat illness in and of itself may be a risk factor for future heat related illness. The decision to return the athlete and the process of risk reduction is complex and requires input from all of the components of the team. Involving the entire sports medicine team often allows for the safest, most successful return to play strategy. Care must be taken once the athlete does begin to return to activity to allow for re-acclimatization to exercise in the heat prior to resumption particularly following a long convalescent period after more severe heat related illness.

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Kevin McCurdy and John Walker

Context: Within each hamstring muscle, there are segments with separate nerve innervation. However, a better understanding of activation levels within these regions during resistance exercise could lead to region-specific training for improved performance and injury prevention. Objective: To compare muscle activation levels within regions of the hamstrings during various resistance exercises. Design: Within-subjects repeated measures. Setting: Biomechanics laboratory. Participants: Eighteen young adult females with previous competitive sport participation and resistance training experience. Intervention: One set of 3 repetitions with an 8RM load on the bilateral squat, modified single-leg squat, stiff-legged dead lift, and leg curl (LC). Main Outcome Measures: Normalized surface electromyography of 4 hamstring regions (proximal-medial, proximal-lateral, distal-medial, and distal-lateral). Results: For LC only, electromyography measures for the proximal-lateral location were significantly lower than for the distal-lateral, t 18 = 5.6, P < .001, and proximal-medial, t 18 = 2.4, P = .01 locations for concentric contractions. Similar results were observed for eccentric contractions. No other exercises revealed regional activation differences. When comparing the pooled proximal (medial and lateral) region across exercises, the LC demonstrated significantly greater activation than the modified single-leg squat, t 18 = 5.20, P < .001, stiff-legged dead lift, t 18 = 7.311, P < .001, and bilateral squat, F 3,54 = 49.8, P < .001. Similar significantly greater levels were also found during the LC for the pooled distal, medial, and lateral regions. In addition, the modified single-leg squat electromyography was significantly greater at all regions in comparison with the stiff-legged dead lift and bilateral squat. Conclusions: The data did not reveal consistent regional differences within the different exercises included in this study. However, the data indicate that the LC produces the highest hamstring activation in all regions across exercises. Inclusion of single-joint knee-flexion exercises would appear to be most beneficial for hamstrings development in a resistance-training program.

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. King PhD * Jennifer M. Medina McKeon PhD, ATC, CSCS * 24 2 70 77 10.1123/ijatt.2017-0053 ijatt.2017-0053 Prediction of Recurrent Injury in the Same Competitive Sport Season Following Return-to-Play From an Ankle Sprain Ryan S. McCann PhD, ATC, CSCS * Kyle B. Kosik PhD, ATC * Masafumi Terada PhD

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Kelly A. Forrest

Attachment (Bowlby, 1969/1982) is an interdisciplinary theory of social development that views early relationships with caregivers as central to how individuals learn to regulate attention under attachment-related stress (Fonagy & Target, 2002; Main, 2000; Hesse & Main, 2000). This paper proposes that conditions present in competitive sport situations, such as unexpected conditions, fear of failure, fatigue, and coach stress are likely to activate attachment-related attentional processes of athletes and differentially influence attentional flexibility under competitive stress. The attachment-based approach to performance-related problems in which attentional processes are implicated, such as anxiety, choking, and self-regulation, is discussed. Research using the Adult Attachment Interview (George, Kaplan, & Main, 1996) is suggested to investigate the distribution of adult attachment classification in the athlete population.