Background: Cycling is a popular global sport and method of transportation and a significant contributor to admissions to hospital emergency units following an injury. Mountain biking events present additional challenges with remote venues and isolated courses, for which on-site medical care is often provided, for both injury and illness occurring during races. National health data may not represent these unique events, and specific data on incidence of injury and illness in mountain biking events are essential. Therefore, the aim of this study was to review the available injury and illness literature, reporting methods and risk factors in cross-country mountain biking. Methods: Search engines PubMed, Scopus, CINAHL (EBSCOhost), Scopus, PEDro and the Cochrane Library were systematically searched, and a grey literature search was performed. Narrative analyses of the types, severity and area of injuries and illness type and severity were performed as pooling of data was impossible due to insufficient high-quality studies with the same injury and illness definitions. Results: Seven studies comprising 28,021 participants were included for analysis. Four to 71% of participants sustained an injury in a cross-country mountain bike event. Injuries to the skin were the most common, followed by bony injuries and concussion. Five to 47% of cyclists reported the onset of gastrointestinal symptoms post-event. The prevalence of illness during events ranged from 0.5 to 23.0%. Conclusion: The injury and illness definitions were varied and prevented clear comparisons between studies. Injury and illness present a concern in cross-country marathon mountain biking and should be investigated further to provide the true burden of these during race events. Registration: This protocol has been registered with PROSPERO International prospective register of systematic reviews (No: CRD42019134586).

Background: Although stretching is done routinely to prevent injury during explosive sport activities, there is some concern that effective stretching might negatively impact on performance. Objectives: This study’s main objective was to investigate the impact of a specific stretch (CRAC), in which the muscle to be stretched, hamstrings, is actively contracted then relaxed. This is then followed by the antagonist muscle (quadriceps) contracting. Secondly, the impact of the stretch on performance was examined. Methods: A randomised control trial was used. Forty healthy active males between 21 and 35 years of age were assigned to either receive three repetitions of CRAC or rest. Hamstring flexibility and the Illinois Agility Test were the primary outcome measures. Results: The intervention was effective in improving hamstring flexibility by 37% immediately post-application and this was maintained for eight minutes thereafter. It had no significant effect on agility or sprint times. Conclusions: CRAC applied to stretch the hamstring muscles of active males resulted in a large increase of active knee extension range of motion, without decreasing performance. CRAC appears to be a safe and effective method of increasing the length of the hamstrings pre-sport activity and should be utilised by sports physiotherapists if deemed necessary and beneficial following initial assessment.

Background: Professional rugby presents significant injury and illness risks to players, which need to be regularly assessed to monitor the effects of interventions and competition rules changes. Hypothesis/Purpose: The purpose of this study was to determine the incidence and nature of time-loss injuries and illness during the pre-season and competition period of the 2017 Super Rugby tournament in a single South African team. Study Design: Descriptive Epidemiology Study Methods: Forty-five adult players were recruited from one 2017 Super Rugby South African team, with 39 included in the final data set. Daily injury and illness data were routinely collected during the season by support staff over a 28-week period (January to July 2017), based on standardized injury and illness definitions. Retrospective analyses of the data were performed. Results: The incidence of match injuries (241.0 per 1000 player hours) was significantly higher than training injuries (3.3 per 1000 player hours). Twenty one percent of all injuries occurred during the tackle; 37.5% of all injuries were of a “moderate” severity. The proportion of players who sustained a time-loss injury was 76.9% (n=30). The overall incidence of illness was 1.8 per 1000 player days. Acute respiratory tract infection (28.6%) was the most common diagnosis, and the majority of illnesses (64.3%) did not result in time-loss. Conclusion: This study presented a longer study period than previous research by including the pre-season training, but represented only one single team. The incidence of match injuries was significantly higher than previously reported in Super Rugby tournaments, whereas illness rates were significantly lower. Support staff in professional rugby need to be trained on the standardized Orchard System of Classifications to ensure good quality data that can be compared to other teams within the same or other sporting codes. Level of evidence: Level 3

Background: Ultramarathon running has become extremely popular over the years. Despite the numerous health benefits of running, there are also many negative effects of running, such as increased risk of musculoskeletal injury and illness. Monitoring of an athlete’s training load has become extremely important in terms of injury prevention. Currently, the relationship between training loads and injury and illness incidence is uncertain. Objectives: To determine if there are any associations between injury and illness incidences and training loads among ultramarathon runners in the 12 week period preceding an ultramarathon event and the four week period after the event. Methods: This prospective, descriptive, longitudinal study design was conducted in 119 runners who were training for the 2019 Two Oceans ultramarathon event. Data were collected once a week via an online logbook over 16 weeks. Training parameters measured included weekly average running distance, average duration, average frequency and average sessional RPE. Injury data included injury counts, the structure injured, the main anatomical location and the time-loss as a result of injury. Illness data included illness counts, the main illness-related symptoms and the time-loss as a result of illness. Results: The overall injury incidence was five per 1000 training hours and the overall illness incidence was 16 per 1000 training days. There was a significant relationship between external training load and injury and illness incidence for those who ran less than 30 km per week. There was also a significant relationship between the ACWR (Acute Chronic Workload Ratio) and injury incidence when the ACWR was >1.5 and for illness incidence when the ACWR was <0.5. Conclusion: The use of both absolute and relative workloads in the monitoring of an athlete’s training load with the aim of minimising injury and illness risk and maximising performance in ultramarathon runners is recommended.

Background: Although stretching is done routinely to prevent injury during explosive sport activities, there is some concern that effective stretching might negatively impact on performance. Objectives: This study’s main objective was to investigate the impact of a specific stretch (CRAC), in which the muscle to be stretched, hamstrings, is actively contracted then relaxed. This is then followed by the antagonist muscle (quadriceps) contracting. Secondly, the impact of the stretch on performance was examined. Methods: A randomised control trial was used. Forty healthy active males between 21 and 35 years of age were assigned to either receive three repetitions of CRAC or rest. Hamstring flexibility and the Illinois Agility Test were the primary outcome measures. Results: The intervention was effective in improving hamstring flexibility by 37% immediately post-application and this was maintained for eight minutes thereafter. It had no significant effect on agility or sprint times. Conclusions: CRAC applied to stretch the hamstring muscles of active males resulted in a large increase of active knee extension range of motion, without decreasing performance. CRAC appears to be a safe and effective method of increasing the length of the hamstrings pre-sport activity and should be utilised by sports physiotherapists if deemed necessary and beneficial following initial assessment.

Mass participation events are promoted in South Africa as a positive public health initiative. Parkrun has grown to be one of the most popular. The present study identifies the motives of residents in the Western Cape Province to join parkrun and how their involvement influences future physical activity levels. Participants (N = 1787) completed a survey consisting of demographic history, parkrun participation history, motivations for participation, and physical activity-related behaviour changes associated with parkrun participation. The majority of participants were female (n = 952) and over 50 years of age (median = 50; IQR = 38–59). Along with health-related benefits, the provision of a safe and organised event was reported as a key motive to participate. The social connectedness developed by parkrun encouraged continued participation and promoted uptake of more physical activity. Close to half the participants reported increases in physical activity levels after joining parkrun, which demonstrates the benefit obtained from participation in structured mass participation events. With the large diversity in socioeconomic status in South Africa related to physical activity levels, parkrun provides a protected and engaging environment that provides opportunity for increased physical activity and potentially reducing the burden on the healthcare system.