To develop a screening tool for pelvic floor dysfunction (PFD) in female athletes for use by sports medicine clinicians (eg, musculoskeletal/sports physiotherapists, sports and exercise medicine physicians), which guides referral to a PFD specialist (eg, pelvic floor/women’s health physiotherapist, gynaecologist, urogynaecologist, urologist).Between February and April 2022, an international two-round modified Delphi study was conducted to assess expert opinion on which symptoms, risk factors and clinical and sports-related characteristics (items) should be included in a screening tool. We defined consensus a priori as >67% response agreement to pass each round.41 and 34 experts participated in rounds 1 and 2, respectively. Overall, seven general statements were endorsed as relevant by most participants highlighting the importance of screening for PFD in female athletes. Through consensus, the panel developed the Pelvic Floor Dysfunction-ScrEeNing Tool IN fEmale athLetes (PFD-SENTINEL) and agreed to a cluster of PFD symptoms (n=5) and items (risk factors, clinical and sports-related characteristics; n=28) that should prompt specialist care. A clinical algorithm was also created: a direct referral is recommended when at least one symptom or 14 items are reported. If these thresholds are not reached, continuous monitoring of the athlete’s health is indicated.Despite increasing awareness and clinical relevance, barriers to identify PFD in female athletes are still present. The PFD-SENTINEL is a new resource for sports medicine clinicians who regularly assess female athletes and represents the first step towards early PFD identification and management. Further studies to validate the tool are needed.

Muscle injuries are the most common trauma in team and individual sports. The muscles most frequently affected are those of the lower limb, and in particular hamstrings, adductors, rectus femoris and calf muscles. Although several scientific studies have tried to propose different rehabilitation protocols, still too often the real rehabilitation process is not based on scientific knowledge, especially in non-elite athletes. Moreover, the growing use of physical and instrumental therapies has made it increasingly difficult to understand what can be truly effective. Therefore, the aim of the present paper is to review proposed therapeutic algorithms for muscle injuries, proposing a concise and practical summary. Following a three-phase rehabilitation protocol, this review aims to describe the conservative treatment of indirect structural muscle injuries, which are the more routinely found and more challenging type. For each phase, until return to training and return to sport are completed, the functional goal, the most appropriate practitioner, and the best possible treatment according to current evidence are expressed. Finally, the last section is focused on the specific exercise rehabilitation for the four main muscle groups with a structured explanatory timetable.

In recent years medical science and research are increasingly directed towards a holistic approach that considers health as global well-being rather than solely as the absence of disease. In this framework, lifestyle interventions and, in particular, physical exercise, are of crucial importance in prevention and treatment. Therefore, the purpose of this study is to describe this mutual interplay between physical behaviours, sarcopenia, and frailty, as well as to illustrate the role of structured exercise training in aging and disease. Physical activity and exercise training are determinants of lifelong global wellness and healthy aging. On the contrary, sedentary behaviour and physical inactivity are strictly linked to frailty and pre-frailty, both in adults and the elderly, with or without chronic diseases. On the other hand, the presence of pathological conditions is associated with a more inactive and sedentary behaviour. The co-presence of these factors is characterized by a mutual causal exchange in which they are imbricated in a continuous mechanistic interplay that involves inflammation, sarcopenia, osteopenia, functional impairment and many other pathophysiological aspects that rapidly can lead to a status of frailty. A sedentary lifestyle and physical inactivity critically affect alterations in body composition and loss in functional capacity, typically linked to aging and accelerated by chronic diseases. However, physical activity and exercise can counteract the onset of pre-frailty and frailty by conferring beneficial effects on the individual's overall well-being.

Recently, electronic sports (eSports) became one of the growing forms of new media due to the wide diffusion of games and online technologies. Even if there is still a debate about the definition and characterization of eSports, eAthletes train heavily, compete in tournaments, must abide by competition, association, and governing body rules, just like all other athletes. Furthermore, as in any other competitive discipline, there can be injuries. Aberrant sitting posture, repetitive movements, screen vision, prolonged playing hours, and a sedentary lifestyle can lead to several medical hazards in musculoskeletal, ophthalmology, neurological, and metabolic systems. Moreover, several cardiovascular changes occur in eAthletes. This paper aims to explore the different injuries that can occur in a professional eAthlete, suggesting how every high-level gamer could benefit from a pre-participation evaluation and a correct injury prevention strategy.

Sport climbing is becoming incredibly popular both in the general population and among athletes. No consensus exists regarding evidence-based sport-specific performance evaluation; therefore, this systematic review was aimed at analyzing determinants of sport climbing performance and evaluation methods by comparing climbers of different levels. PubMed, Scopus, and Web of Science were searched up to December 20,2022. Studies providing the self-reported climbing ability associated with different functional outcomes in groups of climbers of contiguous performance levels were eligible. 74 studies were finally included. Various methods have been proposed to evaluate determinants of sport climbing performance. Climbing-specific assessments were able to discriminate climbers of different levels when compared to general functional tests. Test validity resulted high for climbing-specific cardiorespiratory endurance as well as muscular-strength, -endurance, and -power; similarly, reliability was good except for cardiorespiratory endurance. Climbing-specific flexibility assessment resulted in high reliability but moderate validity, whereas balance showed low validity. Considerable conflicting evidence was found regarding anthropometric characteristics. The present analysis identified cardiorespiratory endurance as well as muscular-strength, -endurance, and -power as determinants of sport climbing performance. In contrast, balance, flexibility, and anthropometric characteristics seem to count less. This review also proposes an evidence-based Functional Sport Climbing test battery for assessing performance determinants, which includes tests that have been identified to be valid, reliable, and feasible. While athletes and coaches should rely on evidence-based and standardized evaluation methods, researchers may design specific large-scale trials as a resource for providing additional, homogenous, and comparable data to improve scientific evidence and professionalism in this popular sport discipline.

Background and Aims: Premature deaths of bodybuilders have raised questions about the safety and associated risks of this discipline. The main objective of this study was to analyse mortality risk in a large international population of bodybuilders. Methods: Male athletes who performed International Federation of Bodybuilding and Fitness (IFBB) competitions between 2005 and 2020 were identified and classified according to age, division and level. A standardized web-search, tailored to detect deaths, was performed for each athlete using specific keywords, with follow-up through July 2023. Mortality rates have been calculated both as the overall incidence rate during the monitored period as well as the annual incidence rate of those who participated in at least one competition within the previous year, i.e. currently competing athletes. Results: A total of 20 286 athletes competing in 730 IFBB events were identified with an average follow-up of 8.1 ± 3.8 years (i.e. 190 211 athlete-years of surveillance). During the study period, 121 deaths were identified: 73 were considered sudden deaths, of which 46 were classified as sudden cardiac deaths (SCD), including 11 currently competing athletes (mean age 34.7 ± 6.1 years). The incidence of SCD in currently competing athletes was 32.83 cases per 100 000 athlete-years. Available autopsies of SCD cases consistently showed cardiomegaly and ventricular hypertrophy. Professional bodybuilders had a higher risk of SCD than amateurs (HR 5.23 [3.58-7.64]). Conclusions: The results of this study should alert the bodybuilding and medical communities to the need for improved preventive measures to promote safer sports participation.