Exercise dependence (ED) is common in endurance athletes and can lead to physical and psychological distress with various health effects. We designed a prospective cross-sectional study to investigate the personality traits associated with ED among ultraendurance athletes. A total of 507 participants (41.6 (9.8) years, men: 73.7%) completed (1) a screening questionnaire about sociodemographic data, sporting habits, and healthcare data, (2) the Exercise Dependence Scale-Revised (EDS-R, 21 items scored from 1 (never) to 6 (always), 7 subscales), (3) the Big Five Inventory (BFI), and (4) 2 items of the SCOFF (Sick-Control-One Stone-Fat-Food) questionnaire regarding possible eating disorders. Based on the EDS-R scores, 37 (7.3%) participants were at risk for ED (scores ≥ 5/6 on ≥3 subscales), 366 (72.2%) were nondependent but symptomatic (scores ≥ 3/6 on ≥3 subscales), and 104 (20.5%) were asymptomatic. Participants with ED had a greater training volume and a higher prevalence of possible eating disorders. A higher level of neuroticism was associated with increased EDS-R scores (r = 0.294; p < 0.001), with significantly higher scores in the ED group (F = 14.50, p < 0.001). The association between neuroticism and ED was not moderated by the presence of eating disorders. These findings will help to screen ultraendurance athletes at risk for ED and optimize their care.

Background: As strength sports gain popularity, there is a growing need to explore the impact of sustained strength training on cardiac biventricular structure and function, an area that has received less attention compared to the well-established physiological cardiac adaptation to endurance training. Objective: This study aims to implement a 20-week high-intensity strength training program to enhance maximal muscle strength and evaluate its impact on cardiac biventricular adaptation in healthy, untrained men. Methods: A total of 27 healthy and untrained young men (mean age 22.8, SD 3.2 years) participated in a strength training program designed to increase muscle strength. The training program involved concentric, eccentric, and isometric exercise phases, conducted over a consecutive 20-week time frame with a frequency of 3 weekly training sessions. Participants were evaluated before and after 12 and 20 weeks of training through body composition analysis (bioelectrical impedance), a 12-lead resting electrocardiogram, 3D transthoracic echocardiography, cardiopulmonary exercise testing, and muscle isokinetic dynamometry. The progression of strength training loads was guided by 1-repetition maximum (RM) testing during the training program. Results: Of the initial cohort, 22 participants completed the study protocol. No injuries were reported. The BMI (mean 69.8, SD 10.8 kg/m² vs mean 72, SD 11 kg/m²; P=.72) and the fat mass (mean 15.3%, SD 7.5% vs mean 16.5%, SD 7%; P=.87) remained unchanged after training. The strength training program led to significant gains in 1-RM exercise testing as early as 4 weeks into training for leg extension (mean 69.6, SD 17.7 kg vs mean 96.5, SD 31 kg; P<.001), leg curl (mean 43.2, SD 9.7 kg vs mean 52.8, SD 13.4 kg; P<.001), inclined press (mean 174.1, SD 41.1 kg vs mean 229.2, SD 50.4 kg; P<.001), butterfly (mean 26.3, SD 6.2 kg vs mean 32.5, SD 6.6 kg; P<.001), and curl biceps on desk (mean 22.9, SD 5.2 kg vs mean 29.6, SD 5.2 kg; P<.001). After 20 weeks, the 1-RM leg curl, bench press, pullover, butterfly, leg extension, curl biceps on desk, and inclined press showed significant mean percentage gains of +40%, +41.1%, +50.3%, +63.5%, +80.1%, +105%, and +106%, respectively (P<.001). Additionally, the isokinetic evaluation confirmed increases in maximal strength for the biceps (+9.2 Nm), triceps (+11.6 Nm), quadriceps (+46.8 Nm), and hamstrings (+25.3 Nm). In this paper, only the training and muscular aspects are presented; the cardiac analysis will be addressed separately. Conclusions: This study demonstrated that a short-term high-intensity strength training program was successful in achieving significant gains in muscle strength among previously untrained young men. We intend to use this protocol to gain a better understanding of the impact of high-intensity strength training on cardiac physiological remodeling, thereby providing new insights into the cardiac global response in strength athletes. Trial Registration: ClinicalTrials.gov NCT04187170; https://clinicaltrials.gov/study/NCT04187170

Objectives: This study aimed to assess the impact of a 20-week resistance training program on force–velocity (F-V) parameters using an isokinetic two-point method and comparing one-repetition maximum (1-RM) methods in novice lifters. Methods: Previously untrained individuals completed a supervised, three-session weekly resistance training program involving concentric, eccentric, and isometric phases, repeated every 2 to 4 weeks. Isokinetic dynamometry measured the strength of elbow flexors/extensors at 60°/s and 150°/s, and knee flexors/extensors at 60°/s and 240°/s at Baseline, 3 months, and 5 months. F-V parameters, including maximal theoretical force (F0) and the F-V slope, were calculated. Participants also performed 1-RM tests for the upper and lower limbs. Repeated measures ANOVA with effect size (η² > 0.14 as large) was used to analyze changes in F-V parameters and repeated measures correlation was used to test their association with 1-RM outcomes. Results: Eighteen male participants (22.0 ± 3.4 years) were analyzed. F0 significantly increased for all muscle groups (η² = 0.423 to 0.883) except elbow flexors. F-V slope significantly decreased (steeper) for knee extensors and flexors (η² = 0.348 to 0.695). Knee extensors showed greater F0 gains and steeper F-V slopes than flexors (η² = 0.398 to 0.686). F0 gains were associated with 1-RM changes (r = 0.38 to 0.83), while F-V slope changes correlated only with lower limb 1-RM (r = −0.37 to −0.68). Conclusions: The 20-week resistance training program significantly increased F0 and shifted the F-V profile towards a more “force-oriented” state in knee muscles. These changes correlated with improved 1-RM performance. Future studies should include longer follow-ups and control groups.

BACKGROUND As strength sports gain popularity, there is a growing need to explore the impact of sustained strength training on cardiac biventricular structure and function, an area that has received less attention compared to the well-established physiological cardiac adaptation to endurance training. OBJECTIVE This study aims to implement a 20-week high-intensity strength training program to enhance maximal muscle strength and evaluate its impact on cardiac biventricular adaptation in healthy, untrained men. METHODS A total of 27 healthy and untrained young men (mean age 22.8, SD 3.2 years) participated in a strength training program designed to increase muscle strength. The training program involved concentric, eccentric, and isometric exercise phases, conducted over a consecutive 20-week time frame with a frequency of 3 weekly training sessions. Participants were evaluated before and after 12 and 20 weeks of training through body composition analysis (bioelectrical impedance), a 12-lead resting electrocardiogram, 3D transthoracic echocardiography, cardiopulmonary exercise testing, and muscle isokinetic dynamometry. The progression of strength training loads was guided by 1-repetition maximum (RM) testing during the training program. RESULTS Of the initial cohort, 22 participants completed the study protocol. No injuries were reported. The BMI (mean 69.8, SD 10.8 kg/m² vs mean 72, SD 11 kg/m²; P=.72) and the fat mass (mean 15.3%, SD 7.5% vs mean 16.5%, SD 7%; P=.87) remained unchanged after training. The strength training program led to significant gains in 1-RM exercise testing as early as 4 weeks into training for leg extension (mean 69.6, SD 17.7 kg vs mean 96.5, SD 31 kg; P<.001), leg curl (mean 43.2, SD 9.7 kg vs mean 52.8, SD 13.4 kg; P<.001), inclined press (mean 174.1, SD 41.1 kg vs mean 229.2, SD 50.4 kg; P<.001), butterfly (mean 26.3, SD 6.2 kg vs mean 32.5, SD 6.6 kg; P<.001), and curl biceps on desk (mean 22.9, SD 5.2 kg vs mean 29.6, SD 5.2 kg; P<.001). After 20 weeks, the 1-RM leg curl, bench press, pullover, butterfly, leg extension, curl biceps on desk, and inclined press showed significant mean percentage gains of +40%, +41.1%, +50.3%, +63.5%, +80.1%, +105%, and +106%, respectively (P<.001). Additionally, the isokinetic evaluation confirmed increases in maximal strength for the biceps (+9.2 Nm), triceps (+11.6 Nm), quadriceps (+46.8 Nm), and hamstrings (+25.3 Nm). In this paper, only the training and muscular aspects are presented; the cardiac analysis will be addressed separately. CONCLUSIONS This study demonstrated that a short-term high-intensity strength training program was successful in achieving significant gains in muscle strength among previously untrained young men. We intend to use this protocol to gain a better understanding of the impact of high-intensity strength training on cardiac physiological remodeling, thereby providing new insights into the cardiac global response in strength athletes. CLINICALTRIAL ClinicalTrials.gov NCT04187170; https://clinicaltrials.gov/study/NCT04187170

Hip injuries are common in contact sports, particularly in high-impact activities. A well-known type of hip trauma is the hip pointer, which is a contusion of the iliac crest caused by a direct blow. Typically, hip pointers involve the lateral aspect of the iliac crest. In this case report, we present an unusual variation of this injury affecting the posterior iliac crest near the posterior superior iliac spine (PSIS). We describe two cases of elite athletes who sustained posterior iliac crest trauma, a condition we propose naming the “posterior hip pointer”. This report highlights the clinical presentation, imaging findings, treatment approach, and implications for sports medicine.

Psychological factors influence return-to-sport (RTS) decisions after anterior cruciate ligament reconstruction (ACLR). While existing tools measure fear and confidence, none specifically capture athletes' risk-taking tolerance and intentions. This study proposes the development and validation of a scale assessing Risk-taking Intentions and Sport Engagement after ACLR (RISE-ACL scale). Scale development consisted of deductive (literature review) and inductive (expert panel) methods. Eleven experts generated and rated relevant items to be included in the consensus RISE-ACL scale. Content validity was established through expert agreement. For scale validation, 162 ACLR participants, 4-24 months postoperatively (median age: 26.5 years; 65% male), completed the newly developed RISE-ACL scale. Criterion validity used a self-rated risk-tolerance scale (0-100%). Construct validity was examined through correlations with the anterior cruciate ligament (ACL)-Return to Sport after Injury (ACL-RSI) scale and clinical/demographic variables, followed by multivariate modeling. Exploratory factor analysis (principal axis factoring) identified factor structure, and principal component analysis explored a short form. Reliability was assessed via Cronbach's alpha and test-retest intraclass correlation coefficient (ICC). Scale development aimed to a 16-item RISE-ACL scale with good content validity (mean agreement: 86%) and face validity feasibility (mean completion time = 2:05). Criterion validity against the self-rated risk-tolerance scale (0-100%) was moderate and statistically significant (ρ = 0.348, p < 0.001). Construct validity analyses showed that in multivariate modeling, only ACL-RSI remained a statistically significant independent predictor of RISE-ACL scores (Wald χ² = 6.36, p = 0.012). Factor analysis yielded three interpretable factors: (1) External Pressure, (2) Internal Pressure/Defiance, and (3) Urgency-explaining 47.72% of variance. Factor 3 correlated most with self-perceived risk-taking (ρ = 0.340) and factor 2 most negatively with ACL-RSI (ρ = -0.166). Reliability showed good internal consistency (Cronbach's α = 0.84) and test-retest reliability (ICC = 0.84). A 6-item short form was proposed, showing a strong correlation with the total score (ρ = 0.891). The RISE-ACL is a 16-item self-administered scale designed to assess patients' risk-taking intentions during RTS after ACLR. Validation demonstrated it is a reliable and valid tool, supporting shared decision-making to enhance RTS quality. This study was registered under the clinical trial registration number NCT06748066. II.