Background: Platelet-rich fibrin matrices release a natural mixture of growth factors that play central roles in the complex processes of tendon healing. Hypothesis: Application of autologous platelet-rich matrices during Achilles tendon surgery may promote healing and functional recovery. Study Design: Case-control study and descriptive laboratory study; Level of evidence, 3. Methods: Twelve athletes underwent open suture repair after complete Achilles tendon tear. Open suture repair in conjunction with a preparation rich in growth factors (PRGF) was performed in 6 athletes and retrospectively compared with a matched group that followed conventional surgical procedure. The outcomes were evaluated on the basis of range of motion, functional recovery, and complications. Achilles tendons were examined by ultrasound at 50 ± 11 months in retrospective controls and 32 ± 10 months in the PRGF group. In the laboratory portion of the study, PRGF treatment was characterized by the number of platelets and concentration of insulin (IGF-I), transformed (TGF-β1), platelet-derived (PDGF-AB), vascular endothelial (VEGF), hepatocyte (HGF), and epidermal (EGF) growth factors in patients affected by musculoskeletal traumatic injuries. Results: Athletes receiving PRGF recovered their range of motion earlier (7 ± 2 weeks vs 11 ± 3 weeks, P = .025), showed no wound complication, and took less time to take up gentle running (11 ± 1 weeks vs 18 ± 3 weeks, P = .042) and to resume training activities (14 ± 0.8 weeks vs 21 ± 3 weeks, P = .004). The cross-sectional area of the PRGF-treated tendons increased less (t = 3.44, P = .009). TGF-β1 (74.99 ± 32.84 ng/mL), PDGF-AB (35.62 ± 14.57 ng/mL), VEGF (383.9 ± 374.9 pg/mL), EGF (481.5 ± 187.5 pg/mL), and HGF (593.87 ± 155.76 pg/mL) significantly correlated with the number of platelets (677 ± 217 platelets/μL, P < .05). Conclusion: The operative management of tendons combined with the application of autologous PRGF may present new possibilities for enhanced healing and functional recovery. This needs to be evaluated in a randomized clinical trial.

Sports periodization has traditionally focused on the exercise aspect of athletic preparation, while neglecting the integration of other elements that can impact an athlete’s readiness for peak competition performances. Integrated periodization allows the coordinated inclusion of multiple training components best suited for a given training phase into an athlete’s program. The aim of this article is to review the available evidence underpinning integrated periodization, focusing on exercise training, recovery, nutrition, psychological skills, and skill acquisition as key factors by which athletic preparation can be periodized. The periodization of heat and altitude adaptation, body composition, and physical therapy is also considered. Despite recent criticism, various methods of exercise training periodization can contribute to performance enhancement in a variety of elite individual and team sports, such as soccer. In the latter, both physical and strategic periodization are useful tools for managing the heavy travel schedule, fatigue, and injuries that occur throughout a competitive season. Recovery interventions should be periodized (ie, withheld or emphasized) to influence acute and chronic training adaptation and performance. Nutrient intake and timing in relation to exercise and as part of the periodization of an athlete’s training and competition calendar can also promote physiological adaptations and performance capacity. Psychological skills are a central component of athletic performance, and their periodization should cater to each athlete’s individual needs and the needs of the team. Skill acquisition can also be integrated into an athlete’s periodized training program to make a significant contribution to competition performance.

In this study, we examined gender and age differences in physical performance in football. Thirty-four elite female and 34 elite male players (age 17 ± 1.6 to 24 ± 3.4 years) from a professional football club were divided into four groups (n = 17 each) according to gender and competitive level (senior males, senior females, junior males, and junior females). Players were tested for specific endurance (Yo-YoIR1), sprint over 15 m (Sprint-15m), vertical jump without (CMJ) or with (ACMJ) arm swing, agility (Agility-15m), and ball dribbling over 15 m (Ball-15m). The Yo-YoIR1 and Agility-15m performances showed both a gender and competitive level difference (P < 0.001). Senior and junior males covered 97 and 153% more distance during the Yo-YoIR1 than senior and junior females, respectively (P < 0.001). Gender but not age differences were found for Sprint-15m performance (P < 0.001). No difference in vertical jump and Ball-15m performances were found between senior and junior males (P > 0.05). More marked gender differences were evident in endurance than in anaerobic performance in female players. These results show major fitness differences by gender for a given competitive level in football players. It is suggested that training and talent identification should focus on football-specific endurance and agility as fitness traits in post-adolescent players of both sexes.

The taper is a progressive nonlinear reduction of the training load during a variable period of time, in an attempt to reduce the physiological and psychological stress of daily training and optimize sports performance. The aim of the taper should be to minimize accumulated fatigue without compromising adaptations. This is best achieved by maintaining training intensity, reducing the training volume (up to 60-90%) and slightly reducing training frequency (no more than 20%). The optimal duration of the taper ranges between 4 and more than 28 d. Progressive nonlinear tapers are more beneficial to performance than step tapers. Performance usually improves by about 3% (usual range 0.5-6.0%), due to positive changes in the cardiorespiratory, metabolic, hematological, hormonal, neuromuscular, and psychological status of the athletes.