Background: Rapid weight loss (RWL) is common in weight-class sports, but its magnitude, frequency, methods, and social determinants may differ between disciplines. This study characterized RWL practices among national-team judo and Muay Thai athletes and explored differences between sports. Hypothesis: RWL patterns would differ between judo and Muay Thai, particularly in magnitude, frequency, methods, and sources of influence. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: A total of 25 adult national-team athletes (11 judo, 14 Muay Thai) completed the Rapid Weight Loss Questionnaire (RWLQ). We summarized prevalence, magnitude, frequency, duration, age at onset, postcompetition weight regain, weight-loss methods, and perceived sources of influence. The primary RWLQ score was evaluable for 23 athletes. Between-sport comparisons used Fisher exact tests and permutation-based Wilcoxon rank-sum tests; Benjamini-Hochberg adjustment was used for method-use and influence-score comparison families. Results: Previous RWL was reported by 24 of 25 athletes (96.0%). Among athletes with previous RWL, the median number of episodes in the previous year was 3.5 (interquartile range [IQR], 1.0-10.5). Habitual loss was 6.8% of usual body mass (IQR, 3.9%-8.3%; n = 22). Dehydration-related methods were reported by 22 of 24 (91.7%) and fasting or skipping meals by 18 of 24 (75.0%) participants. Annual episodes were higher in judo (median, 10.0 vs 2.0; P = 0.02), whereas habitual loss was higher in Muay Thai (6.9% vs 4.5%; P = 0.11). Among 23 athletes with evaluable primary RWLQ scores, the medians were 40.0 in judo and 34.0 in Muay Thai ( P = 0.19). Coaches were the most frequently reported influence (20 of 24; 83.3%). Conclusion: RWL was common in this sample and frequently involved dehydration-related practices and food restriction. Exploratory comparisons suggested differences in the frequency and magnitude of weight loss between sports, but the small sample and imbalance in sex distribution limit sport-specific inference. Clinical Relevance: Multidimensional assessment should consider the athlete’s wider sporting environment.
Background: Anterior cruciate ligament (ACL) injuries are common in athletic people, with young female athletes at particularly high risk. After ACL injury, reconstruction, and return to sport, many sustain contralateral ACL (CACL) injuries. While tibial plateau cartilage surface geometry has been associated with first-time ACL injury risk, its role in subsequent CACL injury remains unclear. Hypothesis: The normal knee of female athletes who suffered a first-time ACL injury, underwent reconstruction, returned to preinjury activities and subsequently suffered a CACL injury will have tibial plateau cartilage surface geometry that is different compared with an equivalent population who did not sustain a subsequent CACL injury. Study Design: Prospective cohort study. Level of Evidence: Level 2. Methods: A total of 199 subjects who suffered a first-time ACL injury, had reconstruction, returned to preinjury activities and had a contralateral knee that was normal underwent bilateral magnetic resonance imaging (MRI) scan acquisitions. Tibial plateau cartilage geometry was assessed on the uninjured, normal knees using T1-weighted Fast Field Echo MRI. Parasagittal slices at maximum cartilage concavity in medial and lateral compartments of the tibia were characterized by fitting fifth-order polynomials. Female athletes who sustained a CACL injury within 4 years of reconstruction and return to sport (n = 12) were matched and compared with a group of female athletes who did not sustain CACL injury (n = 24). Random coefficient mixed-effects regression was used to assess group differences in polynomial functions. Results: No significant differences in tibial cartilage surface geometry were found between the first-time ACL and first-time ACL + CACL injury groups in the medial ( P = 0.23) and lateral ( P = 0.18) compartments. Conclusion: These findings suggest that characterization of tibial plateau cartilage geometry in the normal knee of subjects who underwent reconstruction after a first-time ACL injury is insufficient to predict who will on go on to suffer a subsequent CACL injury. Clinical Relevance: More comprehensive predictive models incorporating anatomic, biomechanical, and psychological factors are likely needed to identify those at increased risk for CACL injury after a first-time ACL injury and reconstruction.
Background: Relative energy deficiency in sport (RED-S) is a condition caused by low energy availability (LEA) and is associated with adverse health and performance outcomes in athletes. Although volleyball involves considerable physical stress and repetitive jumping, little is known about RED-S knowledge and risk of LEA in elite female volleyball players. Hypothesis: Elite female volleyball athletes have limited awareness of RED-S, and athletes at risk for LEA according to the LEAF-Q are more likely to be injured. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Elite female volleyball athletes competing in the Turkish Women’s Elite Volleyball League during the 2024-2025 season were recruited. Participants completed an online survey including demographic information, the Low Energy Availability in Females Questionnaire (LEAF-Q), and items assessing knowledge, awareness, and support-seeking behaviors related to RED-S. Athletes were classified as “at risk” for LEA using a LEAF-Q cutoff score of ≥8. Associations between LEAF-Q risk status and injury history during the previous year were analyzed. Results: A total of 148 athletes participated. The mean LEAF-Q score was 5.50 ± 3.48, and 25% of athletes were classified as at risk for LEA according to the LEAF-Q. Most athletes (92.6%) reported never having heard of RED-S or the Female Athlete Triad. Athletes identified as at risk by the LEAF-Q were significantly more likely to have sustained an injury in the previous year than athletes not at risk (odds ratio, 7.86; 95% CI, 3.03-20.41). Conclusion: Elite female volleyball athletes demonstrated low knowledge of RED-S, while a substantial proportion were identified as at risk for LEA. LEA risk was associated strongly with injury history, supporting the clinical relevance of LEAF-Q screening in this population. Clinical Relevance: Routine LEAF-Q screening combined with sport-specific education may facilitate early identification of athletes who may require further clinical evaluation for LEA-related problems and may inform prevention-oriented support strategies in elite female volleyball players.
Background: Adolescent female athletes often exhibit more pronounced lower-limb asymmetry due to physiological differences, increasing injury risk. Despite documented efficacy in team sports for injury mitigation and performance enhancement, integrative neuromuscular training (INT) effects on unilateral and bilateral lower-limb capabilities in trained adolescent female sprinters remain undetermined. Hypothesis: We hypothesized that an 8-week INT program would significantly improve unilateral and bilateral lower-extremity performance measures in adolescent female sprinters compared with traditional sprint-specific training. Study design: Randomized controlled trial. Level of evidence: Level 1. Methods: Twenty-four national second-level adolescent female sprinters (aged 16-18 years) were randomly assigned to an 8-week INT group (n = 12) or a control group (CON, n = 12) that continued traditional sprint-specific training. Measurements obtained before and after the intervention included the hop test, star excursion balance test (SEBT), 3-repetition maximum (3RM) unilateral and bilateral back squat, 100-m run, standing long jump (SLJ), and limb symmetry index (LSI). Results: After the intervention, the INT group outperformed the CON group on the nondominant side in all hop tests (P < 0.001; eta(p)& sup2; = 0.74-0.88), six directions of the SEBT (P < 0.001; eta(p)& sup2; = 0.44-0.88), and the 3RM unilateral back squat (P < 0.01; eta(p)& sup2; = 0.65). On the dominant side, the INT group also outperformed the CON group in the single hop for distance (P < 0.001; eta(p)& sup2; = 0.80) and three directions of the SEBT (P < 0.01; eta(p)& sup2; = 0.38-0.84). In addition, the INT group showed significantly greater improvements than the CON group in the LSI from unilateral tests (all P < 0.01; eta(p)& sup2; = 0.26-0.88), as well as in the 100-m run and SLJ (P < 0.001; eta(p)& sup2; = 0.61-0.69). Conclusion: The 8-week INT program was associated with improvements in dynamic balance, explosive power, and limb symmetry in adolescent female sprinters, with greater benefits observed on the nondominant side.
