The National Interscholastic Cycling Association Injury Surveillance System was implemented in 2018 to characterize acute traumatic injuries and identify associated risk factors in interscholastic youth cross-country mountain bike racing in the United States. Designated reporters collected data weekly during the 2018-2022 seasons. Variables collected included demographic information, injury characteristics, and other associated factors. In 119,098 student-athlete years, there were 2,655 injury events (injury event proportion = 2.23%). The wrist/hand was the most common body part injured (23.2%), followed by head/brain (23.0%), and shoulder/clavicle (15.9%). Males experienced a higher proportion of upper limb injuries than females (57.6% and 49.6%, respectively; p < 0.001); females experienced a higher proportion of lower limb injuries than males (29.5% and 24.8%, respectively; p = 0.020). Injury event proportion decreased by 27% (p < 0.001) during the study period. Acute traumatic injuries are common but injury proportion is low. Most injuries are minor but serious injuries do occur, resulting in time-loss from riding.

To date, no literature exists on mountain biking injuries in coaches. This study described cross-country mountain biking injuries among coaches in National Interscholastic Cycling Association (NICA) sanctioned leagues from 2018 to 2022. Data were collected using the NICA injury surveillance system (ISS), a web-based injury and exposure reporting system for youth mountain biking, and were analysed using descriptive and univariate inferential statistics. A total of 401 injury events, including 661 distinct time-loss injuries, were reported in 59,545 coach-years over five seasons, resulting in an injury event proportion of 0.67%. The median time-loss due to injury was about 31 days for all injured coaches. The most commonly injured body part was shoulder/clavicle (32.7% of all injury events), followed by head/concussion (18.0% of all injury events) and wrist/hand (17.7% of all injury events). Fracture was the most common diagnosis (27.1% of all non-head injuries). Male coaches sustained upper-limb injuries significantly more often than did female coaches (62.9% vs. 51.5%; p = 0.044), whereas the rate of lower-limb injuries was significantly higher among female coaches than male coaches (33.3% vs. 17.9%; p = 0.001). Fractures and concussions are the most common diagnoses. These findings could be used for designing future injury prevention programmes.

ABSTRACT:This case report details a diagnosis of myositis ossificans in a collegiate golfer with right ulnar-sided hand pain after striking the ground on a swing. Despite conservative treatment and a thorough workup, the patient's ulnar-sided hand pain did not improve. An ultrasound eventually revealed myositis ossificans within the abductor digiti minimi muscle. The patient received an ultrasound-guided fenestration and injection of lidocaine and dexamethasone into the affected muscle, leading to complete symptom resolution. Myositis ossificans is often secondary to trauma, causing bone formation in soft tissue, leading to pain, limited range of motion, and disability. This case highlights the importance of considering myositis ossificans in cases of persistent muscular pain and the diagnostic challenges related to ulnar-sided hand anatomy.

ObjectiveTo describe the incidence and burden of illness at the Tokyo 2020 Paralympic Games, which was organised with strict COVID-19 countermeasures. MethodsDaily illnesses were recorded via the web-based injury and illness surveillance system (teams with their own medical staff; n=81), and local polyclinic services (teams without their own medical staff; n=81). Illness proportion, incidence and burden were reported for all illnesses and in subgroups by sex, age, competition period, sports and physiological system. Results4403 athletes (1853 female and 2550 male) from 162 countries were monitored for the 15-day period of the Tokyo Paralympic Games (66 045 athlete days). The overall incidence of illnesses per 1000 athlete days was 4.2 (95% CI 3.8 to 4.8; 280 illnesses). The highest incidences were in wheelchair tennis (7.1), shooting (6.1) and the new sport of badminton (5.9). A higher incidence was observed in female compared with male athletes (5.1 vs 3.6; p=0.005), as well as during the precompetition versus competition period (7.0 vs 3.5; p<0.0001). Dermatological and respiratory illnesses had the highest incidence (1.1 and 0.8, respectively). Illness burden was 4.9 days per 1000 athlete days and 23% of illnesses resulted in time loss from training/competition>1 day. ConclusionThe incidence of illness at the Tokyo 2020 Paralympic Games was the lowest yet to be recorded in either the summer or winter Paralympic Games. Dermatological and respiratory illnesses were the most common, with the burden of respiratory illness being the highest, largely due to time loss associated with COVID-19 cases. Infection countermeasures appeared successful in reducing respiratory and overall illness, suggesting implementation in future Paralympic Games may mitigate illness risk.

INTRODUCTION:Understanding the physical and mental health of collegiate dancers is important for developing appropriate screening protocols and treatment interventions. This study aims to provide descriptive data on the overall health, injury burden, and well-being of a group of collegiate dancers, including the interactions between injury, nutrition, and mental health, to provide insight for wellness screening and interventions in collegiate dance programs.METHODS:Members of the School of Dance at the University of Utah were sent an electronic general health survey. The survey included questions regarding medical history, family history, injuries, diet, sleep quality, symptoms of depression and anxiety, and history of eating disorders.RESULTS:Of the 231 dancers who received the survey, 198 responded (response rate = 85.7%). Fifty 2% of respondents had an active injury. Symptoms of depression and anxiety were common (35.4%), and 37.4% of the dancers were interested in receiving mental health support. Symptoms of depression and anxiety had a significant association with both a history of injury and active injuries (P = .033 and .039, respectively). History of eating disorder was also significantly associated with active injuries (P = .005). The most commonly injured body area was ankle or foot (n = 144, 72.7%), followed by lower leg or shin (n = 76, 38.4%), and knee (n = 61, 30.8%). Over a quarter of the dancers (n = 54, 27.3%) reported having trouble sleeping, and 9.1% reported having a history of eating disorder.CONCLUSIONS:This study highlights the important interplay between mental health, sleep, nutrition, and injury. These results show that in a group of collegiate dancers, active injuries and mental health concerns are common, and that there are statistically significant associations between injury, nutrition, and mental health. These data provide insight into factors that affect dancer wellness and help inform future screening and intervention protocols for dance programs.

Abstract A web-based injury surveillance system was implemented through a collaboration between University of Utah researchers and the National Interscholastic Cycling Association (NICA) to better understand injury characteristics in mountain biking. Data were collected from NICA leagues during the 2018 and 2019 seasons. Injuries were tracked in 41,327 student-athlete-years, identifying 1750 unique injuries during 1155 injury events. Rider-dependent and rider-independent variables were analyzed. The most commonly reported injuries were concussion (23.6%), injuries to the wrist/hand (22.3%), and shoulder (15.6%). Half of all injury events occurred on downhills. Men and women reported similar yet significantly different injury rates (2.69% and 3.21%, respectively; P = 0.009). Women sustained more lower-limb injuries (37.8% vs 28.3%; P = 0.003). Nearly 50% of crashes resulted in an emergency room visit. Youth mountain bike racing is a rapidly growing sport. Acute traumatic injuries are common. Injury surveillance system data are now being used to inform injury prevention strategies and direct future research.

Interscholastic youth cross-country mountain bike racing in the United States has grown significantly over the past decade, yet little is known about the risk profile in this age group. Aiming to protect participants, we implemented a prospective, longitudinal injury surveillance system for the purpose of better understanding youth mountain biking injuries and implementing safety measures. Data were collected during competition years 2018–2020, totaling 66,588 student athlete-years. Designated reporters from each team received weekly emails with exposure and incident report forms. Variables analyzed included demographic, rider-related, trail-related, and other data. Injury characteristics during the COVID-19 pandemic in 2020 were compared to the years 2018 and 2019. More student athletes participated in the 2020 season (25,261) than in prior seasons (18,575 in 2018 and 22,752 in 2019). During competition year 2020, overall injury proportion was lower (1.7% versus 3.0% in 2018 and 2.7% in 2019). Variables associated with injury, body part injured, type of injury, time-loss, and disposition following injury were similar between all years. Despite the pandemic and resultant changes to competition, student athletes continued to ride their bikes and become injured, but the proportion of injuries differed. This report details injury characteristics in youth mountain bike racing, including a comparison of before and during the pandemic.

Background Youth mountain bike racing is a rapidly growing sport in the United States. An injury surveillance system (ISS) is now implemented through a collaboration between University of Utah researchers and the National Interscholastic Cycling Association (NICA), referred to as NICA-ISS, to better understand injury characteristics in this sport and pursue data-driven injury prevention strategies. Objective Describe types of and factors associated with injuries sustained by youth mountain bike racers during NICA-sanctioned mountain bike racing and training. Design NICA-ISS was developed using a web-based system. Data were collected from NICA leagues during the 2018–2020 seasons. Designated reporters on each team were asked to complete weekly incident and exposure report forms. Setting Nation-wide youth mountain biking leagues in the United States. Participants Student-athletes on NICA teams in grades 8–12 participating in the 2018–2020 seasons. Assessment of Risk Factors Variables analyzed included injury characteristics, athlete demographics, trail conditions, incline during crash, weather, crash circumstances (practice, race, passing, trail familiarity), and health factors (dehydration, sleep, illness). Main Outcome Measurements Proportions/rates of injuries overall, by type and location, and by group of athletes. Results Injuries were tracked in 66,588 student-athlete-years, resulting in 2,587 injuries in 1,677 student-athlete injury events reported. The most commonly reported injury was concussion (23.3%), followed by injury to the wrist/hand (22.7%), shoulder (16.7%), and knee (14.3%). Over a half (52.1%) of injury events occurred on downhills. Males and females reported similar injury rates (2.43% and 2.86%, respectively), but females sustained significantly more lower limb injuries (p = 0.003). A large portion (72.4%) of injured athletes were unable to complete the ride; 49.3% of crashes resulted in an emergency room visit. Conclusions Acute traumatic injuries are common in mountain bike racing, including concussions and injuries to the upper extremities. Males and females have similar injury rates but different injury types. To our knowledge, this is the largest mountain bike racing ISS in existence.

Background Youth mountain bike racing is a rapidly growing sport in the United States. An injury surveillance system (ISS) was implemented through a collaboration between University of Utah researchers and the National Interscholastic Cycling Association (NICA) to better understand the characteristics of injuries in this sport and pursue data-driven injury prevention strategies. Objective Describe the types of and factors associated with injuries sustained by coaches during NICA-sanctioned mountain bike training. Design A longitudinal ISS was developed using a web-based system. Data were collected from NICA leagues during the 2018 racing season. Designated injury reporters from each team received a weekly email with a link to an injury report form. Coach injury data were reported concurrently with student-athlete injury data. Setting Nation-wide youth mountain biking leagues in the United States. Participants 8,739 coaches participated in the 2018 season, the inaugural year of the NICA ISS. Assessment of risk factors Variables analyzed included injury characteristics, coach demographics, and factors associated with injuries. Main outcome measurements Summary measures (frequency and proportion) of injuries and associated factors. Results A total of 138 injuries from 68 injury events were reported by coaches. The most common injury location and type were shoulder (38.2%) and concussion (17.6%), respectively. 60.3% of all coaches’ injuries occurred on downhills. Males and females reported similar injury rates (0.87% and 0.76%, respectively), while injury characteristics differed between sexes, with females sustaining more lower limb injuries. 58.8% of injured coaches sought care in an emergency department. 13.2% of injury events resulted in hospital admission. 43.3% of injury events resulted in time loss of 4 weeks or greater. Conclusions Interscholastic mountain bike racing is a rapidly growing sport. Acute traumatic injuries are common, not only in athletes but in coaches as well. Dissimilarly to student-athletes, coaches sustained upper extremity injuries more often than concussions. To our knowledge, this is the first ISS to track injuries in coaches.

Background Youth mountain bike racing is a rapidly growing sport in the United States. An injury surveillance system (ISS) was implemented through a collaboration between University of Utah researchers and the National Interscholastic Cycling Association (NICA) to better understand injury characteristics in this sport and pursue data-driven injury prevention strategies. Objective Describe types of and factors associated with injuries sustained by youth mountain bike racers during NICA-sanctioned mountain bike racing and training. Design A longitudinal ISS was developed using a web-based system. Data were collected from NICA leagues during the 2018 season. Designated injury reporters from each team received weekly emails with an exposure form and an incident report form. Setting Nation-wide youth mountain biking leagues in the United States. Participants 18,577 student-athletes in grades 8–12 participated in the 2018 season, the inaugural year of the NICA ISS. Assessment of risk factors Variables analyzed included injury characteristics, athlete demographics, trail conditions, incline at crash site, weather, crash circumstances (practice, race, passing, familiarity with trail), and health factors (dehydration, sleep, illness). Main outcome measurements Injuries were reported by proportion (per 100 participants) due to insufficient compliance with exposure reporting. Results A total of 837 injuries in 554 student-athlete injury events were reported. The most commonly reported injury was concussion (22.2%), followed by injury to the wrist/hand (19.0%), shoulder (15.7%), and knee (13.7%). 48.2% of injury events occurred on downhills. Males and females reported similar injury rates (2.87% and 3.41%, respectively), but females sustained more lower limb injuries (p<0.001). 70.2% of injured athletes were unable to complete the ride. 47.1% of crashes resulted in an emergency room visit. Conclusions Interscholastic mountain bike racing is a rapidly growing sport. Acute traumatic injuries are common, including concussions and injuries to the upper extremities. Male and female riders have similar injury rates but different injury types. To our knowledge, this is the largest mountain bike racing ISS in existence.

Objectives: To describe the design and implementation of an injury surveillance system for youth mountain bike racing in the United States, and to report preliminary first-year results. Design: Descriptive sports injury epidemiology study. Methods: After two and a half years of development and extensive beta-testing, an electronic injury surveillance system went live in January, 2018. An automated email is sent to a Designated Reporter on each team, with links to the injury reporting form. Data collected include demographic information, injured body part, injury diagnosis, trail conditions and other factors associated with injury occurrence. Results: 837 unique injuries were reported in 554 injury events among 18,576 student-athletes. The overall injury event proportion was 3.0%. The most common injury among student-athletes was concussion/possible concussion (22.2%), followed by injuries to the wrist and hand (19.0%). Among 8,738 coaches, there were 134 unique injuries reported that occurred in 68 injury events, resulting in an overall injury event proportion of 0.8%. The shoulder (38.2%) was the most commonly injured body part among coaches. Injuries among coaches tended to more frequently result in fractures, dislocations and hospital admission compared with injuries among student-athletes. Among student-athletes, female riders sustained lower limb injuries more than male riders (34.0% vs. 20.7%, p < 0.001). Conclusions: A nationwide injury surveillance system for youth mountain bike racing was successfully implemented in the United States. Overall injury event proportions were relatively low, but many injury events resulted in concussions/possible concussions, fractures, dislocations and 4 weeks or longer of time loss from riding. (c) 2020 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Understanding and characterizing confounding factors to the Athlete Biological Passport (ABP) is crucial for the reliable interpretation of biological profiles in the antidoping field. The physiological effects on hematological parameters and plasma volume (PV) following competition in a long-distance triathlon, as seen in the Ironman discipline, have yet to be fully described and are the focus of this study. Complete blood count blood tests were conducted on 19 Ironman triathletes before and after an Ironman triathlon to characterize changes in hematological parameters and the effect on ABP interpretation, as it was hypothesized that changes in the plasma volume may result in the presentation of atypical ABP profiles. Baseline blood samples were collected from the athletes prior to the event, and one sample was collected per day for up to 1 week following the race. Differences were observed between the male and female athletes across multiple parameters. Most importantly to the ABP, decreases in hemoglobin concentration (HGB) and hematocrit (HCT) were identified post-race, with the largest decreases identified on day +2. The average HGB returned to pre-race baseline levels on day +5. Beginning 5-6 days after the race, increases in the reticulocyte percentage (Ret%) were identified. Atypical Passport Findings were identified in 32% (6/19) of the ABPs, flagged mainly due to atypical hemoglobin concentration and one instance in which the OFF-score exceeded the adaptive model limits. These results offer a characterized timeline of hematological changes and expected shifting of plasma volume following an Ironman triathlon providing important data for the reliable interpretation of ABP profiles in this field.

Objective: To characterize factors associated with helmet use and risk-taking behavior among recreational skiers and snowboarders. Design: Observational study. Setting: Large, western United States mountain resort. Participants: 1285 male and female recreational skiers and snowboarders were interviewed during a single winter ski season. Independent Variables: Helmet use, demographic, and sport-related characteristics. MainOutcomeMeasures: Brief sensation seeking scale (BSSS) as a measure of risk-taking behavior and self-reported risk compensation. Results: Of the respondents (N = 1285), 17.5%, 12.5%, and 70.0% reported that they never, sometimes, and always wore a helmet, respectively. Multiple linear regression analysis showed that individuals reporting sometimes wearing a helmet had significantly higher BSSS scores than those reporting never wearing a helmet (P = 0.031) or always wearing it (P = 0.018). Male gender, younger age, snowboarding, higher perceived sport ability, more days per year skiing or snowboarding, and more time spent in the terrain park were significantly associated with higher BSSS scores (P < 0.05). Logistic regression analysis focusing on subgroups of respondents who reported either sometimes or always wearing a helmet indicated that the odds of taking more risks when wearing a helmet for inconsistent helmet users was 75% higher than the odds for those who reported always wearing a helmet (P = 0.06). Conclusions: Inconsistent helmet users have characteristics of risk-taking behavior and risk compensation. Male gender, younger age, snowboarding, higher perceived sport ability, and more time spent on the mountain and in the terrain park are also important determinants of risk-taking behavior.

The benefit of sport for athletes with impairments is well established. However, sport participation is not without risk. The existing literature informs us that injury patterns are sport and disability specific. Further research is needed to study injuries in this population.

SCIENTIFIC ABSTRACT Clinical experience highlights the dangers of the sport of mountain biking, with a high volume of contusions, laceration, fractures and concussions. Scientific literature to date has been sparse with regards to injuries in this population. While participation in this sport can transform the lives of the racers with its emphasis on fitness and fun, injuries can significantly limit the student-athlete’s ability to exercise. However, this project has strong potential to make high school mountain bike racing a safer sport. PURPOSE: To determine the most common injury occurring in mountain biking athletes and identifying specific risk factors in the most common injury—concussions. METHODS: An incident survey was developed using redcap software to give coaches the capacity to report trauma and all circumstances contributing to their athletes’ injuries. The Spring 2018 league presented 4,671 students, and the end of the Fall 2018 league added 13,343 more student athletes. In total, this presented a total of 18,014 student athletes from 2018 to look at. Demographics were recorded: age, year in school, division, sex, league, and state. The incline and trail conditions were also accounted for as variables. Weather was marked on the survey, and circumstances for crashes were accounted for—practice, race, passing, familiarity with trail, etc. Statistical and machine learning methods were then used to recognize the most commonly occurring injury and decipher risk factors. RESULTS: It is still to early in the project for firm conclusions, but early analysis of the NICA database has shown concussions to account for up to 23% of all injuries recorded in the injury surveillance system in 2018. Team practice accounts for 56.3% of injuries. Downhill racing accounts for 72% of concussions, as well as a distinct gender bias with males. CONCLUSION: Concussions account for the most injuries with regard to competitive mountain biking. The varsity league accounts for the least amount of concussions, which suggests injury prevention needs to be taught early on to less experienced riders. Safety strategies on courses, with equipment, and with skills training should be implemented to lower the amount of concussions (and total injuries) for athletes in the coming years.

Context:Clomiphene is a performance-enhancing drug commonly abused by males in sport, but the extent to which testosterone increases in healthy males following its use is unknown. In addition, evidence suggests that clomiphene, a mixture of cis- and trans-isomers zuclomiphene and enclomiphene, is detectable in urine for months following use; the isomer-specific urinary detection window has yet to be characterized in a controlled study.Objective:To determine the effect of once-daily, 30-day clomiphene treatment on serum testosterone and gonadotropin levels in the subject population studied and the urinary clearance and detection window of clomiphene isomers following administration for antidoping purposes.Participants and Design:Twelve healthy males aged 25 to 38 years, representing a recreational athlete population, participated in this open-label, single-arm study.Intervention:Oral clomiphene citrate (50 mg) was self-administered once daily for 30 days. Serum and urine samples were collected at baseline and at days 7, 14, 21, 28, 30, 32, 35, 37, 44, 51, and 58; urine collections continued periodically up to day 261.Results:Mean testosterone, LH, and FSH levels increased 146% (SEM, ±23%), 177% (±34%), and 170% (±33%), respectively, during treatment compared with baseline. Serum drug concentrations and urinary excretion were nonuniform among individuals as isomeric concentrations varied. The zuclomiphene urinary detection window ranged from 121 to >261 days.Conclusions:Clomiphene significantly raised serum testosterone and gonadotropin levels in healthy men and thus can be abused as a performance-enhancing drug. Such abuse is detectable in urine for ≥4 months following short-term use.