Objective: To review 16 years of National Collegiate Athletic Association injury surveillance data for women’s lacrosse and identify potential areas for injury prevention initiatives. Background: Women’s lacrosse is a fast-paced, primarily noncontact sport. Participation in collegiate women’s lacrosse almost doubled between the 1988–1989 and 2003–2004 seasons. Lacrosse equipment consists of sticks made of wood or a synthetic material and a hard rubber ball. Until recently, mouth guards were the only required protective equipment. Main Results: Collegiate women’s lacrosse game injury rates increased over the 16-year study period. More than 60% of all severe game injuries were lower extremity sprains and strains and knee internal derangements, most frequently the result of noncontact incidents. The most common injury scenarios by injury mechanism and player activity were no contact while ball handling (16.4%) and contact from a stick while ball handling (10.5%). Contact from a stick or a ball accounted for 5.6% and 5.2% of injuries sustained during shooting activities, respectively. Approximately 22% of all game and 12% of all practice injuries involved the head and neck. Contact from a stick accounted for the majority (56.0%) of above-the-neck injuries in games; contact from the ball accounted for 20.0% of these injuries. Participants had 5 times the risk of sustaining a concussion in a game as in a practice (0.70 versus 0.15 injuries per 1000 athletic-exposures, rate ratio 4.7, 95% confidence interval 3.8, 6.5). Recommendations: To reduce the lower extremity injuries that comprise the greatest injury burden in women’s lacrosse, future researchers should evaluate proprioceptive, plyometric, and balance training interventions designed specifically for female players. Other research areas of great interest involve determining whether protective eyewear (mandated in 2004) reduces injuries to the eye, orbit, and nasal area and identifying any unintended consequences of the mandate, such as increased risk of injuries to other areas of the face or more aggressive play.

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Descriptive epidemiology of collegiate men's football injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004

Objectives 
Few epidemiological studies have focused on the psychological health of high level athletes. This study aimed to identify the principal psychological problems encountered within French high level athletes, and the variations in their prevalence based on sex and the sport practiced.


Methods 
Multivariate analyses were conducted on nationwide data obtained from the athletes' yearly psychological evaluations.


Results 
A representative sample of 13% of the French athlete population was obtained. 17% of athletes have at least one ongoing or recent disorder, generalized anxiety disorder (GAD) being the most prevalent (6%), followed by non-specific eating disorders (4.2%). Overall, 20.2% of women had at least one psychopathology, against 15.1% in men. This female predominance applied to anxiety and eating disorders, depression, sleep problems and self-harming behaviors. The highest rates of GAD appeared in aesthetic sports (16.7% vs. 6.8% in other sports for men and 38.9% vs. 10.3% for women); the lowest prevalence was found in high risk sports athletes (3.0% vs. 3.5%). Eating disorders are most common among women in racing sports (14% vs. 9%), but for men were found mostly in combat sports (7% vs. 4.8%).


Discussion 
This study highlights important differences in psychopathology between male and female athletes, demonstrating that the many sex-based differences reported in the general population apply to elite athletes. While the prevalence of psychological problems is no higher than in the general population, the variations in psychopathology in different sports suggest that specific constraints could influence the development of some disorders.

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Psychological Balance in High Level Athletes: Gender-Based Differences and Sport-Specific Patterns

This review updates and complements the review of energy balance and body composition in the Proceedings of the 2003 IOC Consensus Conference on Sports Nutrition. It argues that the concept of energy availability is more useful than the concept of energy balance for managing the diets of athletes. It then summarizes recent reports of the existence, aetiologies, and clinical consequences of low energy availability in athletes. This is followed by a review of recent research on the failure of appetite to increase ad libitum energy intake in compensation for exercise energy expenditure. The review closes by summarizing the implications of this research for managing the diets of athletes.

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Energy availability in athletes

KRAEMER, W. J., A. C. FRY, M. R. RUBIN, T. TRIPLETT-MCBRIDE, S. E. GORDON, L. P. KOZIRIS, J. M. LYNCH, J. S. VOLEK, D. E. MEUFFELS, R. U. NEWTON, and S. J. FLECK. Physiological and performance responses to tournament wrestling. Med. Sci. Sports Exerc., Vol. 33, No. 8, 2001, pp. 1367–1378.PurposeThe

Physiological and performance responses to tournament wrestling

Objective: To present recommendations for the prevention, detection, and comprehensive management of disordered eating (DE) in athletes. Background: Athletes with DE rarely self-report their symptoms. They tend to deny the condition and are often resistant to referral and treatment. Thus, screenings and interventions must be handled skillfully by knowledgeable professionals to obtain desired outcomes. Certified athletic trainers have the capacity and responsibility to play active roles as integral members of the health care team. Their frequent daily interactions with athletes help to facilitate the level of medical surveillance necessary for early detection, timely referrals, treatment follow-through, and compliance. Recommendations: These recommendations are intended to provide certified athletic trainers and others participating in the health maintenance and performance enhancement of athletes with specific knowledge and problem-solving skills to better prevent, detect, and manage DE. The individual biological, psychological, sociocultural, and familial factors for each athlete with DE result in widely different responses to intervention strategies, challenging the best that athletics programs have to offer in terms of resources and expertise. The complexity, time intensiveness, and expense of managing DE necessitate an interdisciplinary approach representing medicine, nutrition, mental health, athletic training, and athletics administration in order to facilitate early detection and treatment, make it easier for symptomatic athletes to ask for help, enhance the potential for full recovery, and satisfy medicolegal requirements. Of equal importance is establishing educational initiatives for preventing DE.

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National Athletic Trainers' Association Position Statement: Preventing, Detecting, and Managing Disordered Eating in Athletes

Purpose: The purpose of this investigation was to examine the weight management (WM) behaviors of collegiate wrestlers after the implementation of the NCAA’s new weight control rules. Methods: In the fall of 1999, a survey was distributed to 47 college wrestling teams stratified by collegiate division (i.e., I, II, III) and competitive quality. Forty-three teams returned surveys for a total of 741 responses. Comparisons were made using the collegiate division, weight class, and the wrestler’s competitive winning percentage. Results: The most weight lost during the season was 5.3 kg ± 2.8 kg (mean ± SD) or 6.9% ± 4.7% of the wrestler’s weight; weekly weight lost averaged 2.9 kg ± 1.3 kg or 4.3% ± 2.3% of the wrestler’s weight; post-season, the average wrestler regained 5.5 kg ± 3.6 kg or 8.6% ± 5.4% of their weight. Coaches and fellow wrestlers were the primary influence on weight loss methods; however, 40.2% indicated that the new NCAA rules deterred extreme weight loss behaviors. The primary methods of w...

Weight loss practices of college wrestlers.

ALDERMAN, B. L., D. M. LANDERS, J. CARLSON, and J. R. SCOTT. Factors Related to Rapid Weight Loss Practices among International-style Wrestlers. Med. Sci. Sports Exerc., Vol. 36, No. 2, pp. 249–252, 2004.PurposeThe deaths of three intercollegiate wrestlers in 1997 prompted the NCAA and gover

Factors Related to Rapid Weight Loss Practices among International-style Wrestlers

Well trained subjects (N = 12) were studied before and after losing approximately 6% of body weight to determine whether physical performance could be maintained while consuming a hypocaloric, high percentage carbohydrate diet. During a 4-d period of weight loss, subjects were randomly assigned to a high carbohydrate (HC) or low carbohydrate (LC) diet. A crossover design was used; subjects were measured before (PRE) and after (POST) weight loss on both diets for a 6-min bout of high intensity arm cranking, weight, skinfold thickness, and profile of mood states (POMS). Hemoglobin, hematocrit, and glycerol concentrations were analyzed for resting blood samples, while lactate, pH, and base excess were analyzed for blood samples drawn at rest and 1, 3, and 5 min after arm cranking. A three-way ANOVA of sprint work revealed a weight loss effect, a diet by weight loss interaction, and an order by diet by weight loss interaction (P less than 0.05). Total sprint work (mean +/- SE) PRE and POST HC was 37.7 +/- 2.1 kJ and 37.4 +/- 2.2 kJ, respectively. Sprint work was higher for PRE LC vs POST LC, with mean values of 37.4 +/- 2.1 kJ and 34.4 +/- 2.2 kJ, respectively. Post-arm cranking lactate was significantly higher PRE compared to POST for both HC and LC. Post-exercise blood pH was lower (P less than 0.05) at PRE vs POST, with no diet effect. Regardless of the diet, POMS variables tension, depression, anger, fatigue, and confusion were significantly elevated from PRE to POST; vigor was significantly lower.(ABSTRACT TRUNCATED AT 250 WORDS)

Weight loss, dietary carbohydrate modifications, and high intensity, physical performance

Purpose: The present investigation was initiated to examine the weight management practices among wrestlers participating in the NCAA Division I, II, and III wrestling tournaments. Part 1 examined the efficacy of body composition assessment between preseason (PRE) and postseason (POST). Part 2 examined rapid weight loss (RWL) during the 20 h preceding the weigh-in and the rapid weight gained (RWG) during the first day's competition.

Methods: Subjects include 811 competitors from Divisions I, II, and III participating in the NCAA national championship tournaments between 1999 and 2004. Measurements included relative body fatness (% BF) and weight (WT) on the day preceding the tournament and the evening of the first day. Minimal weight (MW) was computed with 5% BF. Retrospectively, MW, % BF, and WT from the previous fall were obtained for comparisons from NCAA records.

Results: Part 1: WT and % BF decreased significantly PRE (WT 74.0 ± 11.1 kg; % BF 12.3 ± 3.4%) to POST (WT 71.5 ± 10.4 kg; % BF 9.5 ± 1.8%), but MW (PRE MW 68.0 ± 9.2 kg, POST MW 67.9 ± 9.1 kg) remained unchanged. Heavier wrestlers and Division I and II wrestlers showed the greatest changes in WT and % BF. Part 2: RWL averaged (± SD) 1.2 ± 0.9 kg and relative to weight 1.7 ± 1.2%. Division I and lighter wrestlers showed the greatest change. RWG averaged 0.9 ± 0.8 kg, or 1.3 ± 1.2%. RWG was greater among lighter and Division I and II wrestlers.

Conclusions: Minimal weight estimates PRE appear valid compared with POST. RWL and RWG are reduced significantly over previous investigations with only mat-side weigh-ins. The NCAA weight management program appears effective in reducing unhealthy weight cutting behaviors and promoting competitive equity. Efforts to institute similar programs among younger wrestlers seem warranted.

James R. Scott

Papers

Weight loss practices of college wrestlers.

Factors Related to Rapid Weight Loss Practices among International-style Wrestlers

Weight loss, dietary carbohydrate modifications, and high intensity, physical performance

NCAA rule change improves weight loss among national championship wrestlers.

Fox's Physiological Basis for Exercise and Sport, 6th Edition