Differences in screening and treating relative energy deficiency in sport between the United States of America and Japan.

BACKGROUND: The diagnosis and treatment of relative energy deficiency in sport (RED-S) are challenging owing to variations in symptoms and the absence of specific guidelines. This study aimed to investigate differences in the diagnosis and follow-up of RED-S, its consequences, and related factors among sports medicine physicians with different backgrounds in Japan and the USA and examine the differences between the two countries. METHODS: An anonymous survey regarding the diagnosis and treatment processes of RED-S was distributed to sports medicine physicians via email. Respondents included 58 sports medicine physicians from the USA and 241 from Japan. RESULTS: The findings showed that 77.6% of the US physicians screened athletes for RED-S, whereas 17.5% of their Japanese counterparts did so. Moreover, 98.3% and 36.7% of the US and Japanese physicians, respectively, answered that they screened athletes for eating disorders upon suspicion of low energy availability. Logistic regression analysis revealed that the number of US sports medicine physicians who screened athletes for the female athlete triad (Triad) and RED-S (odds ratio [OR] = 12.78, P<0.001) and adhered to specific criteria for athlete suspension and return-to-play (OR=33.67, P<0.01) was higher than that of their Japanese counterparts. CONCLUSIONS: The prevalence of RED-S-related screening and treatment differed between US and Japanese sports medicine physicians. Educating sports medicine physicians about the diagnosis and treatment of athletes with possible signs of RED-S is important in treating female athletes and further investigations are required to identify why the physicians screened/not screened the athletes.

Training and physiological characteristics of American and Japanese female track and field athletes.

BACKGROUND: Intensive training without appropriate recovery can predispose athletes to injury. Balancing these two facets - training and recovery - is crucial for keeping athletes at their highest possible performance level while lowering their risk of training-related injury. Cultural differences may also affect athletes' training and daily routines, but research investigating the effects of cultural background on female track and field athletes is lacking. METHODS: In total, 49 Japanese and 28 American track and field athletes competing at the national level were included in this study. Their body composition was evaluated and eating attitudes test (EAT-26) and a survey regarding training schedules, recovery practices, and performance levels were conducted. RESULTS: Compared with the Japanese athletes, the American athletes had significantly higher height, weight, and Body Mass Index measurements, although their performance levels did not differ. Japanese athletes trained for significantly longer hours both on school days and non-school days and spent significantly fewer days per week on weight training. The Japanese athletes slept, on average, for 1 hour less per day than the American athletes, and their EAT-26 scores were significantly higher than those of the American athletes (both P<0.01). The number of days off per week was positively correlated with performance, but training hours on school days and fat mass percentage were negatively correlated with performance (P<0.05). Further, days off per week and nationality were correlated with EAT-26 scores (both P<0.05). CONCLUSIONS: The American and Japanese athletes performed similarly, but the Japanese athletes were achieving their performance level with less sleep, longer training hours, and a higher risk of developing an eating disorder.

Biologics.

Biologics are a growing field that has shown immense promise for the treatment of musculoskeletal conditions both in orthopedic sports medicine and interventional pain management. These procedures utilize injection of supraphysiologic levels of platelets and growth factors to invoke the body's own inflammatory cascade to augment the healing of many bony and soft tissue conditions. While many patients improve with conservative care, there is a need to address the gap between those that improve with rehabilitation alone and those who ultimately require operative management. Orthobiologic procedures have the potential to fill this void. The purpose of this review is to summarize the basic science, evidence for use, and post-injection rehabilitation concepts of platelet-rich plasma (PRP) and mesenchymal stromal cells (MSCs) as they pertain to joints, tendons, ligaments, and the spine.