Standardising health history and injury surveillance of participants in endurance events: a modified Delphi consensus statement from the AMSSM runner health consortium.

Endurance events are popular worldwide and have many health benefits. However, runners and Para athletes may sustain musculoskeletal injuries or experience other health consequences from endurance events. The American Medical Society for Sports Medicine (AMSSM) Runner Health Consortium aimed to generate consensus-based survey items for use in prospective research to identify risk factors for injuries in runners and Para athletes training and competing in endurance events. The study design employed a modified Delphi approach, with a panel comprising 28 experts, including healthcare professionals, coaches, and athletes. Potential survey items were generated by panel members who subsequently engaged in three rounds of voting using Research Electronic Data Capture. Items were graded by clarity, relevance, and importance. Items achieving 80% consensus on all three aspects were retained. The response rate was 100% in R round 1 and 96% in Rrounds 2 and 3. Of 124 initial survey items, consensus was reached on 53, 34 and 22 items during Rrounds 1, 2, and 3, respectively. Two accepted items were removed due to redundancy. Combined with 10 non-voting items, 117 items covered key domains, including training and injury history, dietary behaviours and associated factors (such as menstrual function), footwear, mental health, and specific considerations for Para athletes. The consensus-based survey items should be considered by researchers to better understand the health of runners and Para athletes who train and compete in endurance sports to identify risk factors for injury.

Association of self-reported health problems and interpersonal violence in sport: a cross-sectional study in world-level performing athletes.

OBJECTIVES: A paucity of studies assesses the intersection of physical health (injury and illness), mental health and experiences of interpersonal violence (IV, also known as harassment and abuse) in sport. The objectives of this study were to examine the (a) frequency of self-reported physical and mental health problems of elite athletes in the 12 months prior to the survey, (b) differences in physical and mental health between male and female athletes and (c) relationship of athlete health with experiences of IV. METHODS: Elite adult athletes from four sports were approached at eight international events to answer an online questionnaire on their physical and mental health, as well as experiences of IV in sport within the past 12 months. RESULTS: A total of 562 athletes completed the questionnaire. Overall, 75% reported at least one physical symptom, most commonly headache and fatigue (n=188; 33.5% each), followed by musculoskeletal symptoms (n=169; 29.4%). 65.1% reported at least one mental health symptom, mostly of anxiety or depression. More female than male athletes reported physical (F:81.9%; M:68.3%; p<0.001) and mental (F:71.9%; M:58.4%; p<0.001) health problems, while addiction problems were more frequent in male athletes (F:1.8%; M:6.4%; p=0.006. 53.0% of the female and 42.3% of the male participants reported having experienced at least one form of IV. Linear regression analysis demonstrated that all forms of IV, except physical IV (all p's<0.001), were associated with an increasing number of physical and mental health symptoms. In addition, the analysis showed that female athletes had a higher increase in symptoms in response to IV than male athletes. CONCLUSIONS: This study demonstrates the relationship of elite athlete physical and mental health with IV. Injury and illness prevention programmes in international sport should include strategies to reduce IV.

Running shoe cushioning properties at the rearfoot and forefoot and their relationship to injury: study protocol for a randomised controlled trial on leisure-time runners.

Previous work has demonstrated the protective effect of shoe cushioning on injury risk in leisure-time runners, but most models currently available on the market have greater cushioning than those investigated so far. Also, the optimal level of cushioning and the role of cushioning on the forepart of the shoe for injury prevention are still unknown. The main aim of this study is to determine whether (1) current 'extra soft' cushioning material at the rear part of the shoe reduces injury risk compared with stiffer material and (2) cushioning under the forepart of the shoe also contributes to injury risk reduction. This randomised trial with a 6-month intervention will involve 1000+ healthy leisure-time runners who will randomly receive one of the three running shoe versions. Study shoe versions will differ in their cushioning properties (ie, stiffness) at the rear or the forepart. Participants will self-report any lower limb or lower back problems on a dedicated electronic system every week, while the system will collect training data from the participant's sports watch. Time-to-event analyses will be used to compare injury risk between the three study groups and to investigate the association between the runner's characteristics, cushioning level and position, training and injury risk. The study was approved by the National Ethics Committee for Research (Ref: 202405/02 v2.0), and the protocol has been registered on https://clinicaltrials.gov/ (NCT06384872, 02/08/2024). Outcomes will be disseminated through presentations at international conferences and publications in peer-reviewed journals, popular magazines and specialised websites.

Is the Frequency of a Targeted Neuromuscular Training Program a Factor in Modifying Knee Joint Loading During Typical Netball Landing Tasks?

BACKGROUND: Unplanned sidestep cutting and forward single-leg jump-landing contribute to non-contact anterior cruciate ligament (ACL) injuries in netball. Neuromuscular training programs (NMTPs) have shown promising results in reducing injury risk in certain populations when compliance is high. Compliance is easier to achieve when NMTPs are effective yet require minimal time for completion. HYPOTHESIS: Once- and thrice-weekly intervention groups would be equally effective in reducing knee abduction and internal rotation moments during forward single-leg jump landing and unplanned sidestep cutting. STUDY DESIGN: Randomized controlled trial. LEVEL OF EVIDENCE: Level 3. METHODS: External peak knee abduction and peak knee internal rotation moments during unplanned sidestep cutting and forward single-leg jump-landing were assessed pre- and post-intervention for 17 elite-level female netballers assigned randomly to either a once-weekly or thrice-weekly group. Regular netball training continued throughout the intervention, which lasted 6 weeks (30 minutes/session). One-way analysis of covariance (α = 0.05) was utilized to compare post-intervention peak knee abduction and peak knee internal rotation moments between groups, controlling for pre-intervention knee moments during the forward single-leg jump-landing and unplanned sidestep cut. Paired t tests were used to examine within-group changes in knee moments pre- versus post-intervention. RESULTS: For unplanned sidestep cuts on the right leg, both groups differed significantly, with the once-weekly group displaying a decrease in peak knee internal rotation moments [F(1,14) = 5.23; P = 0.04] whereas the thrice-weekly group did not. No other significant group interactions were found. CONCLUSION: A condensed NMTP with targeted exercises, performed once-weekly as part of regular training, shows potential to reduce peak knee internal rotation moments that are injurious to the ACL during unplanned sidestep cutting in adult female netballers. CLINICAL RELEVANCE: A once-weekly targeted NMTP would pose minimal disruption to a high-performing athlete's training schedule and likely increase compliance to ensure the success of the NMTP.

Systematic video analysis of ACL injuries in professional Spanish male football (soccer): injury mechanisms, situational patterns, biomechanics and neurocognitive errors - a study on 115 consecutive cases.

Objective: A few video analysis studies have been published in recent years, but none specifically on Spanish football. We aimed to describe the mechanisms, situational patterns, biomechanics and neurocognitive errors related to anterior cruciate ligament (ACL) injuries in professional Spanish football matches. Methods: We identified 167 consecutive ACL injuries across 12 seasons of the top two leagues in Spanish football. 115 (69%) injury videos were analysed for mechanism and situational pattern, while biomechanical analysis was possible in 81 cases. Neurocognitive errors were investigated for all non-contact injuries. Three independent reviewers evaluated each video. ACL injury epidemiology-month, timing within the match and pitch location at the time of injury was also documented. Results: More injuries occurred in defensive (n=68, 59%) than offensive (n=48, 41%) (p<0.01) playing situations. 16 (14%) injuries were direct contact, 49 (43%) indirect contact and 50 (43%) non-contact. Most injuries (89%) occurred during four main situational patterns: (1) pressing/tackling (n=47, 47%); (2) tackled (n=23, 23%); (3) landing from a jump (n=12, 12%) and regaining balance after kicking (n=6, 6%). Injuries generally involved a knee-dominant loading strategy in the sagittal plane with abducted hip and knee valgus. Of the non-contact injuries, 39 (78%) were deemed to involve a neurocognitive error. More (58%) injuries occurred in the first half of matches (p<0.01). Conclusions: ACL injuries in Spanish football occurred similarly with non-contact and indirect contact mechanisms (44%). Four in five non-contact injuries involved a neurocognitive error. Most injuries occurred during four previously identified situational patterns, with more injuries earlier in the match.

Developing a data-driven multimodal injury and illness prevention programme in male professional football based on a risk management model: the IP2 NetWork.

Background: Current injury prevention programmes in football are limited by a one-size-fits-all approach, which predominantly focuses on preventive exercise programmes while ignoring differences in risk profiles between individuals and teams. Objective: To address this gap, we developed a new data-driven, customisable approach based on the principles of risk management. We collaborated with key stakeholders to identify focus areas for injury and illness prevention and determine their priorities. Setting: The team medical and coaching staff included members from 17 professional football clubs, the national team and a youth football academy in Qatar. Methods: In 2015, we launched a series of annual workshops under the Aspetar Sports Injury and Illness Prevention Programme. The workshops included club medical personnel and fitness coaches in a process to develop team-specific programmes for injury and illness prevention based on the principle of risk management. Over 2 years, workshops refined focus areas through discussions, surveys and small-group presentations, culminating in the creation a novel programme for football injury prevention. Results: Out of 44 focus areas first identified, 23 were selected as priorities for inclusion in multimodal injury and illness prevention programmes. The identified focus areas represent a variety of aspects, including social/behavioural/lifestyle, exercise programmes/training, load management, recovery and equipment. The top priorities included communication, the Nordic hamstring exercise, training load, recovery strategies, nutrition, sleep, warm-up, the Copenhagen adduction exercise and core and dynamic stability. Conclusion: We have developed a comprehensive framework for preventing injuries and illnesses in football grounded in the general principles of risk management. This framework has proven feasible and led to the creation of a new multicomponent programme, The Aspetar IP2 (Injury and Illness Prevention for Performance) NetWork, focusing on a range of areas beyond preventive exercise programmes only.

Artistic gymnastics-specific extension of the IOC 2020 consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport.

The incidence of injuries reported in artistic gymnastics varies greatly. This is partly due to inconsistencies in defining and reporting injuries in artistic gymnastics. The objective was to develop consistent definitions and methodology for reporting injuries in artistic gymnastics. A group of medical practitioners working with international-level artistic gymnasts from America, Asia, Australia and Europe came to a consensus on recommendations for defining and reporting injuries in artistic gymnastics. Development of the consensus statement was achieved through in-person and online discussions, online surveys and post meeting electronic discussions. This consensus statement is meant to serve as an extension to the recommendations made by the IOC on injury surveillance. The statement includes specific recommendations of injury definitions, characterising activity at the time of injury, and describing injury burden in artistic gymnastics. The following consensus statement has been developed to encourage consistency of injury surveillance in artistic gymnastics. Reporting injury in a consistent manner will help understand the true burden of injury in artistic gymnastics and help guide future work in injury prevention.

Types, frequencies and burden of health problems in elite luge athletes: a 46-week prospective cohort study.

Background: There is a research gap in the survey of injuries and illnesses in the sport of luge. Objective: To analyse the type, frequency and burden of injuries and illnesses that occurred over a preparation period and a competition period in elite luge athletes. Methods: In total 40 elite luge athletes, who were all part of a national team and competed internationally, self-reported acute injuries, overuse injuries and illnesses weekly using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Results: The most frequently stated health problems were illnesses with 41.9% (n=75), followed by acute injuries at 31.9% (n=57). Overuse injuries accounted for 24.0% (n=43). Illnesses represented the greatest burden with a median severity score of 60.0 (IQR: 23.63), followed by acute injuries with 42.0 (IQR: 26.83) and overuse injuries with 35.0 (IQR: 23.95). In the case of acute injuries, the anatomical regions most affected were the hand (n=8, 14.0 %), foot (n=8, 14.0 %), head (n=7, 12.3 %) and neck (n=6, 10.5 %). In the case of overuse injuries, the shoulder (n=9, 20.9 %) and lumbar spine (n=7, 16.3 %) were most frequently reported. Strains (n=15, 26.3 %) and contusions (n=14, 24.6 %) were the predominant types of acute injuries. Four concussions were recorded, with none of the athletes taking a break from normal training of more than 3 days. This stands in contrast to the current recommendations for the return to sport after concussion. Conclusion: The results of this study represent the current incidence rates and health burden of acute and chronic injuries in this constantly evolving sport. 95% of all athletes reported at least one health problem during the observation period. These findings support the need for specific prevention programmes. The establishment of a concussion protocol should be considered.

Human rights and the olympics: from an ideological paradox to a new anti-corruption legacy.

This article aims to explore the evolution of the debates surrounding human rights in the discourse(s) of major sporting events (MSEs), particularly the Olympics. The paper will first analyse the western-centric origins of the "universality" of the Olympic philosophy and how it affected the protection and promotion of human rights, as well as addressing practical challenges or limitations faced. It will then focus on unpacking the elements of sportswashing and soft power in the multi-discursive context of sport where power, privilege, politics, and position are (re)produced. In doing so it draws upon the emergent field of Sports Diplomacy as the most appropriate explanatory framework to share in this discourse. Finally, it will explore the potential impact of anti-corruption reforms on the establishment of a meaningful human rights legacy.

Dual career policy at federal universities in Brazil: analysis of academic and sporting support.

Internationally, the implementation of holistic programs aimed at academic, financial and retirement preparation support for student-athletes who find themselves in dual careers, such as university students, has been widespread and intensified. However, little is known about the subject in the Brazilian national context, because although there are related studies, they are punctual and related to specific universities. In view of the above, this study aimed to investigate public policy aimed at student-athletes at Brazilian federal universities. This is an exploratory, qualitative, cross-sectional and documentary study, using the websites, internal regulations and public notices of 69 Brazilian federal universities for the year 2023, using the content analysis technique. The results indicate that 72.05% offer some kind of support to DC based on the holistic model, 66.17% of which is academic and 60.29% sports. Among the academic support, the flexibility of assessments (57.35%) and the differentiated treatment of absences (51.47%) were close. The sporting support is centered on partial payment of competition costs (60.29%) and athlete grants are restricted to 20.58% of universities. It can be concluded that Brazil's federal universities have policies that include support actions that integrate the holistic model (academic), with incipient coverage of scholarships (sports), but do not effectively follow the holistic model.

Prospective cohort study identifying risk factors for sports injuries in adolescent athletes: the Healthy Injury-Free Adolescent Athletes (HIFAA) study.

A high incidence of injuries has been reported in young athletes. Several factors have been associated with athletes' sports injuries. However, scientific evidence is lacking, particularly for adolescent athletes. Hence, the Healthy Injury-Free Adolescent Athletes (HIFAA) was designed to evaluate sports injuries and examine associations with risk factors related to physical load and mental health. Secondary aims are to evaluate differences between sex, age, high school year and sports and examine injuries and the athletic situation 5 to 10 years after graduation. Adolescent athletes aged 15-19 years enrolled in high school and competing in sports to reach a national or international level of sports will be included. At inclusion, athletes will sign an informed consent form and fill out a baseline questionnaire addressing potential risk factors (eg, sports, training and competing health and injuries, and psychosocial status). Athletes will then prospectively be monitored weekly regarding injuries, physical (training/match/competing, perceived exertion) and psychological (fatigue, sleep, mental stress, recovery) load until graduation. A shortened version of the baseline questionnaire will be filled out every year, and a follow-up questionnaire regarding injuries, sporting situations and mental health will be filled out 5-10 years after graduation. Injuries are frequent among adolescent athletes, with consequences ranging from shorter interruptions in sports performance to mental health problems and early termination of sports. A reduction of these injuries is warranted. This study will provide a detailed understanding of risk factors, a prerequisite to introducing appropriate preventive measures.

Twenty year analysis of professional men's rugby union knee injuries from the English premiership shows high rates and burden.

OBJECTIVES: To determine the rates, severity and burden of knee injuries in professional male rugby union from the English Premiership. METHODS: Injury and exposure data were captured over 20 seasons using a prospective cohort design. Knee injury incidence, days' absence and burden were recorded for each injury type and by pitch surface type for match and training. RESULTS: The rate of knee injury in matches was 9.8/1000 hours (95% CIs 9.3-10.3). Mean days lost were 50 (95% CI 46 to 53) in matches and 51 (95% CI 44 to 57) in training. In matches, medial collateral ligament injuries were the most common, while anterior cruciate ligament (ACL) injuries had the highest mean severity and burden. There was no significant change in the count of knee injuries over time; however, average severity increased significantly (annual change: 2.18 days (95% CI 1.60 to 2.77); p<0.001). The incidence of match knee injury was 44% higher on artificial pitches than grass pitches (incidence rate ratio: 1.44 (95% CI 1.21 to 1.69); p<0.01), with no significant difference in severity between surfaces. In matches, the tackle was the event most commonly associated with knee injuries for all diagnoses, except ACL injuries (running). In training, running was a more common injury event than the tackle. CONCLUSION: Knee injuries in matches are common and severe in English professional men's rugby union. Despite an increased focus on player conditioning and injury prevention throughout the study period, rates of knee injury remained stable, and resulting days' absence increased. New strategies for the prevention of knee injuries should be considered a priority.

'Another world of pain'-athlete and sport physiotherapist perspectives on the unique experience of pain in sport.

Our objective was to explore athlete's and sports physiotherapists' experiences of sports-related pain in the upper and lower limb. Using a constructivist and pragmatic perspective, we carried out focus groups comprising a deliberate criterion sample of athletes and sports physiotherapists. We used a topic guide that moved from open exploratory questions to questions focusing on the phenomena of sports-related pain in athletes. We coded, developed candidate themes and refined finalised themes using reflexive thematic analysis. A member of our research team acted as a critical friend adding additional perspectives. We followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). We completed five focus groups comprising 12 athletes (n=5 female, n=7 male) and four sports physiotherapists (n=4 male) including one initial pilot (two athletes). We developed four final themes (1-4) and nine subthemes (1.1-4.3): (1) Athlete Pain Lens (1.1-pain is part of being an athlete and 1.2-pain shapes the life of an athlete), (2) Exploring And Navigating Pain (2.1-the sports-related pain spectrum and 2.2-making sense of pain), (3) The Emotional Toll of Pain (3.1-challenging emotions and 3.2-the impact of time) and (4) Coping, Community and Communication (4.1-coping with pain, 4.2-influence of community and support network and 4.3-communication, the broken key). We highlighted the distinct and challenging phenomenon of sports-related pain experienced by athletes and physiotherapists. Through effective communication, members of the athlete's community may recognise, and adjust to these challenges.

Why Do People Choose a Particular Dog? A Mixed-Methods Analysis of Factors Owners Consider Important When Acquiring a Dog, on a Convenience Sample of Austrian Pet Dog Owners.

Selecting a dog that is incompatible with the owner's expectations can negatively impact both parties. Previous studies on dog acquisition have primarily focused on shelter environments, using closed-ended questions to assess hypothetical preferences. In contrast, our study employed open-ended questions with a convenience sample of Austrian dog owners (N = 1077) to retrospectively explore why the owners chose their dogs. We also examined consistency in owners' responses and the influence of owner characteristics (age, education, household composition, previous dog experience, purpose of acquisition) on their reasons. Content analysis revealed 24 codes; the frequency of codes was 2.4/response. The most frequent codes were breed-based choice (29%), choosing on a whim, without careful consideration (24%), work/sport skills (22%), and rescuing a dog (17%). The least frequent were the age (1%), health (1%), sex (1%), and guarding skills (0.6%) of the dog. Twelve codes were consistent over time, and ten were consistent across dogs, indicating that the owners showed a consistent preference for certain traits. Except for the owner's education level, all characteristics affected the likelihood of mentioning at least one code. Most associations were found with the presence of children in the household: owners with children preferred friendly, easily manageable, and easy-to-train dogs and were less likely to adopt or rescue compared to owners living without children. Our findings also highlight discrepancies between spontaneous (free-text) reports and responses to closed-ended questions, underscoring the importance of qualitative data in better understanding the motivations behind and the factors influencing dog acquisition.

Effect of social support on Muslim women's sporting activities: mediating effect of psychological adjustment.

Objective: This study explores the relationship between social support and sporting activities of Muslim women and constructs a mediation model through role of psychological adjustment. Methods: Using stratified cluster sampling, 301 Muslim women were measured in group psychology using the Social Support Scale and the Sports Activities and Psychological Adjustment Scale. The statistical software SPSS 24.0 and SPSS PROCESS 3.3 were used for statistical processing. The common-method variation test was carried out using the Harman single-factor control test. Finally, the Bootstrap sampling test method and process plug-in were used to test the significance of the intermediary effect. Results: (1) Social support has a significant predictive effect on sports activities (ß = 0.32, p < 0.001); (2) psychological adjustment (ß = 0.552, p < 0.001) mediates the relationship between social support and sporting activities [social support → psychological adjustment → sporting activities (95% Cl, 0.093, 0.323)]. Conclusion: Social support positively influences sporting participation among Muslim women, and psychological adjustment mediates this relationship. Strengthening social support for Muslim women can enhance their psychological adjustment, thereby improving their participation in sporting activities and offering valuable theoretical and practical guidance.

Epidemiology and clinical profile of sports injuries treated in the Douala General and Laquintinie Hospitals, in Cameroon.

Objectives: To describe the epidemiological patterns and clinical characteristics of sports injuries treated at two hospitals in Douala. Methods: This was a cross-sectional study conducted at the Douala General Hospital and Douala Laquintinie Hospital, involving medical records of patients treated for sports injuries from January 2012 to April 2022. Data extracted from records were entered into a data collection software and analysed using Microsoft Excel 2016. Severe injuries were defined as an injury score greater than or equal to 3 on the Abbreviated Injury Scale. Results: The prevalence of sports injuries was 1.12% among all trauma cases. There was a male predominance with 62 (86.1%) males and 10 (13.9%) females. The mean age was 24.97±13.8 years. Most injured persons were students 35 (48.6%), followed by the employed 26 (36.1%), athletes 6 (8.3%) and the unemployed 5 (6.9%). Recreational sports accounted for 43 (59.7%) injuries while 16 (22.2%) injuries occurred during physical education, 8 (11.1%) during trainings and 5 (6.9%) during competitions. Football injuries were 48 (66.7%), running injuries 10 (13.9%) and 9 (12.5%) occurred during long, high and triple jump. Among all injuries, fractures were 43 (59.7%), 11 (15.3%) joint sprains, 5 (6.9%) muscle injuries, 4 (5.6%) brain injuries while 9 (12.5%) were contusions and lacerations. Lower extremity injuries were 34 (47.2%), 21 (29.2%) injuries were on the upper extremities, 4 (5.6%) abdominopelvic, 3 (4.2%) thoracic injuries, 9 (12.5%) head injuries and 1 (1.4%) on the neck. Overall, 53 (73.7%) were severe injuries. Conclusion: The majority of sports injuries treated in these hospitals are fractures that occur during recreational sports, particularly football and predominantly involve the lower extremity. A significant proportion are severe injuries.

Systematic development of an injury and illness prevention programme for athletes with a physical impairment: the TIPAS study.

Background/aim: The participation of individuals with physical impairment in sports has numerous benefits, yet there is also the risk of sustaining sport-related injuries or illnesses. Therefore, prevention programmes of these problems are needed to ensure that individuals can maintain a healthy, active lifestyle. Currently, very few prevention interventions are accessible for these athletes. Therefore, the article aims to describe the development process of the Tailored Injury Prevention in Adapted Sports intervention, an online tailored injury and illness prevention intervention for athletes with a physical impairment. Methods: The development was guided by the Knowledge Transfer Scheme (KTS). Results: In the first step, a cohort study and a qualitative study were conducted to define the problem statement. In the second step, a systematic review was performed in order to learn from theory. Steps 3 and 4 involved an iterative process involving collaboration with diverse expert groups. This included defining athletes' needs and creating a health problem blueprint, after which the intervention content was created. To ensure accuracy and completeness, a feedback loop was incorporated. In the final phase of this step, we refined the language used within the intervention together with athletes. Finally, an effect and process evaluation will take place in the last step of the KTS. Conclusions: Through a five-step approach of the KTS, we developed an online injury and illness prevention intervention for athletes with a physical impairment. This intervention provides direct, timely feedback based on their current health status. Furthermore, it takes the sport and the physical impairment of the athletes into account with regard to the given prevention advices.

Cryotherapy for treating soft tissue injuries in sport medicine: a critical review.

Sports medicine physicians and physiotherapists commonly use cryotherapy (eg, ice application) postinjury to decrease tissue temperature with the objective of reducing pain, limiting secondary injury and inflammation, and supporting healing. However, besides the analgesic effect of cryotherapy, a literature search revealed no evidence from human studies that cryotherapy limits secondary injury or has positive effects on tissue regeneration. Thus, our current understanding of the potential mechanisms and applications of cryotherapy largely relies on the results from animal studies. Importantly, treatment should not aim at obliterating the inflammatory and regeneration processes but instead aim to restore an adapted/normal regulation of these processes to improve function and recovery. However, some animal studies suggest that cryotherapy may delay or impair tissue regeneration. With the translation of laboratory animal studies to human sport medicine being limited by different injury and muscle characteristics, the effect of cryotherapy in patients with musculoskeletal injuries is uncertain. Thus, pending the results of human studies, cryotherapy may be recommended in the first 6 hours following an injury to reduce pain (and possibly haematoma), but it should be used with caution beyond 12 hours postinjury as animal studies suggest it may interfere with tissue healing and regeneration.