Injury and illness in aquatic sport: how high is the risk? A comparison of results from three FINA World Championships.

BACKGROUND: Epidemiological information on injury/illness is required to develop effective injury prevention strategies. AIM: To assess the frequency and characteristics of injuries/illnesses (1) in the 4 weeks prior to and (2) during the Fédération Internationale de Natation (FINA) World Championships 2015 compared with 2013 and 2009. METHOD: (1) Athletes answered a retrospective questionnaire, and (2) the medical staff reported injuries/illnesses prospectively during the championships. RESULTS: (1) A quarter of responding athletes reported symptoms in the 4 weeks prior to the championships. More than half of all affected athletes presented with substantial severity, 80% took medication, 70% had overuse injuries and 30% did not modify their training regime despite symptoms. At the start of the championships, 70% of affected participants were still symptomatic. (2) During the championships, injury and illness incidence was 12.9 per 100 athletes. The most common injuries were shoulder sprains (5.7%) and muscle cramps of the lower back (5.7%). The most common illnesses were infections of the respiratory (33.9%) and gastrointestinal tract (23.5%). Risk factors included discipline and age, but not gender. Incidence was highest in athletes competing in high diving (HD), water polo (WP) and diving (DIV) for injuries, and WP and swimming (SW) for illnesses. The significantly higher incidence of injuries and illnesses at the FINA World Championships 2015 compared with 2013 and 2009 was most probably due to a similarly improved response rate of the medical staff. CONCLUSIONS: In aquatic sports, surveillance and health promotion should focus on prevention of out-of-competition overuse injuries and athlete education.

Review of the Local Organizing Committee (LOC) medical services during the 12th FINA World Swimming Championships (25†m) in Doha, Qatar.

BACKGROUND: One of the primary roles of Fédération Internationale de Natation (FINA) is to promote athlete health. The planning and delivery of major international event medical services is carried out in collaboration with the Local Organizing Committee Medical Commission (LOCMC). Aspetar Orthopaedic and Sports Medicine Hospital provided the medical services to the 12th FINA World Swimming Championships (25 m) creating a unique opportunity for collaboration with FINA. AIM: The purpose of this paper is to review the planning and delivery of medical services and athlete health promotion projects during the 12th FINA World Swimming Championships (25 m) to facilitate the planning of future sporting events of this size and scope. METHODS: The 12th FINA World Swimming Championships (25 m) hosted 974 athletes from 166 countries. The LOC medical team recorded all medical encounters-newly incurred (or acute exacerbations of chronic) injuries and illnesses as well as follow-up consultations. RESULTS: More than 90% of teams did not travel with a team physician and relied on the LOCMC for diagnosis and treatment of injuries and illnesses in athletes and accredited team officials. The LOC medical team had a total of 554 medical encounters: 385 therapy, 34 athlete injury, 65 athlete illness and 70 non-athlete encounters. CONCLUSIONS: The LOCMC in collaboration with FINA delivered comprehensive medical services to athletes, officials and spectators attending the 12th FINA World Swimming Championships (25 m). This review paper provides information relevant to the planning and delivery of LOCMC medical services for future international swimming events contributing to the FINA objective of promoting athlete health.

Competing with injuries: injuries prior to and during the 15th FINA World Championships 2013 (aquatics).

BACKGROUND: Injury and illness surveillance is the foundation for the development of prevention strategies. OBJECTIVE: To examine injuries among the aquatic disciplines in the 4 weeks prior to and during the 2013 FINA World Championships. METHODS: The study was comprised of two components: (1) a retrospective athlete survey recording injuries in the 4 weeks prior to the Championships and (2) a prospective recording of injuries and illnesses by the medical teams of the participating countries and the local host medical team. RESULTS: One-third of the 1116 responding athletes reported an injury/physical complaint in the 4 weeks prior to the Championships. Significantly more women (36.7%) than men (28.6%) reported injuries. Divers reported the highest rate of injury/physical complaints (55.7%). At the start of the Championships, 70% of injured respondents (n=258) were still symptomatic; however, full participation was expected by 76%. During the Championships, 186 new injuries were reported (8.3/100 registered athletes) with the highest injury incidence rate in water polo (15.3/100 registered athletes). The most common injured body part was the shoulder (21%). A total of 199 illnesses were reported during the Championships (9.0/100 registered athletes) with the most common diagnosis of illness being gastrointestinal infection. Environmental exposure (allergy, otitis and jellyfish stings) was responsible for 27% of all illnesses in open water swimming. CONCLUSIONS: Injuries pose a significant health risk for elite aquatic athletes. A prospective study would improve understanding of out-of-competition injuries. Future injury and illness surveillance at FINA World Championships is required to direct and measure the impact of prevention strategies.

Nutritional recommendations for water polo.

Water polo is an aquatic team sport that requires endurance, strength, power, swimming speed, agility, tactical awareness, and specific technical skills, including ball control. Unlike other team sports, few researchers have examined the nutritional habits of water polo athletes or potential dietary strategies that improve performance in water polo match play. Water polo players are typically well muscled, taller athletes; female players display higher levels of adiposity compared with their male counterparts. Positional differences exist: Center players are heavier and have higher body fat levels compared with perimeter players. Knowledge of the physical differences that exist among water polo players offers the advantage of player identification as well as individualizing nutrition strategies to optimize desired physique goals. Individual dietary counseling is warranted to ensure dietary adequacy, and in cases of physique manipulation. Performance in games and during quality workouts is likely to improve by adopting strategies that promote high carbohydrate availability, although research specific to water polo is lacking. A planned approach incorporating strategies to facilitate muscle glycogen refueling and muscle protein synthesis should be implemented following intensified training sessions and matches, particularly when short recovery times are scheduled. Although sweat losses of water polo players are less than what is reported for land-based athletes, specific knowledge allows for appropriate planning of carbohydrate intake strategies for match play and training. Postgame strategies to manage alcohol intake should be developed with input from the senior player group to minimize the negative consequences on recovery and player welfare.

Oral health among Dutch elite athletes prior to Rio 2016.

OBJECTIVES: Elite athletes are at high risk for poor oral health. A screening program to assess oral health and create dental awareness can improve oral health among elite athletes but has not been performed in the Netherlands before. We summarize the first results from such a screening conducted in Dutch elite athletes of the Nederlands Olympisch Committee*Nederlandse Sport Federatie (NOC*NSF, Dutch Olympic Committee). METHODS: In this cross-sectional study, 800 Dutch athletes eligible for the Olympic and Paralympic Games in Rio de Janeiro 2016 were invited to a costless and voluntary oral examination. The decayed, missing, and filled teeth-index (DMFT), the basic erosive wear examination (BEWE) and the Dutch Periodontal Screening-index (DPSI) were used to evaluate athlete's oral health. Information on sociodemographic variables and sport performance were collected in questionnaires. RESULTS: In total, 116 Dutch elite athletes were included in the study. The median (90%-range) DMFT-score was 3.0 (0.0-16.0), the median BEWE-score was 2.0 (0.0-10.0), and the mean± SD DPSI-score was 2.0 ± 0.73. Oral health-related quality of life was generally high, although only 28.2% of the athletes reported never having problems with their dentition or mouth. In 43% of the athlete's clinical findings were reported which needed a direct referral to the general dentist. CONCLUSION: Oral health in this subsample of Dutch elite athletes was surprisingly affected as almost half of them needed dental treatment. Further research is needed to allow conclusions about oral health in Dutch elite athletes more broadly. However, regular screening of oral health incorporated into the general preventive health care of elite athletes is necessary to ensure athletes are fully healthy during competitions like the Olympic and Paralympic Games.