A National 20-year Analysis of Weight Lifting-related Injuries and Fractures Among Adolescents.

BACKGROUND: Increasing strength through weightlifting has become a core component of competitive sports training, recreational exercise programs, and school physical education classes. Although many health benefits exist, there is concern for injury, especially with improper supervision and accelerated progression of training loads. Though organizations have advocated safe training practices, trends in the national health burden of injuries, specifically fractures, associated with weightlifting in the adolescent population have not been investigated. METHODS: The National Electronic Injury Surveillance System database was queried between 2002 and 2021 for patients aged 11 to 21 years presenting to US Emergency Departments with weight lifting-related injuries. The narrative component of each case identified was analyzed to include only patients noted to be using weightlifting equipment or free weights at the time of injury. Estimates and analyses were performed with 95% CIs. RESULTS: Although there has been some variability in weight lifting-related injuries, the incidence remained roughly constant over the 20 years ( R2 =0.0364). 14,497 cases were identified, reflecting a national estimate of 540,986 total injuries and an annual estimate of 27,049 injuries. Most injuries occurred among 15-to-18-year olds (44.1%±1.6%) and 19-to-21-year olds (38.3%±2.0%). The most common injuries were sprain/strain (36.7%±1.3%), contusion/abrasion (15.7%±0.7%), and fracture (9.9%±0.3%). There were 53,813 estimated fractures, giving an annual incidence of 2,691 fractures. As a portion of all injuries, the number of fractures decreased significantly as patients got older, accounting for 26.8%±3.3% at age 11 and only 8.3%±0.9% at age 21 ( R2 =0.6626). Fingers (37.1%±1.8%) and toes (27.9%±1.4%) were the most fractured body parts. Overall, fractures mainly occurred either at school (25.3%±2.0%) or places of recreation (24.7%±2.2%). CONCLUSIONS: Despite the guidelines to improve safety, the national health burden of weight lifting-related injuries among adolescents has remained constant over the past 20 years. Given that most of the fractures occur in the distal extremities, such as toes and fingers, at school and places of recreation, there may be an opportunity to promote safer weightlifting practices and the development of weightlifting equipment with in-built safety mechanisms, especially at gyms and schools. LEVEL OF EVIDENCE: Level III-prognostic.

The Masters athlete in Olympic weightlifting: Training, lifestyle, health challenges, and gender differences.

BACKGROUND: Olympic weightlifting requires strength, speed, and explosive power. Vigorous physical activity such as Olympic weightlifting, for older adults has many benefits from improved strength, social interactions, and a healthy and independent lifestyle. Little is known about the training habits, health, and lifestyle of Masters weightlifters that includes top level athletes as well as beginners, and there is a dearth of data on women. OBJECTIVES: The primary aim was to describe demographics, training habits, and health including prevalence of injury and chronic disease in male and female Masters athletes in Olympic weightlifting. The secondary aim was to study gender differences and the age and impact of menopause on participation in the sport. RESULTS: The 958 participants (46% men), ages 34 to 87, mostly train 3 to 4 days per week in 1 to 2 hour sessions. This is a highly educated and affluent group, 84% are white, 72% are married, 85% are post-secondary graduates. Exercise can also increase the risk of injury compared to less active older adults, but the rates of injury in weightlifting affecting training are lower than seen in other sports. The prevalence of depression and mental health is similar to a general population. Stress levels and sleep disturbances are more common among women than men. Women reach menopause at a similar age as women in industrialized countries, but menopausal symptoms constrained the training. CONCLUSION: Older athletes are capable of rigorous training programs and top performances while adjusting to changes due to biological aging. Weightlifting athletes, coaches, and health professionals must be aware of patterns of injuries and gender differences to incorporate successful prevention strategies. Knowledge of presentations of menopause and impact of menopausal symptoms on training allows women and health care providers to make informed treatment decisions.

High plasma soluble levels of the immune checkpoint HLA-G molecule among bodybuilders.

INTRODUCTION: Studies report that intense physical activity influences the down-regulation of immune function in athletes as well as the interaction between adipose tissue and the immune system. AIM: This study aimed to compare the plasma soluble levels of the immune checkpoint HLA-G (sHLA-G) molecule with the fat mass and muscle mass index among 77 bodybuilders and 64 controls. RESULTS: The comparisons of the percentage of body fat (%BF) revealed that the groups of male and female bodybuilders showed a statistically significant reduction in the percentage of body fat when compared to their control group, (P <0.0001, for both comparisons). Regarding sHLA-G levels, the comparisons showed that the group of male bodybuilders had significantly higher sHLA-G levels compared to the group of female bodybuilders (P = 0.0011). CONCLUSION: Our results showed that in bodybuilders with less body fat, the systemic levels of soluble HLA-G, an immunological molecule with recognized immunosuppressive function, are significantly higher and suggest that this immune mechanism may corroborate the immunosuppressive state in athletes undergoing intense and prolonged physical training.

Effects of bodybuilding supplements on the kidney: A population-based incidence study of biopsy pathology and clinical characteristics among middle eastern men.

BACKGROUND: The incidence of kidney diseases among bodybuilders is unknown. METHODS: Between January 2011 and December 2019, the Iraqi Kurdistan 15 to 39 year old male population averaged 1,100,000 with approximately 56,000 total participants and 25,000 regular participants (those training more than 1 year). Annual age specific incidence rates (ASIR) with (95% confidence intervals) per 100,000 bodybuilders were compared with the general age-matched male population. RESULTS: Fifteen male participants had kidney biopsies. Among regular participants, diagnoses were: focal segmental glomerulosclerosis (FSGS), 2; membranous glomerulonephritis (MGN), 2; post-infectious glomeruonephritis (PIGN), 1; tubulointerstitial nephritis (TIN), 1; and nephrocalcinosis, 2. Acute tubular necrosis (ATN) was diagnosed in 5 regular participants and 2 participants training less than 1 year. Among regular participants, anabolic steroid use was self-reported in 26% and veterinary grade vitamin D injections in 2.6%. ASIR for FSGS, MGN, PIGN, and TIN among regular participants was not statistically different than the general population. ASIR of FSGS adjusted for anabolic steroid use was 3.4 (- 1.3 to 8.1), a rate overlapping with FSGS in the general population at 2.0 (1.2 to 2.8). ATN presented as exertional muscle injury with myoglobinuria among new participants. Nevertheless, ASIR for ATN among total participants at 1.4 (0.4 to 2.4) was not significantly different than for the general population at 0.3 (0.1 to 0.5). Nephrocalcinosis was only diagnosed among bodybuilders at a 9-year cumulative rate of one per 314 vitamin D injectors. CONCLUSIONS: Kidney disease rates among bodybuilders were not significantly different than for the general population, except for nephrocalcinosis that was caused by injections of veterinary grade vitamin D compounds.

Analysis of doping control test results in individual and team sports from 2003 to 2015.

Background: Determining the prevalence of doping in sport might be useful for anti-doping authorities to gauge the effectiveness of anti-doping policies implemented to prevent positive attitudes toward doping. Using questionnaires and personal interviews, previous investigations have found that the prevalence of doping might be different among different sports disciplines; however, there is no sport-specific information about the proportion of adverse and atypical findings (AAF) in samples used for doping control. The aim of the present investigation was to assess the differences in the frequency of adverse analytical and atypical findings among sports using the data made available by the World Anti-Doping Agency. Methods: The data included in this investigation were gathered from the Testing Figures Reports made available annually from 2003 to 2015 by the World Anti-Doping Agency. These Testing Figures Reports include information about the number of samples analyzed, the number of AAFs reported, and the most commonly found drugs in the urine and blood samples analyzed. A total of 1,347,213 samples were analyzed from the individual sports selected for this investigation, and 698,371 samples were analyzed for disciplines catalogued as team sports. Results: In individual sports, the highest proportions of AAF were 3.3% ± 1.0% in cycling, 3.0% ± 0.6% in weightlifting, and 2.9% ± 0.6% in boxing. In team sports, the highest proportions of AAF were 2.2% ± 0.5% in ice hockey, 2.0% ± 0.5% in rugby, and 2.0% ± 0.5% in basketball. Gymnastics and skating had the lowest proportions at (≤1.0%) for individual sports, and field hockey, volleyball and football had the lowest proportions for team sports (≤1.4%). Conclusion: As suggested by the analysis, the incidence of AAF was not uniform across all sports disciplines, with the different proportions pointing to an uneven use of banned substances depending on the sport. This information might be useful for increasing the strength and efficacy of anti-doping policies in those sports with the highest prevalence in the use of banned substances.

Heavy-load resistance exercise during chemotherapy in physically inactive breast cancer survivors at risk for lymphedema: a randomized trial.

Background: Due to long-standing concerns that heavy-load lifting could increase the risk of developing lymphedema, breast cancer survivors have been advised to refrain from resistance exercise with heavy loads. This study prospectively evaluated the effect of heavy-load resistance exercise on lymphedema development in women receiving chemotherapy for breast cancer.Material and Methods: Physically inactive women receiving adjuvant chemotherapy for breast cancer (n = 153) were randomized to a HIGH (supervised, multimodal exercise including heavy-load resistance exercise: 85-90% 1 repetition maximum [RM], three sets of 5-8 repetitions) versus LOW (pedometer and one-on-one consultations) 12-week intervention. Outcomes (baseline, 12 and 39 weeks) included lymphedema status (extracellular fluid [bioimpedance spectroscopy] and inter-arm volume % difference [dual-energy X-ray absorptiometry], lymphedema symptoms [numeric rating scale 0-10]), upper-extremity strength (1 RM), and quality of life domains (EORTC- BR23). Linear mixed models were used to evaluate equivalence between groups for lymphedema outcomes (equivalence margins for L-Dex, % difference and symptoms scale: ±5, ±3% and ±1, respectively). Superiority analysis was conducted for muscle strength and quality of life domains.Results: Postintervention equivalence between groups was found for extracellular fluid (0.4; 90% CI -2.5 to 3.2) and symptoms of heaviness (-0.2; -0.6 to 0.2), tightness (-0.1; -0.8 to 0.6) and swelling (0.2; -0.4 to 0.8). Nonequivalence was found for inter-arm volume % difference (-3.5%; -17.3 to 10.3) and pain (-0.7; -1.3 to 0), favoring HIGH. Strength gains were superior in the HIGH versus LOW group (3 kg; 1 to 5, p < .05). Further, clinically relevant reductions in breast (-11; -15 to -7) and arm (-6; -10 to -1) symptoms were found in the HIGH group.Conclusion: Findings suggest that physically inactive breast cancer survivors can benefit from supervised heavy-load resistance exercise during chemotherapy without increasing lymphedema risk. Trial registration: ISRCTN13816000.

Reliability of force-velocity parameters obtained from linear and curvilinear regressions for the bench press and squat exercises.

This study aimed to compare the goodness of fit and the reliability of different regression models for fitting the force-velocity relationship (FV) of bench press (BP) and squat (SQ). Additionally, the reliability of the position on FV of the velocity (V1RM) and the force performed with the 1RM (F1RM) was explored. Nine rugby players and 12 judokas participated in this study. The FV of BP and SQ were obtained twice by a protocol performed until the 1RM. Individual FV were fitted by linear (LM), quadratic polynomial (PM), and exponential models (EM). Adjusted coefficients of determination of LM and PM (medians higher than 0.919) were higher than for EM. The reliability was higher for LM in comparison with PM. The reliability of V1RM was not acceptable (CV% = 19 and 18% for BP and SQ). High reliability was observed for F1RM (CV% = 3 and 2% for BP and SQ) and for the ratio between F1RM and the force-axis intercept of FV (CV% = 2 and 4% for BP and SQ). The reliability of the relative values of F1RM around 92 and 87% of F0 for BP and SQ suggests the use of these values for monitoring resistance training programmes.

Reliability and validity of different methods of estimating the one-repetition maximum during the free-weight prone bench pull exercise.

This study examined the reliability and validity of three methods of estimating the one-repetition maximum (1RM) during the free-weight prone bench pull exercise. Twenty-six men (22 rowers and four weightlifters) performed an incremental loading test until reaching their 1RM, followed by a set of repetitions-to-failure. Eighteen participants were re-tested to conduct the reliability analysis. The 1RM was estimated through the lifts-to-failure equations proposed by Lombardi and O'Connor, general load-velocity (L-V) relationships proposed by Sánchez-Medina and Loturco and the individual L-V relationships modelled using four (multiple-point method) or only two loads (two-point method). The direct method provided the highest reliability (coefficient of variation [CV] = 2.45% and intraclass correlation coefficient [ICC] = 0.97), followed by the Lombardi's equation (CV = 3.44% and ICC = 0.94), and no meaningful differences were observed between the remaining methods (CV range = 4.95-6.89% and ICC range = 0.81-0.91). The lifts-to-failure equations overestimated the 1RM (3.43-4.08%), the general L-V relationship proposed by Sánchez-Medina underestimated the 1RM (-3.77%), and no significant differences were observed for the remaining prediction methods (-0.40-0.86%). The individual L-V relationship could be recommended as the most accurate method for predicting the 1RM during the free-weight prone bench pull exercise.

Simulated Casualty Evacuation Performance Is Augmented by Deadlift Peak Force.

INTRODUCTION: The purpose of the current study was to examine if isometric peak force and rate of force development (RFD) were related to the ability to successfully perform a simulated casualty evacuation task in both unweighted and weighted conditions. METHODS: Eighteen male participants from Army Reserve Officers' Training Corps (ROTC) completed a maximum isometric deadlift on a force plate (IRB#HE16227). Isometric peak force and RFD were calculated from ground reaction force. Two simulated casualty evacuation performance trials were then completed. The unweighted trial consisted of lifting and carrying a 75 kg dummy as quickly as possible for 50 m. The weighted trial was similar except 9 kg vests were added to both the simulation dummy and the participant to represent 18 kg of duty gear. Independent sample t-tests and Pearson correlations were performed to compare the characteristics of those who passed and failed the weighted trial. RESULTS: All of the participants (n = 18) completed the unweighted casualty evacuation trial, while 72% (n = 13) were able to complete the weighted casualty evacuation trial. The participants that successfully completed the weighted evacuation trial had significantly (p < 0.05) greater isometric peak force (1420 ± 165 vs. 1076 ± 256 N) and lean mass (74.18 ± 3.89 vs. 65.34 ± 3.89 kg) when compared to participants (n = 5) that could not complete the weighted evacuating task trial. Additionally, greater Army Physical Fitness Test scores (288 ± 13 vs. 269 ± 16 arbitrary units) and significantly faster (30.34 ± 4.41 vs. 44.92 ± 10.62 seconds) unweighted evacuation trial times were observed in participants that could complete the weighted evacuation task. Peak force was also significantly correlated with lean mass (r = 0.51, p < 0.05). There was no relationship between RFD and performance of the unweighted or weight trial. CONCLUSION: Isometric deadlift peak force represents an important determinant for the success of a simulated casualty evacuation task and may be a useful marker to include in periodic fitness evaluations of military personnel.

Comparison of the firefighter candidate physical ability test to weight lifting exercises using electromyography.

BACKGROUND: Muscular strength and endurance are important attributes for structural firefighting. Matching resistance exercises to firefighter job demands is not well-established. OBJECTIVE: This study compared the electromyographic (EMG) activity of major muscles during the Candidate Physical Ability Test (CPAT) and weight lifting exercises in firefighters. METHODS: A repeated measures study was conducted in 13 full-duty career firefighters (1 F, 12 M; age 18-44 years). Participants completed seven weight lifting exercises at a university laboratory. They separately completed the CPAT at a firefighting training grounds. During each activity, surface EMG (% maximum voluntary isometric contraction - MVIC) of major muscle groups was recorded and compared between exercises and CPAT. RESULTS: No difference in EMG activity was observed between exercises and CPAT for the deltoid, trapezius, lumbar multifidus, gluteal, and biceps femoris muscles. EMG activity was significantly greater during the CPAT for the abdominal obliques (32.3% ±27.7% vs. 12.1% ±8.3%, p <  0.001) and for the latissimus dorsi (21.8% ±25.1% vs. 11.4% ±7.7%, p <  0.001). CONCLUSIONS: Standard weight lifting and abdominal oblique exercises should be incorporated into resistance training programs for firefighters.

Prevalence of urinary incontinence in women powerlifters: a pilot study.

INTRODUCTION AND HYPOTHESIS: Increased intra-abdominal pressure is associated with urinary incontinence (UI) as is increasing age, obesity, and participating in sport at an elite level. We aimed to determine the prevalence of UI in competitive women powerlifters and establish if commonly cited risk factors affect the incidence of UI. METHODS: The authors developed a 17-item questionnaire to investigate the prevalence of UI and the relationship of UI with age, body mass, resistance training experience, and competition grade in competitive women powerlifters. The questionnaire was distributed through three major powerlifting federations in Australia for 16 months. The data of 134 competitive women powerlifters were collected anonymously using Qualtrics, and were analysed using multivariate analysis. RESULTS: In combination, the age of lifters, resistance training experience, body weight categories, and competition grade accounted for a significant 28% of the variability in the Incontinence Severity Index (ISI) (p < 0.01). However, the ISI was not significantly different among age groups, body weight categories, or competition grade. Approximately, 41% of women powerlifters had experienced UI at some stage in life, and 37% of women powerlifters currently experienced UI during training, competition, or maximum effort lifts. However, the rate of UI experienced during daily life activities was approximately 11%. CONCLUSIONS: This study showed that competitive women powerlifters experience a higher rate of UI during lifting-related activities than in daily life and that the rate of UI correlates positively with age, body weight categories, resistance training experience, and competition grade.

Which sports are more at risk of physical exercise addiction: A systematic review.

INTRODUCTION: Excessive physical exercise may evolve into physical exercise addiction, a recently identified entity with many yet unclear aspects, such as global prevalence and variability according to different types of physical exercise. METHODS: We systematically reviewed the current literature up to June 2018 to collect all studies screening exercise addiction with two of the most frequently used screening scales: the Exercise Addiction Inventory (EAI) and the Exercise Dependence Scale (EDS). RESULTS: We detected forty-eight studies (20 using the EAI, 26 the EDS, and 2 both scales) reporting variable point prevalence of exercise addiction risk, depending on the target population and the investigated sport. The EAI identifies a higher proportion of people at risk for physical exercise addiction among endurance athletes (14,2%) followed by ball games (10,4%), fitness centre attendees (8,2%) and power disciplines (6,4%), while a frequency of 3,0% was reported in the general population. Studies using the EDS found discrepant results. DISCUSSION: This systematic review suggests that sport disciplines are associated with different vulnerability for physical exercise addiction. Besides the different addictive potential of each sport, the heterogeneity of results may be also due to socio-demographic and cultural characteristics of the target populations. The EAI and the EDS identify different proportions of individuals at risk for exercise addiction both in general population and in specific sport categories. As the EAI screens a higher proportion of subjects at risk, especially in endurance disciplines, it could be more appropriate for early detection of at-risk subjects and/or disciplines. CONCLUSION: Tailored prevention strategies for each discipline could help better preserving benefits of sports. More precision in research methods and the use of the most appropriate scale are required to allow a better comparability of prevalence among physical exercise disciplines and in general population.

Defining and defending drug-free bodybuilding: A current perspective from organisations and their key figures.

The use of performance- and image-enhancing drugs in the past seventy years or so has sparked a number of responses, including heated public debates, the creation of dedicated organisations and drug policies, as well as the emergence of communities of practice and belief in support of or in opposition to the phenomenon. Drug-free, known in the field as 'natural', bodybuilding has been developing since the 1970 s as a response to a dominant bodybuilding culture where the use of performance- and image-enhancing drugs has become normalised. Recent years have seen a multiplication of national and international governing bodies, competitions, and participants in drug-free bodybuilding in different parts of the globe. As the field grows, the questions of what constitutes natural bodybuilding and who can authentically represent it become central. Adopting a multi-method, qualitative approach, this article explores the ways organisations and their key figures define and defend their versions of drug-free bodybuilding. The discussion focus is on the policies, meanings and identities embedded in these different versions, and how their production and negotiation makes sense in light of antagonisms between players in the field of natural bodybuilding as well as their relation to drug-enhanced bodybuilding and the wider world of sport. In examining this previously uncharted body culture, the article explores how the use of performance- and image-enhancing drugs provokes responses and processes of contestation and differentiation. In the process, what becomes apparent is the designation and negotiation of drug-free, natural bodies as an ongoing, dynamic, social process.

Is There Any Relationship Between Body Image Perception, Eating Disorders, and Muscle Dysmorphic Disorders in Male Bodybuilders?

Bodybuilding has increasingly become popular between males since male body shape has become a subject of interest in the last decades. Bodybuilders have desired to gain more muscle and paid attention to their body shape. Based on this purpose, they have string rules that include restrictive eating and excessive exercise program. Recent research has demonstrated that desiring more muscular body shape exhibits eating behavior problems and body dissatisfaction issues in bodybuilders. Limited research exists on the relationship between body dissatisfaction and eating disorders in male bodybuilders. The aim of this study was to determine the relationship between body image disturbance and eating disorders in 120 male bodybuilders. The Eating Attitude Test (EAT-40) was used to determine eating disorders, the Muscle Dysmorphia Disorder Inventory was used to determine bigorexia symptoms, and Bodybuilder Image Grid-Original (BIG O) and Scaled (BIG S) forms were used to detect the factors associated with body dissatisfaction. There was a positive relationship between Eating Attitude Test and Muscle Dysmorphia Disorder Inventory total scores. Eating Attitude Test was positively correlated with both fat and muscle dissatisfaction. Our results indicated that eating disorder psychopathology is positively related to body dissatisfaction and body dysmorphic disorders in male bodybuilders.

Influence of age on lifting capacity among manual materials handlers.

BACKGROUND: Recommended weight limit for manual materials handlers has to be decided based on the individual characteristics of the person and age is one of the major variable affecting maximal lifting capacity. But there is limited information on pattern of change in lifting capacity with age. OBJECTIVE: To determine the influence of age on the maximum acceptable weight of lift among manual materials handlers. METHODS: Two hundred and seventeen male construction workers were grouped into four age quotas- 19-28, 29-38, 39-48 and 49-58 years. Lifting capacity was determined using progressive isoinertial lifting evaluation, adopting semi-squat technique of lifting at two levels: waist and shoulder. RESULTS: A statistically significant increase in the maximum acceptable weight was observed from first to second age group followed by a gradual decline. The percentage of decline from second to third age group was 11.89% and 14.34% and from third to fourth age group was 5.60% and 19.90% for waist and shoulder level respectively. CONCLUSION: Pattern of change in lifting capacity with age among manual materials handlers has been investigated in this study. Lifting capacity was found to be the greatest in 29-38 year age group, therefore prescribing recommended weight limit uniformly for all the workers may not be the best practice.

Analysis of USA Powerlifting Federation Data From January 1, 2012-June 11, 2016.

Ball, R and Weidman, D. Analysis of USA Powerlifting federation data from January 1, 2012-June 11, 2016. J Strength Cond Res 32(7): 1843-1851, 2018-In this article, we report 47,913 officially judged contestant results from powerlifting matches from January 1, 2012 to June 11, 2016 for the USA Powerlifting Federation. We found age and sex to be the most complex factors in predicting powerlifting results. For women, in general, the younger the woman is the more they can squat; the older the woman is the less they can squat. For men and women, with the 1 exception for women's squat, the peak age of lifting power is between the ages 24-49, at which point lifting power slowly declines. Women's peak performance declines faster than men's peak performance. Women seem to reach their peak sooner than men and decline sooner than men. We also analyzed match attendance. At matches with a large number of competitors, there is a 1:1.7 ratio of women to men, approximately a 2-3 ratio of women to men. Except for the lightest weight category of men, the ratio of weight to lift decreases the more they weigh. For example, a lighter person can generally lift a greater percentage of their weight than a heavier person. In addition, men in general can lift a heavier ratio of their weight when compared with women. The powerlifting stereotype of mostly heavy men lifting extremely large amounts of weights is simply wrong. There is a large amount of variation in age, weight, and sex.

Distal clavicular osteolysis in adults: association with bench pressing intensity.

OBJECTIVES: To investigate the association between distal clavicular osteolysis (DCO) and bench pressing intensity. METHODS: From a retrospective review of MRI shoulder reports of individuals between 20 and 40 years of age, 262 male patients with DCO and 227 age-matched male patients without DCO were selected. All patients had completed a bench pressing questionnaire. The patients' bench pressing frequency (times per week), duration (years of bench pressing), bench pressing weight (maximum bench pressing weight with one repetition = 1RM) and the ratio of bench pressing weight to body weight were compared between both groups using Chi-square and Mann-Whitney tests. RESULTS: The results showed that 56 % (146/262) of patients with DCO were high-intensity bench pressers (1RM more than 1.5 times the body weight) compared to 6 % (14/227) in patients without DCO. High-intensity bench pressing was a risk factor for DCO (OR = 19; 95 %CI = 11-35; p < 0.001). Low-intensity bench pressing (1RM less than 1.5 times the body weight) was not a risk factor for DCO (OR = 0.6; 95 % CI = 0.4-0.8). High frequency (>1×/week) and duration (>5 years) of bench pressing were risk factors. In bench pressers who suffered from DCO, the mean 1RM was 283 lbs (±SD 57) compared to 209 lbs (±SD 60) in bench pressers not affected by DCO (p < 0.001, Mann-Whitney). CONCLUSIONS: High-intensity, but not low-intensity bench pressing is a risk factor for DCO.

Utilization of 2013 BRFSS Physical Activity Data for State Cancer Control Plan Objectives: Alabama Data.

OBJECTIVES: All comprehensive US cancer control plans mention physical activity and implement physical activity promotion objectives as part of these cancer plans. The purpose of this investigation was to describe the physical activities reported by Alabama adults in the 2013 Behavioral Risk Factor Surveillance System (BFRSS) and to compare these activities by age group and relative exercise intensity. METHODS: This investigation used data on 6503 respondents from the 2013 BRFSS sample of respondents from Alabama with landline and cellular telephones. Respondents were asked whether they engaged in any physical activities or aerobic exercises such as running, calisthenics, golf, gardening, or walking. Information was collected on strengthening activities such as yoga, sit-ups, push-ups, and using weight machines, free weights, and elastic bands. Relative exercise intensity was estimated for each aerobic activity by comparing the 60% maximal oxygen uptake with metabolic equivalent values. RESULTS: Approximately two-thirds (63.7%) of respondents reported that they engaged in exercise in the past 30 days; 45.4% participated in enough aerobic activity per week to meet guidelines, and 25.9% met the muscle-strengthening guidelines. Only 10.1% of respondents 65 years old and older met both aerobic and muscle-strengthening guidelines, compared with 15.2% of those 18 to 64 years old (P < 0.05). The most common activity reported for ages 18 to 64 years was walking (53.3%), followed by running (12.7%), and gardening (4.7%). Among adults aged 65 and older, the top three activities were walking (63.2%), gardening (13.3%), and use of a bicycle machine (2.9%). The activity intensity was significantly greater for walking, gardening, and household activities among older adults compared with those younger than age 65. CONCLUSIONS: Because the recommended levels of physical activity are not met by a majority of Alabama residents, it is important to incorporate this information into state cancer objectives. Older adults may have higher relative energy costs compared with younger adults. Future studies should discern whether activities previously classified as low intensity have adequate health benefits, especially for cancer survivors and older adults with comorbidities.

Frequency, imaging findings, risk factors, and long-term sequelae of distal clavicular osteolysis in young patients.

OBJECTIVE: Atraumatic distal clavicular osteolysis (DCO) has been described in adult male weightlifters. Our purpose was to investigate the frequency, magnetic resonance imaging (MRI) characteristics, risk factors, and long-term sequelae of DCO in young patients. MATERIALS AND METHODS: Individuals with atraumatic DCO were identified in a retrospective review of 1,432 consecutive MRI shoulder reports in patients between 13 and 19 years of age. MRI findings of DCO, association with athletic activity, short-term clinical outcome after 3-6 months, and long-term clinical and MRI outcome after 2 years were analyzed. A pre-MRI questionnaire assessed the patients' athletic history including overhead activity and weightlifting. RESULTS: At a mean age of 15.9 years, 6.5 % (93/1432) of patients had atraumatic DCO, and 24 % were females. The combination of an overhead sport (basketball, volleyball, tennis, swimming) and supplemental weight training was a risk factor for DCO (odds ratio = 38, p = 0.01). Ninety-three percent of patients responded to conservative therapy. On follow-up imaging, 71 % of DCO patients had acromioclavicular (AC) joint osteoarthritis (vs. 35 % in controls, p = 0.006); 79 % had flattening of the distal clavicle and interval widening of the AC joint to a mean of 5.0 mm (compared to 2.4 mm in controls, p < 0.001). Severity of DCO edema was associated with pain (p < 0.02) at initial presentation and with AC joint osteoarthritis (p = 0.004) on follow-up. CONCLUSION: In athletic teenagers, the combination of weightlifting and overhead activity is a risk factor for atraumatic DCO, and females are affected in 24 %. Long-term sequelae include widening of the AC joint and AC joint osteoarthritis.

Effects of set configuration of resistance exercise on perceived exertion.

Set configuration refers to the repetitions performed with regard to the maximum possible number of repetitions, a factor affecting RPE that has not been previously studied. This study analyzed the effect of set configuration and muscle mass on RPE. Eight students (M age = 23.7 yr. ± 1.7) completed four sessions corresponding to types of exercise with different amount of muscle mass (bench press and parallel squat) and two set configurations: a session with five sets of repetitions to failure and a cluster session. The cluster session involved the same intensity, volume, and rest than the failure session, guaranteeing the same work-to-rest ratio. RPE was higher in Failure vs Cluster sessions and higher in parallel squat vs bench press. This suggests that set configuration influences RPE. Similarly, RPE can be affected by the muscle mass of the exercise performed.