A focus on elite sport and exercise medicine

For those physiotherapists, doctors and physiologists working within elite sport and exercise medicine there is plenty to read. Aspetar’s Professor Sebastien Racinais et al broach the question as to whether athletes should be tested in the heat before a competition where the climate during the competition is likely to be hot ( see page700 ) . This is the first in a series of short tips in BJSM on preparing athletes for the heat ahead of Tokyo 2021. The answer seems to be an unequivocal yes! Training in the heat prior to a competition allows heat acclimatisation and improves athlete’s health and performance.

While you can’t watch football live as we write, we can discuss the medicine of elite football. Dr Alejandro López-Valencian, from the University Miguel Hernández in the beautiful Alicante region of Spain, shares his comprehensive systematic review and meta-analysis of the epidemiology of professional football. Using time loss from training or match play as the key outcome ( see page711 ) , the authors report the high incidence of injury among male professional football players and make a strong case for prevention strategies. This nicely leads on to the prospective study authored by Southampton’s First Team Sports Scientist Dr Laura Bowen and her team, which examines the relationship between the acute versus chronic workload ratio and injury rate ( see page731 ) . This has been a topic of much discussion! The authors suggest teams monitor workload carefully using this ratio aiming to prevent or minimise spikes.

BJSM has been the home for many papers by the world’s leading sports cardiologists. In this issue, you can read that the 2017 European Society of Cardiologists recommendations for ECG interpretation in adolescent white and black soccer players held up under careful scrutiny and appear to be more effective than previous methods of ECG interpretation ( see page739 ) .

BASEM supports BJSM in embracing the voice of patients. Read about the challenges faced by elite sportsmen and women when they retire from sport. Mr Patrick Dawson is brutally honest in his informative account of going from hero to zero in the sport of judo ( see page755) .

We are also experts in musculoskeletal medicine—not sport alone!

A major component of sport and exercise medicine–musculoskeletal medicine–is the bread and butter for the majority of our membership. Peripatetic professor Peter O’Sullivan et al give us their top 10 facts on back pain ( see page698) . Great value for those managing back pain such as sport and exercise medicine consultants, physiotherapists, GPs in sports medicine and exercise rehabilitation instructors.

Alongside back pain, osteoarthritis contributes substantially to the burden of disease in our community and if clinicians understand risk factors, we can educate and counsel those affected to better manage their condition. Sweden’s Dr Barbara Snoeker et al’s data ( see page725 ) illustrate the increased risk associated with specific structures that are affected in the label ‘acute knee injuries’. ACL injury provides twice as much risk as a meniscal injury for long-term knee osteoarthritis. Ouch! (We are sorry about that!)

Methodology & statistics

Also in this issue, we highlight statistics and research methods and how they influence results—and ultimately, how we practice ( see page750 ) . The quality of research within sport and exercise medicine and sports physiotherapy is increasing rapidly, and one reason for this is better data interpretation, more advanced methods and clearly stated hypotheses. All members of the multidisciplinary membership can learn from these papers that are written with us in mind.

Usually we would be promoting our annual conference, and as this issue goes to press, we fear that we have to postpone the planned BASEM 2020 conference. That should not stop our learning, and actually this type of event may strengthen us for the future—in ways such as our embracing video methods. Who has not become better at flipping between systems? As experts in physical activity, let’s all keep providing inventive and accessible ways to exercise when restricted at home. Exercise is even more critical at a time when people’s anxiety has escalated. Keeping with our UK highlights, here is Edinburgh’s professor Nanette Mutrie (@NanetteMutrie) on a free BJSM podcast: http://ow.ly/FosF50zbsxm. It is our duty to help the world with physical activity in the time of COVID-19.