Sports injury is a common problem in athletes’ training. The sports injury assessment model is a physical method to determine the sports injury attributes of specific parts by predicting and evaluating the risk of sports injury. In this paper, we use a neural network to realize big data analysis of sports injury data. Big data network is a method of capturing Internet information by means of cloud computing, which is usually (...) used in the construction of Wan and LAN. This paper analyzes the source of sports risk and the main injury factors, designs the sports injury estimation model based on big data analysis, establishes a new assessment model based on RBF neural network, and builds the big data network environment required for the model operation by improving the topological structure, combining big data and deep neural network. In the built environment, the risk assessment of sports injury can be completed by determining the risk source and identifying the risk factors. The realization of the model can be constrained by the uncertainty conditions so that it can achieve a good operation state. (shrink)

Disclosing the ontology of sports injuries by looking closer at their meaning provides us with insight into the professional ethics of the sports medicine specialist. The aim of this article is twofold: to disclose the “the ontology of sports injuries,” and to use the disclosure as an insightful perspective for dwelling on the ethics of sports medicine. Because of the unique nature of sports, the standard ethical prescriptions usually associated with medical ethics are of little (...) use for the sports medicine specialist in treating sport injuries. In spelling out the special ethical context of sports medicine, this paper suggests several distinctions. I propose several models, which provide different conceptions of what constitutes a sport injury: (1) The Medical Model; (2) The Normative Model; (3) The Liberal Model; (4) The Phenomenological Model. The implications of each of these models for sports medicine is assessed, and through them the concept of a sports injury is clarified in a way that can assist us in inferring what is to be done from an ethical point of view. (shrink)

The framing of the risks of experiencing mild traumatic brain injury in American football and ice hockey has an enormous impact in defining the scope of the problem and the remedies that are prioritized. According to the prevailing risk frame, an acceptable level of safety can be maintained in these contact sports through the application of technology, rule changes, and laws. An alternative frame acknowledging that these sports carry significant risks would produce very different ethical, political, and (...) social debates. (shrink)

In this paper, we explore the issue of the elimination of sports, or elements of sports, that present a high risk of brain injury. In particular, we critically examine two elements of Angelo Corlett’s and Pam Sailors’ arguments for the prohibition of football and Nicholas Dixon’s claim for the reformation of boxing to eliminate blows to the head based on the empirical assumption of an essential or causal connection between brain injuries incurred in football and the development (...) of a degenerative brain disease known as chronic traumatic encephalopathy ; and John Stuart Mill’s rejection of consensual domination. We present four arguments to contest the validity of Corlett, Dixon’s and Sailor’s positions. Specifically, we argue that certain autonomy-based arguments undermine paternalist arguments for reform; the nature of the goods people pursue in their lives might justify their foregoing future autonomy; Mill’s argument against consensual domination draws on ambiguous and arbitrary distinctions; the lack of consensus and empirical evidence regarding CTE arising from brain injuries in sport underdetermines calls for reform. We conclude that these proposals for reforming or eliminating sports with high risks of brain injuries are not well founded. (shrink)

Children in North America, some as young as eleven or twelve, routinely don helmets and pads and are trained to move at high-speed for the purpose of engaging in repeated full-body collisions with each other. The evidence suggests that the forces generated by such impacts are sufficient to cause traumatic brain injury among children. Moreover, there is only limited evidence supporting the efficacy of interventions typically used to reduce the risks of such hazards. What kind of risk assessment enables (...) such activities to be a relatively common feature of childhood in Canadian and American society?In order to understand this state of affairs, we must examine the particular risk frame under which such hazards are commonly assumed. Risk assessments are embedded in the cultures in which they are situated and must be evaluated in their social contexts. (shrink)

Head injuries are an inherent risk of participating in the major collision sports played in Australia. Protocols introduced by the governing bodies of these sports are ostensibly designed to improve player safety but do not prevent players suffering from repeated concussions. There is evidence that repeated traumatic brain injuries increase the risk of developing a number of long term problems but scientific and popular debates have largely focused on whether there is a causal link between concussion and chronic (...) traumatic encephalopathy. We argue that the governing bodies of collision sports played in Australia have used uncertainty about CTE to justify a “wait and see” approach instead of attempting to prevent repeated head injuries. This stance is difficult to defend when these governing bodies claim to give a high priority to protecting player welfare. (shrink)

After years of skepticism and denials regarding the significance of concussions in sport, the issue is now front and center. This is fitting, given that the impact of concussions in sport is profound. Thus, it is with trepidation that one ventures to direct some attention onto brain injuries other than concussions incurred through sport. Given a closer look, however, it may be that considering various kinds of brain injuries, with different causes, will help us better understand the range and seriousness (...) of brain injuries in sport. My focus is on emotional trauma in sport. I argue that severe emotional pathology is evidence of underlying brain injury. Any attempt to minimize the significance of emotional disturbance that results from emotional trauma as ‘merely’ psychological in nature is thus misguided. (shrink)

AimsSport specialization is an actual trend in youth athletes, but it can increase injury risk. The aim was to determine the eventual correlation between sports specialization and injury risk in various sports, using a biopsychosocial approach.Methods169 sport-specialized athletes completed [; overall,, ] a self-reported questionnaire regarding sociodemographic, physical-attitudinal, injuries and psychological-attitudinal To analyze data univariate and correlate analyses were used.ResultsOf 169 athletes enrolled, 53% were single-sport specialized. In team sports a high risk of having to (...) remain at rest for up to 1 month because of overuse was observed. Males who suffered direct trauma in the team group were more exposed to that type of injury, and also the type of specialization figured significantly. In addition, interoceptive awareness correlates with injury. This study shows that, even though young athletes seem to be at a high risk of becoming injured, early team sport specialization and a high performance level cannot be considered to be the only risk factors. (shrink)

Despite a growing body of research on the sociology of time and, analogously, on the sociology of sport, to date there has been relatively little sports literature that takes time as the focus of the analysis. Given the centrality of time as a feature of most sports, this would seem a curious lacuna. The primary aims of this article are to contribute new perspectives on the subjective experience of sporting injury and to analyze some of the temporal (...) dimensions of sporting “injury time” and subsequent rehabilitation. The article is based on data derived from a 2-year autoethnographic research project on 2 middle/long-distance runners, and concludes with some indicative comments regarding the need for sports physiotherapists and other health-care practitioners to take into account the subjective temporal dimension of injury and rehabilitative processes. (shrink)

Introduction: People with Spinal Cord Injury are at risk of feeling socially disconnected. Competitive esports present an opportunity for people with SCI to remotely engage in a community. The aim of this study is to discuss barriers to esports participation for people with SCI, present adaptive solutions to these problems, and analyze self-reported changes in social connection.Materials and Methods: We presented a descriptive data collected in the process of a quality improvement initiative at Mount Sinai Hospital. In 2019, seven (...) individuals with cervical SCI and quadriplegia participated in a special interest group on esports. Group scores were then analyzed for evidence of between subjects variability using a single sample t-test. A Pearson's correlation was conducted to determine the relationship between social connectedness and demographic data.Results: All players experienced functional limitations as a result of their injury but managed to design personalized gaming setups with adaptive equipment that allowed them to successfully compete in esports. All players reported a positive change in perceived social connectedness after participating in the special interest group. Score on Social Connectedness Scale negatively correlated with Time since injury.Discussion: It is feasible to create adaptive gaming setups that can be used by people with differing degrees and severity of SCI in a competitive esports environment. Technology and adaptive competitive esports have a potential to improve social connectedness and inclusion in people with quadriplegia. Further research on efficacy and effectiveness of these inclusive environments and their effects on quality of life, activity, and participation is warranted. (shrink)

The psychological factors influencing a return to sport has gained increased research attention. In the current investigation, we explored professional basketball players’ perceptions of the psychological factors facilitating a return to performance equal to or exceeding previous performance standards. We also sought to describe athletes’ experiences – both positive and negative – of returning to sport following injury recovery. Ten Italian professional male basketball players (age range 22-36 years), were retrospectively interviewed in relation to three time-periods: (1) from the (...) commencement of rehabilitation to their first official competition, (2) the first official competition, and (3) the six-months following the initial competition. Hierarchical content analysis of the data revealed numerous themes across the three time periods. In regards to Period 1, participants indicated that social support, investment in rehabilitation and training programs, coping skills and motivation were fundamental in reaching pre-injury performance levels. During their first official game (i.e. Period 2), athletes reported that realistic performance expectations, focusing on the performance, positive emotions, motivation, arousal and social support facilitated their return to sport. Athletes however, also described a predominance of factors that hindered their return to pre- injury levels (i.e., low confidence in personal abilities, decrements in skill execution and dysfunctional physical sensations). Moreover, participants typically described a substandard level of performance during their first competition back following injury. In recounting experiences during the six months following their first official game, basketballers reported improvements in skill execution and highlighted the importance of coping skills, motivation and social support. The process of restoring self-confidence in one’s ability to successfully perform was perceived as crucial in enabling participants to move beyond a mere return to sport to a return to high performance ─ that is, to reach a level of proficiency equal to or exceeding previous performance standards. Findings support the relevance of cognitive, emotional and behavioral responses highlighted in the Integrated Model and suggest the importance of addressing psychological factors throughout the return-to-sport process. Finally, results from the present study hold a number of practical implications for athletes’ aiming to achieve a return to pre-injury levels. (shrink)

Based upon a collaborative autoethnographic research project, this article explores from a sociological perspective the emotional dimension of the injured sporting body. It takes as its analytic focus the journey, rehabilitative, emotional and narrative, of two middle-aged, non-élite, middle/long-distance runners who encountered serious, long-term knee injuries. The paper examines in particular the interactional and narrative elements of the rehabilitative journey, focussing on dimensions of the emotion management, emotion work, and emotional intersubjectivity of the researcher/author and her training partner as they (...) struggled to contend with the liminality of the injured athletic role, and to maintain positive identities in the face of serious threat to their running selves. (shrink)

The Concussion in Sport Group guidelines have successfully brought the attention of brain injuries to the global medical and sport research communities, and has significantly impacted brain injury-related practices and rules of international sport. Despite being the global repository of state-of-the-art science, diagnostic tools and guides to clinical practice, the ensuing consensus statements remain the object of ethical and sociocultural criticism. The purpose of this paper is to bring to bear a broad range of multidisciplinary challenges to the processes (...) and products of sport-related concussion movement. We identify lacunae in scientific research and clinical guidance in relation to age, disability, gender and race. We also identify, through multidisciplinary and interdisciplinary analysis, a range of ethical problems resulting from conflicts of interest, processes of attributing expertise in sport-related concussion, unjustifiably narrow methodological control and insufficient athlete engagement in research and policy development. We argue that the sport and exercise medicine community need to augment the existing research and practice foci to understand these problems more holistically and, in turn, provide guidance and recommendations that help sport clinicians better care for brain-injured athletes. (shrink)

In recent years it has become increasingly the norm in football1 to kick the ball out of play when a player is, or appears to be, inadvertently injured. Kicking the ball out of play in football represents a particular instantiation of a generally understood fair play norm, the voluntary suspension of play (VSP). In the philosophical literature, support for the VSP norm is provided by John Russell (2007) who claims that his interpretivist account of sport is helpful for evaluating complex (...) moral issues in sport in general and issues related to injury in football in particular. This paper examines whether Russell's interpretivist-backed account of autonomy can adequately inform football players as to the nuanced and ambiguous moral considerations that arise in relation to the VSP norm. The paper goes on to identify the highly complex dynamic circumstances football players need to consider in order to better discharge their moral responsibilities when faced with inadvertent injuries. (shrink)

This article first summarizes research regarding the relationship between sports that intentionally structure multiple types of brain trauma into their practice, such as rugby and boxing, and the range of negative health outcomes that flow from participation in such sports. The resultant brain injuries are described as ‘now’ and ‘later’ diseases, being those that affect the child immediately and then across their lifetime. After highlighting how these sports can permanently injure children, it examines this harm in relation (...) to existing British laws and policies concerning child abuse. The conclusion drawn is that neither children nor adults on their behalf are legally able to give informed consent for participation, and that impact sport organisations effectively groom children into sustaining and accepting brain trauma. Adults providing brain-traumatizing versions of these sports are thus described as being complicit in a form of child abuse that we term brain abuse. The contradictions in existing sports policy are highlighted, where policy describes that children are to be protected from harm, and yet the very practice of such sports creates harm by design. Implications of the argument are that children should be prohibited from partaking in impact sports. (shrink)

It is generally accepted that we need more research into concussions and other injuries with potential long-term effects in sport because such research underpins effective, evidence-based prevention, management, support, and treatment. This paper provides an analysis of the obligations of sports federations to support and facilitate such research, as well as an analysis of the role active participants in the sport should have in the research process. The paper focuses on concussion and concussion research, though very similar arguments apply (...) to other common sports injuries with potential long-term effects. The paper argues that sports federations have a moral obligation and a prudential interest in initiating, facilitating, and funding concussion research. This follows from their duty of care towards active participants and from considerations of reciprocity. The ability to discharge these research obligations depends on the resources available to a particular federation, but those who can discharge them should do so. The paper further argues that athletes and other active participants in sport should be involved in all aspects of the concussion research process from conception to design, i.e. that Active Participant Involvement and Engagement (APIE) should be a non-negotiable element of concussion research projects. This is supported by instrumental reasons, but also by philosophical argument based on standpoint epistemology and on ethical arguments related to the interests of active participants. Standpoint epistemology is the epistemological position that the knowledge a person has and can have depends on that person’s standpoint in the world. Keywords: Concussion, funding, participant involvement, sport, sport association, sport federation. (shrink)

This paper describes how body regimes are effectuated in the prevailing treatment strategy of physiotherapy. The process of self‐mastering in the context of sports‐related injuries is highlighted. Through a Foucauldian perspective on body regimes the aim is to shed light on the process of individualization and self‐mastery in rehabilitation. The treatment of illness in the physiotherapy clinic does not characterize the patient as sick, and exempt the patient from daily duties and expectations. The empirical data include 17 qualitative illness (...) narratives and several years of fieldwork observing patients with anterior cruciate ligament (ACL) injuries in a physiotherapy clinic. The study demonstrates how the expectation that the patients be active and self‐mastering permeates the total process of treatment. The individual responsibility for personal well‐being is a recurrent phenomenon in public health services in general, and specifically prominent in the rehabilitation of sports injuries. (shrink)

The fatal on-field head injury and subsequent death in Sydney of 25-year-old professional cricketer Phillip Hughes has led to an exceptional outpouring of shock and grief throughout Australia, the cricketing world, and beyond. It was not just one more death. Not even the particular poignancy of a promising young life cut brutally short can account for the reaction.There were heartfelt tributes from players, prime ministers, and presidents. Parliament observed a minute’s silence. The Queen sent a private message to Hughes’s (...) parents. Schoolboy cricketers formed guards of honor and wore black armbands. One batsman paused as his run tally reached 63 to kiss his own black armband (63 was as far as Hughes got before his.. (shrink)

Professional sports with high rates of concussion have become increasingly concerned about the long-term effects of multiple head injuries. In this context, return-to-play decisions about concussion generate considerable ethical tensions for sports physicians. Team doctors clearly have an obligation to the welfare of their patient (the injured athlete) but they also have an obligation to their employer (the team), whose primary interest is typically success through winning. At times, a team’s interest in winning may not accord with the (...) welfare of an injured player, particularly when it comes to decisions about returning to play after injury. Australia’s two most popular professional football codes—rugby league and Australian Rules football—have adopted guidelines that prohibit concussed players from continuing to play on the same day. I suggest that conflicts of interest between doctors, patients, and teams may present a substantial obstacle to the proper adherence of concussion guidelines. Concussion management guidelines implemented by a sport’s governing body do not necessarily remove or resolve conflicts of interest in the doctor–patient–team triad. The instigation of a concussion exclusion rule appears to add a fourth party to this triad (the National Rugby League or the Australian Football League). In some instances, when conflicts of interest among stakeholders are ignored or insufficiently managed, they may facilitate attempts at circumventing concussion management guidelines to the detriment of player welfare. (shrink)

All around the world in March, due to COVID-19, competitive sport calendars were suddenly canceled, jeopardizing the training programs of athletes. Moreover, in Italy, the government banned all non-essential travel across the entire country from the beginning of March. Consequently, Italian cyclists were banned from leaving their homes and therefore unable to perform their ordinary training activities. The Italian Association of Professional Cyclists early on during that period noticed that several cyclists were experiencing a worrying decrease in their mental well-being (...) and asked the authors to set up an online Sport Psychology Intervention during lockdown to enhance the athletes' mental health. Through a number of unprecedented events and considerations, the aim of the current investigation was to assess the Italian cyclists' mental health during the lockdown and its changes after the SPI. We validated the Italian version of the Sport Mental Health Continuum Short Form —presented in Study 1—and then applied it to a sample of Italian professional cyclists—presented in Study 2—prior to and after the SPI. To achieve these objectives, the reliability and construct validity of the Italian version of the Sport MHC-SF were tested in Study 1. RM-MANOVA tests were run to evaluate the effect of SPI on cyclists in Study 2. A total of 185 Italian athletes were involved in the validation of the MHC in Study 1 and 38 professional cyclists in Study 2. Results from Study 1 suggested a three-factor higher order model of Sport MHC-SF [Model fit: χ2 = 471.252, p < 0.000; CFI = 0.951; RMSEA = 0.049; RMR= 0.048]. MCFA showed that the default model kept invariance among groups of athletes. Results from Study 2 highlighted that professional cyclists who followed the SPI were able to cope better with psychological stressors, showing improved well-being compared to the athletes that did not. No significant differences were found for emotional and social well-being. The present multi-study paper contributes to the theoretical field with a validated measure of Sport MHC-SF translated in the Italian language and culture. It also provides practical implications related to cases of reduced mental health due to injury, illness, or similar situations of home confinement in the future. (shrink)

Until recently, the problem of traumatic brain injury in sports and the problem of performance enhancement via hormone replacement have not been seen as related issues. However, recent evidence suggests that these two problems may actually interact in complex and previously underappreciated ways. A body of recent research has shown that traumatic brain injuries, at all ranges of severity, have a negative effect upon pituitary function, which results in diminished levels of several endogenous hormones, such as growth hormone (...) and gonadotropin. This is a cause for concern for many popular sports that have high rates of concussion, a mild form of TBI. Emerging research suggests that hormone replacement therapy is an effective treatment for TBI-related hormone deficiency. However, many athletic organizations ban or severely limit the use of hormone replacing substances because many athletes seek to use them solely for the purposes of performance enhancement. Nevertheless, in the light of the research linking traumatic brain injury to hypopituitarism, this paper argues that athletic organizations’ policies and attitudes towards hormone replacement therapy should change. We defend two claims. First, because of the connection between TBI and pituitary function, it is likely many more athletes than previously acknowledged suffer from hormone deficiency and thus could benefit from hormone replacement therapy. Second, athletes’ hormone levels should be tested more rigorously and frequently with an emphasis on monitoring TBI and TBI-related issues, rather than simply monitoring policy violations. (shrink)

Through the overall situation of athletes’ competition pressure, the pressure level of participating athletes can be understood and revealed. Analyzing the sources of stress and influencing factors of athletes can find measures to relieve and reduce stress and provide theoretical reference for the regulation of athletes’ competition pressure. Based on genetic algorithm and neural network theory, this paper proposes a method of tracing the sports competition pressure based on genetic algorithm backpropagation neural network to solve the problem that traditional (...) neural network learning algorithm is slow and easy to fall into local minimum. There is no significant difference between male and female athletes in the level of competition pressure. Athletes have the same training methods and the same goals, and the competition pressure tends to be the same, with no obvious difference; athletes with different educational backgrounds have no significant differences in training, academics, sports injuries, interpersonal relationships, social expectations, and evaluations. Due to the particularity of the stage, the competition pressure of fourth-year undergraduate and third-year masters is significantly higher than that of other grades. The number of athletes participating in college table tennis tournaments has very significant differences in competition dimensions. There is significant difference in training and self-expectation dimension difference. The competition pressure of athletes who participated in the college table tennis championship for the first time was significantly higher than that of athletes who participated repeatedly. There were significant differences between athletes before and after adapting to the venue. Before adapting to the venue, the competition pressure of athletes is generally greater. After adapting to the venue, the competition pressure of athletes has been relieved. (shrink)

While provisions of youth sports concussion laws are very similar, little is known as to how they are being implemented, factors that promote or impede implementation, or the level of compliance in each jurisdiction. We aimed to describe state experiences with implementation in order to inform ongoing efforts to reduce the harm of sports-related traumatic brain injury and to guide future evaluations of the laws’ impacts and the development of future public health laws. We conducted key-informant interviews (...) in 35 states with recently enacted concussion legislation. States varied considerably in their readiness and capacity for implementation. Factors facilitating implementation included existing partnerships, procedures, and resources; centralized implementation authority; prior related efforts; and involvement in the policymaking process by those now charged with implementation. Inhibitors included ambiguous statutory language, unclear delegation of authority, and compliance difficulties. Ongoing challenges persist, including primary prevention; determining which providers are qualified to make return-to-play assessments and contents of those assessments; compliance difficulties in rural and under-served areas; and unclear responsibility for enforcement. Despite the similarity of youth sports concussion laws, early evidence suggests there is considerable variation in their implementation. These findings are critical for ongoing empirical investigations to accurately evaluate the laws’ provisions and to identify successful legal approaches to protecting young athletes. (shrink)

Returning to sport after the sports injury is a difficult decision because it’s multicausal and the fact that a rash decision can result in numerous negative consequences. Given the importance of psychological variables for the correct rehabilitation of the injured athlete and his or her optimal return to sports practice, there seems to be little information on this subject. In this sense, the objective is to determine the relationship between the subjective psychological disposition of the athlete in (...) the process of Return to Play with the type of mood profile and his mental health. This is based on the fact that each athlete evaluates his or her recovery differently and has different levels of anxiety, depression, and stress. For this purpose, four athletes participated in the study. Two males and two females from the sports of indoor soccer and soccer, who had just returned to sports after a moderate or severe injury. The average age was 24.25 years. Various measurements were taken after practices and after matches, to assess mood, psychological readiness, anxiety, stress, and depression. The results confirm Morgan’s iceberg profile and the influence that subjective psychological perceptions and assessed emotional states have on athletes’ incorporation into their sports practice with a guarantee of success. (shrink)

Over the past decade, a flurry of media stories devoted to sports-related concussions have drawn attention to the previously “silent epidemic” of traumatic brain injury in athletes. From 2001 to 2009, the annual number of sports-related TBI emergency department visits in individuals age 19 and under climbed from 153,375 to 248,414, an increase of increase of 62 percent. Multiple head injuries place youth athletes at risk for serious health conditions, including cerebral swelling, brain herniation, and even death (...) — postconcussive conditions that have collectively been referred to as “second impact syndrome.” Studies have shown that children and teens — and girls, in particular — are more likely to sustain a concussion and have a longer recovery time than adults. Recent research also suggests that even subconcussive hits in children and adolescents may result in longer-term health effects such as decreased cognitive functioning, increased rates of depression, memory problems, and mild cognitive impairment. (shrink)

Every year millions of people suffer minor brain injuries, many of which occur in collision sports. While there has been substantial commentary and debate about the nature of this public health crisis, it is clear that the scientific and clinical arguments reflect values preferences and judgments that are often invisible in documents which combine artful language with undue focus paid to sources of uncertainty at the cost of clarity and transparency. This essay gives a brief history of these patterns (...) and proposes a remedy. (shrink)

This study investigated potential risk factors (coping, perfectionism and self-regulation) for substantial injuries in contemporary dance students using a prospective cohort design, as high-quality studies focusing on mental risk factors for dance injuries are lacking. Student characteristics (age, sex, BMI, educational program and history of injury) and psychological constructs (coping, perfectionism and self-regulation) were assessed using the Performing artist and Athlete Health Monitor (PAHM), a web-based system. Substantial injuries were measured with the Oslo Sports Trauma Research Center (OSTRC) (...) Questionnaire on Health Problems and recorded on a monthly basis as part of the PAHM system. Univariate and multivariate logistic regression analyses were conducted to test the associations between potential risk factors (i.e. student characteristics and psychological constructs) and substantial injuries. 99 students were included in the analyses. During the academic year 2016-2017, 48 students (48.5%) reported at least one substantial injury. Of all factors included, coping skills (OR: 0.91; 95% CI: 0.84–0.98), age (OR: 0.67; 95% CI: 0.46–0.98) and BMI (OR: 1.38; 95% CI: 1.05–1.80) were identified as significant risk factors in the multivariate analysis. The model explained 24% of the variance in the substantial injury group. Further prospective research into mental risk factors for dance injuries with larger samples sizes is needed to develop preventive strategies. Yet, dance schools could consider including coping skills training as part of injury prevention programs and, perhaps, providing special attention to younger dancers and those with a higher BMI through transitional programs to assist them in managing the stress they experience throughout their (academic) career. (shrink)

Abstract:Patients with repeated minor head injury are a challenge to our clinical skills of neurodiagnosis because the relevant evidence objectively demonstrating their impairment was collected in New Zealand (although published in theBMJandLancet) and, at the time, was mired in controversy. The effects of repeated closed diffuse head injury are increasingly recognized worldwide, but now suffer from the relentless advance of imaging technology as the dominant form of neurodiagnosis and the considerable financial interests that underpin the refusal to recognize (...) that acute accelerational injury is the most subtle and insidiously damaging (especially when seen in the light of biopsychosocial medicine), and potentially one of the most financially momentous (given the large incomes impacted and needing compensation) phenomena in modern sports medicine. The vested interests in downplaying this phenomenon are considerable and concentrated in North America where diffuse head injury is a widespread feature of the dominant winter sports code: Gridiron or American Rules football. The relationship of this to shattered lives among the brightest and best of young men and the relatively dated objective evidence are a toxic mix in terms of ethical analysis and, therefore, there is a malignant confluence of social forces that tends toward minimizing the injury. (shrink)

In this article, I will examine the role of risk in the risky nature sports. Risky nature sports are identified as nature sports where participants may reckon with the possibility of severe injury or death if things go wrong. The first part of the article identifies some evolutionary, historical, and conceptual characteristics of nature sports and risk. In the second part of the article, I discuss the concept of risk and its meaning in risky nature (...) sports. Additionally, I address questions concerning the moral tone and context of risk-taking. In most academic disciplines, risk is typically understood as something negative that should always be avoided. But risk also includes positive possibilities, which may, such as in risk sports, outweigh the negative or can even be inherently positive and a value in itself. In the third part, I discuss how important risk is in nature sports. Is it a defining core or more peripheral? This leads to the question of the value. Does the risk element add to the value of the sport? I finally discuss how risk sports can be meaningful parts of the participants’ lives. (shrink)

Concussion and Mild Traumatic Brain Injury affect millions of people worldwide. mTBI has been called the “signature injury” of the recent conflicts in Iraq and Afghanistan, affecting thousands of active duty service men and women, and veterans. Sport-related concussion represents a significant public health problem, with elite and professional athletes, and millions of youth and amateur athletes worldwide suffering concussions annually. These brain injuries have received scant attention from neuroethicists, and the focus of this special issue is on (...) defining the ethical considerations and developing and elucidating the neuroethical contributions to the discussion about concussion and mTBI. (shrink)

Several studies have shown that physical exercise improves behavior and cognitive functioning, reducing the risk of various neurological diseases, protecting the brain from the detrimental effects of aging, facilitating body recovery after injuries, and enhancing self-efficacy and self-esteem. Emotion processing and regulation abilities are also widely acknowledged to be key to success in sports. In this study, we aim to prove that regular participation in sports enhances cognitive and emotional functioning in healthy individuals. A sample of 60 students, (...) divided into sportive and sedentary, were subjected to a neuropsychological tests battery to assess their overall cognitive abilities, verbal and graphic fluency, as well as their emotional awareness skills. Our results showed that sportive students performed better than sedentary ones in all cognitive tasks. Regarding emotional processing abilities, significant differences were found in the TAS-20 total score as well as in the Difficulty Describing Feelings subscale and the Difficulty Identifying Feeling subscale. Lastly, gender differences were found in the External-Oriented Thinking subscale. Overall, our findings evidence that PE has positive effects on cognitive functioning and emotion regulation, suggesting how sports practice can promote mental health and wellbeing. (shrink)

The therapy/enhancement distinction is a controversial one in the philosophy of medicine, yet the idea of enhancement is rarely if ever questioned as a proper goal of sports medicine. This opens up latitude to those who may seek to use elite sport as a vehicle of legitimation for their nature-transcending ideology. Given recent claims by transhumanists to develop our human nature and powers with the aid of biotechnology, I sketch out two interpretations of the myth of Prometheus, in Hesiod (...) and Aeschylus, which can help frame the moral limits of sports medicine. By way of conclusion I assemble some banal reminders: We are mortal beings; our vulnerability to disease, injury and the waning of our powers, far from something we can overcome or eliminate, represent natural limits both for morality and medicine generally and sports medicine in particular. (shrink)

Magnetic resonance imaging (MRI) can provide a number of measurements relevant to sport-related concussion (SRC) symptoms; however, most studies to date have used a single MRI modality and whole-brain exploratory analyses in attempts to localize concussion injury. This has resulted in highly variable findings across studies due to wide ranging symptomology, severity and nature of injury within studies. A multimodal MRI, symptom-guided region-of-interest (ROI) approach is likely to yield more consistent results. The functions of the cerebellum and basal (...) ganglia transcend many common concussion symptoms, and thus these regions, plus the white matter tracts that connect or project from them, constitute plausible ROIs for MRI analysis. We performed diffusion tensor imaging (DTI), resting-state functional MRI, quantitative susceptibility mapping (QSM), and cerebral blood flow (CBF) imaging using arterial spin labeling (ASL), in youth aged 12-18 years following SRC, with a focus on the cerebellum, basal ganglia and white matter tracts. Compared to controls similar in age, sex and sport (N = 20), recent SRC youth (N = 29; MRI at 8 ± 3 days post injury) exhibited increased susceptibility in the cerebellum (p = 0.032), decreased functional connectivity between the caudate and each of the pallidum (p = 0.035) and thalamus (p = 0.021), and decreased diffusivity in the mid-posterior corpus callosum (p < 0.038); no changes were observed in recovered asymptomatic youth (N = 16; 41 ± 16 days post injury). For recent symptomatic-only SRC youth (N = 24), symptom severity was associated with increased susceptibility in the superior cerebellar peduncles (p = 0.011) and reduced activity in the cerebellum (p = 0.013). Fewer days between injury and MRI were associated with reduced cerebellar-parietal functional connectivity (p < 0.014), reduced activity of the pallidum (p = 0.002), increased CBF in the caudate (p = 0.005), and reduced diffusivity in the central corpus callosum (p < 0.05). Youth SRC is associated with acute cerebellar inflammation accompanied by reduced cerebellar activity and cerebellar-parietal connectivity, as well as structural changes of the middle regions of the corpus callosum accompanied by functional changes of the caudate, all of which resolve with recovery. Early MRI post-injury is important to establish objective MRI-based indicators for concussion diagnosis, recovery assessment and prediction of outcome. (shrink)

Research suggests that extensive training is necessary for the development of sporting expertise. Research also suggests that extensive training can lead to overuse injuries. The aims of this paper are to: expand the concept of expertise in high performance sport, and contribute to the discussion of how high performance athletes move towards expert performance in sustainable ways. To achieve these aims, data from retrospective interviews with four Olympians from four different sports are presented. As a way of extending traditional (...) approaches, a pedagogical framework focusing on dispositional learning is employed to examine athletic development. The notion of threshold concepts is used as a specific analytic tool for thinking about how athletes come to make sense of their sporting environments. Interpretations of the data provide insights into the nature of thresholds in high performance sport, factors that facilitate threshold crossing, and factors that may prevent athletes from making advances, all of which have implications for practitioners interested in developing expertise. (shrink)

Only too often critical realist contributions to understanding and explaining social phenomena fall into one of two discrete categories: exercises in philosophy or social theory, or empirical research that strikes as more or less atheoretical. This paper continues a long-term project to build bridges between abstruse issues of philosophy and theory and attempts to grasp the ‘how’ and ‘why’ of actual social events. The topic selected is elite professional rugby union and the principal theme is its emergence as an extreme (...) sport and the risk of serious injury. It is argued that the injurious nature of elite rugby has its causal genesis in the professionalization of the sport and that a critical realist-oriented sociology has an important contribution to make in framing and gasping how and why this is. (shrink)

The South Korean elite sport system is facing a wide range of problems that account for the high dropout rate among college student-athletes. However, research on dropout rates of student-athletes is so far been limited, which amplifies the actual voices of this group, their dropout experiences, and their challenges, while they were in the career transition process. Therefore, this study used a critical phenomenological approach as a primary methodological lens to gather information on 15 formal Korean male college student-athletes on (...) dropping out of team sports, exploring their life challenges during their career transitions out of the sport. The result showed two main thematic categories with sub-themes, which include factors affecting burning out and terminating athletic careers: injury and failure of rehabilitation and bullying and abandonment; and factors hindering post-retirement career advancement: prejudice and exclusion and absence of mentors and counselors. This study used Social Cognitive Career Theory to explore the participants' progression through specific interventions that engage and empower. Overall, the current study calls upon researchers, counselors, and administrators to continue exploring advocacy efforts with this population to alter policy and practice. (shrink)

Comparative judgments abound in sports. Fans and pundits bandy about which of two players or teams is bigger, faster, stronger, more talented, less injury prone, more reliable, safer to bet on, riskier to trade for, and so on. Arguably, of most interest are judgments of a coarser type: which of two players or teams is, all-things-considered, just plain better? Conventionally, it is accepted that such comparisons can be appropriately captured and expressed by sports rankings. Rankings play an (...) important role in sports arguably because of the conventional acceptance that rankings capture and express all-things-considered relations between the ranked teams or players. Standard ranking practices rely on a number of widely held assumptions. I discuss three of the most important and argue that at least one of them must be false. If this is right, the strong and growing commitment to using rankings to determine participation in tournaments and the awarding of championships is mistaken. At the least, given the con... (shrink)

Comparative judgments abound in sports. Fans and pundits bandy about which of two players or teams is bigger, faster, stronger, more talented, less injury prone, more reliable, safer to bet on, riskier to trade for, and so on. Arguably, of most interest are judgments of a coarser type: which of two players or teams is, all-things-considered, just plain better? Conventionally, it is accepted that such comparisons can be appropriately captured and expressed by sports rankings. Rankings play an (...) important role in sports arguably because of the conventional acceptance that rankings capture and express all-things-considered relations between the ranked teams or players. Standard ranking practices rely on a number of widely held assumptions. I discuss three of the most important and argue that at least one of them must be false. If this is right, the strong and growing commitment to using rankings to determine participation in tournaments and the awarding of championships is mistaken. At the least, given the conventional wisdom about rankings, my argument provides good reasons to be skeptical that any particular ranking ‘gets it right’. At the limit, it suggests that our most basic assumptions about all-things-considered athletic quality are wrong. (shrink)

Freudian psychoanalysis offers us often neglected but unique and very fruitful possibilities for an original interpretation of sport. In this article we first look at some basic Freudian concepts, such as the role of sexuality, the unconscious and dreams. In doing so, it becomes clear that sport can and should be interpreted in a similar way to Freud’s interpretation of dreams. Just as dreams need to be decoded and interpreted, sport needs to be decoded and interpreted in order to understand (...) it. On this basis, we then build a system for understanding sport that also incorporates the other important concepts of Freud’s psychoanalysis. The concepts of repression, symptom formation and the role of symbols prove to be particularly relevant for understanding sport. Decoding symbols in sport (e.g. scoring a goal) shows us that sport is a derivative of the libido and has an unconscious sexual structure. Unveiling the hidden unconscious sexuality of sport shows us that (male) sport was created for the sake of women, so that men (as winners) could gain a privileged status in female desire. Sport turns out to be a symbolic substitute for the satisfaction of human sexual needs. However, to better understand the competitive nature of sport, one must include the Oedipus and castration complex. It is castration anxiety that drives sporting competition. Victory is symbolically linked to the castration of the opponent. Next we turn to Freud’s concept of transference. It helps us to understand the complexity of the relationship between the athlete and the coach. This has a strong influence on athletic success. When things do not go as planned for an athlete and unexpected injuries occur, Freud’s concept of ‘advantage through illness’ can help us understand the athlete’s ‘escape into injury’. (shrink)

Lower extremity non-contact soft tissue injuries are prevalent in elite futsal. The purpose of this study was to develop robust screening models based on pre-season measures obtained from questionnaires and field-based tests to prospectively predict LE-ST injuries after having applied a range of supervised Machine Learning techniques. One hundred and thirty-nine elite futsal players underwent a pre-season screening evaluation that included individual characteristics; measures related to sleep quality, athlete burnout, psychological characteristics related to sport performance and self-reported perception of chronic (...) ankle instability. A number of neuromuscular performance measures obtained through three field-based tests [isometric hip strength, dynamic postural control and lower extremity joints range of motion ] were also recorded. Injury incidence was monitored over one competitive season. There were 25 LE-ST injuries. Only those groups of measures from two of the field-based tests, as independent data sets, were able to build robust models [area under the receiver operating characteristic curve score ≥0.7] to identify elite futsal players at risk of sustaining a LE-ST injury. Unlike the measures obtained from the five questionnaires selected, the neuromuscular performance measures did build robust prediction models. The inclusion in the same data set of the measures recorded from all the questionnaires and field-based tests did not result in models with significantly higher performance scores. The model generated by the UnderBagging technique with a cost-sensitive SMO as the base classifier and using only four ROM measures reported the best prediction performance scores. The models developed might help coaches, physical trainers and medical practitioners in the decision-making process for injury prevention in futsal. (shrink)

Mass participation sport events have become a popular form of recreational sport participation. Understanding experiences of participants is pivotal to designing and implementing socially just and sustainable events. Applying constructivist grounded theory methodology, this inquiry explored experiences of participation in MPSEs, with particular attention to the impact of gender on participation experiences. In-depth interviews were conducted with 13 women who participated in MPSEs. Fear and power were two core themes in interviewees’ experiences. Fear of sexual assault, injury, and “something (...) bad” was a significant element in women’s experiences which related to perceptions of place and time. The second theme, power, was generated from strong sport identities, camaraderie among female runners, all-women races, and finishing mixed-gender races. The findings provide some guidelines for practitioners to enhance experiences of female participants and encourage repeated participation that is key to sustainability of the events. (shrink)

Competitive sport is not governed by luck egalitarianism. Luck egalitarianism is intended to minimise or prevent all inequalities that arise from luck, as these inequalities are judged to be unjust. Sigmund Loland1 correctly notes that there are elements of luck egalitarian practice in sports: competitors must run the same distances, use the same equipment and so on. However, these measures of standardisation do not level the playing field, because competitors are at liberty to use as much money as they (...) can to further their own chances of success. They may buy the best equipment they or their sponsors can afford; they may spend money to access world-class training facilities; they may employ the most expensive coaches, physiotherapists and nutritionists; they may use personal wealth to minimise the need to earn money and maximise training time. Differences in wealth lead to enormous inequalities between competitors, and these differences largely come down to the luck of their position in various socioeconomic hierarchies. Every sportsperson is affected by socioeconomic luck. Luck plays a role in other ways, too: an archer’s shot is affected by a gust of wind; an athlete’s hopes are dashed by injury; a team’s path through a tournament depends on the initial draw. For a luck egalitarian, …. (shrink)

Competitive athletes act within cultures of risk in sports and often decide to return to sport despite having acute health problems. The outcomes of such risky return-to-play decisions can not only negatively affect their future health, but also limit their sports performance or even upset their career paths. Following risk-management-decision theory with its focus on active risk defusing, we developed a model for understanding the process of return-to-play decision making from an athlete’s perspective. Based on the method of (...) active information search, a quasi-naturalistic return-to-play decision scenario was created in order to assess amateur team sport athletes’ decision making strategies. The main goals were to identify different information acquisition patterns and to analyze the influence of social pressure to play hurt on decision making. A total of 72 competitive team sport athletes (36 females, 36 males, m= 25.7 years of age, 3rd to 6th league level) out of three disciplines (volleyball, basketball, and handball) participated in the experimental study. Facing the same medical scenario (a partial tear of the supraspinatus tendon), athletes show different approaches to return-to-play decision making. The main focus is on potential sporting consequences of withdrawal from competition due to injury, while only few players favoring well-informed decisions based on thorough risk analysis. The athletes who chose the medically risky alternative to play hurt mostly employed strategies of active risk defusing, which got activated when severe sporting consequences were perceived. Those who chose to withdraw from competition primarily referred to maximin heuristic, particularly when social pressure to play was reduced. The findings can be used to improve rehabilitation. (shrink)

Academic scholarship has steadily reported unfavourable clinical findings on the sport of boxing, and national medical bodies have issued calls for restrictions on the sport. Yet, the positions taken on boxing by medical bodies have been subject to serious discussions. Beyond the medical and legal writings, there is also literature referring to the social and cultural features of boxing as ethically significant. However, what is missing in the bioethical literature is an understanding of the boxers themselves. This is apart from (...) their brain injuries, the debates about the degenerative brain disease known as chronic traumatic encephalopathy, and related issues about the disease. This article argues that the lives of boxers, their relationships, their careers, and their futures, also requires its own research, particularly in telling stories about their lives, and those lives and futures which boxing affects. The article uses two approaches. First, to imagine a more enduring “whole of life viewpoint” by using an extended future timeframe. Second, to consider perspectives of a person’s significant others. After reviewing the boxing literature, the article discusses social settings and then explores the hidden social relationships in life after boxing. With these longer time and close relationship viewpoints, three important themes emerge: family and kinship; age, stage and career; and the effects of boxing fatalities. These analyses are used in conjunction with relevant clinical findings. which complement the telling of stories to improve medical information, and engages professional and public empathy for people’s experience of illness and difficulties in coping. (shrink)

BackgroundAn injury followed by surgery poses many challenges to an athlete, one of which is rehabilitation, with the goal of returning to sport. While total restoration of physical abilities is a primary goal for most athletes, psychosocial factors also play an important role in the success of an athlete's return to sport. The purpose of this review was to examine the effectiveness of exercise and psychosocial interventions on RTS rates, which might be one of the most important outcomes for (...) elite athletes.MethodsTo carry out this review, PubMed, SAGE Journals, Web of Science, SPORTDiscus, ScienceDirect, and Google Scholar databases were searched from inception to July 2022. The inclusion criteria consisted exercise or psychosocial intervention for athletes after anterior cruciate ligament reconstruction, with reporting RTS rates as an outcome.ResultsFrom 1032 identified articles, four reports met inclusion criteria, all of which examined the recovery after ACLR. The mean MINORS score for the included studies was 16.3 ± 6.1, of which non-comparative studies scored 11.0 ± 1.4, while comparative studies scored 21.5 ± 0.7. There were consistent findings for benefits of exercise and psychosocial interventions on RTS rates. Return to preinjury rates in the reviewed studies vary between 63 and 95% with lower % observed in female athletes and with shorter follow-up. Interventional studies reporting RTS rates with a larger sample size and longer follow-up are needed.ConclusionPhysical and psychological function, as well as social support can be influenced by appropriate interventions, indicating future work on rehabilitation programs for return to preinjury might consider taking the holistic approach addressing those. (shrink)