Exertional heat illness can affect athletes during high-intensity or long-duration exercise and result in withdrawal from activity or collapse during or soon after activity. These maladies include exercise associated muscle cramping, heat exhaustion, or exertional heatstroke. While certain individuals are more prone to collapse from exhaustion in the heat (i.e., not acclimatized, using certain medications, dehydrated, or recently ill), exertional heatstroke (EHS) can affect seemingly healthy athletes even when the environment is relatively cool. EHS is defined as a rectal temperature greater than 40 degrees C accompanied by symptoms or signs of organ system failure, most frequently central nervous system dysfunction. Early recognition and rapid cooling can reduce both the morbidity and mortality associated with EHS. The clinical changes associated with EHS can be subtle and easy to miss if coaches, medical personnel, and athletes do not maintain a high level of awareness and monitor at-risk athletes closely. Fatigue and exhaustion during exercise occur more rapidly as heat stress increases and are the most common causes of withdrawal from activity in hot conditions. When athletes collapse from exhaustion in hot conditions, the term heat exhaustion is often applied. In some cases, rectal temperature is the only discernable difference between severe heat exhaustion and EHS in on-site evaluations. Heat exhaustion will generally resolve with symptomatic care and oral fluid support. Exercise associated muscle cramping can occur with exhaustive work in any temperature range, but appears to be more prevalent in hot and humid conditions. Muscle cramping usually responds to rest and replacement of fluid and salt (sodium). Prevention strategies are essential to reducing the incidence of EHS, heat exhaustion, and exercise associated muscle cramping.

Overall, caffeine ingestion improves MVC strength and muscular endurance. The effect on strength appears exclusively in the knee extensors, and the effect on muscular endurance appears only detectable with open end point tests.

Db measured with the BOD POD was higher than the criterion HW, thus yielding lower %fat scores for the BOD POD. In addition, BOD POD determined %fat was lower than DXA and 3C determined values in a subgroup of subjects. Assessment of %fat using the BOD POD is reliable and requires minimal technical expertise; however, in this study of collegiate football players, %fat values were underpredicted when compared to HW, DXA, and the 3C model.

Despite variability among studies, DEH impairs cognitive performance, particularly for tasks involving attention, executive function, and motor coordination when water deficits exceed 2% BML.

Training and nutrition are highly interrelated in that optimal adaptation to the demands of repeated training sessions typically requires a diet that can sustain muscle energy reserves. As nutrient stores (i.e. muscle and liver glycogen) play a predominant role in the performance of prolonged, intense, intermittent exercise typical of the patterns of soccer match-play, and in the replenishment of energy reserves for subsequent training sessions, the extent to which acutely altering substrate availability might modify the training impulse has been a key research area among exercise physiologists and sport nutritionists for several decades. Although the major perturbations to cellular homeostasis and muscle substrate stores occur during exercise, the activation of several major signalling pathways important for chronic training adaptations take place during the first few hours of recovery, returning to baseline values within 24 h after exercise. This has led to the paradigm that many chronic training adaptations are generated by the cumulative effects of the transient events that occur during recovery from each (acute) exercise bout. Evidence is accumulating that nutrient supplementation can serve as a potent modulator of many of the acute responses to both endurance and resistance training. In this article, we review the molecular and cellular events that occur in skeletal muscle during exercise and subsequent recovery, and the potential for nutrient supplementation (e.g. carbohydrate, fat, protein) to affect many of the adaptive responses to training.

This double-blind experiment examined the effects of a caffeinated sports drink during prolonged cycling in a warm environment. Sixteen highly trained cyclists completed 3 trials: placebo, carbohydrate-electrolyte sports drink (CES), and caffeinated sports drink (CES+CAF). Subjects cycled for 135 min, alternating between 60% and 75% VO2max every 15 min for the first 120 min, followed by a 15-min performance ride. Maximal voluntary (MVC) and electrically evoked contractile properties of the knee extensors were measured before and after cycling. Work completed during the performance ride was 15-23% greater for CES+CAF than for the other beverages. Ratings of perceived exertion were lower with CES+CAF than with placebo and CES. After cycling, the MVC strength loss was two-thirds less for CES+CAF than for the other beverages (5% vs. 15%). Data from the interpolated-twitch technique indicated that attenuated strength loss with CES+CAF was explained by reduced intrinsic muscle fatigue.

Post-exercise nutrition is critical to facilitate recovery from training. To determine if added protein (P) or increased carbohydrate (CHO) differentially improves recovery, eight runners ingested: 6% CHO (CHO6), 8% CHO + 2% protein (CHO-P), and isocaloric 10% CHO (CHO10) following a 21-km run plus treadmill run to fatigue (RTF) at 90% VO2max. RTF was repeated after 2 h recovery. After 24 h, a 5 km time trial was performed. Insulin and blood glucose were higher (P < 0.05) following CHO10 compared to CHO-P and CHO6, but did not affect improvement from the first to second RTF (29.6% +/- 6, 40.5% +/- 8.8, 40.5% +/- 14.5) or 5 km time (1100 +/- 36.3, 1110 +/- 37.3, 1118 +/- 36.5 s). CK was not different, but perceived soreness with CHO-P (2.1 +/- 0.5) was lower than CHO10 (5.2 +/- 0.7). Additional calories from CHO or P above that provided in sports drinks does not improve subsequent performance after recovery; but less soreness suggests benefits with CHO-P.

A prevailing theory (and practical application) is that elite performance requires early childhood skill development and training across various domains, including sport. Debate continues whether children specializing early (ie, training/competition in a single sport) have true advantage compared with those who sample various sports early and specialize in a single sport later (adolescence). Retrospective data and case studies suggest either model yields elite status depending upon the sport category (ie, situational: ball games, martial arts, fencing; quantitative: track and feld, swimming, skiing; or qualitative: gymnastics, diving, figure skating). However, potential risks of early specialization include greater attrition and adverse physical/emotional health outcomes. With the advent of the IOC Youth Olympic Games, increased emphasis on global youth competition has unknown implications but also represents a potential platform for investigation. Modification of youth competition formats should be based upon multidisciplinary research on psycho-physiological responses, and technical-tactical behaviors during competition. The assumption that a simple scaled-down approach of adult competitions facilitates the development of technical/tactical skills of youth athletes is not necessarily substantiated with field-based research. Relatively little evidence exists regarding the long-term effects of rigorous training and competitive schedules on children in specific sports. It is clear that more prospective studies are needed to understand the training dose that optimally develops adaptations in youth without inducing dropout, overtraining syndrome, and/or injury. Such an approach should be sport specific as well as gender based. Until such evidence exists, coaches and sport administrators will continue to rely upon their sport-specific dogma to influence programmatic development of our most vulnerable population.