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Testosterone boosters (TB) are multi-ingredient dietary supplements that have gained popularity among athletes and the general population. However, certain ingredients in TB are associated with adverse events. The aim of the present study was to analyze dietary TB supplements available for sale online on shop.bodybuilding.com and amazon.com in ten distribution area markets. We evaluated the top five best-selling TB and the most frequently used ingredients of 50 selected TB and the evidence for their efficacy and safety, as well as legislation, statements in the European Union (EU) and sports organizations such as International Olympic Committee (IOC), International Society of Sports Nutrition (ISSN), Australian Institute of Sport (AIS) and World Anti- Doping Agency (WADA). Among 50 TB, 361 components and 98 ingredients were identified. The following ingredients were included in the final review: fenugreek, D- aspartic acid (DAA), 3,3′-diindolylmethane (DIM) or indole-3-carbinol (I3C), Eurycoma longifolia, Cordyceps spp., and ecdysteroids. In EU an authorized health claims refer to few ingredients in TB, mainly minerals, vitamins. Some ingredients were recognized by international sports organizations such as the ISSN, AIS, and WADA and some were identified as unauthorized ingredients/novel food in the EU. Selected ingredients can possibly increase the risk of endocrine system dysregulation. [ABSTRACT FROM AUTHOR]

Evaluating anti-doping measures is essential to optimise their effectiveness. Comparing sporting results that have a higher doping prevalence, such as weightlifting, before and after the implementation of anti-doping measures may serve as an effectiveness indicator. The results of the most successful weightlifters of both sexes in two time periods, 2009–2015 and 2016–2022 were analysed. The Sinclair Total (ST) to compare the relative strength of weightlifters from different weight categories was calculated. A significant decrease in the ST during 2016–2022 (p < 0.001) in athletes of all ages and both sexes overall was reported. When analysed by age, there was a decrease in ST in juniors and seniors of both sexes (p = 0.010 and p < 0.001, respectively), but not in youth. There was a decrease in the ST in senior men (p < 0.001), junior women (p < 0.001) and senior women (p < 0.001). In elite weightlifting, adult athletic results declined during 2016–2022, which may partly be explained by the implementation of new methods to detect long-term anabolic androgenic steroid metabolites as well as other policies. This may highlight the effectiveness of these methods both in the prevention and detection of anti-doping rule violations. [ABSTRACT FROM AUTHOR]

The aim of the study was to compare the status of somatic maturity, anthropometry, strength, speed, and soccer-specific technical skills of players from leading youth soccer academies born in different quarters of the same calendar year. A total of 678 young male soccer players from eight leading Russian soccer academies took part in the study. The following anthropometric measures and physical characteristics were measured: height, weight, body mass index, countermovement jumps (CMJ), 5, 10, and 20 m sprints, speed dribbling, foot and body ball juggling, and short and long pass accuracy. The determination of somatic maturity as a percentage of projected adult height was collected. All subject dates of birth were divided into four quartiles according to the month of birth. The analysis of all data obtained was conducted both within the total sample and by quartiles of birth, according to the age group categories of 12–13 years, 14–15 years, and 16–17 years and the degree of somatic maturity. There was a widespread relative age effect, with 43.5% of early-born players and only 9.6% of late-born players representing the sample. Early-born players were more mature than late-born players (p < 0.001 and p < 0.001) but had no statistically significant differences in strength, speed, or soccer-specific skills. [ABSTRACT FROM AUTHOR]

Studies examining the effects of new anti‐doping measures on sports performance in elite athletes are scarce. During the last decade, a number of new anti‐doping methods for the detection of anabolic androgenic steroids were developed. We hypothesized that the implementation of these methods may cause a decrease of performance in athletic disciplines where given substances are widely used. For this purpose, the performance results for 10 athletic disciplines from country (Country A), which was widely accused of systematic doping use, were gathered and pooled into the 2012–2015 and 2016–2019 periods. These periods were seen as before and following the implementation periods, where the effects of new anti‐doping methods could be manifested. Also, the performance results of their rival athletes from Country B were analyzed for comparison. The incidence of anti‐doping rule violations for both countries was followed. The analysis revealed a decrease in performance results of Country A athletes in eight of 10 disciplines. The performance results of Country B's athletes in seven of 10 disciplines did not and in three disciplines did demonstrate statistically significant change. The decrease in performance of Country A athletes followed a high incidence of steroid detection cases by means of new anti‐doping methods. It is highly likely that the consequent performance decrease is due to the implementation of new anti‐doping methods. The results of the study bring new facts on the effects of new anti‐doping methods implementation and demonstrate following decrease in performance results in population of athletes from the country widely accused of doping use. [ABSTRACT FROM AUTHOR]

Background: The relative age effect (RAE) is most prevalent in highly competitive youth soccer and persists to a lesser extent in senior soccer. However, it is known that soccer players born in the second half of the year are as successful at senior level, indicating that they are equally talented although under-represented at youth level due to bias during the selection process, in which the emphasis is on more pronounced physical qualities in a specific period of time. Examining the prevalence of the RAE among professional soccer players depending on the level of competition and playing position, as well as analyzing the relationship between the player's birth quarter and market value, are of scientific interest. Methods: The dates of birth, playing position, and market value of all adult male soccer players included in the final rosters of teams from the top-division of 54 European countries, listed on www.transfermarkt.com on August 15th, 2020, were analyzed (18,429 soccer players in total). All players were categorized into four groups according to the quarter of birth (Q) and playing position. All teams were further sub-divided in groups depending on the soccer clubs' level of representation in the UEFA Champions League. Results: Of 18,429 players, 30.9% were born in Q1, 25.7% in Q2, 23.8% in Q3 and 19.6% in Q4. The number of soccer players born in Q1 was lower in less competitive leagues. The number of players born in Q1 decreased as the level of competition decreased; the highest percentage of these players was observed in clubs that are among the top 50 ranked in UEFA or compete in the most prestigious European championships. The RAE was less pronounced in teams that participate in lower competitive championships. There was no significant difference in market value between players playing position and level of competition when born in different quarters. Although, the most expensive soccer players in the European championships were late-born forwards. Players of various groups differed in their market value. Conclusions: The RAE is currently prevalent in all the most competitive senior soccer leagues and teams in Europe regardless of playing position. There are no significant differences in market value between players of the same playing position and level of competition when born in different quarters. The most expensive soccer players in the European championships are forwards born in Q4. These findings may indicate that the under-representation of "late-born" soccer players in youth, and then consequently in adult soccer, is not associated with lower talent, but with other factors, possibly based on physiological characteristics and socio-cultural factors. Further measures are needed to mitigate the discriminatory effects of selection bias based on the RAE. [ABSTRACT FROM AUTHOR]

Platelet-rich plasma (PRP) injections are extremely popular in the management of sports injuries in elite athletes. However, data on the use of various administration protocols of PRP are contradictory. The efficacy of platelet-rich plasma in the treatment of muscle injuries in professional soccer players has to be contextualized within the sport-specific rehabilitation program. Despite the questionable role of PRP, a well-structured rehabilitation program is still regarded as the gold standard. We examined the efficacy of various PRP protocols in the management of muscle injuries in professional soccer players in respect to treatment duration and injury recurrence. A retrospective cohort study. Muscle injuries in professional soccer players (n = 79, height 182.1 ± 5.9 cm, weight 76.8 ± 5.8 kg, BMI 23.1 ± 1.4 kg/m2) from three elite soccer clubs from the Russian Premier League were recorded during the 2018–2019 season. The injuries were graded based on MRI, using the British Athletic Muscle Injury Classification. Treatment protocols included the POLICE regimen, short courses of NSAID administration, and the specific rehabilitation program. The sample group of players were administered PRP injections. The average treatment duration with PRP injection was significantly longer than conventional treatment without PRP, 21.5 ± 15.7 days and 15.3 ± 11.1 days, respectively (p = 0.003). Soccer-specific rehabilitation and obtaining MRI/US before the treatment was associated with significantly reduced injury recurrence rate (p < 0.001). There was no significant difference between the PRP injection protocol applied to any muscle and the treatment duration in respect of grade 2A–2B muscle injuries. The total duration of treatment of type 2A–2B injuries was 15 days among all players. In the group receiving local injections of PRP, the total duration of treatment was 18 days; in the group without PRP injections, the treatment duration was 14 days. In our study, PRP treatment was associated with longer treatment duration, regardless of which muscle was injured. This may reflect the tendency to use PRP in higher-degree injuries. Soccer-specific rehabilitation significantly reduced the injury recurrence rate when compared to the administration of PRP injections. MRI/US imaging before returning to play was also associated with a lower injury recurrence rate. There was no significant difference between the PRP injection protocol applied to any muscle and the treatment duration in treatment of type 2A–2B muscle injuries. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the effect of a single intake of citrulline at 3 g and 6 g doses in adult elite soccer players performing sport-specific exercise. Materials and Methods: This randomized double-blind placebo-controlled study analyzed 18 soccer players from the top divisions of three European countries. Participants were randomized into three groups of six each and performed a field-based soccer-specific test for 18 min. Comparative analysis of heart rate, fatigue and post-exercise recovery was conducted. Results: There were no statistically significant differences in most of the analyzed parameters, nor at any of the time points for lactate concentration. Players' RPE exercise test score did not reveal any differences. Conclusions: Neither a single intake of 3 g nor of 6 g of citrulline malate affected physical performance, subjective feelings of fatigue or post-exercise recovery in adult elite soccer players who performed a soccer-specific test. [ABSTRACT FROM AUTHOR]

There are little data on the incidence, and clinical course of COVID-19 among professional soccer players, and the studies examining putative complications of COVID-19 infections are probabilistic. On February 28, the WHO raised the COVID-19 threat assessment to its highest level. The COVID-19 outbreak became a significant challenge for world health. Around 30 million people got infected with COVID-19 since the beginning of this year. More than 900.000 decease. Thus, examining the incidence of COVID-19 and various aspects of its clinical course in a group of adult professional soccer players would be of great practical interest. The incidence, clinical practice, and severity of COVID-19 infection, as well as the duration of treatment and return to play was studied based on a survey of team physicians and medical records assessment in the group of adult professional soccer players representing the clubs of the Russian Premier-League (RPL) during the period of championship resumption from 01.04.2020 until 20.09.2020. COVID-19 infection was detected in 103 soccer players during COVID-19 screening. This number comprises 14.5% of all soccer players on the rosters of RPL soccer teams and is subjected to regular COVID-19 testing. The asymptomatic course was observed in 43.7% of cases (n = 45). These players were isolated, and their clinical condition was monitored closely. In 56.3% of patients (n = 58), fatigue, headache, fever, and anosmia were the most common symptoms. COVID-19 infection was commonly diagnosed among adult professional soccer players in Russia. However, most cases had a mild course and did not impair return to regular exercise. Only two players were hospitalized with lung lesions and returned to regular sports. [ABSTRACT FROM AUTHOR]

Injuries of the metatarsal bones in football are relatively rare and in most cases are localized in the fifth metatarsal. The gold standard of the diagnosis of fractures in this area can be X-rays, which in most cases allows verifying the diagnosis. The treatment tactics depend on the localization of the fracture according to Lawrence and Botte's classification: 3 zones of localization are distinguished. Fractures located in zones 2 and 3 belong to a high-risk group due to delayed consolidation and nonunion and therefore athletes are most often treated with osteosynthesis using intramedullary screws. The minimal recovery time for this type of treatment is at least 8 weeks. This report describes 7 cases of the fifth metatarsal bone fractures, located in zones 2 and 3 in professional football players who were treated with an immobilization boot, cryotherapy, nutritional supplements of calcium and vitamin D, and local injections of platelet-rich plasma, which contains numerous growth factors. The deadline for returning to regular training activities was 43 to 50 days, and there was no relapse of damage within 6 months of follow-up. Levels of Evidence: Level of evidence 4: case report study [ABSTRACT FROM AUTHOR]

Context: Our goal was to review the current literature regarding the ability of substances that have recently been included in the WADA prohibited list (i.e., meldonium, trimetazidine, xenon, and cobalt) or in the monitoring program (i.e., ecdysterone and bemethyl) to enhance performance in athletes or cause adverse effects. Evidence Acquisition: To find out which studies led to the prohibition of the substances mentioned, we searched the PubMed database using keywords including the substances’ or methods’ names, as well as phrases related to various aspects of sports activities and health assessments of athletes. Results: The results obtained during our systematic literature search clearly indicate that there is a lack of scientific evidence supporting the impact of several substances prohibited by WADA (i.e., meldonium, trimetazidine, xenon, and cobalt) on athletic performance or on health in athletes. Conclusions: There is insufficient evidence that the previously mentioned substances have any performance enhancing potential. If left on the list, meldonium may be classified as a “specified substance” because of its wide availability and due to the fact that this drug that can be easily bought over the counter without a prescription. [ABSTRACT FROM AUTHOR]

Study Design: Cross-sectional study.Objective: The aim of this study was to evaluate the actual prevalence of degenerative spinal changes and their association with age in a cohort of professional soccer players.Summary Of Background Data: Presently, there are data that athletes have more degenerative changes than nonathletes; however, the research examining the prevalence of degenerative spinal conditions among professional elite soccer players is scarce.Methods: Professional male soccer players were included in the study (n = 40, average age 26,6 ± 4,5 years, average height 18 ± 0.07 m, weight 76.7 ± 7.1 kg). Lumbosacral spine MRI scanning at the L1-S1 level has been performed. Two radiologists with at least 7 years of experience of working with athletes evaluated all images independently of each other.Results: 92.5% (n = 37) of soccer players had ≥1 spinal degenerative condition. Thirty-five percent (n = 14) of players had three to five, and 50% (n = 20) had six or more conditions. The average age of players who had six or more conditions was significantly higher than those who had zero to five or three to five conditions-28.1 ± 4.8 years versus 25.1 ± 3.6 years (P = 0.029), and 24.8 ± 3.6 years, respectively.Kruskal-Wallis test has shown no association between the number of degenerative conditions and weight (P = 0.98) as well as body mass index (P = 0.99). The age was associated with degenerative changes (P = 0.008).Disc desiccation was the most common pathologic condition, which was found in 82.5% of athletes. Facet joint arthropathy and spondylosis were present in 70, and 50% of the studied lumbar spine MRI scans, respectively. The spondylolysis prevalence of 20% was noted.Conclusion: Elite professional soccer players demonstrate a high prevalence of asymptomatic degenerative lumbar spinal degenerative changes, which are significantly associated with age. These conditions might lead to the development of symptomatic lower back pain, given the high-intensity exercise required in professional soccer. It is presently unclear what measures might be applied for the primary prevention of these degenerative spinal conditions.Level of Evidence: 4. [ABSTRACT FROM AUTHOR]