ECSS Paris 2023: OP-MH29
INTRODUCTION: Tendinopathy is a considerable problem in elite athletes. Collagen supplementation has been shown to increase collagen synthesis and tendon mechanics in healthy female elite athletes. However, it remains unknown if collagen supplementation could serve as an effective add-on treatment to heavy slow resistance (HSR) training for the treatment of tendinopathy in females. Purpose/hypothesis The purpose of this study was to examine whether daily ingestion of hydrolyzed collagen, compared with placebo, on top of HSR had any beneficial effect upon patellar, Achilles, and plantar fascia tendinopathy in female elite athletes. We hypothesized that 12 weeks of collagen supplementation would have greater improvements than placebo on the primary outcome, pain during sport (Numeric Rating Scale [NRS]), and secondary outcomes after both 12 weeks (primary end-point) and 38 weeks. METHODS: Thirty-six female elite athletes with chronic patellar, Achilles, or plantar fascia tendinopathy completed 12 weeks of thrice-weekly (one supervised) HSR, and were randomized to daily ingestion of 10 grams of hydrolyzed collagen (intervention) or maltodextrin (placebo). The primary outcome was NRS during sport. Secondary outcomes included NRS scores (after sport, in the morning, maximum during the week, during tendon provocation), function and symptoms (Victorian Institute of Sport Assessment [VISA], Foot function index [FFI] questionnaires), tendon ultrasound morphology (thickness, echogenicity, and hypervascularity [power Doppler area, PDA]). All outcomes were assessed at baseline, 12 weeks, and 38 weeks. RESULTS: After 12 weeks, both groups demonstrated comparable and clinically meaningful improvements in the primary outcome, the NRS during sport (mean ± SEM), with sustained effects observed at 38 weeks (Collagen group: 0 weeks, 4.53 ± 0.46; 12 weeks, 1.86 ± 0.46; 38 weeks, 1.17 ± 0.50. Placebo: 0 weeks, 4.71 ± 0.43; 12 weeks, 1.38 ± 0.43; 38 weeks, 1.91 ± 0.47). Secondary outcomes: After 12 weeks, both groups exhibited comparable clinically relevant improvements weeks in NRS scores (after activity, in the morning, at maximum during the week, and during provocation), and VISA-A including FFI scores and these were maintained after 38 weeks; however, no improvement was observed for VISA-P. Ultrasound power Doppler findings improved 12 weeks in both groups, with changes favoring the placebo group. There were no significant differences between groups. CONCLUSION: This study did not confer any additional clinical effect of daily collagen supplementation as an adjunct to 12 weeks of HSR on clinical or structural outcomes compared with placebo in female elite athletes with tendinopathy (Achilles, Patellar or plantaris). Registration: ClinicalTrials.gov (NCT04578418)
Read CV Christian CouppéECSS Paris 2023: OP-MH29
INTRODUCTION: Sleep health is multidimensional. Focusing on a single sleep parameter like duration or efficiency fails to capture the complexity of sleep-related health, particularly in athletic populations where sleep health may be shaped by training-related stressors and behavioral psychosocial factors. Despite growing evidence linking sleep to recovery and performance, the role of sleep health in preventing injuries and illnesses among athletes remains insufficiently addressed. In this study we analyzed the association between sleep health and annual injury and illness load in a representative sample of >2000 Swiss elite athletes, considering as well stress and substance related predictors of sleep health. METHODS: A total of 2293 athletes (46.4% female; age 22.1 ± 7.5 years) completed a questionnaire that contained baseline demographics, sleep health and habits (Bernese Sleep Health Questionnaire), and sport characteristics. Sleep health was quantified using a composite sleep health score (SHS; range 0–8), integrating sleep duration, efficiency, timing, daytime sleepiness, restfulness, regularity, snoring, and sleep-related disorders. Annual injury and illness load were expressed as days per year. A linear regression model was applied to identify determinants of sleep health. Associations between sleep health and injury and illness load were examined using negative binomial regression models adjusted for perceived stress, training hours per week, travel, performance level, sport category, age, and gender. RESULTS: Sleep health showed a strong association with illness load: each 1-point increase in SHS was associated with a 14% reduction in illness days per year (IRR = 0.86, p < .001). Moreover, each 1-point increase in the sleep health score was associated with a 5% reduction in injury days per year (IRR = 0.95, p = .018). Additionally, stress (IRR = 1.07, p = .04), training volume (IRR = 1.01, p < .001), and travel exposure (IRR = 1.07, p = .04) were also associated with injuries. In general, poorer sleep health was associated with higher stress, together with unfavorable sleep behavior like greater evening caffeine, alcohol, nicotine, and sleeping pill use (all p < .001). CONCLUSION: Sleep health is inversely associated with both illness and injuries in athletes, pointing to a central role of sleep in physiological recovery and immune function. Sleep health represents a modifiable and monitorable parameter that is closely linked to stress and substance-related behaviors. Therefore, measuring and improving sleep health in athletes through screening and counseling may potentially be a potent approach to reduce illness days and to support athletes' health and injury-prevention strategies.
Read CV Serena CeccantiECSS Paris 2023: OP-MH29
INTRODUCTION: Athletes frequently present to healthcare clinicians with sports-related pain, including acute soft‑tissue injury and delayed‑onset muscle soreness (DOMS). Despite the widespread use of non‑steroidal anti‑inflammatory drugs (NSAIDs) and paracetamol, the high prevalence and risks associated with their inappropriate use highlight the need for sport‑specific, evidence‑informed guidance. [1,2] To address this gap, a modified Delphi approach was applied to integrate expert opinion with current evidence to establish consensus recommendations for NSAIDs and paracetamol use in acute soft-tissue injury and DOMS among athletes and healthcare clinicians. METHODS: A two-step modified Delphi method was employed to establish consensus among a multidisciplinary international panel. The panel consisted of six experts from Germany, Belgium, the United States, Finland, and Switzerland, each with >5 years of relevant clinical/research experience (sports medicine, orthopaedics, physiotherapy, pharmacology/pharmacy, pain/anesthesiology), convening virtually and in person. Pre‑meeting literature summaries from PubMed and Embase (inception–September 2025) with informed consensus development across three predefined domains: acute soft-tissue injury, DOMS, and performance. Anonymous voting conducted via Qualtrics using a 5-point Likert scale (“Strongly agree” to “Strongly disagree”), with consensus defined as ≥67% agreement. Two rounds were planned a priori, concluding after round 2 when no further substantive modifications were proposed, and item ratings finalised. RESULTS: Twenty statements were evaluated across two Delphi rounds. Four were revised after round one. Consensus was achieved on 19 statements, as 2 were combined into 1. For acute soft‑tissue injury, the panel agreed that short‑term oral or topical NSAIDs or oral paracetamol are appropriate when no contraindications exist, with oral therapy of NSAIDs limited to 3–7 days. Topical NSAIDs may be initiated within 24 hours to enhance analgesia, not exceeding 2–3 applications daily according to label‑directed frequency and duration. For DOMS, recommendations were similar, with oral NSAIDs use restricted to 3–5 days and topical NSAIDs applied within 24 hours under the same label‑based limits. Concurrent oral NSAIDs with paracetamol may be considered when monotherapy is insufficient. Safety considerations included contraindications to oral NSAIDs in gastrointestinal ulcer, renal impairment, hypersensitivity and caution in older adults, adolescents, individuals with cardiovascular risk, those on anticoagulants, and during pregnancy/lactation. The panel did not endorse the use of oral NSAIDs or paracetamol by athletes as a means to enhance performance. CONCLUSION: These consensus statements provide standardised, evidence-based guidance on NSAIDs and paracetamol use for acute soft-tissue injury and DOMS, and may assist healthcare professionals in clinical decision-making. [1] Prior 2012 [2] Xiong 2025
Read CV Frédérique BariguianECSS Paris 2023: OP-MH29