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This study investigated whether an internet-based intervention aimed at enhancing the psychological well-being of female soccer players before the competitive season could be effective approach to meet the needs of the players. Players (n= 43; 17–26 years old)on the four separated teams in Finland’shighest league were assigned to either a guided six-week online Acceptance and Commitment Therapy intervention (ACTi) or to a control condition (CON). A between-groups pre–post (ACTi vs. CON) design was implemented before the competitive season. Players in the ACTi were offered three group sessions, performed internet-based tasks, and were individually supported by a guide. The results demonstrated that the ACTi players maintained their sports-related well-being (between-group, d = 0.72), while the sports-related well-being of the CON players, especially emotional and social well-being, had declined. In addition, ACTi players’perceived stress (d = 0.60) and depression (d = 0.88) declined, while their psychological flexibility in sports (d = 0.41) increased compared to the CON players. These results suggest that before the competitive season, players’ sports-related well-being decreases. The ACT intervention seemed to prevent this decrease and provide players with the skills to cope with emotional and social stressors related to the competitive season.

Purpose: To investigate differences in athletes’ knowledge, beliefs, and training practices during COVID-19 lockdowns with reference to sport classification and sex. This work extends an initial descriptive evaluation focusing on athlete classification. Methods: Athletes (12,526; 66% male; 142 countries) completed an online survey (May–July 2020) assessing knowledge, beliefs, and practices toward training. Sports were classified as team sports (45%), endurance (20%), power/technical (10%), combat (9%), aquatic (6%), recreational (4%), racquet (3%), precision (2%), parasports (1%), and others (1%). Further analysis by sex was performed. Results: During lockdown, athletes practiced body-weight-based exercises routinely (67% females and 64% males), ranging from 50% (precision) to 78% (parasports). More sport-specific technical skills were performed in combat, parasports, and precision (∼50%) than other sports (∼35%). Most athletes (range: 50% [parasports] to 75% [endurance]) performed cardiorespiratory training (trivial sex differences). Compared to prelockdown, perceived training intensity was reduced by 29% to 41%, depending on sport (largest decline: ∼38% in team sports, unaffected by sex). Some athletes (range: 7%–49%) maintained their training intensity for strength, endurance, speed, plyometric, change-of-direction, and technical training. Athletes who previously trained ≥5 sessions per week reduced their volume (range: 18%–28%) during lockdown. The proportion of athletes (81%) training ≥60 min/session reduced by 31% to 43% during lockdown. Males and females had comparable moderate levels of training knowledge (56% vs 58%) and beliefs/attitudes (54% vs 56%). Conclusions: Changes in athletes’ training practices were sport-specific, with few or no sex differences. Team-based sports were generally more susceptible to changes than individual sports. Policy makers should provide athletes with specific training arrangements and educational resources to facilitate remote and/or home-based training during lockdown-type events.

Purpose Long-term sports training, such as skill and endurance training, leads to specific neuroplasticity. However, it remains unclear if muscle stretch-induced proprioceptive feedback influences corticospinal facilitation/inhibition differently between skill- and endurance-trained athletes. This study investigated modulation of corticospinal excitability following rapid ankle dorsiflexion between well-trained skill and endurance athletes. Methods Ten skill- and ten endurance-trained athletes participated in the study. Corticospinal excitability was tested by single- and paired-pulse transcranial magnetic stimulations (TMS) at three different latencies following passive rapid ankle dorsiflexion. Motor evoked potential (MEP), short-latency intracortical inhibition (SICI), intracortical facilitation (ICF), and long-latency intracortical inhibition (LICI) were recorded by surface electromyography from the soleus muscle. Results Compared to immediately before ankle dorsiflexion (Onset), TMS induced significantly greater MEPs during the supraspinal reaction period (~ 120 ms after short-latency reflex, SLR) in the skill group only (from 1.7 ± 1.0 to 2.7 ± 1.8%M-max, P = 0.005) despite both conditions being passive. ICF was significantly greater over all latencies in skill than endurance athletes (F(3, 45) = 4.64, P = 0.007), although no between-group differences for stimulations at specific latencies (e.g., at SLR) were observed. Conclusion The skill group showed higher corticospinal excitability during the supraspinal reaction phase, which may indicate a “priming” of corticospinal excitability following rapid ankle dorsiflexion for a supraspinal reaction post-stretch, which appears absent in endurance-trained athletes.

Background: The identification of risk factors for sports injuries is essential before injury prevention strategies can be planned. Hypothesis: Previous acute knee injury and lower perceived knee function measured by Knee injury and Osteoarthritis Outcome Score (KOOS) will increase the risk of acute knee injury in youth team-sports athletes. Study Design: Prospective cohort study. Level of Evidence: Level 3. Methods: At baseline, youth (≤21 years old) male and female basketball and floorball athletes completed a questionnaire on previous acute knee injuries and perceived knee function (KOOS). A total of 211 male and 183 female athletes were followed for an acute knee injury up to 3 years. Unadjusted and adjusted Cox regression models were used in risk factor analyses. Results: In male athletes, previous acute knee injury and lower KOOS Pain, Activities of Daily Living, Sport and Recreation, and knee-related Quality of Life subscale scores increased the risk of acute knee injury in the unadjusted analyses. Adjusted analyses for male injuries were not performed because of low number of acute knee injuries (n = 18). In female athletes, previous acute knee injury increased the risk of acute knee injury when adjusted for athletes’ age and body mass index (hazard ratio, 2.6 [95% CI, 1.3-5.2]). In female athletes, none of the KOOS subscale scores were associated with the increased risk of acute knee injury in the adjusted analyses. Conclusion: Previous acute knee injury was associated with the risk of new acute knee injury in youth male and female athletes. In youth male athletes, additionally, lower perceived knee function in 4 out of 5 KOOS subscale scores were associated with the increased risk of new acute knee injury. Clinical Relevance: The treatment and rehabilitation of the present acute knee injury and secondary prevention of reinjury should be emphasized in youth team-sports athletes.

Venäjä oli yksi Kansainvälisen Olympiakomitean perustajajäsenistä vuonna 1894. Venäläiset osallistuivat Lontoon olympiakisoihin vuonna 1908 ja Tukholman kisoihin neljää vuotta myöhemmin. Vuoden 1917 sosialistinen vallankumous muutti koko valtion – mukaan luettuna urheilun käytännöt. Vuosina 1918–1921 käydyn verisen sisällissodan ja vuonna 1922 tapahtuneen Neuvostoliiton perustamisen jälkeen valtio pyrki organisoimaan uudelleen koko ruumiinkulttuurin. Neuvostoliittolaisessa ruumiinkulttuurissa ihannoitiin sotilaallista valmiutta, työkuntoisuutta ja urheilullisuutta. Kilpaurheilun suosio kasvoi huomattavasti 1920-luvulla. Vuonna 1928 venäläiset organisoivat mahtavat urheilukisat, Moskovan spartakiadit. Kyseessä oli lukuisia urheilumuotoja käsittänyt työläistapahtuma vastapainoksi Amsterdamissa samana vuonna järjestetyille ”porvarillisille” olympiakisoille. Neuvostoliiton urheilijat osallistuivat kesäolympiakisoihin ensi kertaa Helsingissä vuonna 1952. Olympiakisoissa Neuvostoliitto oli menestyksekäs. Vuosina 1952–1988 neuvostourheilijat saavuttivat 1 010 mitalia kesäkisoissa ja vastaavasti 194 mitalia vuosien 1956–1988 talvikisoissa. Neuvostoliiton hajoamisen jälkeen Venäjän urheilijat ovat kilpailleet Kansainvälisen Olympiakomitean lipun alla. Aiemmat neuvostotasavallat ovat osallistuneet kansainvälisiin urheilutapahtumiin itsenäisinä valtioina. Neuvostoliittolainen urheilujärjestelmä on kuitenkin vaikuttanut merkittävästi ei vain Venäjällä vaan myös monissa muissa uusista valtioista. Neuvostoliitossa urheilulla oli merkittävä sija opetusjärjestelmässä ja kansallisen itsetunnon rakentamisessa. Monet neuvostourheilun käytännöt ovat tiiviisti jatkaneet olemassaoloaan myös NL:n hajoamisen jälkeen., Russia was one of the founding members of International Olympic Committee in 1894. Russians participated in Olympic Games in London (1908) and Stockholm (1912). The socialist revolution in 1917 changed the whole state, including its sport practices. After the bloody civil war (1918–1921) and the establishment of the Soviet Union (1922), the state strived to reorganize the whole body culture. In the Soviet body culture, the military body, working body and sporting body were idealized. The popularity of competitive sports increased considerably in the 1920’s. In 1928, Russians organized a huge sport event, Moscow Spartakiad. It was a multi-sports event for workers and an alternative to the “bourgeois” Olympic Games held in Amsterdam in the same year. The athletes of the Soviet Union participated in Summer Olympics for the first time in Helsinki in 1952. The Soviet Union was successful in Olympics. Between 1952 and 1988 the Soviet athletes accomplished 1 010 Olympic medals in Summer Olympics, and between 1956 and 1988 they accomplished 194 medals in Winter Olympics. After the collapse of the Soviet Union, athletes of Russia have competed under the flag of International Olympic Committee. The previous Soviet republics have participated in international sport events as independent states. The influence of the Soviet sport system has been significant not only for Russia but for many new countries as well. Sports were an important part of the education system and identity work in the Soviet Union. Many of the Soviet sport practices have persisted and continued to exist after the fall of the socialist state.

Objectives Earlier qualitative researchers studying athletes’ dual careers (DCs) have shown that sociocultural discourses on gender are ingrained in DC policies and practices, creating gender inequalities and hierarchies. In this study, we aimed to extend this body of research by examining how Finnish elite youth ski coaches discursively construct athletes’ education and gender in their talk and coaching practices. Similarly, we examined how coaches’ beliefs about athletes' holistic development are interlinked with broader sociocultural discourses on gender. Design Qualitative study. Methods We conducted semi-structured interviews with 10 Finnish ski coaches (seven male, three female) aged 25–62 years (M = 38.5), and then analyzed the data using reflexive thematic analysis, interpreted through a feminist poststructuralist lens. Findings Coaches’ discursive practices regarding education depended on their athletes' ages. For athletes in secondary education, the coaches predominantly drew on DC discourses that emphasized the compatibility of sports and education, but for athletes transitioning to senior-level sports, they drew on dominant performance discourses, believing that athletes at the senior level should prioritize their sports. Moreover, coaches discursively constructed athletic development as especially important for female athletes, who were perceived as less capable of excelling in sports and therefore needing to invest in multiple careers. Conclusions By drawing on gender stereotypes and binary understandings of gender, the coaches discursively reproduced gender hierarchies and unequal power relations in sports. These gendered discourses influence athletes' DC aspirations and the gendering of DC pathways. peerReviewed

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IntroductionAlthough maximal oxygen uptake (VO2max) is generally recognized as the single best indicator of aerobic fitness in youth, interpretation of this parameter and the extent to which it can be improved by training remain controversial, as does the relative importance of VO2max for performance in comparison to other factors such as power production. Here, we examined the influence of endurance training on the VO2max, muscle power and sports-related performance of cross-country skiers attending a school specializing in sports, as well as potential relationships between any changes observed to one another and/or to perceived stress scale (Cohen) and certain blood parameters.MethodsOn two separate occasions, prior to the competition season and separated by one year of endurance training, the 12 participants (5 males, 7 females, 17 ± 1 years) carried out tests for VO2max on a treadmill, explosive power utilizing countermovement jumps (CMJ) and ski-specific maximal double pole performance (DPP) employing roller skis on a treadmill. Blood levels of ferritin (Fer), vitamin D (VitD) and hemoglobin (Hg) were monitored, and stress assessed with a questionnaire.ResultsDPP improved by 10 ± 8% (P DiscussionWhereas one year of endurance training improved the cross-country ski-specific performance of young athletes significantly, the increase in their maximal oxygen uptake was minimal. Since DPP was not correlated with VO2max, jumping power or the levels of certain blood parameters, the improvement observed probably reflected better upper-body performance.

Background Although there is growing evidence that former professional athletes from sports characterised by repetitive head impact subsequently experience an elevated risk of dementia, the occurrence of this disorder in retired amateurs, who represent a larger population, is uncertain. The present meta-analysis integrates new results from individual-participant analyses of a cohort study of former amateur contact sports participants into a systematic review of existing studies of retired professionals and amateurs. Methods The cohort study comprised 2005 male retired amateur athletes who had competed internationally for Finland (1920–1965) and a general population comparison group of 1386 age-equivalent men. Dementia occurrence was ascertained from linked national mortality and hospital records. For the PROSPERO-registered (CRD42022352780) systematic review, we searched PubMed and Embase from their inception to April 2023, including cohort studies published in English that reported standard estimates of association and variance. Study-specific estimates were aggregated using random-effect meta-analysis. An adapted Cochrane Risk of Bias Tool was used to assess study quality. Findings In the cohort study, up to 46 years of health surveillance of 3391 men gave rise to 406 dementia cases (265 Alzheimer’s disease). After adjustment for covariates, former boxers experienced elevated rates of dementia (hazard ratio: 3.60 [95% CI 2.46, 5.28]) and Alzheimer’s disease (4.10 [2.55, 6.61]) relative to general population controls. Associations were of lower magnitude in retired wrestlers (dementia: 1.51 [0.98, 2.34]; Alzheimer’s disease: 2.11 [1.28, 3.48]) and soccer players (dementia: 1.55 [1.00, 2.41]; Alzheimer’s disease: 2.07 [1.23, 3.46]), with some estimates including unity. The systematic review identified 827 potentially eligible published articles, of which 9 met our inclusion criteria. These few retrieved studies all sampled men and the majority were of moderate quality. In sport-specific analyses according to playing level, there was a marked difference in dementia rates in onetime professional American football players (2 studies; summary risk ratio: 2.96 [95% CI 1.66, 5.30]) relative to amateurs in whom there was no suggestion of an association (2 studies; 0.90 [0.52, 1.56]). For soccer players, while dementia occurrence was raised in both erstwhile professionals (2 studies; 3.61 [2.92, 4.45]) and amateurs (1 study; 1.60 [1.11, 2.30]) there was again a suggestion of a risk differential. The only studies of boxers comprised former amateurs in whom there was a tripling in the rates of dementia (2 studies; 3.14 [95% CI 1.72, 5.74]) and Alzheimer’s disease (2 studies; 3.07 [1.01, 9.38]) at follow-up compared to controls. Interpretation Based on a small number of studies exclusively sampling men, former amateur participants in soccer, boxing, and wrestling appeared to experience an elevated risk of dementia relative to the general population. Where data allowed comparison, there was a suggestion that risks were greater amongst retired professionals relative to amateurs in the sports of soccer and American football. Whether these findings are generalisable to the contact sports not featured, and to women, warrants examination. Funding This work was unfunded. peerReviewed

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Background Low energy availability (LEA) can have negative performance consequences, but the relationships between LEA and performance are poorly understood especially in field conditions. In addition, little is known about the contribution of macronutrients to long-term performance. Therefore, the aim of this study was to evaluate if energy availability (EA) and macronutrient intake in a field-based situation were associated with laboratory-measured performance, anthropometric characteristics, blood markers, training volume, and/or questionnaire-assessed risk of LEA in young female cross-country (XC) skiers. In addition, the study aimed to clarify which factors explained performance. Methods During a one-year observational study, 23 highly trained female XC skiers and biathletes (age 17.1 ± 1.0 years) completed 3-day food and training logs on four occasions (September–October, February–March, April–May, July–August). Mean (±SD) EA and macronutrient intake from these 12 days were calculated to describe yearly overall practices. Laboratory measurements (body composition with bioimpedance, blood hormone concentrations, maximal oxygen uptake (VO2max), oxygen uptake (VO2) at 4 mmol·L−1 lactate threshold (OBLA), double poling (DP) performance (time to exhaustion), counter movement jump (height) and the Low Energy Availability in Females Questionnaire (LEAF-Q)) were completed at the beginning (August 2020, M1) and end of the study (August 2021, M2). Annual training volume between measurements was recorded using an online training diary. Results The 12-day mean EA (37.4 ± 9.1 kcal·kg FFM−1·d−1) and carbohydrate (CHO) intake (4.8 ± 0.8 g·kg−1·d−1) were suboptimal while intake of protein (1.8 ± 0.3 g·kg−1·d−1) and fat (31 ± 4 E%) were within recommended ranges. Lower EA and CHO intake were associated with a higher LEAF-Q score (r = 0.44, p = 0.042; r = 0.47, p = 0.026). Higher CHO and protein intake were associated with higher VO2max (r = 0.61, p = 0.005; r = 0.54, p = 0.014), VO2 at OBLA (r = 0.63, p = 0.003; r = 0.62, p = 0.003), and DP performance at M2 (r = 0.42, p = 0.051; r = 0.44, p = 0.039). Body fat percentage (F%) was negatively associated with CHO and protein intake (r = -0.50, p = 0.017; r = -0.66, p = 0.001). Better DP performance at M2 was explained by higher training volume (R2 = 0.24, p = 0.033) and higher relative VO2max and VO2 at OBLA at M2 by lower F% (R2 = 0.44, p = 0.004; R2 = 0.47, p = 0.003). Increase from M1 to M2 in DP performance was explained by a decrease in F% (R2 = 0.25, p = 0.029). Conclusions F%, and training volume were the most important factors explaining performance in young female XC skiers. Notably, lower F% was associated with higher macronutrient intake, suggesting that restricting nutritional intake may not be a good strategy to modify body composition in young female athletes. In addition, lower overall CHO intake and EA increased risk of LEA determined by LEAF-Q. These findings highlight the importance of adequate nutritional intake to support performance and overall health. peerReviewed

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Tässä tutkimuksessa käsitellään Suomessa yleisesti verovelvollisten urheilijoiden urheilutulojen verotusta. Keskeisimmiksi tutkimuskysymyksiksi muodostui urheilutoimintaan kuuluvien tulojen ja hyväksyttävien vähennysten määrittäminen, urheilutoiminnan keskeisimmät verosuunnittelumahdollisuudet, sekä urheilutulojen verotusoikeuden jakautuminen eri valtioiden välillä rajat ylittävissä kansainvälisissä tilanteissa. Tutkimuksen taustalla on huippu-urheilun kaupallistuminen ja kansainvälistyminen, ja sitä seurannut useiden urheilijoiden tulotason nouseminen. Urheilutoiminnan harjoittaminen sisältää useita erityispiirteitä perinteisemmäksi miellettäviin ammatteihin verrattuna, joista ainoastaan osa on huomioitu verolainsäädännössä. Kyseisiä erityispiirteitä ovat muun muassa: Urheilu-uran tuloa tuottavan vaiheen lyhyt kesto, urheilutoiminnan kansainvälisyys, ja urheilijan usein korkeiksi muodostuvat ansiot. Esitettyihin tutkimuskysymyksiin haetaan vastauksia käyttämällä lainopillisia menetelmiä. Lainopillisessa tutkimuksessa pyritään systematisoimaan oikeussäännöksiä ja myös selvittämään oikeussäännösten sisältöä. Tutkimuksessa on käytetty lähteenä lainsäädäntöä, joka katsotaan vahvasti velvoittavaksi oikeuslähteeksi. Lainsäädännön lisäksi lähteenä on käytetty myös oikeustapauksia, sekä oikeuskirjallisuutta. Tutkimuksessa selvisi, että verolainsäädännössä urheilutoiminnan erityispiirteitä on huomioitu tulojen jaksottamisen osalta urheilijarahastojen ja valmennusrahastojen myötä. Urheilutoimintaan liittyvien menojen vähennysoikeus on myös laaja, sisältäen kuitenkin joitakin epäselviä rajanvetotilanteita. Urheilutoimintaa on myös mahdollista harjoittaa elinkeinotoimintana, jos toiminnan katsotaan täyttävän elinkeinotoiminnan tunnusmerkit. Tällöin urheilijan on mahdollista saada osa tuloistaan verotetuksi pääomatuloina, mikä moi olla erityisesti suurituloisimmille urheilijoille suotuisaa tulojen noustessa kireäksi muodostuvan ansiotuloverotuksen myötä. Kansainvälisissä rajat ylittävissä tilanteissa urheilutulojen ensisijainen verotusoikeus on useimmissa tilanteissa tulon lähdevaltiolla OECD:n malliverosopimuksen 17 artiklan perusteella.

Previous research has revealed the challenges of sports graduates. Of particular concern is the question of how sports graduates navigate these difficulties in the job market. This study sought to understand the modern careers of sports graduates by describing different career story models among sports degree graduates. Life story data collection was employed to capture the various influences affecting career paths. The data consisted of 59 career life stories collected from Finnish sports degree graduates who were recruited through an open writing invitation. Data were analysed with the narrative method. Five typical career story models were identified among Finnish sports degree graduates: (1) From struggles to career change; (2) Momentum for a new career; (3) No pain, no gain; (4) Natural path to success; and (5) From aspirations to an uncertain future. Collectively, these story models suggest that graduates seem to balance between their personal enthusiasm for sport and fitness and the realities of working life. Many graduates contemplated leaving the industry, and remaining in the sports industry was defined by how much working life met the expectations shaped by education or personal dreams. These findings indicate that since many sport graduates struggle with the structural challenges of the sports industry, additional support through student counselling and in finding quality entry-level jobs might be beneficial in preventing career change and supporting careers in sports. Narrative career counselling is suggested to promote the wellbeing of individuals who struggle in their careers. peerReviewed

SummaryBackgroundTraumatic brain injury is associated with the future risk of depression and suicide, and this raises the possibility that former participants in sports characterised by low intensity repetitive head impact may also subsequently experience an increased burden of these mental health outcomes. Using new data from a cohort study integrated into a meta-analysis of the current evidence, we compared the occurrence of depression and suicide in former contact sports athletes against general population controls.MethodsThe cohort study comprised 2004 retired male athletes who had competed internationally on an amateur basis for Finland between 1920 and 1965, and 1385 age-equivalent male general population controls. Former contact sports participants were drawn from soccer, boxing, or Olympic-style (non-professional) wrestling. During follow-up, cases of major depressive disorder and suicide were captured via linkage to mortality and hospitalisation registries. In a PROSPERO-registered (CRD42022352780) systematic review, we searched PubMed and Embase from their inception to October 31 2022 for reports of cohort studies of contact sports participation and later risk of depression and suicide that were published in English and reported standard estimates of association and variance. Study-specific estimates were aggregated using random-effect meta-analysis. The Newcastle-Ottawa Scale was used to appraise the quality of each study.FindingsIn analyses of the Finnish cohort data, up to 45 years of health surveillance gave rise to 131 hospitalisations for major depressive disorder and 61 suicides. In survival analyses (hazard ratio [95% confidence interval]) adjusted for age and socioeconomic status, former boxers (depression: 1.43 [0.73, 2.78]; suicide: 1.75 [0.64, 4.38]), wrestlers (depression: 0.94 [0.44, 2.00]; suicide: 1.60 [0.64, 3.99]), and soccer players (depression: 0.62 [0.26, 1.48]); suicide: 0.50 [0.11, 2.16]) did not have statistically significantly different rates of major depressive disorder or suicide relative to general population controls. The systematic review identified 463 potentially eligible published articles, of which 7 met inclusion criteria. All studies sampled men and 3 were evaluated as being of high quality. After aggregating results from these retrieved studies with new data from the cohort study, we found that retired soccer players appeared to have a somewhat lower risk of depression (summary risk ratio: 0.71 [95% 0.54, 0.93]) relative to general population controls, while the rate of suicide was essentially the same (0.70 [0.40, 1.23]). Past participation in American football was associated with some protection against suicide (0.58 [0.43, 0.80]) but there were insufficient studies of depression for aggregation. All studies showed directionally consistent relationships and there was no indication of inter-study heterogeneity (I2=0%).InterpretationBased on a small cluster of studies exclusively comprising men, retired soccer players had a lower rate of later depression, and former American football players had a lower risk of suicide. Whether these findings are generalisable to women requires testing.FundingNone.Research in contextEvidence before this studyA series of cohort studies suggest that brain injury serious enough to necessitate hospitalisation is associated with elevated rates of later depression and suicide. This raises the possibility that former participants in sports characterised by low intensity repetitive head impact, who have an increased risk of other mental health disorders in later life such as dementia, may also experience an increased burden of depression and suicide. Searching PubMed and Embase using terms for specific contact sports (e.g., ‘boxing’, ‘martial’, ‘wrestling’, ‘football’, ‘soccer’, ‘hockey’, ‘rugby’), depression and suicide (e.g., depression, dysthymic; suicide) revealed relevant studies in former athletes from American football, soccer, and rugby union but no evidence for boxing, wrestling, or other contact sports. Overall, there was a suggestion of mixed results and an absence of a quantitative synthesis of findings for depression.Added value of this studyIn the first cohort study to simultaneously examine the risk of depression and suicide across multiple contact sports, there was no convincing evidence that retired boxers, wrestlers, or soccer player had a different rate of these health outcomes than the general population. After incorporating these new results into a meta-analysis, former soccer players had a lower risk of depression but there was no clear link with suicide. Retired American footballers appeared to experience lower suicide rates at follow-up.Implications of all the available evidenceCounter to the apparent impact of traumatic brain injury, a background in contact sports was not associated with elevated rates of depression or suicide. Indeed, former soccer athletes (depression) and American football players (suicide) seemed to experience some protection against these health outcomes. The existing evidence base is, however, hampered by an absence of studies of women, and is modest in scale and narrow in scope, currently not including several popular contact sports.

Background Regardless of competitive athletes’ body image pressures, only few studies have focused on adolescent sport participants’ body image and the findings are inconclusive. Furthermore, the role of competitive goals in sports on adolescents’ body size perception has not been studied. We examined the factors associated with adolescents’ competitive goals in sports and body size perception, and the associations between adolescents’ competitive goals in sports and body size perception. Methods The cross-sectional study consisted of 475 goal-oriented sports club participants and 936 reference youths (aged 14–16 years). The study questionnaire included multiple choice items on health behaviours, motives to exercise, competitive goals in sports and body size perception. The multinomial logistic regression analysis was used to investigate the associations. Results Adolescents with competitive goals in sports perceived their body size as about the right size more frequently than reference youths (68% vs 47%, p p Conclusions Adolescents’ BMI, appearance/weight motives to exercise, and perceived physical fitness were more strongly associated with body size perception than their competitive goals in sports. However, perceived fatness among girls with competitive goals in sports should be considered in organized sports.

Being a mixed martial arts fighter and a devout Christian seems to present an apparent contradiction that requires identity work to bring these identities into unity. We used Dialogical Self Theory and explored the autobiography of Ron ‘H2O’ Waterman, a professional fighter turned evangelist, to understand how the tensions between the different identities or I-positions were negotiated. We identified two I-positions, ‘Ron the Fighter’ and ‘Ron the Pater Familias’, which related differently to religion, sport, and masculinity. Importantly, the negotiations were not between MMA and faith, but between these two I-positions that served the different needs for self-enhancement and union with somebody else. The findings illustrate that some degree of narrative coherence is needed for maintaining psychological well-being, which in Waterman’s case was established by finding a third position that incorporated parts of both I-positions. We suggest that Dialogical Self Theory provides a promising perspective for understanding identity intersectionality in sport and how healthy and problematic stories are developed. Practical applications include supporting athletes in developing ‘meta-positions’ that can articulate the conflicts between incompatible I-positions and help identify ways to move forward. peerReviewed

Objectives Obtaining education is an important milestone in athletes’ preparation for their professional career after sport. Literature indicates that combining school and sport is not an easy task for many aspiring youth athletes. It has been proposed that career adaptability, which refers to psychosocial resources enabling individuals to solve complex occupational transitions, present and anticipated vocational development tasks, and career related challenges could be a relevant concept for applied work with student-athletes. In this study, we examined whether there are distinct developmental profiles of career adaptability among adolescent athletes across the upper secondary school years. We also investigated the associations between career adaptability and sport withdrawal and academic achievement. Design and methods A total of 391 Finnish-speaking student-athletes completed the questionnaire on career adaptability (Career Adapt-Abilities Scale – Dual Career Form; Ryba & Aunola, 2015; Ryba et al., 2017) at the beginning and end of upper secondary school. The participants’ background information about their sport participation and grade point average were collected upon completion of each grade of upper secondary school. The data were analysed using cluster analysis, cross-tabulation, and one-way analysis of variance. Results Four distinct adaptability profiles were identified: higher adaptability, lower adaptability, increasing adaptability, and decreasing adaptability. Higher and lower adaptability profiles showed stable levels of adaptability across time, whereas the adaptability level either increased or decreased in the other two profiles. Student-athletes with a lower career adaptability profile were overrepresented among those who withdrew from competitive sports, and they reported lower grade point averages than those with higher scores of career adaptability. Conclusions High scores of career adaptability were associated with high grades, whereas low scores of career adaptability were associated with low grades and a probability to withdraw from competitive sport. Therefore, it is recommended that career adaptability be considered as important self-regulation resources for sustaining dual career pathways over time. peerReviewed

Objectives The aim of this study was to investigate the association between pelvic kinematics during the standing knee lift (SKL) test and low back pain (LBP) in youth floorball and basketball players. Design A prospective cohort study. Setting Finnish elite youth floorball and basketball players. Participants Finnish elite youth female and male floorball and basketball players (n = 258, mean age 15.7 ± 1.8). Main outcome measures LBP resulting in time loss from practice and games was recorded over a 12-month period and verified by a study physician. Associations between LBP and sagittal plane pelvic tilt and frontal plane pelvic obliquity during the SKL test as measured at baseline were investigated. Individual training and game hours were recorded, and Cox’s proportional hazard models with mixed effects were used for the analysis. Results Cox analyses revealed that sagittal plane pelvic tilt and frontal plane pelvic obliquity were not associated with LBP in floorball and basketball players during the follow-up. The hazard ratios for pelvic tilt and pelvic obliquity ranged between 0.93 and 1.08 (95% CIs between 0.91 and 1.07 and 0.83 and 1.29), respectively. Conclusions Pelvic movement during the SKL test is not associated with future LBP in youth floorball and basketball players.

Adolescence is characterized by pubertal physical changes, cognitive development, and modified social expectations. Adolescent athletes often enter a more challenging stage of athletic development associated with increased specialization, and become vulnerable to feelings of burnout. It is therefore important to consider intrapersonal psychological factors that can improve sport participation experiences and prevent burnout. Accordingly, the aim of the current study was to examine the interplay between self-perceptions and emotion-related (i.e., psychobiosocial) experiences (e.g., feeling confident, focused, determined, physically charged, and skillful) in predicting burnout symptoms in adolescents. A sample of 12–14-year-olds (n= 338, 176 girls and 162 boys;Mage = 13.42,SD= 1.12) and 15–17-year-olds (n= 302, 142 girls and 160 boys;Mage = 15.78,SD= 1.17), participating in individual or team sports, were involved in a cross-sectional study to assess positive and negative self-perceptions, functional and dysfunctional psychobiosocial experiences, and burnout symptoms (i.e., emotional and physical exhaustion, reduced sense of accomplishment, sport devaluation). Path analysis results suggest that higher scores on global physical self-perception, self-esteem, and sport competence were associated with lower burnout symptoms, while higher scores on social physique anxiety were associated with higher scores on sport devaluation. Moreover, self-esteem and sport competence were shown to have significant indirect effects on burnout dimensions via functional psychobiosocial experiences. Differences by gender (p< 0.001) and by age category (p< 0.001) in the variable scores were also found. Compared to girls, boys reported higher scores on competence, functional psychobiosocial experiences, global physical self-perception, self-esteem, emotional and physical exhaustion, and lower scores on social physique anxiety. Compared to 12–14-year-olds, 15–17-year-olds reported lower scores on global physical self-perception and self-esteem, and higher scores on social physique anxiety, reduced sense of accomplishment, and sport devaluation. This study adds to the literature on burnout by considering the role of intrapersonal factors (i.e., global physical self-perception, self-esteem, sport competence, and social anxiety) in predicting burnout symptoms in adolescent athletes, and the mediating effects of psychobiosocial experiences. From an applied perspective, sport coaches should implement strategies to foster positive self-perceptions, promote pleasant psychobiosocial experiences, and prevent burnout.

Study aim: The aim of this study was to evaluate if young female skiers meet their energy and macronutrient requirements, and how energy availability (EA) and macronutrient intake affects their performance during an intensive training camp. Material and methods: 19 female cross-country skiers (age 16.7 ± 0.7) filled in 48-hour food and training logs during a 5-day training camp. Fasting concentrations of hemoglobin, leptin, triiodothyronine (T3), insulin, insulin-like growth factor 1 (IGF-1), and glucose were measured before (PRE) and after (POST) the camp. Blood lactate (LA), heart rate (HR) and rating of perceived exertion (RPE) from a submaximal treadmill running test, jump height from counter movement jump (CMJ), and power from a reactive jump test (RJ) were also measured PRE and POST. Results: Mean EA was 40.3 ± 17.3 kcal · kgFFM–1 · d–1. 58% of the participants had suboptimal EA, 37% had low EA, and 53% had suboptimal carbohydrate intake. HR, HR/RPE ratio, LA/RPE ratio, CMJ, hemoglobin, leptin, T3, and insulin decreased from PRE to POST. RPE and glucose increased from PRE to POST. EA during the camp correlated with changes in LA (r = 0.54, p = 0.018), LA/RPE (r = 0.65, p = 0.003), and RJ (r = 0.47, p = 0.043). Conclusions: Many athletes had difficulties in meeting their energy and carbohydrate requirements during a training camp. Furthermore, sufficient EA may help to avoid overreaching and to maintain performance during an intensive training period.

New forms of neoliberal femininity create demanding horizons of expectation for young women. For talented athletes, these pressures are intensified by the establishment of dual-career discourses that construct the combination of high-performance sport and education as a normative, ‘ideal’ pathway. The pressed time perspective inherent in dual-careers requires athletes to employ a variety of time-related skills, especially for young women who aim to live up to ‘superwoman’ ideals that valorise ‘success’ in all walks of life. Drawing on existential phenomenology, and in-depth interviews with 10 talented Finnish sportswomen (aged 19–22), we explored their experiences of lived time when pursuing dual-careers in upper secondary sport schools. Exploring participants’ bodily experiences of inhabiting the achievement life-world, we analyse how these sportswomen either learned ways of living up to this ambitious script or came to understand the detrimental effects of the script, necessitating other ways of being. For those who experience a disjuncture between the ‘perfect’ and their embodied experience, self-care practices are needed to restore life-world harmony, and orient to alternative futures.

The focus of dual career (DC) research has shifted from exploring individual experiences within Athletic Talent Development Environments (ATDEs) toward understanding the impact of the environment and the broader cultural context on individuals’ developmental trajectories in Dual Career Development Environments (DCDEs). To comply with national and EU recommendations for socially responsible elite sport, many successful ATDEs list DC as one of their primary values and advertise themselves as DCDEs in order to attract more athletes. The present study aimed to evaluate whether and how a talent development environment for youth athletes in Finland has transformed from an ATDE to DCDE by exploring the environment’s success factors and organisational culture. This study is grounded in the theoretical framework of Holistic Ecological Approach and follows the Real-Time Case Method. Principal methods of data collection included interviews, observations, and documents. The results indicated that the environment was characterised by an incoherent organisational culture, and the environment was identified as an ATDE rather than a DCDE. We suggest that for the Finnish sports environment to successfully transform into a functioning DCDE, changes in the organisational culture are necessary and DC recommendations should be integrated into the environment to provide resources for student-athletes to develop a balanced life and the prerequisites to succeed in future endeavours. peerReviewed

It is not known whether decrease in physical activity (PA) is associated with binge drinking among former athletes. The purpose of this study was to investigate the reciprocal associations between PA and use of alcohol among former athletes and controls at four time points. Furthermore, we examined whether there were longitudinal latent profiles related to use of alcohol, smoking and PA during the follow-up. Finnish male former elite athletes (n = 1633) and matched controls (n = 1099) questionnaire-reported their PA, alcohol consumption and smoking at four time points in 1985, 1995, 2001 and 2008. Former athletes were more physically active and smoked less than controls, but in all profiles smoking decreased during the follow-up. Former athletes consumed alcohol significantly more compared to controls in 1985, especially if their athletic career had ended suddenly by sports injury. At other time points, no differences were seen. Five latent profiles were found, and there were significant differences between former athletes and controls in the probabilities to belong to four of them. PA decreased in four of five profiles, while alcohol consumption decreased or increased in some profiles. But PA did not predict later alcohol consumption at any time point. Cross-lagged path model indicated that the mutual associations of alcohol use and PA were weak at most. Although risk of excessive alcohol consumption may increase in individuals, whose athletic career has ended suddenly by sports injury, overall PA and alcohol affected each other’s development only modestly among former athletes and controls during the 23-year follow-up. peerReviewed

The present study examined the identity profiles that upper-secondary-school Finnish student-athletes show, and the extent to which these profiles were associated with their athletic and academic achievements and withdrawal from sports and school. A total of 391 adolescent athletes (51% females) completed assessments of student and athletic identity four times during their time in upper secondary school. Using growth mixture modeling, three groups were identified: (a) dual identity (77%), (b) changing identity (5%), and (c) athletic identity (18%). The higher the academic achievement was at Time 1, the more likely the athletes were to show dual identity than athletic identity profile. Similarly, athletes with dual identity showed higher subsequent academic achievement at Time 4 than those with an athletic identity profile. Finally, athletes with dual identity were more likely and athletes with athletic identity less likely to withdraw from sport activities during upper secondary school than expected by chance. peerReviewed

Purpose Exercise and aging may modulate muscle protein homeostasis and autophagy, but few studies examine highly-trained middle-aged or older individuals. This study elucidated the effects of a new long-term training stimulus on markers of muscle autophagy and unfolded protein response (UPR) and on sprint running performance in masters sprinters. Methods Thirty-two male competitive sprinters (aged 40–76 years) were randomly divided into experimental (EX) and control (CTRL) groups. The EX training program was a combination of heavy and explosive strength and sprint exercises aimed at improving sprint performance. Fifteen and thirteen participants completed the 20-week intervention period in EX and CTRL, respectively. The latter were told to continue their routine exercises. Key protein markers were analyzed by western blotting from vastus lateralis (VL) muscle biopsies. Muscle thickness of VL was analyzed by ultrasonography and sprint performance by a 60-meter running test. Results EX induced improvement in 60-meter sprint performance when compared to controls (time x group, P = 0.003) without changes in VL muscle thickness. Content of lipidated microtubule-associated protein 1A/1B-light chain 3 (LC3-II) increased in EX (P = 0.022) suggesting increased autophagosome content. Additionally, an autophagosome clearance marker sequestosome 1 (p62) decreased in EX (P = 0.006). Markers of UPR selectively modulated with decreases (e.g. ATF4, P = 0.003) and increases (e.g. EIF2α, P = 0.019) observed in EX. Conclusions These findings suggest that a new intensive training stimulus that combines strength training with sprint training may increase muscle autophagosome content in a basal state without any evidence of impaired autophagosome clearance in masters sprinters. Simultaneously, the combined training may have a selective effect on the content of UPR signaling components. peerReviewed

Using the multi-states (MuSt) theory as a framework, the present study focused on the individual (personality) antecedents of psychobiosocial states. Psychobiosocial states comprise emotional subjective experiences and their correlates (cognitive, motivational, volitional, bodily, motor-behavioural, operational, and communicative), that can be functional for performance (helpful) or dysfunctional (harmful). Specifically, we examined the relationships between two perfectionism dimensions (perfectionistic strivings and concerns) and functional and dysfunctional psychobiosocial states. The hypothesised mediational role of competitive appraisals was also tested. Participants (N = 271, 138 female, 133 male, M age = 22.74 ± 7.01) completed questionnaires assessing the targeted variables. Structural equation modelling revealed that perfectionistic strivings were positive predictors of functional states directly and via challenge appraisals. On the other hand, perfectionistic concerns were positive predictors of dysfunctional states directly and via threat appraisals. Results provide support to MuSt theory and extend the literature on the antecedents of athletes’ performance related feeling states. Findings also provide support for the holistic conceptualization of psychobiosocial states encompassing the functionality dimension. The results highlight the importance of developing interventions aimed at helping athletes high in perfectionistic concerns evaluate situations as a challenge (and less of a threat) and increasing their perceived resources. peerReviewed

AimTo evaluate differences in menstrual and pubertal history and trends in eating behaviours among women with and without a competitive sports background. Additionally, we investigated if menstrual history and eating behaviours are associated with sports career-related factors.MethodsThis retrospective study was conducted on 100 women with a competitive endurance sports background and their age-matched, gender-matched and municipality-matched controls (n=98). Data were collected using a questionnaire using previously validated instruments. Generalised estimating equations were used to calculate associations of menstrual history and eating behaviours with outcome variables (career length, participation level, injury-related harms and career termination due to injury).ResultsAthletes reported higher rates of delayed puberty and menstrual dysfunction than controls. No differences between the groups were observed in the Eating Disorder Examination Questionnaire short form (EDE-QS) scores at any age. Previous disordered eating (DE) was associated with current DE in both groups. Among athletes, higher EDE-QS scores during the sports career were associated with a shorter career (B=−0.15, 95% CI −0.26 to –0.05). Secondary amenorrhoea was associated with lower participation level (OR 0.51, 95% CI 0.27 to 0.95), injury-related harms during the career (OR 4.00, 95% CI 1.88 to 8.48) and career termination due to injury (OR 1.89, 95% CI 1.02 to 3.51).ConclusionThe findings indicate that DE behaviours and menstrual dysfunction, specifically secondary amenorrhoea, have a disadvantageous relationship with a sports career in women competing in endurance sports. DE during the sports career is associated with DE after the career.

Purpose Whether elite athletes, who have been exposed to vigorous-intensity exercise combined with other stressors, have elevated systemic low-grade inflammation, remains largely unclear. To address this question, we studied the levels of six inflammatory cytokines as potential biomarkers of a low-grade inflammatory state in elite athletes after an 11-month training and competition season. Methods We collected sera from 27 Finnish elite cross-country skiers and 27 gender- and age-matched, moderately-exercising controls. The serum concentrations of C-reactive protein (CRP), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α), glycoprotein acetyls (GlycA), interleukin 10 (IL-10), and interferon gamma (IFN-γ) cytokines were quantified as surrogate markers of low-grade inflammation. Results The athletes were found to have significantly lower concentrations of CRP (P = 0.0232) and higher concentrations of IL-10, TNF-α, and IFN-γ (P = 0.0097, P = 0.0256, and P = 0.0185, respectively) than the controls. No significant differences between athletes and controls were detected in the concentrations of IL-6 and GlycA. The inflammatory score (IS) did not differ significantly between athletes and controls. Conclusion The results of this study argued against the hypothesis of a significant chronic low-grade inflammation in response to prolonged high-performance exercise among elite endurance athletes.

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Previous studies on periodization have led to the view that most athletes fail to peak at major events. These conclusions might be based on definitions of “peak performance” that are too narrow. In this study, a track and field athlete was defined as succeeding in a competition if their outcome was within the acceptable range from the best result of the season. The data are from seven championship finals and semifinals together with 42 Diamond League competitions from the 2010s, altogether 7,087 individual results. All field events and running events up to 400 m were included. The majority of athletes succeeded in major events (67.0% in sprint and 57.5% in field events). Overall, championship finals elicit success rates that are more than 70% higher than the basic level achieved in Diamond League competitions (p

The age-related decline in muscle function, particularly muscle power, is associated with increased risk of important clinical outcomes. Physical activity is an important determinant of muscle function, and different types of physical activity e.g. power-based versus endurance-based exercise appear to have differential effects on muscle power. Cross-sectional studies suggest that participation in power-based exercise is associated with greater muscle power across adulthood but this has not been investigated longitudinally. We recruited eighty-nine male and female power and endurance master athletes (sprint and distance runners respectively, baseline age 35–90y). Using jumping mechanography, we measured lower limb muscle function during a vertical jump including at least two testing sessions longitudinally over 4.5 ± 2.4y. We examined effects of time, discipline (power/endurance) and sex in addition to two- and three-way interactions using linear mixed-effects models. Peak relative power, relative force and jump height, but not Esslingen Fitness Index (indicating peak power relative to sex and age-matched reference data) declined with time. Peak power, force, height and EFI were greater in power than endurance athletes. There were no sex, discipline or sex*discipline interactions with time for any variable, suggesting that changes were similar over time for athletes of both sexes and disciplines. Advantages in lower limb muscle function in power athletes were maintained with time, in line with previous cross-sectional studies. These results suggest that improvements in lower limb function in less active older individuals following power-based training persist with continued adherence, although this requires further investigation in interventional studies. Supplementary Information The online version contains supplementary material available at 10.1007/s00223-021-00907-3.

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This study aims to highlight how an existential-humanistic perspective can inform athlete support and in doing so, emphasise the importance of explicating the philosophical underpinnings of athlete lifestyle support. Drawing on applied experience with elite youth cricketers over a twelve-month period, ethnographic data was collected through the observation, maintenance of case notes and a practitioner reflective diary. Based on thematic analysis (Braun & Clarke, 2006), we created three non-fictional vignettes that we use to illustrate how existential-humanistic theorising can inform lifestyle support. We discuss the implications of this professional philosophy in terms of considerations for performance and talent development programmes and how holistic support for athletes is positioned. We also discuss implications for athlete lifestyle and performance psychology practitioners, with regard to training, underpinning theoretical grounding of support and the strategic positioning of their practitioner roles.

Exercise has been shown to affect gut the microbiome and metabolic health, with athletes typically displaying a higher microbial diversity. However, research on the gut microbiota and systemic metabolism in elite athletes remains scarce. In this study, we compared the gut microbiota profiles and serum metabolome of national team cross-country skiers at the end of an exhausting training and competitive season to those of normally physically-active controls. The gut microbiota were analyzed using 16S rRNA amplicon sequencing. Serum metabolites were analyzed using nuclear magnetic resonance. Phylogenetic diversity and the abundance of several mucin-degrading gut microbial taxa, including Akkermansia, were lower in the athletes. The athletes had a healthier serum lipid profile than the controls, which was only partly explained by body mass index. Butyricicoccus associated positively with HDL cholesterol, HDL2 cholesterol and HDL particle size. The Ruminococcus torques group was less abundant in the athlete group and positively associated with total cholesterol and VLDL and LDL particles. We found the healthier lipid profile of elite athletes to co-occur with known health-beneficial gut microbes. Further studies should elucidate these links and whether athletes are prone to mucin depletion related microbial changes during the competitive season. peerReviewed

The key challenges in sustainable elite sports concern young athletes´ holistic development. Consequently, preparation for dual careers has been recommended to enhance athletes’ well-being and equip them for life after sports. The aim of this study was to examine the developmental associations between self-esteem and career adaptability among adolescent athletes across the high school years and investigate the role of gender in these developmental trajectories. A total of 391 student-athletes were followed up four times from the beginning of high school (T1) to its end (T4) using the Dual Career Form of the Career Adapt-Abilities Scale and the Self-Esteem Questionnaire. The results indicated that individual differences in student-athletes’ self-esteem and career adaptability were relatively stable across the high school years and were thus modeled via the between-persons factors capturing differences between individuals across time. The results further showed that the overall levels of self-esteem and career adaptability were positively associated. Males showed higher overall levels of career adaptability and self-esteem than females. This study suggests that it is important to facilitate youth athletes’ self-regulation resources by involving them in vocational developmental tasks. Further, gender differences should be considered when supporting student-athletes’ development. peerReviewed

Purpose The purpose of this study was to compare heart rate (HR) and heart rate variability in young endurance athletes during nocturnal sleep and in the morning; and to assess whether changes in these values are associated with changes in submaximal running (SRT) and counter-movement jump (CMJ) performance. Methods During a three-week period of similar training, eleven athletes (16 ± 1 years) determined daily HR and heart rate variability (RMSSD) during sleep utilizing a ballistocardiographic device (Emfit QS), as well as in the morning with a HR monitor (Polar V800). Aerobic fitness and power production were assessed employing SRT and CMJ test. Results Comparison of the average values for week 1 and week 3 revealed no significant differences with respect to nocturnal RMSSD (6.8%, P = 0.344), morning RMSSD (13.4%, P = 0.151), morning HR (-3.9 bpm, P = 0.063), SRT HR (-0.7 bpm, P = 0.447), SRT blood lactate (4.9%, P = 0.781), CMJ (-4.2%, P = 0.122) or training volume (16%, P = 0.499). There was a strong correlation between morning and nocturnal HRs during week 1 (r = 0.800, P = 0.003) and week 3 (r = 0.815, P = 0.002), as well as between morning and nocturnal RMSSD values (for week 1, r = 0.895, P Conclusion This study concluded that HR and RMSSD obtained during nocturnal sleep and in the morning did not differ significantly. In addition, weekly changes in training and performance were small indicating that fitness was similar throughout the 3-week period of observation. Consequently, daily measurement of HR indices during nocturnal sleep provide a potential tool for long-term monitoring of young endurance athletes.

This study focuses on transgender experiences in martial arts. Interviews with three Finnish and two British transgender martial artists were thematically analyzed, and findings were interpreted through the lens of queer theory. Two themes were identified related to the ways that transgender martial artists experience their sporting contexts, namely martial arts as an empowering and inclusive context and the challenges related to being transgender in martial arts. Two themes were also identified when it comes to participants’ strategies for coping with cis-/heteronormativity in martial arts. Whenever possible, participants employed social change strategies, whereas other times, they drew on self-care strategies. Following this, we suggest a need for context-specific, protective policies; nonbinary means of organizing sport; and gender diversity education for instructors to better cater for the specific needs of transgender people in sport. peerReviewed

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