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Becoming whole: Mental health and psychosocial considerations of the transgender athlete

I think the beauty of being human is that we are incredibly, intimately near each other, we know about each other, but yet we do not know or never can know what it’s like inside another person (O'Donahue, 2008). Jordan K.’s personal story: being different meant violence If you asked me where I was from, I would most likely give you a series of locations and…

The effects of the gender transition on musculoskeletal health

Introduction The estimated prevalence of transgender individuals in the United States is 390 in 100,000 [ ]. In order to better care for the transgender athlete, a provider must understand the biochemical changes that occur during gender transition and their potential effect on athletes' physiology, injury risk, and performance. It is important to gather a detailed history on pharmacological agents and other interventions used throughout patients'…

Introduction to medical transition

For some transgender individuals, medical transition represents an important aspect of gender affirmation and alleviation of feelings of gender dysphoria. As with other aspects of gender transition, personal preferences and goals related to medical transition can vary widely between individuals. Broadly, interventions can be divided into gender-affirming hormone therapy and surgical interventions. Some transgender individuals choose to undergo medical transition, some choose to undergo surgical interventions,…

Special considerations for the transgender and nonbinary athlete

Epidemiology An estimated 0.6% of adults in the United States identify as transgender [ ]. The prevalence of transgender youth has been more difficult to predict. In one study, the youngest group was those aged 13–17 and it was predicted that 0.7% of individuals identified as transgender, which is slightly higher than that of the adult population [ ]. Although the exact prevalence of nonbinary identities…

What does transgender mean?

Introduction Before a practitioner can begin work with a Transgender Athlete, it is important to be comfortable with a vernacular that is applicable to all individuals, but often exclusively associated with members of the LGBTQ+ community. In modern society, terms like Gender, Sex, Identities, Pronouns, and Sexual Orientation , are often viewed through rainbow-colored glasses, despite the universality of these domains. Although these topics apply to…

Esports

History Electronic sports (esports), or competitive sports competition focused around video games, is a rapidly growing industry Esports athletes train 10–12 hours a day, crafting their skills in various console and computer-based video games, including League of Legends, Counterstrike: Global Offensive, Rocket League, Overwatch , and Fortnite. Top-performing esports athletes possess a specific skill set of enhanced neurocognitive processing speed, reaction time, and impulse control, making…

The Extreme Athlete

Introduction The definition of extreme sports (ES) includes any sport featuring high speed, height, real or perceived danger, a high level of physical exertion, highly specialized gear or spectacular stunts, and involving elements of increased risk for major injuries or fatalities. ES activities tend to be individual and can be pursued both competitively and noncompetitively. Often taking place in remote locations and in variable environmental conditions…

Rodeo and Equestrian Sports

Rodeo Introduction Rodeo is a competitive sport with participants of all ages and at all competition levels. Athletes may compete in a single event or multiple events and may attend anywhere from one to four or five events in a single weekend. Most events are derived from skills needed to work cattle. Epidemiology The composite injury rate for professionals is 16.6/1000 competitor exposures and for high…

Rock Climbing

Introduction Rock climbing popularity and access have opened the sport up to climbers of all ages. Beginning with Tokyo 2020, sport climbing included in Summer Olympic Games International Federation of Sports Climbing (IFSC) organizes senior and junior World Championships, World Cup, and international events Climbing requires strength, endurance, flexibility, agility, and courage Equipment advances have made climbing safer Overuse and climbing-specific injuries pose challenges to climbers…

Ultraendurance and Adventure Racing and Events

Introduction Ultraendurance and adventure races are prolonged events, usually longer than 6 hours (and some may be as long as 10 days) that usually take place in remote, austere, harsh, or extreme environments. These events include challenging terrain, extreme elevation changes, inclement weather, and on-course obstacles. Adventure races require participants to perform multiple disciplines that may include trail running, hiking, mountaineering, mountain biking, boating/rafting, climbing, caving,…

Mass Participation Endurance Events

General Principles This chapter develops an algorithm for managing mass participation endurance events. The medical director is the safety and health advocate for athletes who participate in the race. The safety of athletes is the primary purpose of race medical operations. A central medical command structure can improve the efficiency of the medical team, integrate community resources into the medical plan, and reduce response times for…

Inline Skating, Skateboarding, and Bicycle Motocross

Introduction Inline skating, skateboarding, and bicycle motocross (BMX) are relatively new sports that are often included in the category of adventure and extreme sports (AES). These sports have had increased participation and popularity in the last couple of decades, in part because of AES events (such as X-games); inclusion of some AES in the Olympic Games; and social media, Internet sites, sponsorships, television channels, and AES…

Mountain Biking

General Principles Definitions The term “mountain biking” broadly refers to riding bikes with specific design characteristics in various off-road settings. Mountain bikes generally differ from road bikes in several ways: a smaller frame, stronger wheels, larger range of gears, a wider flat or upright handlebar, hydraulic brakes, suspension, and wider, knobby tires. There are many riding and bike types, with some overlap between bikes and riding…

Road Biking

General Principles Races Road Racing Stage races: Multiday races over consecutive days with daily stage winners and an overall winner based on cumulative time; mass start races where the athletes ride in a peloton. Grand tours: Tour de France, Giro d’Italia, and Vuelta a España; usually include a prologue, flat stages for “sprinters,” hilly stages for “climbers,” and time trials. Road races: Mass-start point-to-point races between…

Track and Field

Introduction Overview Track and field often attracts multisport athletes. The sport involves year-round competition and training. Differing athletic events subject athletes to differing demands. For example: The shot put demands explosive power. Endurance events demand high levels of aerobic conditioning and stamina. Sprint distances (100 m, 200 m, and 400 m) demand explosive conditioning for power, flexibility, and anaerobic conditioning. Middle distance races (800 m or…

Dance

Introduction Dance is an activity that can be found in most cultures dating back to ancient times. Dance is unique in its fusion of art and athletic activity. Dance can increase cardiorespiratory fitness, muscular strength and endurance, flexibility, and bone mineral density. Classical ballet provides a foundation for other dance forms. Other popular forms of dance include contemporary (modern), jazz, street, tap, Irish, folk dance, and…

Cheerleading

Introduction November 2, 1898, is considered cheerleading’s official start date when the University of Minnesota organized a “yell leader” group of six male students for football games. By 1923, the University of Minnesota allowed women to participate in cheerleading, but female participation did not start to grow significantly until World War II. Popularity among women continued to grow in the latter half of the 20th century,…

Gymnastics

Introduction Disciplines: acrobatic, artistic, gymnastics for all, parkour, rhythmic, tumbling, and trampoline ( Tables 90.1 to 90.5 ) Olympic disciplines: artistic, rhythmic, trampoline Table 90.1 Acrobatic Gymnastics (Men and Women) Events Levels Women’s pairs Men’s pairs Mixed pairs Women’s group Men’s group Junior Olympic Elite Levels 1–10 Competitive levels: 2–10 Future Stars Junior Senior See . Table 90.2 Artistic Gymnastics Events Women’s Programs Vault Uneven…

Mixed Martial Arts

General Principles Overview The popularity of mixed martial arts (MMA) has grown tremendously in the last 20 years. Despite this incredible growth, consensus with respect to management of common injuries and proper ringside management of these athletes is lacking. Coverage of MMA events can be overwhelming without any basic understanding of either the sport or the ringside considerations for the evaluation and management of competitors. Other…

Wrestling

Acknowledgment The author would like to acknowledge the work of Aaron Monseau, MD, on the previous edition’s chapter. Introduction Wrestling is widely considered to be the world’s oldest sport, dating back to the ancient Greeks. It is a worldwide sport, with particular popularity in Eastern Europe, the Middle East, Asia, and North America. Men’s wrestling was an original Olympic sport. Women’s wrestling was added to the…