Translational sports medicine最新文献

{"title":"Palmar Cooling as a Thermoregulatory Intervention: Mechanistic Basis and Implications for Exercise and Clinical Applications.","authors":"Robert J Heins, William E Reisinger, Brett Norris, Robert Rogers","doi":"10.1155/tsm2/4204958","DOIUrl":"10.1155/tsm2/4204958","url":null,"abstract":"<p><p>During exercise, rising metabolic heat production creates competition for blood flow between skeletal muscle and the cutaneous vasculature. The resulting redistribution elevates cardiovascular (CV) strain and accelerates fatigue, particularly during environmental heat stress or in individuals with impaired thermoregulatory capacity. Strategies that enhance heat dissipation without further burdening CV function may therefore improve exercise tolerance. Palmar cooling (PC) is an intervention that targets the glabrous skin of the hands, where dense arteriovenous anastomoses facilitate high-flow, low-resistance blood flow and efficient convective heat exchange, thereby augmenting systemic heat dissipation through the peripheral circulation. Evidence in healthy and athletic populations suggests that PC can decrease thermal strain while improving endurance capacity, resistance training volume, and perceptual responses when applied under meaningful heat stress, although current findings remain heterogeneous. Given age- and disease-related reductions in thermoregulatory and CV reserve, PC may have translational relevance for enhancing exercise tolerance during rehabilitation, reducing heat-related illness risk, and supporting individuals with cardiopulmonary disease. Improved within-session tolerability may, in turn, facilitate greater cumulative training stimulus and adherence, with potential downstream benefits for overall exercise capacity. This narrative review discusses the thermoregulatory, CV, and exercise physiology underlying PC, evaluates the current evidence, and outlines future directions to support clinical translation.</p>","PeriodicalId":75247,"journal":{"name":"Translational sports medicine","volume":"2026 ","pages":"4204958"},"PeriodicalIF":1.9,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apophyseal Injuries of the Lower Extremities in Male Adolescent Football Players From a Single Academy: A One-Season Prospective Cohort Study.","authors":"Simen Rygh, Thor Einar Andersen, Joar Harøy","doi":"10.1155/tsm2/4422014","DOIUrl":"10.1155/tsm2/4422014","url":null,"abstract":"<p><strong>Background: </strong>Youth football players experience a high incidence of injuries, particularly apophyseal injuries in the lower extremities. However, the prevalence and characteristics of these injuries in male adolescent academy players remain inadequately documented.</p><p><strong>Objective: </strong>To investigate the prevalence, incidence, and characteristics of apophyseal injuries in the lower extremities among male adolescent academy football players over one season.</p><p><strong>Design: </strong>One-season prospective cohort study.</p><p><strong>Participants: </strong>Fifty-eight Norwegian male adolescent academy football players (aged 12-19 years) were investigated during the 2022 football season.</p><p><strong>Methods: </strong>Weekly self-reports of health problems were collected using the Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H2). Clinical examinations were performed to diagnose apophyseal injuries.</p><p><strong>Results: </strong>The average weekly prevalence of self-reported health problems was 37%, while the average weekly prevalence of clinically diagnosed apophyseal injuries in the lower extremities was 12%. The incidence rate for these injuries was 4.6 per 1.000 h of exposure. Pubic apophysitis was the most common injury (32% of diagnosed cases). Most injuries (77%) had a gradual onset, with 81% occurring during or directly after training sessions.</p><p><strong>Conclusions: </strong>Apophyseal injuries represent a significant health problem in male youth football players, with pubic apophysitis being the most prevalent condition. These findings highlight the need for improved awareness, early detection, and targeted injury prevention strategies in youth football.</p>","PeriodicalId":75247,"journal":{"name":"Translational sports medicine","volume":"2026 ","pages":"4422014"},"PeriodicalIF":1.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Effect of Different Resisted Sprint Loads on Joint Kinematics and Electromyographic Activity in Experienced Sprinters.","authors":"Roland van den Tillaar, Sam Gleadhill, Pedro Jiménez-Reyes, Ryu Nagahara","doi":"10.1155/tsm2/2139446","DOIUrl":"https://doi.org/10.1155/tsm2/2139446","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate the acute effect of different active resisted sprint loads upon joint kinematics and leg electromyography (EMG) activity in experienced sprinters.</p><p><strong>Methods: </strong>Thirteen experienced male sprinters (age: 20.5 ± 1.3 years, body mass: 66.8 ± 4.5 kg and body height: 1.74 ± 0.06 m) with best 100-m times of 11.24 ± 0.34 s performed a 50-m sprint with maximal effort from three-point start. Afterwards, they performed different resisted sprints with maximal effort provided by a robotic pulley system that resulted in 65%, 50%, 25% and 10% reduction of peak velocity for, respectively, 10, 20 and 30 m in randomised order while spatiotemporal parameters, joint kinematics and EMG of nine leg muscles were measured from the point which sprint velocity plateaued.</p><p><strong>Results: </strong>The main findings were that increasing velocity-decrement conditions resulted in reduced sprint velocity, shorter step length, lower step frequency and prolonged ground contact time together with joint kinematics changing to a more flexed posture and forward leaning at touch down and less extension at toe off, with lower, maximal angular velocities during contact times. These adaptations resulted in more quadriceps dominant activity with increased stabilizing activity of gluteus medius, while hamstring activity decreased due to the lower angular knee extension during flight times with increasing resisted loads.</p><p><strong>Conclusion: </strong>This study suggests that while resisted sprinting is an effective tool for increasing force production demands, higher resisted loads (> 50% velocity decrement) are associated with progressively different kinematic and neuromuscular patterns, likely reflecting the combined effects of increased force demands and thereby reduced running velocity.</p>","PeriodicalId":75247,"journal":{"name":"Translational sports medicine","volume":"2026 ","pages":"2139446"},"PeriodicalIF":1.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Efficiency as a Potential Marker of Firefighter Expertise: A Pilot Study of Heart Rate Variability Monitoring in Realistic Search-and-Rescue Training.","authors":"Xia Zhong, Yu Yan, Haoxiang Gao, Jingyi Wang, Siyuan Tang, Guang Ge, Jinzhen Zhao","doi":"10.1155/tsm2/5788863","DOIUrl":"https://doi.org/10.1155/tsm2/5788863","url":null,"abstract":"<p><p>Expertise in high-stakes occupations is typically evaluated through performance outcomes, potentially neglecting physiological efficiency-a dimension critical for career longevity in physically demanding work. In this pilot study, we investigated whether expert firefighters achieve comparable task performance with lower cardiovascular activation and faster autonomic recovery than novices during realistic search-and-rescue operations. Twenty-two male firefighters completed navigation tasks in a high-fidelity training facility under operational conditions (complete darkness, full protective equipment). Using a 2 × 2 quasi-experimental design, we manipulated navigation strategies (route-based vs. survey-based) and continuously recorded heart rate variability across baseline, execution, and recovery periods. Our preliminary data suggest that behavioral outcomes and physiological responses may be largely decoupled in this context. Experts and novices demonstrated equivalent task completion times and accuracy. However, experts exhibited substantially lower heart rate elevation during tasks and 46% greater parasympathetic recovery post-task. Critically, an expertise-by-strategy interaction suggested that experts' efficiency advantages were magnified when employing route-based strategies aligned with training protocols, whereas novices showed no strategy-dependent differences. These findings provide preliminary evidence that physiological efficiency represents a distinct expertise component, suggesting that identical overt performance can mask vastly different internal costs. Heart rate variability monitoring may therefore serve as a useful exploratory tool to help identify individuals requiring additional skill consolidation or recovery support before overt performance degrades.</p>","PeriodicalId":75247,"journal":{"name":"Translational sports medicine","volume":"2026 ","pages":"5788863"},"PeriodicalIF":1.9,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Research-Practice Gap: Diffusion and User Experience of a Digital Health Platform in Swedish Athletics.","authors":"Jenny Jacobsson, Per Nilsen, Siw Carlfjord, Jan Kowalski, Örjan Dahlström, Ulrika Tranaeus","doi":"10.1155/tsm2/2452118","DOIUrl":"https://doi.org/10.1155/tsm2/2452118","url":null,"abstract":"<p><strong>Background: </strong>Evidence-based health information often fails to reach everyday sports practice, leaving a gap between research and real-world application. Digital platforms can help bridge this research-practice gap by disseminating accessible and sport-specific health guidance to coaches, parents, and athletes. <i>Frisk Friidrott</i>, developed by the Swedish Athletics Federation, is a digital health platform providing evidence-based information on injury prevention, training, nutrition, and mental health in youth athletics.</p><p><strong>Objective: </strong>To evaluate the diffusion and user experience of <i>Frisk Friidrott</i> among one group of intended end users, coaches and parents, for youth aged 12-15 years in Swedish Athletics.</p><p><strong>Methods: </strong>A multimethods, cross-sectional study was conducted among coaches and parents of athletes aged 12-15 years. Quantitative data (<i>n</i> = 267) were collected through a web-based survey and analyzed descriptively. Qualitative data were obtained from open-ended survey responses (<i>n</i> = 40) and semistructured interviews (<i>n</i> = 5) and analyzed thematically. Two dimensions from the Reach, Effectiveness, Adoption, Implementation and Maintenance Sports Setting Matrix (RE-AIM-SSM framework), reach and adoption, were used to evaluate diffusion, while constructs from the Technology Acceptance Model, perceived usefulness and perceived ease of use, were applied to assess user experience.</p><p><strong>Results: </strong>Thirty-one percent of respondents had heard of the platform, and 27% had initially adopted it. Adoption was higher among coaches, especially those with training in sports medicine or athletics. Adopters reported high perceived usefulness and credibility but identified navigation and structural limitations as barriers to ease of use.</p><p><strong>Conclusion: </strong>Passive diffusion resulted in modest reach. Integrating the platform into coach education and improving usability and promotion may enhance adoption and sustained engagement within Swedish Athletics.</p>","PeriodicalId":75247,"journal":{"name":"Translational sports medicine","volume":"2026 ","pages":"2452118"},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing Clinically Relevant Cut-Off Values for Trunk Muscle Size in Relation to Lower Limb Injuries in AFL Players.","authors":"Clint Frazer, M Dilani Mendis, Peter Blanch, Brittany Grantham, Julie A Hides","doi":"10.1155/tsm2/5549825","DOIUrl":"10.1155/tsm2/5549825","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between trunk muscle morphology and lower limb injury risk in elite Australian Football League (AFL) players and to explore clinically interpretable cut-off values for injury risk stratification.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Method: </strong>Participants included 43 athletes from one professional AFL team (mean age 23.9 years, height 190 cm, mass 90.2 kg). Preseason ultrasound imaging was used to assess trunk muscle size and function, including cross-sectional area (CSA) of the lumbar multifidus and quadratus lumborum (QL) and thickness of the transversus abdominis (TrA) and internal oblique (IO). Players were monitored over a full playing season for lower limb injuries resulting in games missed. Group comparisons and unadjusted logistic regression analyses were performed. Receiver operating characteristic (ROC) analyses were used to explore potential cut-off values.</p><p><strong>Results: </strong>Smaller multifidus CSA (L₅ average < 8.17 cm²; OR 10.0 [2.2-45.2]; <i>p</i> < 0.01) and larger QL CSA (average > 8.44 cm²; OR 7.3 [1.8-29.8]; <i>p</i> < 0.01) were associated with increased odds of lower limb injury. Trunk muscle thickness and contraction measures were not associated with lower limb or soft tissue injuries (all <i>p</i> > 0.05), with small and inconsistent effect sizes.</p><p><strong>Conclusion: </strong>Trunk muscle morphology is associated with lower limb injury risk in elite AFL players. These findings provide preliminary, clinically interpretable cut-off values that may assist in identifying athletes at increased risk; however, these thresholds require validation in larger cohorts. Trunk muscle assessment may support injury-risk screening and guide targeted physiotherapy interventions in applied high-performance settings.</p>","PeriodicalId":75247,"journal":{"name":"Translational sports medicine","volume":"2026 ","pages":"5549825"},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Semiprofessional Scottish Football Players' Acceleration and Deceleration Loads Across Playing Positions During Competitive Play and Training.","authors":"Mark Farrell, Judith V Lane, Prateek Rangra","doi":"10.1155/tsm2/6295249","DOIUrl":"10.1155/tsm2/6295249","url":null,"abstract":"<p><strong>Background: </strong>High-intensity accelerations (HIAccs) and high-intensity decelerations (HIDecs) are critical to football performance, yet little is known about their demands in semiprofessional contexts where training frequency and resources differ from the professional game.</p><p><strong>Purpose: </strong>This study quantified HIAcc and HIDec loads during competitive match play and training across playing positions in semiprofessional Scottish football.</p><p><strong>Methods: </strong>Thirty-three players were monitored over two competitive seasons (2021-2023) using 10-Hz Global Positioning System (GPS) devices, generating 1333 individual observations. Linear mixed models assessed total distance, frequency and peak magnitude of HIAcc and HIDec at two intensity thresholds (3-4 m/s² and > 4 m/s²) across playing positions and session types (MD-4, MD-2 and match day).</p><p><strong>Results: </strong>Position (<i>p</i> < 0.001) and session type (<i>p</i> < 0.001) significantly influenced HIAcc and HIDec demands. Full-backs recorded the highest deceleration loads, particularly > 4 m/s², whilst wide midfielders accumulated greater acceleration distances than central players. MD-4 sessions often exceeded match-day acceleration values (106%-120%), whereas match days consistently imposed higher deceleration demands. These patterns diverged from those reported in professional cohorts.</p><p><strong>Conclusion: </strong>Semiprofessional players display distinct positional and session-specific loading patterns compared with professional football. Tailored, position-specific training and modified periodisation strategies appear necessary to align training with the physical demands of competition in this population.</p>","PeriodicalId":75247,"journal":{"name":"Translational sports medicine","volume":"2026 ","pages":"6295249"},"PeriodicalIF":1.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical Analgesic Therapies for Acute, Sports-Associated Soft Tissue Injuries.","authors":"Mitchell S Howard, Wade Lee-Smith, Justin P Reinert","doi":"10.1155/tsm2/9124204","DOIUrl":"10.1155/tsm2/9124204","url":null,"abstract":"<p><p>Acute musculoskeletal injuries are common among sports participants and are frequently treated with topical analgesics; however, the comparative efficacy and safety of topical formulations remain under investigation. The objective of this study was to evaluate the efficacy and safety of topical nonsteroidal anti-inflammatory drugs (NSAIDs) and alternative topical therapies in the management of acute sports-associated soft tissue injuries, including sprains, strains, contusions, and soreness. A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, including randomized controlled trials that evaluated topical NSAIDs or other topical analgesics in patients with acute sports-related musculoskeletal injuries. Bias was assessed with the RoB-2 tool. The primary efficacy outcome was reduction in pain, measured by the visual analog scale (VAS) or similar validated tools, while the primary safety outcome was the incidence of treatment-emergent adverse effects. Eight randomized controlled trials comprising 1027 patient encounters met inclusion criteria. Across studies, topical diclofenac, ibuprofen, ketoprofen, and etofenamate demonstrated statistically significant reductions in VAS pain scores compared with placebo. Meta-analysis of all included trials revealed no significant reduction in pain intensity in active topical interventions versus placebo (95% CI -0.3768-5.2806; <i>p</i> = 0.09). A direct comparative analysis of diclofenac versus other NSAIDs did not demonstrate a statistically significant difference (effect size -2.07; 95% CI -5.60-1.46; <i>p</i> = 0.25), though heterogeneity of studies may limit these findings. Adverse effects were primarily mild and localized and were no different between groups (RR = 0.79; 95% CI 0.45-1.39; <i>p</i> = 0.41). Topical NSAIDs and alternative topical formulations may provide improved pain outcomes but did not show superiority between NSAID agents.</p>","PeriodicalId":75247,"journal":{"name":"Translational sports medicine","volume":"2026 ","pages":"9124204"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Speed-Related Running Mechanics Using IMU in Runners.","authors":"Raúl Cejudo-Alba, Xantal Borràs-Boix, Juan Pardo Albiach, Javier Martínez-Gramage","doi":"10.1155/tsm2/6892376","DOIUrl":"10.1155/tsm2/6892376","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this descriptive study was to evaluate lower-limb biomechanical parameters in runners of different sexes and analyse how these parameters are modulated across three intensities (65%, 85% and 100% maximal aerobic speed [MAS]).</p><p><strong>Methods: </strong>One hundred recreational runners (50 women, 50 men) completed a 2000-m time trial to determine MAS, followed by three 2-min treadmill bouts at 65%, 85% and 100% MAS. Kinematic and mechanical variables were recorded using the RunScribe™ inertial measurement system, with sensors positioned bilaterally on the shoes and on the sacral region.</p><p><strong>Results: </strong>Linear mixed-effects models showed a significant main effect of speed condition for most biomechanical outcomes. As speed increased from 65% to 100% MAS, runners showed shorter contact time and greater flight time, stride length, step rate, braking Gs, peak vertical ground reaction force, loading rates, shock, total shock and max pronation velocity. A significant main effect of sex was observed for several variables: men showed higher BG, flight time, stride angle, stride length, peak vertical ground reaction force, leg spring stiffness, loading rates and max pronation velocity, whereas women showed longer contact time. Sex × speed interactions were significant only for shock, total shock and max pronation velocity, indicating that most speed-related adaptations occurred in a similar direction in men and women.</p><p><strong>Conclusions: </strong>These findings provide a descriptive characterisation of sex- and speed-related IMU-derived running mechanics in runners. Standardised treadmill testing across relative intensities may help characterise how lower-limb mechanics are modulated by sex and running speed. Because injury incidence, running economy, race performance and longitudinal adaptations were not assessed, braking- and impact-related variables should be interpreted as hypothesis-generating rather than as evidence of injury risk or performance.</p>","PeriodicalId":75247,"journal":{"name":"Translational sports medicine","volume":"2026 ","pages":"6892376"},"PeriodicalIF":1.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing the Risk of Unintentional Doping From Supplements: A Practical Guide for Athletes and Support Teams.","authors":"Laura Mancin, Graeme L Close, Asker Jeukendrup, Marco Freschi, Jamie Pugh, Massimiliano Sala, Veronica Baioccato, Marco Vecchiato, Giuseppe D'Antona, Stefano Palermi","doi":"10.1155/tsm2/5919439","DOIUrl":"10.1155/tsm2/5919439","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Context: &lt;/strong&gt;Dietary supplements are widely used across all levels of sport. While the 'food first but not food only' approach remains central to sports nutrition, selected supplements may support performance, recovery or health when used appropriately. However, variable regulation, product contamination, mislabelling and inappropriate decision-making may expose athletes to inadvertent antidoping rule violations (ADRVs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Evidence acquisition: &lt;/strong&gt;This structured narrative review searched PubMed and Scopus for literature published between January 2000 and December 2025. Evidence from primary studies, randomised controlled trials, systematic reviews, meta-analyses, mechanistic studies, contamination analyses, behavioural research, consensus statements and official guidance documents from major sports and antidoping organisations was critically evaluated and synthesised. A PRISMA-style literature identification and evidence-selection diagram is provided as Supporting Table S1; the review was not designed as a systematic review or meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Narrative clinical review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Level of evidence: &lt;/strong&gt;Level V for the overall narrative framework, with supplement-specific strength of recommendation reported separately.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Evidence supporting supplementation varies substantially across categories. Creatine and caffeine have the most consistent evidence for selected performance outcomes, whereas beta-alanine, dietary nitrate and sodium bicarbonate show context-specific benefits. Iron and vitamin D have clearer clinical indications when deficiency is present, but limited evidence supports routine use in replete athletes. Many recovery- or health-oriented supplements rely on smaller, heterogeneous studies or indirect outcomes. Contamination risk is also heterogeneous and is highest for multi-ingredient products, preworkout supplements, weight-loss products, muscle-building products, 'testosterone boosters', selective androgen receptor modulators (SARMs) and other substances positioned as supplements despite pharmacological or prohibited profiles. Effective risk reduction requires individual nutritional assessment, evidence-based selection, third-party certification, product verification, education of athletes and Athlete Support Personnel, and systematic documentation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Supplement use in athletes should be considered a controlled, individualised and documented intervention rather than routine practice. The proposed framework integrates efficacy, evidence quality, mechanisms of action, contamination pathways, behavioural determinants, strict liability and antidoping risk to support safer supplementation decisions. Protecting athlete health and the integrity of clean sport requires a shift from performance-driven to risk-aware supplementation.Strength-of-Recommendation Taxonomy (SORT): Overall framework: B/C, bas","PeriodicalId":75247,"journal":{"name":"Translational sports medicine","volume":"2026 ","pages":"5919439"},"PeriodicalIF":1.9,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}