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Optimizing Athlete Health and Performance: Multidisciplinary Perspectives in Sports Medicine

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A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (1 May 2026) | Viewed by 9860

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Special Issue Editors

Dr. Carlos Braga

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Guest Editor Assistant

1. Federação Portuguesa de Rugby, 1600-131 Lisboa, Portugal
2. Faculdade de Medicina, Universidade de Coimbra, 3004-528 Coimbra, Portugal
3. USF Norton de Matos, ULS Coimbra, 3030-790 Coimbra, Portugal
4. Centro de Estudos e Investigação em Saúde—CEISUC, 3004-512 Coimbra, Portugal
Interests: sports medicine; athlete health; preventive medicine; sports performance; interdisciplinary approaches in sports medicine; injury prevention and rehabilitation; public health in sports

Dr. Júlio A. Costa

E-Mail Website
Guest Editor

FPF Academy, Portuguese Football Federation, FPF, Oeiras, Portugal
Interests: exercise physiology; injury prevention; strength and conditioning; monitoring of training and match load; health outcome
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Special Issue Information

Dear Colleagues,

Athlete health and performance optimization comprise a rapidly evolving field that demands a multidisciplinary perspective. Advances in sports medicine, cardiology, physiology, nutrition, biomechanics, psychology, and data science are reshaping the way we understand athlete care, from prevention to performance enhancement. The complexity of modern sports requires an integrated approach that not only addresses injury treatment and recovery but also emphasizes prevention, health promotion, and long-term well-being.

This Special Issue aims to compile contributions from diverse areas of expertise to explore innovative strategies that optimize athlete health and performance. Topics of interest include the management of overtraining and fatigue, the prevention and rehabilitation of musculoskeletal injuries, the role of nutrition and supplementation, and psychological and cognitive aspects of performance. We also welcome approaches utilizing wearable technologies, artificial intelligence, and precision medicine in sports.

In addition, this Special Issue aims to highlight emerging concerns in cardiovascular health and screening in athletes and former athletes, including cardiac adaptations to training, long-term heart health, and the role of technology in monitoring and prevention.

By garnering multidisciplinary perspectives, this Special Issue hopes to facilitate the exchange of exchange between clinicians, researchers, coaches, and policymakers. It seeks to foster evidence-based practices that safeguard athlete health while maximizing performance across all levels of sport, from recreational to elite competition.

Dr. Carlos Braga
Guest Editor Assistant

Dr. Júlio A. Costa
Guest Editor

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Keywords

sports medicine
athlete health
performance optimization
injury prevention
multidisciplinary approaches
rehabilitation
nutrition in sports
wearable technologies
preventive medicine
sports psychology

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Published Papers (6 papers)

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Research

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12 pages, 551 KB

Open AccessArticle

Injury History and Mental Health Indicators in Young Soccer Players: A Cross-Sectional Study

by Alejo García-Naveira, Carmen Cerezuela Díaz, Laura Gil-Caselles and Aurelio Olmedilla-Zafra

Medicina 2026, 62(4), 667; https://doi.org/10.3390/medicina62040667 - 1 Apr 2026

Viewed by 702

Abstract

Background and Objectives: The relationship between mental health and sports injuries has become increasingly important in youth soccer, due to developmental changes in this population, the high demands of training, and the competitive pressures of sport. This cross-sectional study examined the association between injury history (no injuries, 1–2, >2 injuries), mental health indicators (anxiety, stress, depression), and differences by sex, competitive category, and playing position. Materials and Methods: 146 soccer players (79 males, 67 females; ages 12–30; mean age = 16.65, SD = 2.34 years) from youth and senior categories of a professional club in Spain completed the STAI-T (trait anxiety), DASS-21 (state anxiety, stress, depression), sociodemographic and sports-related variables (gender, sports category, playing position), and self-reported injury history: no injuries (n = 39), 1–2 injuries (n = 80), >2 injuries (n = 27). The statistical analyses performed were one-way ANOVA (ηp²), χ² tests, and Games-Howell post hoc tests. Results: 73.3% of the players reported ≥1 injury (54.8% 1–2 injuries; 18.5% >2), with no differences by gender, position, or category (χ² range: p > 0.05). The ANOVA revealed significant differences for trait anxiety (F(2, 143) = 3.68, p = 0.029, ηp² = 0.049; small-to-moderate), and state anxiety (F(2, 143) = 4.63, p = 0.014, ηp² = 0.061; moderate). No effects were found for stress/depression (p > 0.12). The post hoc test (Games-Howell) indicates that the group with no injuries showed significantly lower trait anxiety (p = 0.038, d = 0.33) vs. 1–2 injuries, and state anxiety (p = 0.012, d = 0.70) vs. >2 injuries. Stress and depression showed a non-significant upward trend. Conclusions: A greater history of injuries is associated with higher levels of anxiety in youth soccer players. The findings suggest routine assessment of anxiety and training in emotional self-regulation for injury prevention and rehabilitation. Longitudinal studies are needed to clarify the bidirectional relationship. Full article

(This article belongs to the Special Issue Optimizing Athlete Health and Performance: Multidisciplinary Perspectives in Sports Medicine)

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16 pages, 660 KB

Open AccessArticle

Ventilatory Efficiency and End-Tidal CO₂ Kinetics During Active Recovery Following VT₂—Referenced Intermittent Exercise in Basketball

by Ștefan Adrian Martin, Barbara Cintia Sándor, George Mihăță Gavra, Gabriela Szabo and Roxana Maria Martin-Hadmaș

Medicina 2026, 62(3), 552; https://doi.org/10.3390/medicina62030552 - 16 Mar 2026

Viewed by 449

Abstract

Backround and Objectives: Basketball performance is shaped by repeated high-intensity actions interspersed with brief recovery. Conventional continuous or strictly incremental testing may not fully capture short active-recovery dynamics relevant to stop-and-go sports. Material and Methods: This study applied a VT₂-referenced progressive–intermittent treadmill protocol and focused on 60-s active-recovery kinetics to describe effort tolerance in an applied basketball setting. Basketball players from Mureș County completed anthropometry (24 h pre-test, fasted) and a single laboratory visit. Pre-test training and diet were standardized for 48 h (submaximal training; predominantly carbohydrate intake). CPET was performed in 3-min stages (6.5 km·h⁻¹ start; +0.7 km·h⁻¹ per stage) and stopped at RER = 1.00 and/or blood lactate = 4.0 mmol·L⁻¹ (operational VT2). After 3 min active recovery, participants completed six 60-s high-speed bouts separated by 60-s active recovery intervals (AR1–AR6), with intensities prescribed at 120–180% of VT2-derived speed, followed by an 8-min active recovery. For each AR interval, linear regression over 0–60 s yielded slopes for VO₂, VO₂/HR, VCO₂, V̇E, VE/VO₂, VE/VCO₂, and PetCO₂. Results: VT₁ was determined at 2.29 m·s⁻¹ (VO₂ 32 mL·min⁻¹·kg⁻¹) and VT2 at 3.07 m·s⁻¹ (VO₂ 42 mL·min⁻¹·kg⁻¹). Maximal intermittent speed was 5.33 m·s⁻¹ (VO₂ 45.5 mL·min⁻¹·kg⁻¹; RER 1.06; PetCO₂ 38 mmHg). VO₂ differed across successive bouts (p = 0.0001), while PetCO₂ showed a small downward drift across repetitions. Peak indices (max speed, VE/VCO₂max, PetCO₂max, VEmax) were associated with phase-specific recovery slopes across early, mid, and late recovery periods (false discovery rate–adjusted correlations). Lactate decreased over 8 min, but lactate change rates were not associated with peak indices. Conclusions: The VT₂-referenced progressive–intermittent protocol appears feasible in basketball players and provides phase-dependent recovery information that complements conventional peak CPET outcomes, with potential relevance for applied team settings. Full article

(This article belongs to the Special Issue Optimizing Athlete Health and Performance: Multidisciplinary Perspectives in Sports Medicine)

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17 pages, 458 KB

Open AccessArticle

Acute Effects of Percussive Massage Intensity on Change-of-Direction Performance, Vertical Jump Kinetics, and Neuromuscular Performance Across Morning and Evening Sessions in Trained Male Football Players

by Özgür Eken, İlinsu Demiralp, Birgül Arslanoğlu, Tahir Volkan Aslan, İsmihan Eken, Burak Yagin and Monira I. Aldhahi

Medicina 2026, 62(3), 439; https://doi.org/10.3390/medicina62030439 - 26 Feb 2026

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Abstract

Background and Objectives: Percussive massage devices (PMDs) are increasingly used as warm-up tools to enhance neuromuscular performance; however, evidence regarding the optimal intensity and its interaction with circadian variation remains limited. This study examined the acute effects of two percussive massage intensities (low: 28 Hz; moderate: 35 Hz) compared with no massage on change-of-direction (COD) performance, vertical jump kinetics, and neuromuscular variables in trained male football players across morning and evening sessions. Materials and Methods: Eighteen trained male football players completed a randomized, counterbalanced crossover design involving three protocols (no massage, 28 Hz, and 35 Hz) performed in both morning (09:00–11:00) and evening (17:00–19:00) sessions following a standardized warm-up protocol. COD performance (T-Test and Illinois COD Test), countermovement jump height, and model-derived kinetic variables were assessed. Results: Significant main effects of the protocol were observed for T-test performance, jump height, velocity-related variables, and kinetic outcomes (p < 0.001; large effect sizes), with both percussive massage intensities outperforming the no-massage condition. Significant protocol × time-of-day interactions emerged for jump height, force, and impulse-related variables (p < 0.05), indicating greater morning-specific benefits following moderate-intensity (35 Hz) massage. The Illinois COD Test showed no significant protocol-related changes. Conclusions: Acute percussive massage enhances COD performance and vertical jump-related outcomes in trained football players. While both intensities are effective for general performance enhancement, moderate-intensity massage (35 Hz) appears to be more effective for optimizing force–time characteristics and attenuating morning-related performance decrements. These findings support the inclusion of intensity- and time-specific percussive massage strategies in warm-up routines. Full article

(This article belongs to the Special Issue Optimizing Athlete Health and Performance: Multidisciplinary Perspectives in Sports Medicine)

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14 pages, 770 KB

Open AccessArticle

Acute Effects of Marathon and Ultramarathon Running on Body Composition in Trained Male Athletes

by Serkan Düz, İsmail İlbak, Ayşe Eda Kınacı Öğüt, Peter Sagat and Peter Bartik

Medicina 2025, 61(12), 2123; https://doi.org/10.3390/medicina61122123 - 28 Nov 2025

Viewed by 2013

Abstract

Background and Objectives: This study aimed to compare acute changes in body composition parameters following marathon (42.195 km) and ultramarathon (61 km) runs in trained male athletes, with particular focus on hydration dynamics and metabolic stress. Materials and Methods: Sixteen male amateur endurance runners were assigned to two groups: marathon (n = 8) and ultramarathon (n = 8). Body composition was assessed at three time points pre-race, immediately post-race, and 24 h post-race using bioelectrical impedance analysis. Measurements included body weight (BW), body mass index (BMI), total body water (TBW), total body fat (TBF), lean body mass (LBM), right arm fat (RAF), left arm fat (LAF), right leg fat (RLF), left leg fat (LLF), and torso fat (TF). Results: Both groups exhibited significant reductions in BW and BMI post-race (p < 0.05), with more pronounced changes observed in the ultramarathon group. Partial restoration of these metrics occurred within 24 h, primarily due to glycogen resynthesis and fluid retention. TBW remained stable immediately post-race but increased notably during recovery, particularly in ultramarathon runners, suggesting more effective hydration responses. Muscle and fat-free mass changes were minimal but more favorable in the ultramarathon group. Both total and regional fat percentages declined significantly post-race in both groups, with ultramarathon runners showing greater reductions. Conclusions: Endurance running induces short-term but substantial alterations in body composition, with ultramarathon participation eliciting more pronounced metabolic and fluid balance responses. These findings highlight the importance of race-specific nutritional and hydration strategies tailored to event type and duration. Full article

(This article belongs to the Special Issue Optimizing Athlete Health and Performance: Multidisciplinary Perspectives in Sports Medicine)

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19 pages, 2497 KB

Open AccessArticle

Curve Sprint Ability as an Indicator of Neuromuscular Function and Physical Fitness in Youth Soccer Players: Comparative Insights from U14 and U16 Groups

by Zarife Pancar, Burak Karaca, Yung-Sheng Chen, José Antonio Sánchez Fuentes, Santiago Navarro Ledesma, José Carlos Barbero-Álvarez and Francisco Tomás González-Fernández

Medicina 2025, 61(11), 1981; https://doi.org/10.3390/medicina61111981 - 5 Nov 2025

Cited by 1 | Viewed by 1082

Abstract

Background and Objectives: In modern soccer, players frequently perform curved sprinting (CS) actions that combine speed, agility, and neuromuscular control, highlighting the importance of assessing CS performance in youth athletes. This study aimed to investigate age-related differences in CS performance and its relationship with key components of physical fitness—including aerobic capacity, vertical jump height, and agility-based field tests—in U14 and U16 male soccer players. Materials and Methods: A total of 76 registered players participated, evenly divided between the two age groups. Statistical analyses included t-tests, correlation, and regression modeling to determine key predictors of curve-sprint performance. Results: U16 players showed significant between-group differences, with faster CS times on both the good and weak sides (p < 0.001, d = 0.93–1.08), as well as superior performance in the countermovement jump (p < 0.001, d = 1.12), Illinois Agility Test (p < 0.01, d = 0.70), and 5-0-5 change-of-direction (COD) test (p < 0.01, d = 0.74). Significant negative correlations were found between CMJ height and CS times (r = –0.40 to –0.73), indicating that greater explosive power was associated with better CS performance. Moderate to very strong positive correlations were observed between CS and agility measures (r = 0.43 to 0.79), particularly in the U16 group, whereas VO₂max showed no meaningful relationship with CS performance (r = –0.16 to –0.30, p > 0.05). Conclusions: These results suggest that CS may serve as an indicator of neuromuscular power and agility, both of which improve with age. From a practical perspective, regular curve-sprint assessments and multidirectional drills may support talent development by helping coaches monitor neuromuscular efficiency and movement coordination in young players. Full article

(This article belongs to the Special Issue Optimizing Athlete Health and Performance: Multidisciplinary Perspectives in Sports Medicine)

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Review

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24 pages, 2379 KB

Open AccessReview

Glutamine Supplementation and Exercise: A Narrative Review of Biochemical Mechanisms and Timing Strategies

by Branka Djordjevic, Vladana Stojiljkovic, Aleksandra Velickov, Jana Kocic, Jelena Milenkovic, Andrej Veljkovic, Jelena Basic and Tatjana Cvetkovic

Medicina 2026, 62(2), 329; https://doi.org/10.3390/medicina62020329 - 6 Feb 2026

Viewed by 3998

Abstract

Intense physical activity imposes substantial oxidative, metabolic, and immunological stress on the human body. It is often accompanied by reductions in plasma glutamine levels, making this amino acid conditionally essential. Glutamine plays a vital role in energy production, nitrogen transport, acid–base balance, antioxidant defense, and immune function. It is required in the biosynthesis of neurotransmitters, nucleotides, nicotinamide-derived coenzymes, glutathione, and hexosamines, making it a candidate for supporting exercise recovery. In addition, glutamine may support key mechanisms involved in muscle adaptation and recovery during exercise-induced stress by contributing to redox balance, energy sensing, anabolic signaling, intestinal barrier integrity, and immune function. This narrative review aims to synthesize biochemical mechanisms underlying glutamine effects relevant to exercise and evaluate preclinical and clinical findings on supplementation outcomes, with emphasis on timing strategies. Preclinical findings demonstrate that glutamine can modulate protein synthesis, reduce oxidative stress, improve intestinal integrity, and attenuate immune and inflammatory disturbances. Limited preclinical data suggest that post-exercise supplementation may better resolve muscle and organ damage. Clinical trials, however, report heterogeneous outcomes: several studies show improvements in markers of intestinal permeability and intestinal epithelial damage, oxidative stress, muscle damage, and inflammation, whereas others report minimal or no effect, including limited influence on performance outcomes. Variability in timing protocols, participant characteristics, and measured endpoints contributes to inconsistent findings. Overall, glutamine demonstrates several biologically plausible mechanisms that could support recovery and overall health in active individuals, athletes, and specific clinical populations. However, current evidence remains insufficient to determine clear supplementation benefits or define an optimal timing strategy. Future research using standardized protocols and integrated biochemical and functional endpoints is needed to clarify timing effects. Until such evidence emerges, recommendations should remain individualized, considering athlete-specific needs. Full article

(This article belongs to the Special Issue Optimizing Athlete Health and Performance: Multidisciplinary Perspectives in Sports Medicine)

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