Concussions are common in stick-handling sports, including lacrosse or hockey, where high-speed play combines player contact with equipment- and projectile-related impacts. In a cohort of lacrosse and hockey athletes who sustained a sport-related concussion (SRC), this study compared: 1) injury mechanisms, 2) initial symptom burden, and 3) recovery timelines between the sports. In this retrospective cohort study of patients (12-23 years) with SRC from lacrosse or hockey, injury mechanism was categorized as player-to-surface, player-to-player, player-to-stick, or player-to-ball/puck. Outcomes included initial Post-Concussion Symptom Scale (PCSS) score and time to return-to-learn (RTL), symptom resolution (SR), and return-to-play (RTP). Nonparametric tests compared groups, and multivariable linear regression evaluated associations between sport and injury mechanism with outcomes, adjusting for age, sex, and prior concussions. Of 80 athletes (median age = 16.6), 37 played lacrosse (60% male) and 43 played hockey (86% male). Injury mechanism differed by sport (p = 0.03): lacrosse had more player-to-surface (35.1% vs. 27.9%), player-to-stick (24.3% vs. 11.6%), and player-to-ball/puck (21.6% vs 9.3%) injuries and less player-to-player (18.9% vs. 48.8%) injuries than hockey. Initial PCSS scores were higher after stick-related injuries (median = 47.5) than other mechanisms (surface = 26.0, player = 20.0, ball/puck = 31.0; p = 0.02), though mechanism was not a significant predictor in multivariable regression. Time to RTL, SR, and RTP did not differ by sport, injury mechanism, or competition setting. Symptom severity and recovery timelines were similar between sports and setting. Stick and ball/puck impacts were associated with greater initial symptom burden and longer RTL, which may warrant closer early monitoring and enhanced school accommodations.
Evaluating psychophysiological markers is key to understanding the allostatic burden of official competitions. This study investigated the associations between responses to competitive anxiety and salivary biomarkers-cortisol (sCort), interleukin-6 (sIL-6), and tumor necrosis factor-alpha (sTNF-α)-in elite female karate athletes during competition. Thirty participants (mean age = 21.8 ± 3.4 years) completed the Persian version of the Competitive State Anxiety Inventory-2 Revised (CSAI-2R) approximately 1 h prior to competition to assess cognitive anxiety, somatic anxiety, and self-confidence. Saliva samples were collected 30 min before the competition to quantify biomarker levels. Significant positive associations were observed between sCort and both somatic and cognitive anxiety (p < 0.05), whereas no significant associations were detected between anxiety subscales or self-confidence and sIL-6 or sTNF-α (all p > 0.05). Multiple regression results showed that cognitive and somatic anxiety significantly predicted sCort (p < 0.05), while none of the CSAI-2R variables significantly predicted sIL-6 (p > 0.05) or sTNF-α (p > 0.05). Logistic regression analysis revealed that somatic anxiety significantly predicted competition outcome (p < 0.05), whereas other variables did not. These findings highlight the potential utility of monitoring somatic anxiety as a marker of competitive anxiety in elite female karate athletes.
Persistent post-concussion symptoms (PPCS) affect 35% of children and adolescents with concussion. This study aimed to characterise sleep patterns in children and adolescents with PPCS and explore the effect of sleep disturbance on clinical concussion outcomes. A prospective longitudinal study was conducted in participants with PPCS (n = 20, aged 11-18 years) presenting to a tertiary referral clinic. Participants completed a battery of concussion assessments at their initial consultation and at 4 weeks follow-up to assess and monitor symptom burden, cognition, balance, mental health, and exercise tolerance. The Insomnia Severity Index (ISI) was used to identify participants with post-concussion clinical insomnia (PCCI). Wrist actigraphy was used to objectively characterise sleep patterns, including total sleep time, sleep latency, wake after sleep onset and sleep efficiency, over a 14-day period. Participants were followed until they were recovered from concussion. Forty-five percent of participants with PPCS also had PCCI. Objective mean ± SD sleep parameters of participants were: total sleep time 452.1 ± 53.8 min, sleep latency 32.2 ± 16.3 min, wake after sleep onset 76.9 ± 21.4 min, and sleep efficiency 85.9 ± 3.7%. Mood disturbance was a significant predictor of sleep disturbance at the 4-week follow-up (P = 0.01). Recovery time was three times greater for participants with PCCI than those with no PCCI (median (interquartile range): 150 (91-247) vs 47 (30-58) days, P = 0.04). Sleep disturbance is significantly associated with poorer mental health and prolonged recovery time in children and adolescents with PPCS.
Bilateral neuromuscular symmetry is a critical factor for safe and effective resistance training. Limited evidence exists on how progressive closed-chain resistance exercises influence upper-limb muscle activation and interlimb balance. Forty healthy, recreationally trained males (mean age 22.8 ± 1.9 years; height 176.2 ± 4.7 cm; weight 73.5 ± 6.2 kg) performed bilateral elbow flexion and extension at 50 %, 75 %, and 90 % of one-repetition maximum (1RM). Surface electromyography (EMG) was recorded bilaterally from the biceps brachii and triceps brachii. Muscle activity was quantified using root mean square (RMS) values, and bilateral coordination was assessed through symmetry indices. EMG amplitude increased significantly with higher load intensities (p < 0.001). Bilateral symmetry improved at 90 % 1RM, as reflected by lower symmetry index values and non-significant interlimb differences. At lower intensities, moderate asymmetries persisted, particularly in antagonist muscles. Progressive closed-chain resistance training enhances neuromuscular activation and promotes interlimb symmetry in the upper limbs, especially under near-maximal loading. These findings suggest that higher load intensities acutely enhance muscle coordination and reduce asymmetry during bilateral resistance exercise.
Poor physical fitness and fatigue are prevalent long-term issues for childhood cancer survivors. This study aimed to determine associations between childhood cancer survivors' self-reported physical fitness domains and their perceptions of links between exercise and fatigue. A cross-sectional survey assessed survivors' self-reported muscle strength, running speed and flexibility using The International Fitness Scale as well as survivors' perceptions of exercise and fatigue. Non-parametric correlation tests were used. One hundred and seven childhood cancer survivors aged 8-18 years participated at a median of six years post-completion of treatment. Poor muscle strength, running speed and flexibility were self-reported by 11%, 18% and 36% of survivors, respectively. Fatigue was perceived as a barrier to exercise by 50% of survivors, while 44% of survivors perceived that exercising reduced fatigue. Poor self-reported muscle strength was significantly associated with perceiving fatigue as a barrier to exercise (rrb = -0.219) and with perceiving exercising to reduce fatigue (T b = 0.192). Poor self-reported running speed was associated with perceiving fatigue as a barrier to exercise (rrb = -0.199) and with perceiving exercising to reduce fatigue (T b = 0.228). An assessment of self-reported physical fitness domains and perceptions of exercise and fatigue is needed among childhood cancer survivors to identify and support those who perceive poor physical fitness domains or believe that fatigue hinders their exercising. Interventions that improve confidence in a childhood cancer survivor's own ability to exercise should be investigated to improve re-engagement with exercise.
Observable signs are an important component of multimodal concussion assessment, with further research needed to understand and improve their applicability to cricket. Participants were elite Australian cricket players who sustained a concussive head impact during a match between July 2015 and June 2024 with video of the incident available. Videos were coded for established signs of concussion and cricket-specific signs potentially indicative of concussion. A random selection of concussive and non-concussive match head impacts were coded to investigate clinical utility of observable signs. From 53 videos of concussive incidents (male n = 41, female n = 12), the median number of established observable signs was 0 (IQR 0-0). The median number of cricket-specific signs per concussive incident was 2 (IQR 1-4). Ten (19%) concussive incidents had no established or cricket-specific signs. The positive predictive value of each video sign for concussion was not significant. Other players or umpire showing urgent concern for the impacted player was the most commonly observed cricket-specific sign. One video angle was sufficient to observe signs in most instances. Elite cricket players who sustain a concussive head trauma infrequently present with established observable signs. Practitioners should be alert to other observable signs to guide whether a player needs to be immediately removed from the field of play for further assessment. Advancements in video quality and availability would further support the match-day doctor.
Martial arts involve cutting, jumping and landing movements known to increase injury risk. Martial artists frequently sustain injuries. Recreational martial arts have yet to implement an evidence-informed prehabilitation programme to prevent these injuries. Here, we evaluate the Martial Arts Striking Sports prehabilitation programme (MASS-12) in a recreational setting. Three traditional martial arts warm-ups and two MASS-12 warm-ups were delivered over 2 weeks as a recreational Jiu Jitsu club hall. A coach and seven athletes (five male, two female), ranging in experience from white belt to brown belt, participated. Main Outcome Measures were the Frontal plane projection angle (FPPA), a measure of dynamic knee valgus and Single leg vertical hops (SLVH), a measure of performance. Over half of recreational athletes reported previous, serious lower limb injuries. Athlete FFPA and SLVH significantly improved (-11.9° to -1.93°, 25.2 vs 27.5 cm, respectively) after the MASS-12. Athletes appreciated the increased feedback and sense of preparedness. The coach found it easy to teach and perceived improvements in performance. The MASS-12 is easy for coaches to implement; improves lower limb alignment; and is accepted by athletes. A significant improvement on current practices, the MASS-12 should be widely implemented in recreational martial arts.
Mental fatigue has been observed to increase early and accumulate during fencing competition days. Traditional warm-up structures in fencing, including coach-led one-on-one combat (TC), always require a physical sparring partner. Virtual reality combat (VC) can engage athletes in an immersive, entertaining sports environment with specific motor-cognitive stimuli to enhance training and mental preparation, which may facilitate a quality warm-up. This study will compare the effects of VC with those of TC in the specialized warm-up section, on fencing-specific performance and fencers' fatigue levels. This study will be a within-subjects, randomized crossover design. It has been ethically approved and registered. Informed consent will be obtained from all participants. Twenty Epee fencers will be recruited and matched for gender and fencing level. The fencers' pair will be randomly assigned in a counterbalanced order to commence the experimental condition with VC or the control condition with TC first. Standardized measures of mental and physical fatigue, and motor-cognitive performance will be conducted pre- and post-warm-ups. Linear mixed-effects models will be used for time, condition, and their interaction effects. Other subjective perceptions after VC/TC and heart rate responses to VC/TC will be collected and compared between conditions via paired samples t-tests. This is the first time the virtual reality technology will be integrated into a traditional fencing warm-up to explore the feasibility of virtual combat as an on-field alternative. The practice-oriented study seeks to inform pre-competition warm-up structures, management of mental fatigue, and subsequent performance enhancement in real-world combat sports.
This study aimed to compare the Flightscope Mevo ​+ ​launch monitor against a previously validated system (Trackman 4) during full golf swings in an indoor setting. Mevo+ and Trackman 4 were compared concurrently for driver (n ​= ​118, 118, 174 shots, respectively). Intraclass correlation coefficients (ICC) reported consistency and absolute agreement. Bland-Altman plots reported limits of agreement. Moderate to excellent consistency was reported for all values for driver (ICC ​= ​0.66-0.996), 7-iron (ICC ​= ​0.50-0.996) and pitching wedge (ICC ​= ​0.55-1.00) except angle of attack which was poor for both 7-iron and pitching wedge (ICC ​= ​0.06 & 0.03, respectively). For absolute agreement, Mevo ​+ ​demonstrated moderate to excellent levels for most driver (ICC range ​= ​0.58-0.98), 7-iron (ICC range ​= ​0.83-0.94) and pitching wedge (ICC range ​= ​0.77-0.999) variables. Driver swing plane (ICC absolute ​= ​0.24), 7-iron angle of attack, clubhead speed, dynamic loft and spin rate (ICC absolute ​= ​0.02, 0.44, 0.23, 0.49, 0.42, respectively) and pitching wedge angle of attack, dynamic loft, and swing plane (ICC absolute ​= ​0.01, 0.25, 0.43, respectively) had poor agreement. Mevo+ is consistent with Trackman 4 for all variables except angle of attack. It does however provide different absolute values, but usually in a consistent, systematic manner, across a number of variables. Coaches, club fitters, golfers, and scientists should be aware of these systematic differences when attempting to compare performance across launch monitors or when solely using the Mevo ​+ ​system to aid performance, club building and fitting, or for research purposes.
Heart rate variability (HRV) analysis is a useful tool for evaluating the heart's ability to adjust to external loads. This study aimed to assess the gender impact on cardiac autonomic modulation response in Cameroonian handballers. ology: A prospective analytical study was conducted on sports teams. Participants were divided into three groups; people who practiced little or no sporting activity (sedentary, male), those who were regularly physically active in a handball team (male and female athletes). Resting Heart Rate (HR) was recorded for 10 min and analysed. Male players had significantly higher HR than women (68.75 vs 60.38; p < 0.001). SDNN (Standard Deviation of the inter-beat interval of normal sinus beats), RMSSD (Root Mean Square of the Successive Differences) and pNN50 (proportion of successive NN intervals that differ by more than 50 ms) were lower in sedentary people (16.22; 9.97; 0.16) than in male handballers group (29.00; 16.44; 2.15; p < 0.001 and p < 0.05). Very-low-frequency relative power was higher in male players than in female players (30.82 vs 21.29; p < 0.05). However, male Low-Frequency relative power, High-Frequency absolute and relative power (69.26; 3.46 and 6.96) were significantly lower than in female players (77.12; 4.19 and 9.67, with p < 0.05; p < 0.05; p < 0.01 respectively). The effect size for gender was low for the Low-Frequency parameter. The findings revealed an association between sports practice and high HRV values but do not allow for a clear conclusion regarding the impact of gender on the parasympathetic and sympathetic parameters determining HRV.
To explore the proportion of female field hockey players who experienced urinary incontinence (UI) and pelvic floor symptoms, and the impact their symptoms have on their participation and healthcare-seeking behaviour. We employed a retrospective study design utilising an anonymous survey to address the study aim. Female field hockey players aged 14 and above who participated in the 2023 winter competition in Australia at any level were eligible to participate in the study. We collected demographic data, the Questionnaire for Urinary Incontinence Diagnosis (QUID) and the impact of pelvic floor symptoms on participation. Demographic data were reported as proportions, with all data analysed at the cohort level and stratified based on primary age group competition (Juniors, Seniors, Masters). 746 females consented to answer the survey about pelvic floor function with an average age of 33.6 years (range 14-74). One in four participants reported some kind of UI, however; just 30 % of females with symptoms saw a health professional for their symptoms. Frequency of symptoms increased by level of competition (i.e., more frequent in Masters compared to Juniors or Seniors). Most females who reported symptoms (∼50 %) during exercise did not change their participation; however, 22 %-36 % modified or stopped their activities. Symptoms of UI in female field hockey players are frequent, with the majority not seeking health care assistance for their symptoms. Therefore, education programs focused on UI management strategies such as early identification and healthcare referral should be prioritised within female field hockey.
While delayed removal from play has been associated with worse outcomes following sport-related concussions (SRC), factors that predict delayed removal (vs. immediate) remain poorly understood. This study aimed to identify predictors of delayed removal following an SRC. A retrospective analysis included athletes aged 12-23 who presented to a regional sports concussion center within one day of injury. Patient demographics, injury characteristics, and clinical recovery metrics were extracted from medical records. Removal timeline was categorized as immediate (removed from play at time of injury) or delayed (continued participation). Comparisons across groups and a multivariable logistic regression model were conducted to identify predictors of delayed removal. In 291 athletes (29.6% female, median age = 15.6 [IQR = 14.5-16.8]), 109 (37.5%) had delayed removal (29.4% female; median age 15.7 [IQR 14.5-16.9]). Sex, race, sport, school, and competition type did not differ significantly between immediate and delayed removal groups. Athletes with loss of consciousness (LOC) had over 81% lower odds of delayed removal (OR = 0.19, 95%CI: 0.08-0.44; p < 0.01), and those evaluated on the field had 70% lower odds of delayed removal (OR = 0.30, 95%CI: 0.17-0.54; p < 0.01). Initial symptom scores were lower among those immediately removed (19.0 [IQR = 6.0-38.2]) compared to the delayed removal group (24.0 [IQR = 11.0-44.0]; p = 0.05). Return-to-learn, symptom resolution, and return-to-play timelines did not differ significantly between groups. On-field evaluations and observable clinical signs such as LOC strongly reduced risk of delayed removal from play after SRC. These findings emphasize the critical role of athletic trainers and prompt sideline recognition in reducing delayed removal and acute symptom burden.
Recent research has shown that prepubertal males outperform females in running competitions; however, prior studies have focused on distances of 100-1600 m and most have relied on U.S.-based data. This study evaluated sex-based differences in running performance among under-8, under-9, and under-10 athletes in 70 m, 100 m, 200 m, and 400 m races at the 2024 Little Athletics New South Wales (NSW) Regional Track & Field Championships in Australia. Official race times for all competitors (n = 1442 males; 1405 females) from all seven NSW regional meets were analyzed. Performance was compared by sex for both preliminary and final times using two-way ANOVA. Additional analyses examined time gaps between successive finishers within each sex and time differences between male and female athletes placing in the same ordinal position, using ANOVA on ranks. Males ran significantly faster than females across all events and age groups (P < 0.05), with an average advantage of 4.88 ± 0.57 % and medium to large effect sizes (Hedges' g = 0.451-0.878). In contrast, within-sex time gaps between successive finishers did not differ significantly (males: 1.63 ± 0.12 %; females: 1.71 ± 0.17 %). These findings confirm previously reported male performance advantages in prepubertal children and extend the evidence to a shorter sprint distance (70 m) and to Australian data. Notably, between-sex performance differences were more than twice as large as the variability within sex among comparably placed finishers. These results may help inform research and practice on youth sport talent identification and development.
To investigate whether the magnitude of post-exercise hypotension (PEH) is greater in female endurance athletes with oligomenorrhea/amenorrhea (OAA) compared with eumenorrheic (EA) athletes, and to examine the associated hemodynamic correlates. Ten EA athletes (tested during the early follicular phase) and eight OAA athletes performed incremental cycle exercise to exhaustion. Brachial blood pressure (BP), cardiac output (CO), total peripheral resistance (TPR), and spontaneous baroreflex sensitivity (SBRS) were assessed at baseline and at 15 (P15), 30 (P30), and 60 (P60) min post-exercise in the supine position. Linear mixed-effects models were used to compare temporal responses between groups. Both groups demonstrated significant PEH. Absolute systolic BP showed no between-group differences at baseline or during post-exercise recovery, whereas absolute diastolic BP (DBP) and mean arterial pressure (MAP) were higher at baseline in the OAA group. When expressed as changes from baseline, reductions in DBP and MAP at P60 were significantly greater in the OAA group than in the EA group (both p < 0.05). Post-exercise changes in CO and relative changes in TPR and SBRS demonstrated significant main effects of time (p < 0.05) but showed no significant between-group differences. These findings suggest that chronic hypoestrogenism may augment PEH in female endurance athletes through mechanisms not fully explained by systemic TPR or SBRS.
This narrative review aimed to explore publicly available documents and policies that provide recommendations regarding safe sport and exercise participation for people with epilepsy. It also considered whether these documents addressed the needs of individuals with intellectual disability and other neurological conditions who have a co-occurring diagnosis of epilepsy. A literature search was conducted across four electronic databases including PubMED, Embase, SPORTDiscus and Web of Science, accompanied by a hand search through Google Advanced Search. Documents were included if they were: 1) publicly available 2) produced by national and international government organisation, 3) published after 2016, 4) available in English, and 5) consisted of a full-text document. A total of 11 papers were included. From the recommendations provided to the public four themes emerged, 1) general epilepsy advice, 2) guidance on what to do during participation, 3) considerations to avoid, and 4) activity specific recommendations. Eight of the papers provided recommendations to sport and exercise professionals, falling under three themes, 1) general epilepsy advice, 2) recommendations for sport and exercise professionals, and 3) key knowledge required to safely work with people with epilepsy. Of the 11 included papers, only four provided recommendations specific to people with disability. Findings revealed that whilst documents acknowledged risks, they did not provide strategies for risk mitigation or management to support participation in a variety of physical activity contexts. Additionally, the specific and often more complex needs of people with disability who have a co-occurring diagnosis of epilepsy were often overlooked.
Elite athletes are screened for conditions associated with sudden cardiac arrest or death. The complexities of the real-world implementation of cardiac screening are poorly understood. The aim of this study was to understand the barriers and enablers to best practice athlete cardiac screening programs in Australia and New Zealand. Semi-structed interviews were conducted with chief medical officers (CMOs) of elite sporting organisations in Australia and New Zealand and transcribed verbatim. Interview questions were focused on CMOs' perceptions of cardiac screening within their sporting organisation. Inductive thematic analysis was used to assign themes. Twelve chief medical officers were interviewed between June 2023 and May 2024. Several themes were identified as barriers and enablers to best practice athlete cardiac screening. These themes were: 1. availability of sports cardiology expertise; 2. organisational investment in cardiac screening; 3. timing of screening; 4. accessibility of athletes; 5. athletes aged under 18; and 6. athlete engagement with cardiac screening. For CMOs, key enablers to best practice cardiac screening were access to sports cardiology expertise, together with organisational investment in the form of administrative assistance and sufficient funding to run cardiac screening. A key barrier was the organisational pressure on clinicians to make a clinical decision without sufficient clinical information, especially when screening occurred very close to competition. To implement best practice cardiac screening, there needs to be greater access to sports cardiology expertise, improvement in funding models, and policies guiding the timing of screening before competition.
There is growing concern over potential neurological impairment associated with accumulation of repetitive head acceleration events (HAE) in sport, particularly during periods of neurological vulnerability, including youth. Despite the high volume of HAEs sustained during downhill mountain biking, it is currently unknown downhill mountain biking is associated with neural function in youth. Thus, the purpose of this study was to investigate the association between exposure to downhill mountain bike racing and sensory, attentional, and cognitive processing in youth using N100, P300 and N400 Event related Potentials (ERPs). Fifteen participants (6 female, 9 male; ages 15-24 years) contributed 38 ERP observations at baseline timepoints and following up to 5 days of elite downhill mountain bike competition. Conditional linear regression models demonstrated that the average marginal difference in N400 amplitude in measures taken post-mountain bike exposure was 1.26 μV (95% CI: -2.16, -0.36; p = 0.006) less than before riding. N400 latency, P300 amplitude and latency, and N100 amplitude and latency were unchanged from baseline by days (range: 1-4) of mountain biking (all p > 0.26). In agreement with studies in hockey and football, our results showed that participation in downhill mountain biking is associated with acute cognitive neural processing impairments. The contribution of exercise, focus and HAEs to these impairments is unclear. This study expands the growing evidence of neural processing impairments occurring acutely following sport participation to the understudied sport of downhill mountain biking.
Since their introduction in professional football, penalty shoot-outs represent key moments in matches. Motor imagery (MI) can improve soccer performance, but different MI modalities can be used to mentally simulate motor actions. This study aimed to evaluate whether the MI modality used by the players would influence their penalty shoot-out performance. Twenty youth skilled football players from the Elite Center of the French Regions of America (CERFA) voluntarily participated in this experiment (Mage ​= ​16.4 years). After an assessment of their MI ability, the participants completed 4 counterbalanced experimental sessions spread over 4 weeks, each including the completion of 5 penalty shoot-outs. The sessions consisted of a control condition (count-down and actual execution) and 3 MI conditions during which the players had to mentally imagine themselves performing a penalty shoot-out according to one of the MI modalities: Internal Visual Imagery (IVI), External Visual Imagery (EVI), or Kinesthetic Imagery (KI), before kicking. Number of goals scored, shooting accuracy and ball speed were measured and served as dependent variables. The soccer players benefited from MI. Indeed, in both the IVI and KI conditions, their performances were significantly higher than in the no-MI (i.e., control) condition with respect to the total number of goals scored and shooting accuracy variables. Practically, we suggest skilled football players imagine, from an internal perspective, taking a successful penalty kick before shooting.
Safety in community cricket, particularly head injury, is essential. This study utilised an online, cross-sectional survey open to all community players in Australia. Among 467 respondents (86% male; ages 12 to 60+ years), 36% reported being hit on the head, helmet, or neck at least once in the past 12 months. Of those hit, 81% were wearing a helmet and 35% reported a traumatic head injury. 80% of respondents always wore a helmet when batting against pace. Awareness of Australian Cricket's guidance varied: 80% were aware of the Helmet Recommendations, whereas 49% were aware of the Community Cricket Concussion and Head Trauma Guidelines. These findings add to evidence of a risk of traumatic head injury associated with participation in community cricket and suggest that, while helmet recommendations are generally known and often followed, there remains scope to improve consistency of use, optimal protection, and concussion-guideline awareness and application.
Coaching professional sport is stressful, yet there is little information detailing the physiological and psychological responses of coaches during match-play. This case report examined physiological and psychological alterations when coaching professional Australian Rules football. One experienced head coach was monitored for heart rate, stress-related hormones and psychological stress before, during and after seven matches. Heart rate fluctuated during match-play, with locomotion during match breaks contributing to elevated values. Stress hormones did not change, while the psychological questionnaire revealed differences in perceptions of accomplishment, success, recovery and stress related to match outcome. This case report indicated substantial elevations in heart rate while coaching professional football and furthermore, differences in psychological outcomes from winning or losing suggests the need to develop contextualised recovery and coping strategies. With coaching eliciting alterations to physical and psychological markers in this case, confirmatory research with larger cohorts should examine cardiovascular health and well-being strategies in coaches.