14/01/2023
The major limiting factors during exercise in the heat are linked to inexorable increases in core temperature [25], cardiovascular strain [29] and/or reductions in central drive [30]. Conceptually, regarding most endurance athletes and military personnel, the capacity to dissipate heat and offset one, or all, of these eventualities in hot environments predominantly occurs via three modifiable factors: lowered metabolic heat production, enhanced skin vasodilation (i.e., convective heat loss) or evaporative heat transfer (i.e., sweating [37,38,39]). The two supplements deemed to have the strongest empirical evidence to support these mechanisms [6], and reportedly serve to aid endurance exercise performance in temperate conditions, are caffeine (1,3,7-trimethylxanthine [1, 40]) and dietary nitrate (NO3− [4]). Mechanistically, there is a sound theoretical basis for both caffeine and NO3− supplementation to offset fatigue in the heat through increased central drive (caffeine [41]), and nitric oxide’s (NO) action on eccrine sweat gland function and subcutaneous microvascular control (NO3− [42,43,44]). However, numerous studies have reported negative or null performance and thermoregulatory effects for both of these supplements during exercise in the heat
14/01/2023
Olympic Committee (IOC [6]), American College of Sports Medicine (ACSM [7]) and the Union of European Football Associations (UEFA [8]) provide specific recommendations for certain performance enhancing dietary supplements that are thought to have sufficient evidence for use by endurance athletes during training and competition. In tactical occupational settings, official legal information on the use of dietary supplements is often provided [9]; however, specific guidance on ergogenic aids is not. Despite this, the use of supplements among military personnel in training [10, 11] and during operations [12, 13] has been well reported. While it has been recognised that contextual factors should be considered when selecting dietary supplements [6, 9], there is limited guidance on this relating to endurance exercise performed in hot environments. This is particularly surprising, given that many endurance events and major international competitions take place in a combination of hot and humid conditions [14, 15]. For example, the forthcoming Tokyo 2021 Olympic Games are expected to take place in air temperatures exceeding 30 °C, with a humidity index of ~ 38 [16, 17]. Furthermore, military training and operations are also often conducted in extreme environments, in combination with prolonged endurance activity
12/01/2023
However, to evaluate the prognosis of soleus muscle injuries, we must consider not only the involvement but also the distribution of connective aponeuroses, which conditions the direction and pennation angles of the muscle fibres. Ignoring this aspect is probably one of the main reasons why descriptive epidemiological series on soleus muscle injuries are not reliable and fail to find a reproducible prognostic pattern [5,6,7]. Indeed, classification systems would be more clinically relevant if they reflected the anatomical and functional roles of muscles as organs within a system, and offered a common nomenclature