Lies to hide doping in professional sport

Press release:

How do top athletes talk about doping when they themselves are using performance-enhancing drugs? Or do they just avoid the issue? A new study by the University of Göttingen reveals that any decision to use drugs almost inevitably means the decision to engage in deceptive communication such as lying or omitting information. Those using drugs, for example, regularly describe anti-doping policies as being more intense than ever or overly restrictive, play down the extent of the doping problem, or portray themselves as victims. The results were published in the European Journal for Sport and Society.

Dr Marcel Reinold, Head of Sport and Health Sociology at the Institute of Sport and Exercise Sciences at Göttingen University, analysed autobiographies of professional cyclists for the study. All of these autobiographies were written at a time before the cyclists were exposed as having used performance-enhancing drugs. The best-known examples are the two best-selling autobiographies by Lance Armstrong, former seven-time Tour de France winner, written in the early 2000s. In them, Armstrong portrays himself as “clean”, although investigations by the US Anti-Doping Agency some ten years later revealed otherwise. “The main goal of this research is to identify the techniques of deceptive communication about doping – that is, typical communication strategies and statements that drug-users routinely employ to manipulate information and conceal doping,” says Reinold.

Previous research on this subject has mainly emphasised that drug cheats adhere to a “law of silence”. In effect, they usually simply ignore the subject of doping. This comparative analysis of the autobiographies shows, however, that prominent cyclists are under enormous social pressure to talk about the darker side of their sport in order to avoid suspicion of concealing drug use. Their writing, therefore, showed that they went beyond the relatively trivial technique of staying silent, instead using more complex techniques of deceptive communication. For instance, the doping control system is regularly described as more intense than ever before, as well as being overly restrictive. At the same time, they play down just how widespread doping can be. The clear intention is to suggest – despite evidence to the contrary – that in a “strictly controlled” and largely “drug-free” environment, there is simply no reason to use performance-enhancing drugs.

“The aim is clearly to convince the public that everything about the cyclist concerned is indeed honest and open,” says Reinold. “These techniques help deceivers to present themselves as compliant with the anti-doping system and also to appear credible in their commitment against drugs. Furthermore, it helps to allay suspicion, prevent others discovering the lies and generally control the flow of incriminating information in such a way that prevents leaks or detection.”

High genetic running capacity promotes efficient metabolism with aging

Press release:

High running capacity is associated with health and longevity. However, whether high genetic running capacity promotes more efficient metabolism with aging is not known. A new study conducted in collaboration between the universities of Shanghai Jiao Tong University (China) and Jyväskylä (Finland) investigated the effects of genetic running capacity and aging on tissue metabolism. The study reveals that adipose tissue may have a key role in healthy aging.

Running capacity, expressed as aerobic capacity, refers to an individual’s capacity to utilize oxygen and is known to decrease with age, thereby affecting the whole body metabolism and health.

“We currently lack the information whether high genetic aerobic capacity promotes healthier metabolism in different tissues as we age,” explains Academy of Finland postdoctoral researcher Sira Karvinen from the Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.

To study the question, animal models of high-capacity runners (HCR) and low-capacity runners (LCR) were utilized. These rodent lines differ in their aerobic capacity genetically. Samples of serum, muscle and adipose tissue were harvested from young and aged animals to explore the tissue metabolites.

“According to our results, high genetic running capacity was associated with more efficient amino acid metabolism in skeletal muscle. Inefficient amino acid metabolism is linked to increased adiposity and risk of metabolic diseases,” says Karvinen.

High genetic running capacity and aging interactively affected lipid metabolism in muscle and adipose tissue, possibly contributing to healthier metabolism with aging.

The results suggest that adipose tissue may have a more significant role in promoting healthy aging than previously thought. According to the current literature, around 50% of an individual’s aerobic capacity is genetically inherited and the other 50% can be gained via physical activity.

“Regular exercise promotes health whether you have genetically high or low aerobic capacity. Hence, it is highly recommended to promote one’s metabolism with exercise especially at older age, when aerobic capacity as well as other health parameters decline,” says the principal investigator, Professor Heikki Kainulainen from the Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.

New research may explain why some people derive more benefits from exercise than others

Press release:

Although everyone can benefit from exercise, the mechanistic links between physical fitness and overall health are not fully understood, nor are the reasons why the same exercise can have different effects in different people. Now a study published in Nature Metabolism led by investigators at Beth Israel Deaconess Medical Center (BIDMC) provides insights related to these unanswered questions. The results could be helpful for determining the specific types of exercise most likely to benefit a particular individual and for identifying new therapeutic targets for diseases related to metabolism.

“While groups as a whole benefit from exercise, the variability in responses between any two individuals undergoing the very same exercise regimen is actually quite striking. For example, some may experience improved endurance while others will see improved blood sugar levels,” said senior corresponding author Robert E. Gerszten, MD, Chief of the Division of Cardiovascular Medicine at BIDMC. “To date, no aspects of an individual’s baseline clinical profile allow us to predict beforehand who is most likely to derive a significant cardiorespiratory fitness benefit from exercise training.”

To uncover the details behind exercise’s effects on the body and how these might differ from one person to the next, the team, including first author Jeremy Robbins, MD, of the Division of Cardiovascular Medicine at BIDMC, measured the blood levels of approximately 5,000 proteins in 650 sedentary adults before and after a 20-week endurance exercise program.

“We were particularly interested at looking at proteins in the blood to study the effects of exercise because there is a growing body of evidence showing that exercise stimulates the secretion of chemicals into circulation that can impart their effects on distant organs,” Robbins said.

A set of 147 proteins in the blood indicated an individual’s cardiorespiratory fitness, or VO2max, at the start of the study. Another set of 102 proteins indicated an individual’s change in VO2max following the completion of the exercise program.

“We identified proteins that emanate from bone, muscle, and blood vessels that are strongly related to cardiorespiratory fitness and had never been previously associated with exercise training responses,” said Gerszten, who is also the Herman Dana Professor of Medicine at Harvard Medical School and a Senior Associate Member of the Broad Institute of MIT and Harvard.

Robbins added, “Even though prior studies have shown that an individual’s baseline fitness level is unrelated to their response to exercise training, it was fascinating to see that there was minimal overlap between the protein profiles of baseline VO2max and its response to the exercise training intervention.”

With this information, the research team developed a protein score that improved their ability to predict an individual’s trainability, or change in VO2max. For example, the score identified individuals who were unable to significantly improve their cardiorespiratory fitness despite participating in the standardized exercise program. “Baseline levels of several proteins predicted who would respond to the exercise training protocol far better than any of our established patient factors,” Gerszten said.

In a separate community-based study, though part of the same paper, the scientists found that some of these proteins were linked to an elevated risk of early death, highlighting the link between cardiorespiratory fitness and long-term health outcomes.

“We now have a detailed list of new blood compounds that further inform our understanding of the biology of fitness and exercise adaptation, and predict individual responses to a given exercise regimen,” said Gerszten, who is also the Director of the Program in Personal Genomics and Cardiometabolic Disease at BIDMC. “While no pill is ever likely to recapitulate the diversity of benefits from exercise, our study has helped create a roadmap to further explore potential interventions and provides an important step in individualizing exercise as a therapy.” He noted that additional research is needed to expand the study’s findings to larger populations and to further refine the precise effects of the different proteins before and after exercise.

Finally, an excuse for pregnant women to eat bacon and eggs

Press release:

If you’re pregnant and looking for an excuse to eat bacon and eggs, now you’ve got one: a new research study published in the January 2010 print issue of the FASEB Journal (http://www.fasebj.org) by a team of University of North Carolina researchers shows that choline plays a critical role in helping fetal brains develop regions associated with memory. Choline is found in meats, including pork, as well as chicken eggs.

“Our study in mice indicates that the diet of a pregnant mother, especially choline in that diet, can change the epigenetic switches that control brain development in the fetus” said Steven Zeisel, the senior scientist involved in the work and a senior member of the FASEB Journal‘s editorial board. “Understanding more about how diet modifies our genes could be very important for assuring optimal development.”

Zeisel and colleagues made this discovery by feeding two groups of pregnant mice different diets during the window of time when a fetus develops its hippocampus, that part of the brain responsible for memory. The first group received no choline while the other received choline (1.1g/Kg). The group that received no choline had changes in epigenetic marks on the proteins (histones) that wrap genes in cells responsible for the creation of new brain cells (neural progenitor cells). Then, by isolating these cells from the developing brains and growing them in cell culture, the scientists determined the expression of genes for two proteins that regulate neuronal cell creation and maturation. These two proteins (G9a and Calb1) were changed in the brains of fetuses whose mothers were fed low choline diets.

“We may never be able to call bacon a health food with a straight face, but the emerging field of epigenetics is already making us rethink those things that we consider healthful and unhealthful,” said Gerald Weissmann, MD, Editor-in-Chief of the FASEB Journal. “This is yet another example showing that good prenatal nutrition is vitally important throughout a child’s entire lifetime.”

The Agricultural Research Service’s Nutrient Data Laboratory makes a database available to the public in an effort to help them get healthful amounts of choline in their diets. The database provides researchers and consumers with the means to estimate daily choline intake from consumption of more than 400 different foods and can be accessed at http://www.ars.usda.gov/main/site_main.htm?modecode=12-35-45-00. The Agricultural Research Service says that “experts suggest that an adequate choline intake is 425 milligrams a day for women and 550 milligrams a day for men. Top sources of choline include meat, nuts, and eggs.”

Is bacon and eggs the ‘breakfast of champions‘?

How tendons become stiffer and stronger

Press release:

Tendons are what connect muscles to bones. They are relatively thin but have to withstand enormous forces. Tendons need a certain elasticity to absorb high loads, such as mechanical shock, without tearing. In sports involving sprinting and jumping, however, stiff tendons are an advantage because they transmit the forces that unfold in the muscles more directly to the bones. Appropriate training helps to achieve an optimal stiffening of the tendons.

Researchers from ETH Zurich and the University of Zurich, working at Balgrist University Hospital in Zurich, have now deciphered how the cells of the tendons perceive mechanical stress and how they are able to adapt the tendons to the demands of the body. Their findings have just been published in the journal Nature Biomedical Engineering [https://doi.org/10.1038/s41551-021-00716-x].

At the core of the newly discovered mechanism is a molecular force sensor in the tendon cells consisting of an ion channel protein. This sensor detects when the collagen fibres, that make up the tendons, shift against each other lengthwise. If such a strong shear movement occurs, the sensor allows calcium ions to flow into the tendon cells. This promotes the production of certain enzymes that link the collagen fibres together. As a result, the tendons lose elasticity and become stiffer and stronger.

Gene variant overreacts

Interestingly, the ion channel protein responsible for this occurs in different genetic variants in humans. A few years ago, other scientists found that a particular variant called E756del is clustered in individuals of West African ancestry. At that time, the importance of this protein for tendon stiffness was not yet known. One-third of individuals of African descent carry this gene variant, while it is rare in other populations. This gene variant protects its carriers from severe cases of the tropical disease malaria. Scientists assume that the variant was able to prevail in this population because of this advantage.

The researchers led by Jess Snedeker, Professor of Orthopaedic Biomechanics at ETH Zurich and the University of Zurich, have now shown that mice carrying this gene variant have stiffer tendons. They believe that tendons “overshoot” in their adaptive response to exercise due to this variant.

Major performance advantage

This also has direct effects on people’s ability to jump, as the scientists showed in a study with 65 African American volunteers. Of the participants, 22 carried the E756del variant of the gene, while the remaining 43 did not. To account for various factors that influence a person’s ability to jump (including physique, training, and general fitness), the researchers compared the performance during a slow and a fast jump. Tendons play only a minor role during slow jumping manoeuvres but are particularly important during fast jumps. With their study design, the scientists could isolate the effect of the gene variant on the jumping performance.

This showed that carriers of variant E756del performed 13 percent better on average. “It’s fascinating that a gene variant, which is positively selected due to an anti-malaria effect, at the same time is associated with better athletic abilities. We certainly did not expect to find this when we started the project,” says Fabian Passini, doctoral student in Snedeker’s group and first author of the study. It may well be that this gene variant explains in part why athletes hailing from countries with a high E756del frequency excel in world-class sports competitions, including sprinting, long-jumping and basketball. To date, there has been no scientific investigation into whether this gene variant is overrepresented among elite athletes. However, such a study would be of scientific interest, Passini says.

The findings about the force sensor and the mechanism by which tendons can adapt to physical demands are also important for physiotherapy. “We now have a better understanding of how tendons work. This should also help us treat tendon injuries better in future,” Snedeker says. In the medium term, it may also be possible to develop drugs that dock onto the newly discovered tendon force sensor. These could one day help to heal tendinopathies and other connective tissue disorders.

Vitamin D deficiency may impair muscle function

Press release:

Vitamin D deficiency may impair muscle function due to a reduction in energy production in the muscles, according to a mouse study published in the Journal of Endocrinology. Vitamin D deficient mice were found to have impaired muscle mitochondrial function, which may have implications for muscle function, performance and recovery. This may suggest that preventing vitamin D deficiency in older adults could help maintain better muscle strength and function and reduce age related muscle deterioration, but further studies are needed to confirm this.

Vitamin D is a hormone well known to be important for maintaining bone health and preventing rickets and osteoporosis. In recent years, vitamin D deficiency has been reported to be as prevalent as 40% in European populations and linked to increased risk for several conditions, including COVID-19, cancer and diabetes. Although these studies report association rather than causation, the benefits of vitamin D supplementation are now a major subject of health debate. Multiple studies have also linked low vitamin D levels to poor muscle strength, particularly in older people. Skeletal muscle enables us to move voluntarily and perform everyday activities. It is essential that they have enough energy to power these movements. Specialised organs in cells, called mitochondria, convert nutrients in to energy to meet this demand. Previous studies indicate that impaired muscle strength in people with vitamin D deficiency may be linked to impaired muscle mitochondrial function. Determining the role of vitamin D in muscle performance of older people is also difficult, as they may suffer from a number of pre-existing health conditions that can also affect their vitamin D status. Therefore, previous studies have been unable to determine how vitamin D may directly affect muscle performance.

Dr Andrew Philp and his team at the Garvan Institute of Medical Research in Australia, and collaborating universities, used a mouse model to determine the effects of diet-induced vitamin D deficiency on skeletal muscle mitochondrial function in young, male mice. Mice were either fed a diet with normal quantities of vitamin D, or with no vitamin D to induce deficiency, for a period of 3 months. A typical vitamin D level for humans is 40-50 nmol.L-1, and acute vitamin D deficiency is diagnosed when levels drop below 12 nmol.L-1. On average, the mice in this study had vitamin D levels of 30 nmol.L1, with diet-induced vitamin D deficiency leading to levels of just 3 nmol.L-1. Although this level was more extreme than typically observed in people, it is still within the clinically-recognised range. Tissue and blood samples were collected monthly to quantify vitamin D and calcium concentrations and to assess markers of muscle mitochondrial function and number. After 3 months of diet-induced vitamin D deficiency skeletal muscle mitochondrial function was found to be impaired by up to 37%. This was not due to a reduced number of mitochondria or a reduction in muscle mass.

“Our results show there is a clear link between vitamin D deficiency and oxidative capacity in skeletal muscle. They suggest that vitamin D deficiency decreases mitochondrial function, as opposed to reducing the number of mitochondria in skeletal muscle.” Dr Philp comments. “We are particularly interested to examine whether this reduction in mitochondrial function may be a cause of age related loss in skeletal muscle mass and function.”

These findings suggest that vitamin D deficiency may impair mitochondrial function and reduce the amount of energy produced in the muscles, which may lead to poor muscle function. Therefore, preventing vitamin D deficiency in older people may help maintain muscle performance and reduce the risk of muscle related diseases, such as sarcopenia. However, further studies that investigate the direct effect of vitamin D deficiency on muscle function and strength are necessary to confirm this.

Whilst this study indicates that vitamin D deficiency can alter mitochondrial function in skeletal muscle, Dr Philp and his team were unable to determine precisely how this process occurred. Therefore, their future work aims to establish how vitamin D deficiency alters mitochondrial control and function in skeletal muscle.

Icing muscle injuries may delay recovery

Press release from Kobe University:

A study using a mouse model of eccentric contraction (*1) has revealed that icing injured muscles delays muscle regeneration. The discovery was made by a research group including Associate Professor ARAKAWA Takamitsu and then PhD. Student KAWASHIMA Masato from Kobe University’s Graduate School of Health Sciences, and Chiba Institute of Technology’s Associate Professor KAWANISHI Noriaki et al. In addition, the researchers illuminated that this phenomenon may be related to pro-inflammatory macrophages’ (*2, 3, 4) ability to infiltrate damaged cells. This research raises questions as to whether or not severe muscle injuries (such as torn muscles) should be iced.

These research results were published online as one of the Journal of Applied Physiology‘s Articles in Press on March 25, 2021.

Main points

  • The research results revealed that applying an ice pack to a severe muscle injury resulting from eccentric contraction may prolong the time it takes to heal.
  • The cause of this phenomenon is that icing delays the arrival of pro-inflammatory macrophages, which are responsible for the phagocytosis (*5), or removal, of damaged tissue. Furthermore, this makes difficult for the macrophages to sufficiently infiltrate the damaged muscle cells.

Research Background

Skeletal muscle injuries encompass a range of damage to muscles; from a microcellular level to a severe level. These injuries include not only those that happen during sports or schools’ physical education lessons but also external injuries that occur as a result of accidents and disasters.

‘RICE treatment’ is a common approach for skeletal muscle injuries, regardless of the extent of the injury. This acronym stands for Rest, Ice, Compression and Elevation and is often used in physical education, sports and even medicine. Ice is commonly applied regardless of the type of muscle injury, yet little is known about the long-term effects of icing.

Ice is used to suppress inflammation, however, inflammation in response to tissue injury is one of the body’s healing mechanisms. This has come to be understood as a vital response for tissue regeneration. In other words, suppressing inflammation with ice may also inhibit the body’s attempt to repair itself.

Experiments investigating the effect of icing muscles after injury have produced conflicting results. Some have reported that it delays muscle regeneration while others have stated that it doesn’t inhibit this process. However, none of the research up until now has investigated the effects of icing using an injury model that mimics common sports injuries caused by muscle contraction.

Using a mouse model of eccentric contraction injury, the current research team decided to observe the effects of post-injury icing. In this mouse model, injuries were induced to resemble severe torn muscles.

Research Methodology and Results

Eccentric contraction was induced by electrically stimulating the leg muscles of the mice and then exerting a stronger force during this stimulation to make the leg muscles move in the opposite direction. After this, the muscles were harvested. Icing was performed by placing polyurethane bags of ice on top of the skin over three 30 minute sessions per day, with each session being 2 hours apart. This was continued until two days after the injury. The icing was based on the usual clinically recommended method.

The researchers investigated the regenerated skeletal muscle two weeks after injury, comparing the icing group with the non-icing group. A significantly higher percentage of smaller regenerated muscle fibers were found in cross-sections from the icing group, with a greater number of medium to large fibers in the non-icing group (Figure 1). In other words, this revealed that skeletal muscle regeneration may be delayed as a result of icing.

Next, the researchers periodically took samples of muscle from the icing and non-icing groups of animals in order to investigate what was happening in the regeneration process up until this point.

In the regeneration process, inflammatory cells gather at the site of the injury, remove the debris from the damaged muscle and then begin to build new muscle. However, the results revealed that it is harder for inflammatory cells to enter the injured muscle cells if ice is applied (Figure 2).

Macrophages are typical of the inflammatory cells that enter the injured muscle. These consist of pro-inflammatory macrophages, which phagocyte damaged tissue thus causing inflammation, and anti-inflammatory macrophages (*6), which suppress the inflammatory reaction and promote repair. It is thought that pro-inflammatory macrophages change their characteristics, becoming anti-inflammatory. The results of this research team’s experiments showed that icing delays the arrival of pro-inflammatory macrophages at the site of the injury (Figure 3).

These results indicate the possibility that macrophages are unable to sufficiently phagocyte the damaged muscle when ice is applied after severe muscle injuries caused by eccentric contraction, consequently delaying the formation of new muscle cells.

Comment from Associate Professor Arakawa

In sports, the mantra of immediately applying ice to an injury is commonplace, regardless of the injury’s severity. However, the mechanism that we illuminated through this research suggests that not icing a severe muscle injury may lead to faster recovery. The idea of immediately cooling any type of injury is also entrenched in schools’ physical education classes. I hope that in the future, the alternative option of speeding up recovery by not cooling severe muscle injuries will become known.

However, even though icing may disrupt the recovery process for severe muscle injuries, there is no denying the possibility that there are degrees of mild muscle injuries that can be iced. The next issue is to work out where to draw the line. We are now in the middle of investigating what effect icing has on slight muscle injuries.

Next, we will continue to investigate how icing should be carried out according to the extent of the muscle injury. We aim to contribute guidelines that will enable people in sports and clinical rehabilitation to make accurate judgements about whether or not to ice an injury.

Pink drinks can help you run faster and further, study finds

Press release:

A new study led by the Centre for Nutraceuticals in the University of Westminster shows that pink drinks can help to make you run faster and further compared to clear drinks.

The researchers found that a pink drink can increase exercise performance by 4.4 per cent and can also increase a ‘feel good’ effect which can make exercise seem easier.

The study, published in the journal Frontiers in Nutrition, is the first investigation to assess the effect of drink colour on exercise performance and provides the potential to open a new avenue of future research in the field of sports drinks and exercise.

During the study participants were asked to run on a treadmill for 30 minutes at a self-selected speed ensuring their rate of exertion remained consistent. Throughout the exercise they rinsed their mouths with either a pink artificially sweetened drink that was low in calories or a clear drink which was also artificially sweetened and low in calories.

Both drinks were exactly the same and only differed in appearance – the researchers added food dye to the pink drink to change the colour.

The researchers chose pink as it is associated with perceived sweetness and therefore increases expectations of sugar and carbohydrate intake.

Previous studies have also shown that rinsing the mouth with carbohydrates can improve exercise performance by reducing the perceived intensity of the exercise, so the researchers wanted to assess whether rinsing with a pink drink that had no carbohydrate stimulus could elicit similar benefits through a potential placebo effect.

The results show that the participants ran an average 212 metres further with the pink drink while their mean speed during the exercise test also increased by 4.4 per cent. Feelings of pleasure were also enhanced meaning participants found running more enjoyable.

Future exploratory research is necessary to find out whether the proposed placebo effect causes a similar activation to the reward areas of the brain that are commonly reported when rinsing the mouth with carbohydrates.

Talking about the study, Dr Sanjoy Deb, corresponding author on the paper from the University of Westminster, said: “The influence of colour on athletic performance has received interest previously, from its effect on a sportsperson’s kit to its impact on testosterone and muscular power. Similarly, the role of colour in gastronomy has received widespread interest, with research published on how visual cues or colour can affect subsequent flavour perception when eating and drinking.

“The findings from our study combine the art of gastronomy with performance nutrition, as adding a pink colourant to an artificially sweetened solution not only enhanced the perception of sweetness, but also enhanced feelings of pleasure, self-selected running speed and distance covered during a run.”

Where did the toning shoes go?

They did not go anywhere, they are just not a prominent today as they once were.

The toning shoes (or more likely called the unstable footwear today) were that category of footwear that made extraordinary promises that were not and have not been supported by the evidence. The shoes tend to have a rocker under the sole that makes them unstable. Because of this instability, the muscles work harder and the gait is different. It was claimed that this could cure cellulite (it can’t) and increases your exercise to give you a tone up (again unsubstantiated by the actual evidence). All this resulted in litigation and fines from regulatory agencies for false advertising.

All that did not mean that the category of footwear did not have some use. The very nature of toning shoes is that they have some sort of rocker on the sole which can be quite useful for people with osteoarthritis in the first metatarsophalangeal joint. The change is gait reportedly help some people with postural and low back problems, and can also make worse some people, so some trial and error was needed to see if they can help. More research needs to be done to see who they can best help and what the indications may be.

Do not write the toning shoes off just because of the litigation and embarrassing celebratory endorsements they used to have. They do have their uses.

Study shows significant benefit of PolarCap® in recovery from sports-related concussions

Press release:

PolarCool AB (publ), a Swedish medical device company focusing on treatment of sports-related traumatic brain injury (TBI) and whiplash, today announced that it has submitted a 510(k) pre-market notification to the U.S. Food and Drug Administration (FDA) for the PolarCap® System.

This submission follows publication of statistically significant clinical results in the scientific journal Concussion, showing clear benefit for use of the PolarCap® System in the treatment of concussions among players of 15 elite Swedish Ice-Hockey teams in the Swedish Hockey Leagues (SHL).

The incidence of sports-related concussions is a significant national health concern in Sweden, as it is here in the U.S., and there is growing evidence that repetitive traumatic brain injury can cause long-term changes in brain structure and function. This is of particular concern in the field of contact sports, such as ice hockey, where available treatment options are limited.

“With this important FDA submission, we are paving the way for the first-ever sports-related TBI treatment model,” said Martin Waleij, PolarCool Chairman of the Board. “Supported by robust clinical evidence enabling players to safely return to play much earlier, our 510(k) submission is the first step in the FDA review process. We look forward to this review and are confident that speedy clearance for the PolarCap® System is on the horizon.”

The study, led by investigators from Lund University at Skåne University Hospital in Lund, Sweden, Luleå University of Technology in Luleå, and BrainCool AB, represents the largest study population focused on sports-related concussion treatment in Sweden or the U.S., and shows statistical benefits of therapeutic cooling using the PolarCap® System head and neck cooling technology.

“Publication of these study results in the journal Concussion marks a significant milestone for sports medicine around the globe,” said Erik Andersson, Chief Executive Officer of PolarCool, maker of the PolarCap® System that was used in the Lund study. “We are eager to proceed with larger studies and to partner with academic medical centers and professional sports organizations to further validate the benefits of this medical cooling technology–with the ultimate goal of improving both short- and long-term safety for players of all contact sports.”

The Swedish Hockey League, the players organization SICO and PolarCool are actively collaborating to improve player safety. Two PolarCap® Systems are available at all games and the league is working to establish a standardized acute treatment method concussion injuries.

“It is very positive that we can constitute that the introduction of the Polar Cap has meant fewer long time absences among players that were treated by cooling directly after a concussion, with this treatment we have another tool to use (against head injuries),” said SHL Sports Director & Vice CEO Johan Hemlin in a recent SHL press release.

Fifteen teams from elite ice-hockey leagues for males in Sweden were given the option to participate in the intervention group (receiving selective head-neck cooling after a sports-related concussion) or the control group (standard sports-related concussion management). Selective head-neck cooling was initiated at a mean of 12.3 ± 9.2 min after the concussion in 29 players, and 52 SRC controls received standard management. Results showed significant benefits of cooling in treating concussions with a median time to return to play for the players who underwent cooling of 7 days, versus 12 days for those who did not. The study also shows promising reduction in the proportion of long-term absence, which can be as long as three weeks or more, among treated players.