Zideman David A, Derman Wayne, Hainline Brian, Moseley G Lorimer, Orchard John, Pluim Babette M, Siebert Christian H, Turner Judith A
Medical & Scientific Department, International Olympic Committee Medical and Scientific Games Group, Lausanne, Switzerland.
Department of Surgical Sciences, Institute of Sport and Exercise Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
Clin J Sport Med. 2018 Sep;28(5):485-489. doi: 10.1097/JSM.0000000000000618.
For elite athletes to train and compete at peak performance levels, it is necessary to manage their pain efficiently and effectively. A recent consensus meeting on the management of pain in elite athletes concluded that there are many gaps in the current knowledge and that further information and research is required. This article presents the crystallization of these acknowledged gaps in knowledge.
Information was gathered from a wide variety of published scientific sources that were reviewed at the consensus meeting and the gaps in knowledge identified.
Gaps have been identified in the epidemiology of analgesic use, the management of pain associated with minor injuries, and the field of play management of pain for athletes with major injuries. From a pharmacological perspective, there is a lack of information on the prescribing of opioid medications in elite athletes and more data are required on the use of local anesthetics injections, corticosteroids, and nonsteroidal anti-inflammatory drugs during training and in competition. Pain management strategies for the general population are widely available, but there are few for the elite sporting population and virtually none for elite athletes with a disability. More research is also needed in assessing cognitive-behavior therapies in improving specific outcomes and also into the new process of psychologically informed physiotherapy. A key issue is the paucity of data relating to incidence or prevalence of persistent pain and how this relates to persistent dysfunction, exercise performance, and physiological function in later life.
The identification of the gaps in knowledge in the management of pain in elite athletes will provide a unified direction for the retrieval of information and further research that will provide reassurance, speed return to active sport, and benefit performance.
对于精英运动员而言，要在巅峰竞技水平上进行训练和比赛，有效管理他们的疼痛是必要的。最近一次关于精英运动员疼痛管理的共识会议得出结论，当前知识存在诸多空白，需要更多信息和研究。本文呈现了这些已被认可的知识空白。
信息收集自各种已发表的科学资料，这些资料在共识会议上被审阅并确定了知识空白。
在镇痛药使用的流行病学、与轻伤相关的疼痛管理以及重伤运动员的赛场疼痛管理方面都发现了空白。从药理学角度来看，缺乏关于精英运动员使用阿片类药物处方的信息，还需要更多关于训练和比赛期间使用局部麻醉剂注射、皮质类固醇和非甾体抗炎药的数据。针对普通人群的疼痛管理策略广泛可得，但针对精英体育人群的却很少，而针对残疾精英运动员的几乎没有。在评估认知行为疗法改善特定结果以及心理知情物理治疗的新过程方面也需要更多研究。一个关键问题是缺乏与持续性疼痛的发病率或患病率相关的数据，以及这与后期生活中的持续性功能障碍、运动表现和生理功能之间的关系。
识别精英运动员疼痛管理中的知识空白将为信息检索和进一步研究提供统一方向，这将提供保障、加速运动员恢复积极运动并有益于运动表现。
