Complete Issue

International Journal of Wrestling Science
Volume 9, Number 2 2019
INTERNATIONAL NETWORK OF WRESTLING RESEARCHERS (INWR)

ADVANCING OUR SPORT THROUGH KNOWLEDGE
FAIRE PROGRESSER NOTRE SPORT PAR LA CONNAISSANCE
ПРОДВИЖЕНИЕ НАШЕГО СПОРТА ЧЕРЕЗ ЗНАНИЕ
PROGRESO PARA NUESTRO DEPORTE MEDIANTE CONOCIMIENTO
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The official journal of the International Network of Wrestling Researchers (INWR)
David Curby, EdD
Editor in Chief
EDITORIAL BOARD
Mario Baić, PhD, Croatia Boris Podlivaev, PhD, Russia

Ioannis Barbas, PhD, Greece Ramazan Savranbaşi, PhD, Turkey
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Fikrat Kerimov, PhD, Uzbekistan Slavi Stanev, PhD, Bulgaria
David Lopez-Gonzalez, Mexico Harold Tünnemann, PhD, Germany
Bahman Mirzaei, PhD, Iran
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Reviewers
Brian Adams MD (USA) Milorad Dokmanac PhD (Serbia) Michel Lafon (France)
Nikos Aggelousis PhD (Greece) Sergio Dos Santos PhD (Brazil) Maria Michalopoulou PhD (Greece)
Euaggelos Almpanidis PhD (Greece) Mindaugas Ežerskis PhD (Lithuania) Robert A. Oppliger PhD (USA)
Ramin Amirsasan PhD (Iran) Ioannis Fatouros PhD (Greece) Jonas Poderys PhD (Lithuania)
B.J. Anderson MD (USA) Emerson Franchini PhD (Brazil) Amir Rashidlamir PhD (Iran)
Mario Baic PhD (Croatia) Jeremy Frank MD (USA) William A Sands PhD (USA)
Tibor Barna PhD (Hungary) Bruno Hartmann PhD (Austria) Babak Shadgan PhD MD (Canada)
Sylvia Bakalova PhD (Bulgaria) Kazunori Iwai PhD (Japan) Victor Shiyan PhD (Russia)
Michel Calmet PhD (France) Tomas Kourtesis PhD (Greece) Dao Chanh Thuc PhD (Vietnam)
Ibrahim Cicioglu PhD (Turkey) William J. Kraemer PhD (USA) Mehmet Türkmen PhD (TUR)
Eckart D. Diezemann MD (Germany) Takeshi Kukidome PhD (Japan) Alan C. Utter PhD (USA)
The ofﬁcial journal of the International Network of Wrestling Researchers (INWR)
Volume 9, Number 2, 2019
CONTENTS
Original Research
1-8 TURKISH NATIONAL WRESTLERS AND HALAL FOOD-RELATED PROBLEMS IN

THE ORGANIZATION OF INTERNATIONAL SPORT
Aydoğan Soygüden & Celal Taşkiran
9-13 MODELING THE FORCE CHARACTERISTICS OF LIFTING ACTIONS BASED ON

ELECTROMYOGRAPHIC RESEARCH IN HIGHLY QUALIFIED WRESTLERS
Dvorkin L. S. & Dyushko O.I.
14-18 MODEL CHARACTERISTICS OF SENSORIMOTOR REACTIONS AND SPECIFIC

PERCEPTIONS OF WRESTLERS AMONG DIFFERENT WEIGHT CATEGORIES
Yuriy Tropin, Georgiy Korobeynikov, David Curby, Andrey Vorontsov & Vladymir Shatskih
Special Section: Summaries of Presentations from the Wrestling Medicine Conference & Wrestling
Team Physician Course, United World Wrestling, Budapest, October 24-26, 2019
20-26 PRINCIPLES OF MUSCULOSKELETAL INJURY PREVENTION IN WRESTLING

Szabolcs Molnár
27-30 ASSESSMENT OF WRESTLING MATS TO PREVENT SPORTS INJURIES

Márton Tomin & Ákos Kmetty
31-32 BEACH WRESTLING: DOHA/QATAR 2019 – EXPERIENCES

José Alfredo Cavalcante Padilha
33-34 CAULIFLOWER EAR AMONG FINNISH HIGH‐LEVEL MALE WRESTLERS AND

JUDOKA
Iida-Kaisa Manninen, Karin Blomgren, Rauno Elokiuru, Mika Lehto, Laura K Mäkinen &
Tuomas Klockars
35-36 DOPING CONTROL RULES UPDATE & UWW TUE PROCESS

Carlos Roy
37-41 OVERVIEW ON DOPING RULES VIOLATIONS IN WRESTLING

Carlos Roy
42-46 EFFECTS OF LOW MOBILITY OF THE SPINE IN YOUNG MALE AND FEMALE
WRESTLERS
Varvara Ioannidou, Evaggelia Makri & Ioannis Barbas
47 INTRAVENOUS FLUID TRANSFUSION ISSUE FROM JUNIOR WORLD

CHAMPIONSHIPS 2019 TALLINN, ESTONIA 12.-18.08.2019
Mika Lehto
48-50 OVERTRAINING AND FATIGUE SYNDROME IN ELITE ATHLETES
Amir Pakravan
51-52 SUCCESSFUL NON-OPERATIVE MANAGEMENT OF NEAR COMPLETE

HAMSTRING INJURY
Jason Crookham
53-55 GENERAL HEALTH MANAGEMENT STRATEGIES IN WRESTLING

Stevan Sikimic
56-62 VETERAN MEDICINE IN WRESTLING: EXAMINATIONS AND PREVENTION

Mika Lehto
63-65 KNEE LIGAMENT INJURIES IN WRESTLERS

Kohei Nakajima, Teppei Tanaka, Naoka Fukuda, Mika Hangai, Yuki Ara,Yusuke Nishida &
Toru Okuwaki
66-68 STUDY OF THE PEAK OXYGEN UPTAKE AND MAXIMAL HEART RATE IN
WRESTLERS
Daniela Cuadra
69-72 MEDICAL COVERAGE OF WRESTLING EVENTS; FROM A TO Z

Szabolcs Molnár
73-74 MOST FREQUENT SHOULDER INJURIES IN MEXICAN JUNIOR AND SENIOR

OLYMPIC WRESTLERS, DESCRIBED BY MUSCULOSKELETAL ULTRASOUND
Francisco Lee
75-78 PRECOMPETITIVE ANTICIPATORY STRESS RESPONSE OF ELITE WRESTLERS

Gábor Farkas, Éva Bretz, Tibor Barna & Károly Bretz
79-85 PREPARTICIPATION MEDICAL EVALUATION: WHY WHEN HOW

86-90 WRESTLING INJURIES; FACTS AND FIGURES, PAST, PRESENT & FUTURE
Babak Shadgan
91-98 MUSCULOSKELETAL INJURIES, MECHANISM, RESULTS & PREVENTION

Loukas Konstantinou
99 RISK OF BLOODBORNE INFECTION TRANSMISSION IN WRESTLING

Reza Naghavi
100-103 SPINE INJURIES IN WRESTLING

Johann Klaus
104-105 WORKSHOP: MAT-SIDE INJURY MANAGEMENT

Amir Pakravan
106-110 SKIN CONDITIONS IN WRESTLING – HOW TO PREVENT

Krisztián Gáspár
111-117 CAN I PROTECT THE WRESTLERS‘ SPINE FROM LONG-TERM DAMAGE?

Eckart D. Diezemann
TURKISH NATIONAL WRESTLERS AND HALAL FOOD-RELATED
PROBLEMS IN THE ORGANIZATION OF INTERNATIONAL SPORT
Aydoğan SOYGÜDEN1, Celal TAŞKIRAN2
1 Erciyes University, Faculty of Sport Science, Kayseri - Turkey
2 Hitit University, Faculty of Sport Science, Çorum – Turkey
aydogan38@hotmail.com
ABSTRACT
The study was carried out in order to determine the halal food problems that the members of the Turkish national
wrestling team have experienced at the international sports organizations held abroad. National wrestlers are
affected psychologically and motivationally in sports performances due to the absence of halal food. This study
aims to draw attention to halal food in international the organization of sports. Materials and Methods: a
questionnaire form was prepared by the researchers and used in the study. There are 12 questions in the
questionnaire including 8 halal food questions and 4 socio-demographic questions. The questions in the
questionnaire were prepared in consultation with academicians working at different universities. The study of
the different age groups (n = 40) were applied to the old and the new Turkish national wrestling team members.
As a result of the questionnaire survey, the data were entered into the SPSS program and statistical
percentages were obtained. Results: in the study 100% of the national wrestlers participating in the study were
male athletes and 45% of the athletes participating in the study were ages between 21-25 years old. In the
study, 85% of the participants were university graduates. In the survey, 70% of the national wrestlers who
participated to the study were stated that they participated in international sport organizations between 1-5 times
and 22.5% between 6-10 times. In the study, 95% of the national wrestlers who participated in the survey
responded “No” to the Question: Can you easily consume the food at the accommodation place in the sports
competitions held abroad?”. In the study, 100% of the athletes participating in the study answered "yes" to the
question: Are you paying attention to the halal food when going on in sports competitions abroad?”. In the study,
80% of the athletes responded "yes" to the question: Does it affect your sport performance because there is no
halal food abroad?”. In the study 92.5% of the athletes answered "yes" to the question "Are you bringing halal
food with you in sports competitions made abroad?”. In the study, participant’s food consumption was declared
by the athletes, 90% vegetable, 87.5% fruit, 85% pilaf (rice), 65% chicken, 60% fish, 32.5% pasta and nuts, and
only 2.5% red meat. Conclusion; we see that athlete’s sports performance, psychological and motivational is
effected among national wrestlers abroad due to the absence of halal food or lack of halal food preparation
process. It is recommended that international sports federations conduct studies on halal food in sport
organizations held abroad. Competition on equal terms for all athletes will contribute to better levels of world
sport.
Key Words: Turkish National Wrestlers, International Sports Organizations and Halal Food
INTRODUCTION
Because of globalization millions of people travel and visit many countries. Especially, in Muslim countries
economic growth will affect the travel sector. Currently, we can see many Muslim people around the world.
These activities also bring more attention to food sectors. In the Muslim majority, the concept of halal is an
absolute key to diet. Muslim consumers nowadays are faced with a broad selection of products and services.
Institutional religion formalizes these into a system which can be taught to each generation. ‘Islam is more than
a religion as it controls the ways of society and factors associated with family, dress, cleanliness and ethics’
(Fam, 2004). Islamic lives bring to many regulations to our life. Muslim have to follow thee regulations and follow
Prophet Muhammed (S.A.V) examples.
A religion may influence consumer behavior and behavior in general (Delener, 1994, Pettinger, 2004), especially
in decisions to buy meals and in establishing food habits (Bonne, 2007). Muslim consumers are trying to very
careful with the food products and many times look for the alternate food. Burgmann, (2007) mentioned in article
that halal food market is the fastest growing in the world. First, it can be linked to religious fervor and beliefs
that it is cleaner, healthier, and tastier, and second, for the tremendous acceptance of halal within the global
population through the process of assimilation.
The degree to which an individual is religious, that is, their religiosity, is part of their self-identity as a Muslim,
and to that extent they will have Muslim attitudes, determines their intention to consume halal foods. However,
the extent to which an individual consumes halal food will also depend on other related factors, such as
availability of halal food, chance, knowledge, and sources including money (Soesilowati, 2010).
The Muslim population in and around us is large and Islam is the fastest growing religion on earth. With Muslims
now making up one quarter of the world’s population, the market opportunities are outstanding and the global
halal marketplace is too lucrative a market for food manufacturers to ignore. There are altogether more than
International Journal of Wrestling Science 2019; Vol 9 Issue 2 p. 1

two billion Muslim populations in the world spreading over 112 countries, across diverse regions such as
Organization of Islamic Conference Nations (1.4 billion), Asia (805 million), Africa (300 million), Middle East
(210 million), Europe (18 million), and Malaysia (16 million) (www.mida.gov.my). With the global halal market
estimated to be worth US$580 billion a year and the halal food industry pegged to grow at a rate of 7 percent
annually (Saad and Patrick, 2008).
Currently, many sports organization made it around the World. International sport organizations non-profit or
professionals make it around the globe. Thousands of athletes, coach, team staff and organization committee
members participate and many of the participants are from Muslim countries. At Olympic Games in Brazil 2016,
207 nations and 11,238 athletes participated. It is estimated that 25 to 35 % of participants are from Muslim
countries, or are Muslims living in non-Muslim countries.
The International Olympic Committee (IOC) is the leading organization in the world of sport. Currently, the IOC
has organized around the worlds 41 summer sports and 15 winter sport and 206 countries member of the
International Olympic Committee (IOC, 2018).
Sport based entrepreneurship is any kind of sport activity that is innovative, opportunity driven and vision
orientated. Entrepreneurship in sport can exist in a number of different international contexts including the
individual, organization or team (Ratten and Ratten, 2011).
The purpose of this research brings more attention to public and international sport federations, that Muslim
athletes and technical staff, delegation perceive difficulty from a of lack of halal food products when they travel
abroad. This problem can affect an athlete’s sports performance, motivation and moral issues.
Halal Food. What is halal food? Halal (, hala¯l, and halaal) is a Quranic word meaning lawful or permitted,
which is the dietary standard prescribed in the Quran. In the Quran, it is mentioned that all foods are halal except
those that are specifically mentioned as Haram, which is prohibited or unlawful. In the English language, it most
frequently refers to food that is permissible according to Islamic law. In the Arabic language, it refers to anything
that is permissible under Islam (Alam and Sayuti, 2011).
Religious control of food consumption patterns is in terms of restrictions on particular foods are seen in several
religions: Jews, for example, are prohibited from eating pork; and beef is prohibited for Hindus. Muslims are
prohibited from eating pork, blood, and animals that have not been killed in the way prescribed by syari`ah law,
and they may not drink alcoholic beverages. Muslims have a religious obligation to consume halal food (Bonne
et al., 2007). Meanwhile, religiosity is the extent of a person’s commitment to his or her religion (2001, Mokhlis
(2006). Religiosity is very important because it determines individual cognition and behavior (Sitasari, 2008). It
is highly likely that religiosity will govern an individual’s behavior, including behavior as a halal food consumer.
Sports and Nutrition. Athletes always need good nutrition, and if athletes cannot get enough and proper
nutrition, will affect their performance directly. Healthy and suitable nutrition plays an important role in the athletic
performance providing the long‐term needs of training and the short‐term needs of competition (Hassapidou,
2001). The science of nutrition in relation to sports performance has progressed and we now have a better
understanding of the relationship between diet and physical performance (Hassapidou, 2001). Many sport
science researchers are trying to improve athlete’s performance through better nutrition.
A review of the most recent studies (Lemon, 1991; Tarnopolsky et al., 1988) suggests that the protein needs of
strength athletes are about 1.2g to 1.7g/kg /day. The mean protein intakes of athletes of all sports, in this study,
were above these recommendations. Proteins are very rich in the meat product, for example beef, chicken, fish
and other animal product. Studies have revealed athletes in negative energy balance (Short and Short, 1983),
with low carbohydrate intakes (Steele, 1970), or athletes with low vitamin and mineral intake (Nieman et al.,
1989; Newhouse and Clement, 1988). Athletes have to balance the intake of many nutritients.
Some sports have different weight classes which requires that these athletes monitor their weight. Eating
problems, as it has been reported, cluster in sports, where low weight is thought to improve performance (e.g.
distance running), where rating may be influenced by appearance (figure skating, gymnastics) or where athletes
must compete in specific weight categories (Sykora et al., 1993).
Existing studies generally find that athletes have problems more frequently than the general population and that
sports characterized by specific weight requirements or appearance expectations (wrestling, gymnastics) have
more problems than sports in which weight is less important (Burke and Deakin, 1994). Most people have heard
the general recommendation that adults eat about 2,000 calories per day. For athletes, however, that may not
be enough; athletes need extra calories to fuel their activities and to encourage muscles and bones to continue
strengthening. Athletes typically need a minimum of 2,000 calories per day, with specific upper-range
p. 2 Official Journal of the International Network of Wrestling Researchers (INWR)

recommendations varying based on the person's age, sex, weight, sport, activity level, goals and overall health
(Manore, 2015). Some sport athletes need more calories daily. For example, a very active six-foot-tall male who
is 25 years old and weighs 175 pounds needs about 3,750 calories per day, according to the USDA's
recommendations (Manore, 2015).
An athlete's caloric needs also vary based on the sport. According to Nanna Meyer, a senior sport dietitian for
Olympic athletes, elite endurance athletes need the most calories because their activities and training last for
the longest periods of time. She suggests a range of 3,000 to 8,000 calories per day for high-level endurance
athletes. Those playing team sports need about 3,000 to 4,500 calories per day, and athletes participating in
sports that need only short bursts of strength or performance, such as powerlifters and gymnasts, need
somewhere in the range of 2,000 to 6,000 calories per day (Manore, 2015).
It is the position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports
Medicine that physical activity, athletic performance, and recovery from exercise are enhanced by optimal
nutrition. These organizations recommend appropriate selection of foods and fluids, timing of intake, and
supplement choices for optimal health and exercise performance (Rodriguez et al., 2009).
Energy and macronutrient needs, especially carbohydrate and protein, must be met during times of high
physical activity to maintain body weight, replenish glycogen stores, and provide adequate protein to build and
repair tissue (Rodriguez et al., 2009). Athletes need to consume enough energy to maintain appropriate weight
and body composition while training for a sport (Thompson et al., 1995). Although athletes expend high amounts
of energy in exercise, they may still need to monitor diet and lifestyle to maintain a competitive body weight
(Manore, 2015). In general, the protein needs of athletes are higher (1.4–1.7 g/kg/bodyweight) (Rodriguez et
al., 2009) than that recommended by the RDA (0.8 g/kg/bodyweight) for non-active individuals (Institute of
Medicine 2005). The amount of additional protein needed will depend on the volume and type of exercise and
the level of energy restriction (Carbone et al., 2012).
Sport and Motivations. In sport performance, there are many internal and external factors that will affect the
athletes’ performances. Especially, in the elite athletes the motivational factor is different than the amateur
athletes. Motivation is the foundation of all athletic effort and accomplishment. Without a desire and
determination to improve your sports performances, all of the other mental factors, confidence, intensity, focus,
and emotions, are meaningless. To become the best athlete, you can be, you must be motivated to do what it
takes to maximize your ability and achieve your goals (Taylor, 2018).
Motivation will impact everything that influences your sports performance: physical conditioning, technical and
tactical training, mental preparation, and general lifestyle include sleep, diet, school or work, and relationships
(Taylor, 2018). However, the majority of this research has examined imagery effects on performance and
learning at the expense of motivational and self-confidence effects (Murphy, 1994). Elite performers have
reported on the motivational effects of imagery (Orlick and Partington, 1988). Motivation represents ‘‘an internal
factor that arouses, directs, and integrates a person’s behavior’’ (Iso-Ahola, 1982, p. 230). Sport motivation can
also be affected by perceptions of the host destination, travel issues and individual factors of gender and cultural
background (Baloglu and McCleary, 1999; Crotts and Litvin, 2003; Hanquin and Lam, 1999; McGehee et al.,
2003).
Motivation can be defined as “the investigation of the energization and direction of behavior” (Roberts and
Treasure, 2001, p. 6). Thus, it comprises the reasons or forces that influence behavior. Motivation is a complex
construct (or latent variable), rather than an observable entity, which contributes to the difficulty in accurately
conceptualizing and measuring it (Lavallee et al, 2003).
METHODS
A 12 item social demographic questionnaire concerning halal food was given to Turkish National Wrestling team
members. In the study, a total of 40 old and new Turkish National Wrestling Team members participated to
study. All survey descriptive data used the SPSS statistical program. The survey was was administered with a
phone interview and all members of the team voluntarily answered the survey questions.
RESULTS
In this section participation gender, age, education and some questions of the halal food asked to both the old
and new member of the Turkish National Wrestling Team. All information is shown in the following tables tables.

Table 1. Distributions of Gender, Age and Education Status of the participants
Gender Frequency %
Male 40 100
Female - -
Total 40 100
Age F %
15-20 3 7.5
21-25 18 45.0
26-30 5 12.5
31-35 6 15.0
36 and above 8 20.0
Total 40 100.0
Education F %
High school 3 7.5
University 34 85.0
Graduate school 3 7.5
Total 40 100.0
In table 1, all national wrestlers who participated in the study consisted of male athletes. The athletes
participating in the study; 45% of them are between the ages of 21-25 years old and 85% of them are university
graduates.
Table 2. Response to question 1.

Question 1: How many international sports events have you participated as a national
athlete abroad?
Response Frequency %
1-5 times 28 70.0
6-10 times 9 22.5
11-15 times 3 7.5
20 times and above - -
Total 40 100.0
In table 2, the national wrestlers participating in the research; 70% of them stated that they participated in
international sports organizations between 1-5 times and 22.5% stated that they participated between 6-10
times total.
Table 3. Responses to questions 2, 3 and 4.

Question 2: Can you easily consume the food at the site of sports competitions abroad?
Yes 2 5.0
No 38 95.0
Total 40 100.0
Question 3: Do you pay attention to halal food in sports competitions abroad?
Yes 40 100.0
No - -
Total 40 100.0
Question 4: Do you know about halal food?
Yes 40 100.0
No - -
Total 40 100.0
95% of the wrestler's Question 2: “Can you easily consume the food at the site during sports events abroad?”,
they were answered “No” to their question. This shows that athletes cannot easily consume foods found in
abroad.
100% of the wrestler's responded “Yes” to Question 3: “Do you pay attention to halal food in sports competitions
abroad?”. With this result, we can conclude that national wrestlers pay attention to halal food consumption.

100% of the wrestler's reponded “Yes” to Question 4: “Do you have any information about halal food?”.
According to this result, it shows that national wrestlers have knowledge about halal food.
Table 4. Responses to questions 5, 6, 7 and 8 with frequency and percentage

Question 5: Does the lack of halal food affect sports performance abroad?
Yes 32 80.0
No 7 17.5
Partially 1 2.5
Total 40 100.0
Question 6: Does the presence of halal certified products in sports competitions abroad affect your
performance?
Yes 33 82.5
No - -
Partially 7 17.5
Total 40 100.0
Question 7: Do you take halal food with you to sports competitions abroad?
Yes 37 92.5
No 3 7.5
Total 40 100.0
Question 8: Do you believe that you cannot get the desired results due to the lack of halal food
abroad?
Yes 18 45.0
No 8 20.0
Partially 14 35.0
Total 40 100.0
80% of the athletes answered “Yes” to Question 5: “Does the lack of halal food affect sports performance in
sports competitions abroad?”. According to this result, it can be concluded that lack of halal food affects the
performance of the athlete.
82.5% of the athletes answered “Yes” to Question 6: “Does the presence of halal-certified products in sports
competitions abroad affect your performance?”. Thus, it can be concluded that athletes can have positive effects
on their sports performance by having access to halal-certified products.
92.5% of the athletes answered “Yes” to Question 7: “Do you take halal food with you in sports competitions
abroad?”. Thus, it can be concluded that athletes feel that it is important to have access to halal-certified
products.
45% of the athletes answered “Yes” and 35% answered “partially" to Question 8: “Do you believe that you
cannot get the desired results due to the lack of halal food abroad?”. According to this result, we can think that
the lack of halal food affects the athletes' performance, psychological and motivational status and prevents them
from getting the desired results.
Table 5. Multiple responses to Question 10: What kind of foods are usually eaten at the sport in competitions
held abroad?
Question 10: What kind of foods are usually eaten at the sport
competitions held abroad?
Food Product % of Athletes who include this food product
Vegetables 90
Fruits 87.5
Pilaf (Rice) 85
Chicken 65
Fish 60
Pasta 32.5
Nuts 32.5
Bread and similar product 4
Red Meat 2.5

In table 5, the results show that the national wrestlers participating in the research stated that they include the
following kinds of food; 90% vegetable, 87.5% fruit, 85% rice (rice), 65% chicken, 60% fish, 32.5% pasta and
dried fruit and nuts. Only 2.5% stated that they eat red meat. The rate of red meat consumed is quite low.
DISCUSSION
In this study, 95% of the participants responded “No” to Question 2: “Can you easily consume the food at the
accommodation place in the sports competitions held abroad?”. In this result showed that elite wrestler cannot
eat food easily abroad. Also elite wrestler was mentioned in the interview; many times they take halal food with
them (Table 3).
In the study 100% percent of the participants pay attention to the halal food products and have knowledge of
the halal food (Table 3). This result showed that participants follow Muslim food regulations and have knowledge
of halal foods.
The study showed that 80% of participants said that a lack of halal food in the sport organization will affect their
sport performance. In elite sport nutrition is a key factor in the success of the athletes. Muslim athletes at the
international sport events usually couldn’t get their proper nutrition because of the lack of halal food products or
lack of the halal food product preparation process.
The study showed that participants in the survey gave multiple answers Question of the: What kind of food are
usually eaten at the sport in competitions held abroad? The participants were given answer the multiple answers
questioned; 90% included vegetables, 87.5% included fruits, 85% included pilaf (Rice pilaf), 65% included
chicken, 60% included fish, 32.5% included pasta and nuts, 4% bread and similar product and only 2.5%
included red meat (Table 5). The result showed that many elite wrestlers didn’t eat any meat product. Meat
products have a very high protein level. Energy and macronutrient needs, especially carbohydrate and protein,
must be met during times of high physical activity to maintain body weight, replenish glycogen stores, and
provide adequate protein to build and repair tissue (Rodriguez et al., 2009). From this result we can see that
usually elite wrestlers must meet protein needs from consumption of carbohydrate food products.
Soesilowati, (2010) showed in the study result that between the degree of individual religiosity and halal food
consumption shows that the higher the degree of a respondent’s religiosity, the greater their concern to consume
halal food. In our study showed also that 100 % participant answered in the survey they have knowledge of the
halal food product.
The most important criteria for the halal food product by the Muslim respondents that their food must be free of
pork and alcohol (Soesilowati, 2010). Usually, most Muslim communities are very careful with pork and alcohol.
But most importantly Muslim communities have to concern with the certificated halal food and halal food product
cooking or preparation process. Recently, customers have not only requested for halal products but also for the
halal process. As a result, customers choose to buy halal products particularly because of the halal process
(Bonne and Verbeke, 2008). On the international level, most of the hotel and other accommodations are
preparing food in the same kitchen. Halal food preparation should be separate.
Sherry et al., (2010) showed that the study examines the experiences of international students at The University
of Toledo, where international students comprise approximately 10% of the student population. This issue was
also raised by other students in other parts of the research, for instance, by a Muslim student with regard to the
absence of Halal food on campus. The lack of halal food products is an most important concern of the many
Muslim peoples in every corner of the international life.
The majority of athlete’s report following some type of dietary regime, with avoidance of red meat, and
vegetarian, Halal, and low lactose regimes are reported most frequently (Pelly and Burkhart, 2011). Western
style food meets most needs, however some athletes follow a culturally specific style of eating and therefore it
is important to have a broad cultural representation on the menu (Pelly and Burkhart, 2011). Athletes report
sufficient items to meet sports nutrition, cultural & special dietary requirements (Pelly et al., 2009; Pelly et al.,
2011; Burkhart and Pelly, 2012). Especially in the big international sport events, such as the Olympics games
(summer and winter), World championships, Mediterranean games, European Championships and similar
events, the organization committee members should be considerate for the inclusion of halal food products and
the preparation of the halal food.
CONCLUSIONS
Elite athletes have a strong consideration for the lack of halal food products abroad. All of the elite athletes
mentioned that lack of halal food products affect their sport performance directly. After this moment whole the
Muslim community and Muslim Country National Sport Federation and Muslim Country National Olympic
committee member requests about halal food consideration and give information about the halal food. If we
don’t mention and request the needs of Muslim athletes, how can we expect some changes? Also halal food

sectors have to improve their standard and quality and be able to serve to international sport organizations
around the world.
Currently, the IOC does not have any study or work about halal food. Some of Olympic athletes mentioned that
the Olympic village have a halal food section, but athletes didn’t know the preparation process of the halal food
product. Because of halal food cooking and preparation process problem many times athletes couldn’t feel
comfortable eating halal products being served. The IOC is the organization that advocates the equal
opportunity of sport and manages world sports. We believe that IOC and International Sport Federation have to
give the opportunity to Muslim athletes for halal food. This movement also brings opportunity to halal food sector.
This year summer Olympic game will be held in Tokyo, Japan. Before Olympic game Muslim country national
Olympic committee and national sport federation and halal food companies give declaration to IOC and
International Sport Federation concern of the halal food.
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MODELING THE FORCE CHARACTERISTICS OF
LIFTING ACTIONS BASED ON ELECTROMYOGRAPHIC
RESEARCH IN HIGHLY QUALIFIED WRESTLERS
Dvorkin L. S, Doctor of Pedagogical Sciences
Kuban State University of Physical Education, Sport and Tourism,Krasnodar, Russia
Dyushko O.I. Candidate of Pedagogical Sciences, Honored Trainer of Russia, coach of Children's Sports
School “Victoria”, Tarko-Sale, Russia
dushko_oleg@mail.ru
АBSTRACT
It is known that fast fibers occupy the bulk of the muscular system of highly qualified power athletes. This allows
them to achieve high results, especially in speed-strength sports. This is also indicated by physiological studies
of individual muscle fibers of representatives of strength sports athletes, who have shown a higher level of
contractility and power of work for several years in relation to untrained persons of the same age. The purpose
of the study was to substantiate the efficiency of the transfer of the weight-lifting training method in stimulating
an increase in the level of strength preparedness of wrestlers based on the study of the bioelectric activity of
muscles. The pedagogical experiment lasted three months and was carried out at the Children's Sport School
“Victoria” of the city of Tarko-Sale in the Yamalo-Nenets Autonomous District. The experiment involved two
groups of wrestlers: experimental group (12 people) and control group (12 people).
The experimental group used the model motor action (MMA) in its strength training, which consisted in the fact
that the traditional for the heavy weightlifters technique for performing the bar from the platform was modified
to take into account the elements of the motor action of the wrestler in the parterre position and in the standing
throw over the chest, namely: during the first second the bar was lifted to the knees, for 2-6 seconds the athlete
held the weight of the bar in a static position, at the level of the knees, and then, at the 7th second, the bar was
lifted until the legs and torso were fully straightened. The wrestlers of the control group trained in the preparatory
period according to the traditional strength training program, namely, without the use of barbell traction with
intensive loads. Control testing was carried out three months later and only in the barbell pull from the platform.
While performing MMA with the help of a myomonitor, the bioelectrical activity of the direct bundle of the
quadriceps muscle of the left and right legs, the right and left side of the latissimus muscle of the wrestler's back
was carried out continuously. It was found out that the use of intensive power loads (ranging from 60 to 100%
of the maximum) when performing bar pull from the platform led after three months to the development of more
economical functioning of the neuromuscular system of wrestlers of the experimental group along with a
background of significantly higher final results of force testing in comparison with the wrestlers of the control
group.
Keywords: modeling of elements of competitive motor action, barbell pull from the platform, bioelectric muscle
activity, wrestlers.
BACKROUND
Recently much attention has been paid to research in the field of physiology of the neuromuscular system during
motor activity in general and, in particular, in sports of speed-strength nature (Aagaard, 2010; Babault, 2001;
Fry, 2004). These studies made it possible to identify not only regularities, but also the mechanisms of the
influence of various loads on the speed of processing information from external stimuli to the results of their
power (speed-power) manifestation under the conditions of specific (competitive) motor actions of athletes
(Bashkin, 2009; Verkhoshansky, 2005). At the same time there is no convincing evidence that the speed-
strength nature of motor actions (or its qualitative manifestations such as dexterity, endurance, etc.) changes
significantly the ratio of two types of muscle fibers (fast and slow) (Fry, 2004). However, strength (speed-
strength) muscle contractions during a long-term training can lead to a change in the ratio of two types of fast
muscle fibers, for example, on the one hand, increase the magnitude of the effect of fast glycolytic fibers, and
on the other hand, reduce the number of fast oxidation-glycolytic fibers (Hakkinen, 1987).
It was also found that as a result of training with intense weight the degree of increase in fast muscle fibers is
significantly accelerated in comparison with slow oxidizing fibers (Hortobagyi, 2000). Therefore, the above facts
confirm the existence of a dependence of the degree of increase (decrease) in the magnitude of muscle fibers
on the specific effects on the neuromuscular system of one or another type of athletic motor activity (Kozlov,
1999). This is indicated by the facts - fast fibers occupy the bulk in the muscular system of highly qualified
wrestlers and weightlifters, which allows them to achieve high results in high-speed power sports (Dvorkin,
2011). This is also indicated by physiological studies of individual muscle fibers of highly qualified athletes from

power sports, who have shown a higher level of constructive ability and work power in relation to untrained
people of the same age and sports qualification (Fry, 2004). This points to conclusion that the physiological
characteristics of the contractile properties of fast muscle fibers allow one to use the possibility of transferring
strength training (speed-strength qualities) with the help of intensive weights of a weight-lifting sport to another
power sport - wrestling (Aagaard, 1994).
The purpose of the study is to substantiate the effectiveness of the transfer of weightlifting training on the
basis of electromyographic research methods to increase the level of development of speed-strength
preparedness of highly qualified wrestlers.
METHODS
This pedagogical experiment lasted three months and took place at the Children's and Youth Sports School
"Victoria" in the city of Tarko-Sale of the Yamalo-Nenets Autonomous Okrug. Two groups of wrestlers took part
in the experiment: experimental group (12 people) and control group (12 people). The gist of the pedagogical
experiment was that with the help of a myomonitor, the bioelectric activity of the direct bundle of the quadriceps
femoris of the left and right legs, the right and left parts of the latissimus dorsi muscle was recorded. For the
experimental group of wrestlers a model motor action (MMA) was developed which consisted in the fact that
changes were made in the traditional technique for weightlifters pulling the bar from the platform, taking into
account the elements of the motor action of the wrestler in the parterre position and in the standing throw over
the chest, namely the beginning muscle bioelectric activity was recorded at the 1st second during the bar pull
from the platform to the knees (first phase), then (in the second phase) for 5 seconds the athlete kept the bar
at the knee level (legs bent you are in the knee joint at an angle of 140-160°, the body is tilted forward at an
angle in the hip joint within 110-130°) and at the 7th second (in the third phase) he completed the MMA by
pulling the bar up until the body and legs in the knee are fully straightened and hip joints (Figure 1).
The special planning of the training load when performing bar pull from the platform for wrestlers of the
experimental group was of great importance. Due to this fact, it was planned to the perform bar lift from the
platform once a week in the preparatory period in the training process of highly qualified wrestlers. The wrestlers
of the experimental group performed this strength exercise with three load options, alternating sequentially,
using the conjugate-sequential method of pulling the bar from the platform 60-80% of the maximum weight, 5
in one session and 3-4 number of bar lifts in one set (option 1), respectively, of a variational-progressive
methodology - 80-100% of the maximum, 5 sets in one lesson and 1-2 reps in one set (option 2) and an integral
technique - a combination of the first two methods equally (option 3).
Wrestlers of the control group trained in the preparatory period according to the traditional strength training
program, namely, without the use of bar traction with intensive weights. A control test was carried out only in
the bar lifted from the platform at the beginning of the experiment and after three months.

Weight is 70% of maximum
110-1300
140-1600
The second phase (2-6 s)

The third phase (7 s)
The first phase (1 s)
Lift of the bar from the platform Hold the bar at the knees in Pulling the bar until the body
to the knees (dynamic mode) isometric mode for 5 s and legs are fully straightened
(explosive forces)
Figure 1 - A diagram of the bar pull from the platform simulating the elements of the motor action of the wrestler
and weightlifter during which the bioelectric activity of the muscles was recorded.
RESULTS
Table 1 represents the results of the control test in the bar pull from the platform. It can be seen that the body
weight of the wrestlers of the two compared groups did not significantly differ (at Р>0.05), and there were also
no significant differences between the two groups of wrestlers in the first test when performing bar pull from the
platform (Р>0.05). Therefore, according to these initial parameters, all participants in the experiment were
homogeneous. During the three months of the preparatory period all the participants in the experiment improved
their initial results in the pull of the bar from the platform. In the experimental group the maximum indices in this
exercise for three months increased on average by 25.2 kg (P<0.001), then in the control group, which did not
use intensive weights in strength training, - by 6.0 kg (P<0.05). In general, the wrestlers of the experimental
group at the end of the study significantly exceeded the wrestlers from the control group when performing bar
pulls from the platform in the final result (at Р<0.01).
Table 1 - Testing results of highly qualified wrestlers in bar traction from the platform to the full straightening of
the legs and torso
Body Weight Initial Final indicators
Groups n (kg) indicators in three months РM2-M1
(kg) (kg)
Experimental 9 82.3±2.4 147.1±4.2 172.3±3.7 Р<0.001
Control 10 83.7±3.8 152.2±5.8 158.2±4.2 Р>0.05
Р>0.05 Р>0.05 Р<0.01
The results of the above mentioned studies allowed us to continue studying the problem of the influence of the
traditional form of strength training using intensive weights taking into account the peculiarities of the wrestler's
motor actions on the functioning of the neuromuscular system using electromyographic studies. Muscle
bioelectric activity was recorded taking into account the phase structure of MMA.
Studies have shown that in the first phase of MMA (bar pull from the platform to the knees), the bioelectrical
activity of the direct bundle of the quadriceps femoris of the left leg was 0.3 mv / s in the control group fighters.
and 0.08 mv / s in the experimental group; in the second phase (holding the bar in a static position at the knee
level from 2 to 6 seconds). respectively - from 0.33 to 0.39 mv / s and from 0.21 to 0.24 mv / s and at the 7th
second of execution MMA (the third phase - bar detonation) – 0.3 and 0.29 mv / s. The value of bioelectric
activity of the quadriceps femoris of the right leg in the first phase in the control group wrestlers was 0.26 mv /
s. and in the experimental – 0.1 mv / s. respectively. in the second phase - from 0.44 to 0.51 mv / s and from
0.11 to 0.49 mv / s. and in the third phase. 6.1 and 4.8 mv / s. respectively (Figures 2 and 3).

mv MB.l MB.p SH.l SH.p
1
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0 seconds
1 2 3 4 5 6 7
Figure 2 - Dynamics of the bioelectric activity of the muscles of the control group wrestlers when lifting the
barbell at 70% of the maximum (first phase: 1 s - bar pull from the platform to the knees. second phase: 2-6 s -
holding the bar in isometric voltage mode and the third phase 7 s - pulling of the bar until the trunk and legs are
fully straightened.
MB.l - quadriceps femoris of the left leg and MB.p - right leg. SH.l - latissimus dorsi (left) and SH.p (right side)
In the third lead of the myomonitor simultaneously with the first two. the bioelectrical activity of the latissimus
dorsi (its right and left parts) was recorded. Studies have shown that if the wrestlers of the control group in the
first phase of MMA at the 1st second had bioelectric activity of the right and left parts of the latissimus dorsi
muscle was 0.21 and 0.34 mv / s. in the experimental group. respectively. 0.11 and 0.11 mv / s. In the second
phase. The bioelectric activity of the left side of the latissimus dorsi muscle in the control group wrestlers was
in the range from 0.31 to 0.39 mv / s. and in the right - from 0.36 to 0.40 mv / s. respectively. In the experimental
group - from 0.20 to 0.30 mv / s; and 0.23 to 0.33 mv / s. In the third phase. the bioelectric activity of the right
side of the latissimus dorsi muscle was 0.8 in the control group wrestlers and 0.7 mv / s in the left part.
respectively. In the experimental group – 0.9 and 0.85 mv / s.
1
mv MB.l MB.p SH.l SH.p
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0 seconds
1 2 3 4 5 6 7
Figure 3 - Dynamics of the bioelectric activity of the muscles of the experimental group of wrestlers
when lifting the barbell at 70% of the maximum (first phase: 1 s - bar traction from the platform to the knees,

second phase: 2-6 s - holding the bar in isometric voltage mode and the third phase 7 s - undermining the bar
until the trunk and legs are fully straightened.
MB.l - quadriceps femoris of the left leg and MB.p - right leg. SH.l - latissimus dorsi (left) and SH.p (right side)
CONCLUSIONS
1. In order to increase the level of functioning of the neuromuscular system in the training process of the
preparatory period of wrestlers it is proposed to use a high-intensity weightlifting exercise (bar pull from the
platform) taking into account the motor action of the wrestler in the parterre position and in the standing throw
over the chest.
2. The bioelectric activity of the muscles of the legs and back was recorded continuously taking into account
the following structure of the bar traction from the platform: the first phase — the bar traction to the knees, the
second phase — holding the bar at the knees for 5 s in the third phase (7th second) – lifting bars to the full
extension of the trunk and legs in the knee and hip joints.
3. It was found that the use of intense power loads (ranging from 60 to 100% of the maximum) when performing
bar lifts from the platform after three months led to the development of a more economical functioning of the
neuromuscular system of the experimental group wrestlers against the background of significantly higher final
results in strength testing compared to the control group of wrestlers.
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MODEL CHARACTERISTICS OF SENSORIMOTOR REACTIONS
AND SPECIFIC PERCEPTIONS OF WRESTLERS AMONG DIFFERENT
WEIGHT CATEGORIES
Yuriy Tropin1, Georgiy Korobeynikov2, Curby David3, Vorontsov Andrey2, Shatskih Vladymir4
1Kharkiv State Academy of Physical Culture. Ukraine

2National University of Physical Education and Sport of Ukraine
3International Network of Wrestling Researchers
4Ukrainian Wrestling Association
k.george.65.w@gmail.com
ABSTRACT
Research has been conducted, in which 24 elite level Greco-Roman wrestlers between 19 and 24 years old
took part. For the convenience of analysis wrestlers were divided into 3 wide-ranging weight groups: lightweight
(under 70kg); middleweight (from 70kg to 92kg) and heavyweight (over 92kg). Based on the test results, model
characteristics of sensorimotor reactions and specific perceptions of elite level wrestlers among different weight
groups were developed. It was found. that practicing wrestling forms an ability to quickly analyze, assess and
predict situations to make right decision in due time during wrestling bout, which explains unreliable differences
(p>0.05) in the majority of psychophysiological indicators of the studied athletes.
Key words: elite wrestlers, models, individual characteristics, weight groups.
INTRODUCTION
Modern high-performance sport requires high level athletes’ preparedness in all aspects. Inability to perpetually
increase training loads is a major problem of high-performance sports. which leads to necessity of further
research, to identify more effective pedagogical tools and methods in preparation systems for elite level athletes
(Кorobeynikov, Korobeinikova & Latyshev, 2014; Podrigalo, Iermakov, Romanenko, Rovnaya, Tropin, Goloha
& Halashko, 2019).
Ability to execute a large number of complex technical and tactical actions, assessment of possible opponents’
actions during a bout. making immediate and sharp decisions in extreme situations considering impact of
disturbing factors – are the major and necessary athletes’ characteristics for achieving competition performance
success, which also displays the level of their psychological preparedness (Latyshev, Rybak, Golovach, Korolev,
Lyashenko & Kvasnitsa, 2019; Tropin & Boychenko, 2018).
Human psychophysiological functions depend on characteristics of the higher nervous system, which
characterize formation and development process of special motor skills in sports (Alekseev, 2007).
Indicators of sensorimotor reactions with different level of complexity can be considered as objective criteria of
the current functional state of the central nervous system (CNS). Sensorimotor reaction time is one of the
simplest neurophysiological indicators, which is relatively accurate and easy to obtain. These indicators display
speed dynamics of nerves processes and their shifts, motor coordination, general working capacity and activity
of the CNS during various periods of athlete preparation (Ashanin & Romanenko, 2015).
Training and competitive activity in martial arts promotes formation a whole complex of specific reactions and
perceptions among athletes. They are based on perception threshold, received by various sensory systems. A
major role is played by musculoskeletal levels, visual, vestibular and audio perceptions. The higher level of an
athlete, the higher value level of psychophysiological functions to achieve better competition results (Podrigalo,
Iermakov, Romanenko, Rovnaya, Tropin, Goloha & Halashko, 2019).
PURPOSE – to develop model characteristics of sensorimotor reactions and specific perceptions among
wrestlers of various weight categories.
METHODS
Research methods: analysis of scientific and methodical information, best practices exploration,
psychophysiological research methods, and mathematical statistics methods.
RESULTS
An analysis of methodological literature and generalization of best practice has established, that in order to
achieve high performance results in sports following structures must be used: a clear management system,

planning and purposeful use of domestic and foreign best practices in training process with of simulation of
studied systems. (Pervachuk, Tropin, Romanenko & Chuev, 2017; Tünnemann & Curby, 2016).
Models can be designed in the form of model characteristics. In most cases. model characteristics are the parts.
margins. elements of sports type in numbers or other units. characterizing competition performance and
properly describing various aspects of athletes’ preparedness. (Nikitushkin & Suslov, 2017).
24 elite level athletes from 19 to 24 years old. practicing freestyle and Greco-roman wrestling, participated in
this research. For the convenience of analysis. wrestlers were divided into three weight groups: lightweight
(under 70kg); middleweight (70kg to 92kg) and heavyweight (over 92kg). Assessment of sensorimotor reactions
and specific perceptions was conducted through series of tests developed for portable computer devices
(Ashanin & Romanenko, 2015). Tests were divided into three groups: assessment of simple sensorimotor
reactions; assessment of complex sensorimotor reactions; and assessment of specific perceptions.
Coefficient of variation was used to determine the homogeneity of sample selection observations (V). It is
believed, that if coefficient of variation is not above 10%. then sample selection can be considered homogenous.
Obtained data indicates about homogeneity indicators of simple and complex reactions, since coefficient of
variation is in range between 2.30% and 10.08%. Indicators of specific perceptions have higher coefficient of
variation (between 13.48 % and 41.67 %), due to the fact that specific perceptions reflect more individually
psychological states of elite wrestlers (Table 1).
Table 1. Coefficient of variation (V, %) of indicators for sensorimotor reactions and specific perceptions
among elite level wrestlers (n=24)
Weight groups
Indicators of
№ sensorimotor reactions Lightweight Middleweight Heavyweight
and specific
perceptions (n=8) (n=8) (n=8)
Simple reactions
1 Simple motility (number 5.78 7.19 5.33
of pressing within 10s)
2 Steadiness to 8.05 2.30 6.71
distracting factors (%)
3 Simple hand-motor 5.41 4.31 9.60
reaction (msec)
4 Simple auditory motor 5.77 5.61 8.38
reaction (msec)
Complex reactions
5 Selection reaction from 6.42 8.56 10.08
static objects (msec)
6 Reaction to a moving 9.40 9.03 9.38
object (msec)
7 Distinction reaction 7.34 4.50 7.18
(msec)
8 Selection reaction from 6.85 6.61 9.82
dynamic objects (msec)
Specific perceptions
9 Pace assessment (80 36.84 33.34 41.67
BPM -1) (msec)
Line accuracy
10 15.21 17.25 36.33
reproduction rate
assessment (mm)
Set line reproduction
11 21.90 32.46 40.17
speed assessment
(mm/s)
Object resize
12 15.20 22.02 13.48
perception assessment
(s)

Based on the tests results. model characteristics of sensorimotor reactions and specific perceptions among
elite level wrestlers were developed (Table 2).
Table 2. Model characteristics of sensorimotor reactions and specific perceptions among elite level
wrestlers of various weight groups (n=24)
Weight groups
Indicators of sensorimotor
№ Lightweight Middleweight Heavyweight
reactions and specific
perceptions (n=8) (n=8) (n=8)
Х ±m Х ±m Х ±m
Simple reactions
1 Simple motility (number of 25.26±0.55 25.48±0.69 25.36±0.51
pressing within 10s)
2 Steadiness to distracting 79.90±2.43 80.71±0.70 80.19±2.03
factors (%)
3 Simple hand-motor reaction 232.76±4.76 230.05±3.75 231.64±8.40
(msec)
4 Simple auditory motor 213.64±4.66 211.46±4.49 214.31±6.79
reaction (msec)
Complex reactions
5 Selection reaction from static 637.78±15.48 650.83±21.05 616.26±23.48
objects (msec)
6 Reaction to a moving object 17.36±0.62 22.59±0.77 16.11±0.57
(msec)
7 280.33±7.78 283.90±4.83 283.91±7.70
Distinction reaction (msec)
8 Selection reaction from 361.74±9.37 363.01±9.07 383.85±14.25
dynamic objects (msec)
9 Pace assessment (80 BPM - 39.56±5.51 35.81±4.51 37.16±5.85
1) (msec)
10 Line accuracy reproduction 0.42±0.02 0.45±0.03 0.50±0.07

rate assessment (mm)
11 Set line reproduction speed 99.38±8.23 84.39±10.35 93.10±14.14
assessment (mm/s)
12 Object resize perception 0.93±0.05 0.87±0.07 0.89±0.05
assessment (s)
Analysis of table 3 allows one to explore similarity of functional states of research samples, along with specific
distinctions between wrestler groups. Differentiation of reliability was observed between light and middleweight
weight groups (t=-5.29; p<0.001), and also between middle and heavyweight weight groups (t=6.75; p<0.001),
during moving object reaction test.
Table 3. Reliability of differentiation indicators of sensorimotor reactions and specific perceptions

among elite level wrestlers of different weight groups
Weight groups
№ Indicators of sensorimotor reactions and specific
perceptions 1 and 2 1 and 3 2 and 3
Simple reactions
t=-0.24; t=-0.13; t=0.13;
1
Simple motility (number of pressing within 10s)
p>0.05 p>0.05 p>0.05
t=-0.32; t=-0.09; t=0.24;
2
Steadiness to distracting factors (%)
p>0.05 p>0.05 p>0.05
t=0.45; t=0.12; t=-0.17;
3
Simple hand-motor reaction (msec)
p>0.05 p>0.05 p>0.05
t=0.34; t=-0.08; t=-0.35;
4
Simple auditory motor reaction (msec)
p>0.05 p>0.05 p>0.05

Complex reactions
t=-0.50; t=0.76; t=1.10;

5
Selection reaction from static objects (msec)
p>0.05 p>0.05 p>0.05
t=-5.29; t=1.49; t=6.75;
6
Reaction to a moving object (msec)
p<0.001 p>0.05 p<0.001
t=-0.39; t=-0.33; t=0.01;
7
Distinction reaction (msec)
p>0.05 p>0.05 p>0.05
t=-0.10; t=-1.30; t=-1.23;
8
Selection reaction from dynamic objects (msec)
p>0.05 p>0.05 p>0.05
t=0.53; t=0.30; t=-0.18;

9
Pace assessment (80 BPM -1) (msec)
p>0.05 p>0.05 p>0.05
t=-0.87; t=-1.05; t=-0.57;
10
Line accuracy reproduction rate assessment (mm)
p>0.05 p>0.05 p>0.05
t=1.13; t=0.38; t=-0.50;
11
Set line reproduction speed assessment (mm/s)
p>0.05 p>0.05 p>0.05
t=0.71; t=0.54; t=-0.30;
12
Object resize perception assessment (s)
p>0.05 p>0.05 p>0.05
Note: 1 – lightweight; 2 – middleweight; 3 – heavyweight. Reliability t=2.15; p<0.05; t=2.98; p<0.01; t=4.14;
p<0.001.
Obtained results show the importance of psychophysiological states of athletes, as a determining factor of
success in various types of wrestling. This also can be proved by research results of several studies. (Shackih,
2012; Korobeynikov, Korobeinikova, Latishev & Shackih, 2017; Tropin, Romanenko & Ponomaryov, 2016).
Usage of psychophysiological indicators of modern statistical methods allows one to create models. They allow
to represent changes, that occur in the body of athletes, more accurately. Rovny & Romanenko (2016).
examined model characteristics of sensorimotor reactions and specific perceptions of elite taekwondo players,
and as a result assessment scales were developed.
He, (2013). determined physiological profile of elite female wrestlers. Author recommends to compare retrieved
results with other wrestlers as a tool to identify individual weaknesses or strengths and to develop education
programs. which will allow to achieve success in wrestling.
Krikukha (2015) created models of psychophysiological indicators of Greco-Roman wrestlers at the technical
development phase and identified the ways for management of technical, tactical and physical preparation of
athletes with consideration of individual psychophysiological status and weight category.
Previously obtained results were supplemented (Curby & Tropin 2019; Pervachuk, Tropin, Romanenko & Chuev,
2017; Tropin & Boychenko, 2018) related to the issues of psychophysiological control in wrestling, and also
about particular features of wrestlers’ preparedness among different weight categories. (Priymakov, 2014;
Тropin, Коrobeynikov, Shatskykh, Коrobeynikova & Vorontsov, 2019).
CONCLUSIONS
Based on the analysis of methodical literature and generalization of best practices it was identified, that
competition performance specificity of wrestlers has an impact on the level of psychophysiological reactions
development. which ensures high athletic result.
It was established. that wrestling forms an ability to quickly analyze, assess and predict situations and make
correct decisions during the bout in a timely manner, which explains unreliable differentiations (p>0.05) in most
psychophysiological indicators among the studied athletes.

Model characteristics of sensorimotor reactions and specific perceptions among elite level wrestlers in various
weight groups were developed. Application of psychophysiological methods can be considered as an effective
way to predict athletes’ success.
REFERENCES
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martial arts. Slobozhansky Science and Sports Newsletter. 4. 15-18.
Alekseev A. (2007). Overcome Yourself. Mental preparation of athletes for competitions. Moscow: Soviet
Sport. 280.
Curby D., Tropin Y. (2019). Differences in manifestation of sensory-motor reactions and specific perceptions
at the men and women doing martial arts. Edinoborstva. 2(12), 68-78.
He, Z. (2013). Physiological profile of elite Chinese female wrestlers. The Journal of Strength & Conditioning
Research. 27, 2374-2395.
Кorobeynikov G., Korobeinikova L.. Latyshev S. (2014). Individualization of training in wrestlers. International
Journal of Wrestling Science. 4(2). 28-33.
Korobeynikov G., Korobeinikova L., Latishev S.. Shackih V. (2017). The impact of emotions on visual-
movement performance and effectiveness of competitive activity of elite wrestlers. Applicable
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Krikukha Y. (2015). Modeling of psychological preparation in Greco-Roman wrestling at the stage of improving
sportsmanship. Omsk Scientific Herald, 4(141). 241-245.
Latyshev N., Rybak L., Golovach I., Korolev B., Lyashenko E.. Kvasnitsa O. (2019). Analysis of the
performances of the participants of the European Championships among cadets in women's
wrestling. Slobozhanskyi herald of science and sport. 5(73), 45-50.
Nikitushkin V., Suslov F. (2017). Sport of the highest achievements: theory and methodology. Tutorial. Litres.
187.
Pervachuk R., Tropin Y., Romanenko V., Chuev А. (2017). Model characteristics of sensorimotor reactions
and specific perceptions of trained wrestlers. Slobozhanskyi herald of science and sport. 5(61), 72-74.
Podrigalo L., Iermakov S., Romanenko V., Rovnaya O.. Tropin Y., Goloha V.,Halashko O. (2019).
Psychophysiological features of athletes practicing different styles of martial arts – the comparative
analysis. International Journal of Applied Exercise Physiology. 8(1), 84-91.
Priymakov A. (2014). Comparative characteristics of the physical fitness structure of highly qualified wrestlers
of light. medium and heavy weight categories. Pedagogy. рsychology and biomedical problems of
physical education and sports. 9, 47-53.
Rovny A., Romanenko V. (2016). Model characteristics of sensorimotor reactions and specific perceptions of
highly qualified combatants. Martial Arts. 12. 54-57.
Shatskikh V., (2012). Informative criteria of psychophysiological wrestlers in the minds of trivial activities.
Pedagogy, psychology and medical and biological problems of physical wrestling and sport. 3,137-
142.
Tropin Y., Romanenko V., Ponomaryov V. (2016). Model characteristics of sensory-motor reactions and
perceptions of specific wrestlers of different styles of confrontation. Slobozhanskyi herald of science
and sport. 3, 70-73.
Тropin Y., Коrobeynikov G.. Shatskikh V., Коrobeynikova L., Vorontsov А. (2019). Моdel characteristics of
technico-tactical fitness of highly skilled Greco-Roman wrestlers of different weight categories.
Science in Olympic Sport. 2, 29-35.
Tropin Y., Boychenko N. (2018). Interrelation of psychophysiological indicators and physical readiness of
qualified wrestlers. Slobozhanskyi herald of science and sport. 2(64), 65-69.
Tünnemann H., Curby D.G. (2016). Scoring analysis of the wrestling from the 2016 Rio Olympic Games.
International Journal of Wrestling Science. 6(4), 90-116.

Special Section: Summaries of Presentations from the Wrestling Medicine
Conference & Wrestling Team Physician Course, United World Wrestling,
Budapest, October 24-26, 2019

PRINCIPLES OF MUSCULOSKELETAL INJURY PREVENTION IN
WRESTLING
Szabolcs Molnár
UWW Medical & Anti-Doping Commission
szabolcsmolnardr@gmail.com
Importance of the topic

Wrestling holds worldwide popularity,
• Russia, former Soviet Union
• Asia (Iran, Japan, Korea, Mongolia, India)
• Europe (Scandinavia, Greece, Turkey, former East-block, France, Germany, Italy)
• Traditional wrestling (Africa, Mongolia, Canary Island, Pakistan)
• America: USA, Canada, Cuba, Brazil,
United States: Large numbers of high school and college males (health system general DATAS!!!). But
Barroso (Brasil), Kordi (Iran), Pasque, Otero (USA) and Yamaner (Turkey) is focusing on
wrestlers!!!! However, the sport's arduous nature results in high injury rates.
INJURY; is a barrier for sport participation and development

1. Therefore, sport organizations need to have a good understanding of nature, specifications, patterns, risk
factors, and mechanisms of injuries
• in order to prevent sport injuries,

• and promote the sport.
This requires establishing Injury Surveillance systems.

Shadgan B, Molnar S, Sikmic S and Chahi A: Wrestling Injuries During the 2016 Rio Olympic Games. Br
J Sports Med 2017;51:387.
Injury definition – what is an injury?

• Kersey and Rowan: any incident in which an official halted a match
the likelihood of overreporting is high, where a bloody nose or stalling tactics by a wrestler may
be included as data.
Kersey RD, Rowan L. Injury account during the 1980 NCAA wrestling championships. Am J Sports Med. 1983 May-Jun;11(3):147-51.
Injury definition – what is an injury?

• Strauss and Lanese: any incident that reached the athletic training room
(tournament injuries /this leaves the potential for many minor injuries to be under-reported)
Strauss RH, Lanese RR. Injuries among wrestlers in school and college tournaments. JAMA. 1982 Oct
22;248(16):2016-9.
Injury definition – where was it documented?
• Lorish et al.; Pasque and Hewett; Kordi:
• (1) limitation of function to an extent that the athlete sought treatment by an athletic trainer
or physician;
• (2) restricted participation of at least one day beyond
the initial injury
Injury definition – where was it documented?

• Kordi: any injuries that requires substantive professional attention before the athlete's return
to participation is permitted
• Hospitalization
• Operation
Kordi R, Heidarpour B, Shafiei M, Rostami M, Mansournia MA. Incidence, nature,and causes of fractures and dislocations in olympic
styles of wrestling in iran: a 1-year prospective study. Sports Health. 2012 May;4(3):217-21
Kordi R, Ziaee V, Rostami M, Wallace WA. Sports injuries and health problems among wrestlers in Tehran. J Pak Med Assoc. 2012
Mar;62(3):204-8.
Injury definition – Babak Shadgan 2017 – UWW MC

Any musculoskeletal or soft tissue complaint incurred during the competitions, that required
medical attention regardless of the consequences with respect to absence from sport.
Shadgan B, Feldman BJ, Jafari S. Wrestling injuries during the 2008 Beijing Olympic Games. Am J Sports Med. 2010 Sep;38(9):1870-6.
Shadgan B, Molnar S, Sikmic S and Chahi A: Wrestling Injuries During the 2016 Rio Olympic Games. Br
J Sports Med 2017;51:387.

Injuryrate:Howtomeasure?
Injury–when and where: season, competition

When:
Preseason, Season, Postseason
Where:
Practice, Competition
Lorish TR, Rizzo TD Jr, Ilstrup DM, Scott SG. Injuries in adolescent and preadolescent boys at two large
wrestling tournaments. Am J SportsMed. 1992 Mar-Apr;20(2):199-202.
Strauss RH, Lanese RR. Injuries among wrestlers in school and college tournaments. JAMA. 1982
Oct22;248(16):2016-9.
Injury: onset and location

• Injury onset:
• Acut
• Overuse
• Reinjury
• Chronic
• Injury location: body region
• head/spine/trunk (range of 24.5–48%)
• upper extremity (range of 9.3–42%).
• lower extremity (range of 7.5–45.1%) and
• skin (range of 5–21.6%).
Hewett TE, Pasque C, Heyl R, Wroble R. Wrestling injuries. Med Sport Sci. 2005;48:152-78.
Requa R, Garrick JG. Injuries in Interscholastic Wrestling. Phys Sportsmed. 1981 Apr;9(4):44-51.
Action or activity
• the exact mechanism of injury is not always easily identified.
• Pasque and Hewett: most of the injuries occurred during takedown, but more specifically, when the
athlete was at a disadvantage or in the defensive position.
• Closed kinetic chain – open kinetic chain (Rögler)
Pasque CB, Hewett TE. A prospective study of high school wrestling injuries. Am J Sports Med. 2000 Jul- Aug;28(4):509-15
Rögler G, Molnár SzL, Berkes I, Barna T, Farkas G, Gál V: Sport Specific Rehabilitation of Wrestlers following an ACL injury. International
Journal of Wrestling Science. 3(2): 130 (2013).
Chronometry – importance of fatigue?

• Lorish et al.: was unable to calculate injury by match, but could determine an injury rate of 3%
for all wrestlers in the first period.
• Strauss and Lanese: reported the greatest number of injuries to be in the second period
• Pasque and Hewett: reported a trend toward more injuries in the latter half of practice and
during the second periods.
Injury severity
Type:
• muscle strains - shoulder or lower back
• joint sprains - ankle, knee or hand/wrist
• abrasions, lacerations - face area, extremities
• contusions - knee, chest and head

• bleeding – nose
• hematoma – auricular (cauliflower)
• luxation – AC, GH, elbow, knee cap
• fracture – fingers, forearm, foot
• concussions
• catastrophic
Injury - severity Shadgan 2017

Injury Severity
• Mild Injuries fully treated on the mat.
• Moderate injuries treated primarily on the mat but needing more attention after the
competition, by which injured athletes were referred to the venue clinic.
• Severe injuries resulted in termination of the match; injured athletes were referred to the
hospital.
Shadgan B, Feldman BJ, Jafari S. Wrestling injuries during the 2008 Beijing Olympic Games. Am J Sports Med. 2010 Sep;38(9):1870-6.
Shadgan B, Molnar S, Sikmic S and Chahi A: Wrestling Injuries During the 2016 Rio Olympic Games. Br J Sports Med 2017;51:387.
Prevention: definition–primary/ secondary/ tertiary

• Primary–avoidance of injury
• Secondary – early diagnosis and treatment
• Tertiary – focus on rehabilitation, reduce and correct the disability
Prevention: targeting injury prevention – Hewett 2005

There are several potential areas for decreasing injury risk in wrestlers, including
• equipment,
• coaching,
• officiating and
• training.
However, informed decisions with regard to preventing injuries are dependent upon
the quality of the basic epidemiological data available, and at that time (2005),
analyses of risk factors and potential preventive measures were lacking in
wrestling.
Prevention: Targeting Injury Prevention - Kordi 2012

Steps:
• Surveillance – data on occurence of injury
• Risk factor identification – baseline survey
• Intervention evaluation - important information for determining the priorities for
• interventions and to inform policy makers and decision makers about the likely extent and impact of
a problem
• Implementation
Kordi R, Ziaee V, Rostami M, Wallace WA. Sports injuries and health problems among wrestlers in
Tehran. J Pak Med Assoc. 2012 Mar;62(3):204-8.
UWW MC 2017-20
Steps:
1. Surveillance (data) - feed backs from the Competitions (medical reports), literature review (articles)
2. Risk factor identification (baseline survey) - feed backs (medical reports), Annual Medical Commission meeting
3. Intervention evaluation (interpretation to policy and decision makers) - presentation in Coach
and Referee Clinic, IOC meeting, circular letters, protocols
4. Implementation; UWW Medical Conference, change of Medical Rules, education (Referees, Local
Medical Teams, UWW doctors)
Injuries by different body parts

• Head/Ear/ Dental
• nose bleeds or minor abrasions
• Facial lacerations
• Acute facial trauma
• Dental injuries
• Auricular hematoma or ‘wrestler’s ear’
• Contusion
• Concussions

Spine: Cervical and Lumbar/Trunk
Non-catastrophic:
• Sprains
• Strains
• neurological trauma such as stingers
Bone trauma:
• fractures
• subluxations or dislocations of the spine occur and can result in devastating catastrophic
injuries
Upper Extremity – common due to the heavy forces placed on this region and the extreme joint
positions:
• Sternoclavicular
• Acromioclavicular
• Glenohumeral
• Biceps
• Elbow
• Wrist and hand
Lower Extremity
• Hip
• Femur muscles – hamstring, quadriceps
• Knee – distortion, ligament, meniscal injury, patellar dislocation
• Shin
• Ankle
• Foot
Skin
• Skin infections continue to be a problem
• Most caused by a fungus (‘ringworm’)
• or the herpes virus
• and staphylococcus or streptococcus bacterial infections.
Risk factors
a. Nature: Contact, collision, extreme demands entire body
b. Exposure (incidence, No, practice, bout)
c. Training methods / technical preparation / strength / anaerobic, aerobic conditioning
d. Protective equipment (head gear, knee pads, mouth guards) / facilities (training, regenerative
and medical)
e. Proper staff: trainers, physiotherapists, masseur, medical staff, team doctor, nutritionist
f. Nutrition, Hydration, Dehydration, fasting and weight loss method
g. Fatigue, Circadian rhythm, sleeping, time zones
h. Age, level (correlation with exposures), Weight
i. Practice / Competition
j. Referees, trainers
k. Compliance: athlete / trainer / team leader
a. Nature: Contact, collision, extreme demands entire body

b. Exposure
• Incidence rates are higher during competition, but more injuries occurred during practice
• (significantly more time is spent in practice.
• 63% in practice, 37% injuries during competition
• Injuries per exposure: 5 injuries per 1,000 practice-exposures versus 9 per 1,000 match-
exposures
• Boden et al.: significantly greater number of catastrophic injuries during match competition
• (80%) or live wrestling (86% of practice injuries)
Strauss and Lanese: Increasing the level of competition and the amount of time- spent wrestling will increase
the exposure of a wrestler to injury
Pasque and Hewett: injuries among high school wrestlers - injured wrestlers had significantly more years of
wrestling experience.
c. Training methods / conditioning

• Inadequate supervision of a wrestling team, especially in younger athletes
• Inadequate wrestling technique
• Poor officiating, rules infractions, and dangerous moves
d. Protective equipment / facilities

• Headgear
• knee pads, shoes
• mouth guards
not obligatory – their use is low
Kvittem: about 70% of the wrestlers sustained at least one orofacial injury.
Parents reported 206 instances of oral trauma. Eighty-eight occurred without mouthguards
and only 12% with mouthguards.
• The wrestling mat - largest piece of equipment.
- A mat in good condition is essential for aiding in the prevention of serious injuries.
- If mats are in poor condition, their ability to absorb shock may deteriorate -increase
injury risk when wrestlers land on them.
- Cleaning: without daily disinfection, counts of microorganisms on the mat will increase -
transmission of dermatological infections from mat to wrestler.
- Unpadded walls, obstacles such as columns or bleachers, inadequate space, and
extreme heat or humidity are obviously detrimental.
- It is important to replace or recondition wrestling mats when they become worn.
• Training facility
Regenerative and Medical areas
Proper staff:
• trainers,
• physiotherapists,
• masseur,
• team doctor,
• medical staff,
• nutritionist
f. Nutrition, Hydration, Dehydration, fasting and weight loss methods

• Wrestlers often loose large amounts of weight in a short period of time.
• Fluctuations in weight frequent throughout the season.
• Weight loss practices: 3–20% of the body weight is lost prior to certification or competition.
• Most of this weight loss occurs on the final day or days before the official weigh-in.
• 3 deaths after rapid weight loss in 1997/98 US High school
• UWW - New health regulations for weigh in ON
THE DAY OF THE COMPETITION
g. Fatigue, Circadian rhythm, sleeping, time zones
h. Age, level (correlation with exposures), Weight

• Differs in different age, level and weight
• Proper matching of athletes-Do Not let wrestle kids from different weights, age and levels
i. Practice/ Competition
j. Referees, trainers – proper basic medical preparation
k. Compliance: athlete / trainer / team leader
(Usually NO) preparticipation physical exam
When to receive medical care
NOT Stress / force to continue
NOT Stress/ force to compete with injury

Intervention and evaluation
Establish a good Healthcare team
• Team physician + physiotherapist
• Prior to the start of the season, all athletes would undergo a preparticipation evaluation,
• including an orthopedic screening, to detect any potential preexisting conditions.
• Dentist + dermatologist
Competition
• UWW health regulation
• Surveillance system
• Education of the local medical team
• Presentation in Coach and Referee Clinic, IOC meeting, circular letters, protocols
Implementation of Preventative Measures

Limiting bleeding time (4 min bleeding time)
More attention to penalize dangerous actions
• Brutal actions
• Strangulation
• Heading, Fisting, Kicking
• Twisting one-leg, arms, fingers
Preventing rapid weight loss (RWL) attempts before competition weigh-in
Reducing overloaded competitions
• increasing weight classes to 10
• 2-day competition
Improving referee-doctor communications
• A sign language is developed and will be applied Revision of UWWMC Medical Coverage
Guideline
Educational Programs:
• Team Doctors
• Coaches Clinics
• Referees
•
UWW Wrestling Injuries Surveillance Program
Started at 2004 Athens Olympic Games, By direct observation and recording all injuries; UWW started from 2016 Rio

Conclusions
 Wrestling is a safe, active and attractive sport.
 UWW is leading one of the most successful Injury analysis and prevention programs.
 Confirmed by IOC, the rate of injuries in wrestling is less than many other Olympic sports.

ASSESSMENT OF WRESTLING MATS TO PREVENT SPORTS INJURIES
Márton Tomin, Ákos Kmetty
Budapest University of Technology and Economics

Faculty of Mechanical Engineering
Department of Polymer Engineering
tominm@pt.bme.hu
BACKGROUND
Personal motivation:
– Development of a falling weight impact testing system
– Measurement settings according to UWW standards:
H=400 mm; m=10,025 kg; d=100 mm
– Testing several wrestling mats
– Experiences:
• There is no unified material
• Energy absorption is not appropriate – traumatic sports injuries
Aim of the research:
– Development of a hybrid foam structure
– Combining different polymer foam layers in an appropriate order
– Increased energy absorption capability + impact damping
Parameter Max. deformation Max. contact time Max. deceleration Min. energy absorption
Value 38 mm 50 ms 30 g 70 %
– Meet the UWW requirements:
PROPERTIES OF POLYMER FOAMS

Polymer foam: two-phase system, containing dispersed gas bubbles surrounded by a polymer matrix material
Production: physical-, chemical- or bead foaming open or closed cell structure
Advantageous properties: low density and mass, outstanding thermal- and sound insulation, high energy
absorption capability – field of application: automotive-, packaging-, building and sports industry.
Compression test:
The stress-strain curve of the foam exhibits three different
regions:
1. Small strains: linear elastic behavior
2. Plateau: collapse of the foam cells
3. Densification zone: meeting of the opposing walls in the
cells
REQUIREMENTS OF POLYMER FOAM IN WRESTLING MATS

Compression set: recovery after static load (e.g. storage conditions)
Materials: XPE, recycled PU, EVA, PVC-NBR
Static stiffness: to prevent the athlete from ankle injuries
Frictional properties: appropriate coefficient of friction to avoid slippery surface
Energy absorption and impact damping: to reduce the force/deceleration effected on the human body during
landing

INVESTIGATING METHODS OF ENERGY ABSORPTION
Falling weight/ falling dart impact testing:
• Dropping a weight with a given geometry and mass from a given height.
• Measuring the force or the deceleration
during the impact.
• Impact energy could be modified by
applying extra mass or increasing the
falling height.
• Most previous researches are focusing
on packaging application of polymer
foams.
• Energy absorption properties of sports
mats is a lack of knowledge.
MATERIALS
Typical foam cell structures:
Investigating the two most commonly used wrestling mat materials:
RESULTS
Investigating the effect of repetitive impacts on the same surface:
- 8 impacts / sample
- 1 minute time duration between the impacts
- Parameters were set according the UWW requirements
PU had higher energy absorption due to bigger deformation.

XPE had lower max deceleration.
Effect of repetitive impacts: deterioration

- Maximum deceleration increases
- Energy absorption decreases
- PU performed better results

The reason of the deterioration in time effected by repetitive impacts is the deformation mechanism of foam cells.
Some of the cell walls started buckling, then collapsed. The one minute time duration was not enough for the
foam cells to recover from the deformation. PU – less deterioration – open cell structure
Before Impact After Impact
FURTHER DEVELOPMENT OPPORTUNITIES

Creating three-layer sandwich foam structures: Investigating the effect of density distribution along the
thickness.
LAYER 1 10mm
LAYER 2 10mm
LAYER 3 10mm
Order of the layers:

Order of layers Density [kg/m3]
I. II. III. IV.
Layer 1 70 30 70 40
Layer 2 50 50 30 70
Layer 3 30 70 70 40
PRELIMINARY EXPERIMENTS
Energy absorption could be increased by modifying the order of the layers: Structures with higher density
upper layer showed better results.

60
50
40
Absorbed energy [%]
30
20
10
0
I. II. III. IV.
Sample
SUMMARY
 Two wrestling mats produced from the most commonly used materials (PU and XPE) were tested by
falling weight impact tests according to UWW standard.
 The goal of the investigations was to evaluate the effect of repetitive impacts.
 The mat from polyurethane foam has higher energy absorption capability and less deterioration
effected by the repetitive impacts, polyethylene mat has lower maximum deceleration.
 The decrease of mechanical properties is caused by foam cell deformation.
 Preliminary experiments were conducted to investigate the effect of density distribution along the
thickness in three-layer foam structures.
 Structures with higher density upper layer showed better results.
FUTURE GOALS
 Compare the recovery behavior of the different samples by compression set measurements and
develop a model which could effectively predict the answer of polymer foams for long-term static
loads in order to investigate the effect of storage of the mats.
 Development of a new “value-added” mat type by combining polymer foam layers with different
matrix materials and structure and optimizing the order of the layers.
The application of the new mat type will potentially decrease the risk of sports injuries.
This project was supported by the János Bolyai Research Scholarship of Hungarian Academy of Science.

BEACH WRESTLING: DOHA/QATAR 2019 – EXPERIENCES
Dr. José Alfredo Cavalcante Padilha – UWW Doctor – Brazil
josealfredopadilha@uol.com.br
BEACH WRESTLING – UWW REGULATIONS

SECTION ONE – GENERAL RULES
Article 5 – Wrestlers’ Uniforms and Appearance It is prohibited to:
• Apply any greasy or sticky substance to the body.
• Arrive at the call room perspiring for the beginning of the match.
• Wear bandages on fingers, wrists, arms or ankles except in the case of injury and on doctor’s
orders. These bandages must be covered with elastic straps.
Also:
• Wrestlers’ fingers and toenails shall be neatly trimmed with no sharp edges.
• Long-haired athletes must attach them or have a pony tail.
• Wrestlers shall be well groomed and their hair and skin shall be free of any greasy, oily or sticky
substance.
Appearance and hygiene
Wrestlers are prohibited from wearing bandages on the wrists, arms or ankles except in the case of
injury or on doctor’s orders.
Article 6 – Competition area

• All United World Wrestling sanctioned events take place in a 7-meter circle
designed by a 8-10-centimeter ribbon of a contrasting color that must contain no metal parts.
• It must be filled with a 30-centimeter (minimum) layer of fine sand free from any stones, shells, or
other objects.
SECTION SEVEN – MEDICAL SERVICES

The organizers of United World Wrestling events are responsible for providing medical service. The medical
staff will be under the authority of a sport doctor in charge and will be responsible for conducting all medical
examinations as well as giving medical surveillance during the entire event. During the competition, the
medical staff shall be ready to intervene in the case of an accident or injury and decide whether a wrestler is
fit to continue the match.
The Head medical officer has full authority to stop a match at any time if he deems either wrestler to be in
danger. He may also stop a match if he feels a wrestler is medically unfit to continue. A wrestler shall not
leave the circle in the event of a serious injury. In such case, the referee shall immediately stop the match and
ask the Head medical officer to examine the wrestler on the spot.
Article 8 – Weigh-In and Medical examination

Weigh-in should be conducted the same day (two hours before the competition) and last 30 minutes.
Athletes shall present their United World Wrestling license and accreditation to the appointed referees
in charge of the weigh-in. Athletes shall wear their competition uniform (shorts or underwear) and be
allowed to check their weight on the scales as many times as they wish within the official weigh-in
time frame.
No weight tolerance shall be granted at the United World Wrestling sanctioned events. The exact
weight of each athlete has to be compiled in the weigh-in list by the referee delegate.
The Medical Examination will be organized simultaneously with the weigh-in.
Article 14 – Injury and Blood time

The referee must stop the match and call for injury time if a wrestler is temporarily injured due to an
incidental blow (i.e. eye poke, head collision, etc.). Injury/blood time per match cannot exceed 2*
minutes per athlete otherwise the athlete loses his bout by injury. (Obs: Duration of the bout: 1 round
of 3 min)
In the event of a wrestler bleeding, the referee shall stop the match and make the competition doctor
intervene. The bleeding wrestler must get out of the competition area in order to be treated. Proper
cleaning utensils and disinfectant solutions must be readily available at the doctor table. It is the
competition doctor duty to determine whether the bleeding and spread of blood have been effectively

stopped and whether or not the athlete may continue competition. In the case of a bloodied or torn
garment that must be replaced, all athletes must have a backup uniform available by their corner.
Article 24 – Anti-Doping and Sanitary conditions

All athletes participating in United World Wrestling sanctioned events agree to submit themselves to
the United World Wrestling Anti-Doping Regulations and to the World Anti-Doping Code
QATAR 2019: Experience and findings
Injury Data
Number of Athletes 80
Mild Injuries 10
Moderate Injuries 1
Severe Injuries 3
Removal to hospital 3
Type of Injury
Sand in eye(s) 5
Contusion, ligament sprain of knee 4
Contusion of shoulder 2
Contusion of neck 1
Contusion of finger 1
Nose bleed 1
DIFFERENCT ASPECTS OF BEACH WRESTLING AND THEIR IMPACT

1. FIELD OF PLAY: FOP is the beach, on sand that is used by people going to the beach. Even with
continuous cleaning, it is impossible to guarantee that no foreign bodies (glass, metal, wood ...) are present in
the sand. The continuous movement of the athletes during the bouts stir up the sand, reaching deeper layers
than those eventually cleaned. This may present a risk to be considered. There were some specific injuries
due
to the
condition of the field of play, such as sand in the eyes. OBS: The athlete can use the ‘sand in the eye’-
moment as a moment to catch his breath. (sand time?)
The soil is unstable (a foot can get stuck in the sand) which can cause a higher incidence of injuries to the
knee or other articulations. The material used for demarcation of the FOP is rather soft, but an athlete can
break a rib if he or she falls directly on it.
2. WEATHER & CLIMATE CONDITIONS

-Beach wrestling is typically organized in locations with a
beach. The sun and the heat are critical wear factors and
minimum conditions should be set for competitions to
occur in these conditions. In Doha (+40ºC during the
day) the competitions started only at 16:00h until more or
less 22:00h.
Different amenities should be provided, such as

sunscreen, extra ice, extra bottles of water and clothes
and hats with UV protection for the personnel. Hyperthermia due to sun exposure should be considered.
Medical services should be prepared for adequate treatment (cold saline infusion etc…)

CAULIFLOWER EAR AMONG FINNISH HIGH‐LEVEL MALE WRESTLERS
AND JUDOKA
Iida-Kaisa Manninen1, Karin Blomgren1, Rauno Elokiuru2,

Mika Lehto3, Laura K Mäkinen1, Tuomas Klockars1
1 Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of
Helsinki, Helsinki, Finland
2 KIHU - Research Institute for Olympic Sports, Jyväskylä, Finland
3 Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
iida-kaisa.manninen@helsinki.fi
AIM OF THE STUDY

To study the prevalence, concerns, and treatment practices related to cauliflower ear among Finnish wrestlers
and judokas.
BACKGROUND
 Cauliflower ear is an acquired deformity of the auricle caused by trauma
 Prevalence among wrestlers 39% - 44%
 Haematoma between perichondrium and auricular cartilage results in cartilage necrosis followed by
fibroneocartilage formation
Schuller Arch Otolaryngol Head Neck Surg 1989; Kordi RJ Sports Sci Med. 2007
Cauliflower ear may cause:

 aesthetic discomfort
 ear canal obstruction may cause cerumen accumulation
 external ear infections and even hearing loss.

Haematomas should be evacuated promptly to avoid formation of cauliflower ear. Treatment options are
aspiration or incision with post-drainage interventions such as suturing, dressings or splints to prevent the re-
accumulation of the haematoma. Protective headgear is suggested to reduce the occurrence of cauliflower
ear.
METHODS
32 Finnish wrestlers and 31 judokas completed a questionnaire at training sessions or at competition
Participants were adults competing at the national or international levels
Lateral digital photographs of participants’ ears were taken
A senior author graded the overall appearance of the auricles on a scale from 0 to 5 (0 = normal auricle, 5 =
extreme cauliflower ear).

RESULTS
Demographics
Use of headgear, treatment of auricular haematoma and attitude towards cauliflower ear
Cauliflower ear was more prevalent among male athletes (84%, 46/55) than female athletes (0%, 0/8, P <
0.001). Almost all (96%) had sought treatment for an auricular hematoma. The most prevalent treatment
modality was needle aspiration (96%). 76% had received treatment from individuals not representing
healthcare profession. No complications from treatment were reported. Almost all participants (96%) reported
some symptom from the cauliflower ear, typically pain. None regretted their cauliflower ear(s), and 41% of
athletes with cauliflower ear considered it desirable.
CONCLUSIONS
Cauliflower ear is a common and symptomatic deformity among high-level Finnish wrestlers and judokas
Despite the symptoms, it is accepted and sometimes even desired among the athletes

DOPING CONTROL RULES UPDATE & UWW TUE PROCESS
Carlos Roy
United World Wrestling
carlos@unitedworldwrestling.org
Doping Control - Rights & Responsibilities

Athletes’ rights
 Have a representative (coach, doctor) and, if available, an interpreter accompany him/her to
the doping control station
 Ask for additional information about the Sample collection process
 Request a delay in reporting to the Doping Control Station
Athletes’ responsibilities
 Comply with Sample collection procedures (and the Athlete should be advised of the possible
Consequences of Failure to Comply)
 Produce identification
 Remain within direct observation of the DCO/Chaperone at all times from the point initial
contact is made by the DCO/Chaperone until the completion of the Sample collection
procedure
 Report immediately for Sample collection, unless there are valid reasons for a delay
Reasons for delaying doping control

In-competition
 Participation in a medal ceremony
 Fulfilment of media commitments
 Performing a warm down
 Obtaining necessary medical treatment
 Locating a representative and/or interpreter
 Obtaining photo identification
 Any other reasonable circumstances, as determined by the DCO, taking into account any
instructions of the Testing Authority
Out-of-competition
 Locating a representative
 Completing a training session
 Receiving necessary medical treatment
 Obtaining photo identification
 Any other reasonable circumstances, as determined by the DCO, taking into account any
instructions of the Testing Authority
Requirements for Urine Samples

Urine samples: a minimum of 90 mL
 Sample collection process continues until the minimum volume is produced
 DCO has the responsibility for declaring the Sample volume insufficient and for collecting the
additional Sample(s) to obtain a combined Sample of sufficient volume.
Insufficient volume:
If several samples are produced to reach a sufficient, a procedure is followed to record and
protect the partial sample (refer to ISTI)
Partial samples are combined to reach the sufficient volume.
Specific gravity: measured at 1.005 or higher with a refractometer (or 1.010 or higher with lab
sticks)
 It is the responsibility of the Athlete to provide a Sample with a Suitable Specific Gravity for
Analysis.
 Sample Collection Personnel shall advise the Athlete of this requirement at the time of
Notification in order to discourage excessive hydration prior to the provision of the Athlete’s
first sample.
 Sample collection process continues until the minimum specific gravity is reached.
If his/her first Sample is too dilute, he/she shall be advised to not hydrate any further until a Sample with a
Suitable Specific Gravity for Analysis is provided. The DCO should wait as long as necessary to collect such a
Sample. Exceptional circumstances making it impossible to continue with the Sample Collection Session shall
be determined on a case by case basis. Common sense and DCO’s experience should help determining

those circumstances. For instance: the place where sample collection is underway is closing and there is no
suitable alternative place for carrying it on. Or the athlete has a severe condition requiring urgent medical
treatment, making it impossible to collect the sample.
Therapeutic Use Exception (TUE)

A TUE is the authorization granted to an athlete to use a Prohibited
substance to treat a legitimate medical condition/illness.
A TUE may be granted if the 4 following conditions are met:
 A wrestler would have significant health problems without
this substance
 The use of the substance will not produce an enhancement
of performance other than the return to the wrestler’s normal
state of health
 There is no other reasonable therapeutic alternative than the
use of the prohibited substance
 The necessity for the use of the otherwise prohibited
substance cannot be a consequence of prior non-therapeutic
use of any substance from the Prohibited List.
Process
 International level wrestlers (holders of a UWW license) must
apply to UWW
 National level wrestlers must apply to their NADO (National
Anti-doping Organization
 Application: min. 30 days before a competition
 Completed TUE Form + Supporting documents (medical file)
Retroactive TUEs
The rule is that an athlete must obtain a TUE prior to using a
prohibited substance.
There are situations for which TUEs may be granted retroactively:
 Emergency treatment or treatment of an acute medical condition was necessary; or
 Due to other exceptional circumstances, there was insufficient time or opportunity for the athlete to
submit, or the TUEC to consider, an application for the TUE prior to Sample collection; or
 Applicable rules required the athlete or permitted the athlete to apply for a retroactive TUE. This is
applicable to Persons who are not International-Level or National-Level athletes (Code Article 4.4.5)
and (where the relevant NADO so chooses) to National-Level Athletes in sports specified by the
relevant NADO (ISTUE Article 5.1 Comment); or
 It is agreed, by WADA and by the ADO to whom the application for a retroactive TUE is or would be
made, that fairness requires the grant of a retroactive TUE.
A medical emergency or acute medical situation occurs when the wrestler’s medical condition justifies
immediate Administration of a Prohibited Substance or Method and failure to treat immediately could
significantly put the wrestler’s health at risk.
Other Things to know

 A TUE granted by a NADO is valid ONLY on the NATIONAL LEVEL!
 UWW does not automatically recognize a TUE granted by a NADO
 A wrestler with a TUE granted by a NADO who plans to compete on the international level must apply
to UWW to have his/her TUE recognized on the international level
 A change in the dosage of a treatment requires a new TUE
 WADA does not grant TUEs
Team Physician Responsibility
 To stay up-to-date with anti-doping policies and the current Prohibited List in order to verify whether or
not a Wrestler is allowed to use a particular substance
 If the substance or method is prohibited, ascertain whether or not the athlete is eligible for a TUE
(criteria for TUEs)
 Even if the physician inadvertently prescribes a prohibited substance, the principle of “strict liability”
remain in effect.
Appeals
 WHAT IF A TUE IS REFUSED BY UWW?
→ AN APPEAL MAY BE FILED TO WADA
 WHAT IF WADA DOES NOT REVERSE THE DECISION?
→ AN FINAL APPEAL MAY FILED TO THE COURT OF ARBITRATION FOR SPORT

OVERVIEW ON DOPING RULES VIOLATIONS IN WRESTLING
Carlos Roy
United World Wrestling
carlos@unitedworldwrestling.org
BACKGROUND
Elements Of The Anti-Doping Program
1. Testing & Investigation
2. Results management
3. Therapeutic Use Exemptions (TUEs)
4. Education & Outreach
All signatories must implement the World Anti-doping Code and the related International Standards to be
«Code Compliant». WADA monitors all organizations, and now has a variety of tools to ensure that they
implement and enforce all rules provided for by the World Anti-doping Code and the International Standards.
UWW – INTERNATIONAL TESTING AGENCY (ITA)

ITA was founded in 2018. It was first during the 2018 Winter Games in PyongChang. The ITA is an
international organisation constituted as a not-for-profit foundation, based in Lausanne, Switzerland. Its
mission is to offer comprehensive anti-doping services, independent from sporting or political powers to
International Federations It was created to separate the antidoping activities from sports organzations and
strengthen the independence of the fight against doping. A number of International Federations have signed
an agreement with ITA to run part or the complete antidoping program.
Whereabouts + ADAMS: only for those wrestlers who are included in the group for out-of-competition. tests.
These wrestlers have already been contacted directly by ITA and have been informed of their responsibilities.
Biological Passport: there are 2 types of passports: a blood passport (not yet used by UWW) and a steroid
passport (runs automatically in the ADAMS system whenever an analysis result is reported in ADAMS and
linked to an athlete’s profile).
In-competition testing: some medals + some randoms + some targeted athletes are tested. UWW cannot
provide more details on the strategy of testing.
Therapeutic Use Exemption (TUE): no changes to the procedure. For those who need a Therapeutic Use
Exemption for medical conditions such as diabetes, the application must be made at least 30 days before
competition.
For emergencies (accidents, etc.), the application can be made after, but the use of a banned substance shall
be medically justified.
- International level wrestlers who hold a UWW licence): must apply to UWW
- National level wrestlers (no UWW licence, no international competition): must apply to their National
Agency.
INTERNATIONAL TESTING AGENCY (ITA)

• Risk Assessment & test planning
• Testing operations
• Whereabouts management
• Biological passport (steroid passport)
• Results management (decisions for anti-doping rules violations + whereabouts failures)
UWW
• Education & Outreach
• Therapeutic Use Exemptions (TUE)
Doping Risk Assessment in Wrestling & Test Distribution Plan

• Several indicators analyzed and combined to evaluate the risk of doping:
• Physical demands (power & strength, Cardio endurance, muscular endurance, speed)
• Performance enhancing substances (based on laboratories reports 2010-2018)
• Other factors (country risk, doping history in a country, level of anti-doping education)
• Individual risks (World ranking, individual testing history, additional individual intelligence)
• Scores between 1 and 3 (3 = highest risk level)
Physical demand in Wrestling: High (based in academic research). This characteristics of the sport
does not allow focus either on out-competition or in-competition.
PEDS: trends of PEDS use – 3 main substances. No specific trends between styles or categories

Country Risk: is a combination of 3 indicators: (1) Prevalence of political or economic corruption
within society (Transparency International Corruption Perception Index 2018) combined with the (2)
ratio between ADRV & number of tests in a given country and (3) Doping history in Wrestling in a
given country = country risk assessment 1 to 3.
Example
• Carlos ROY (FS, 125 kg), from the Republic of Lausanne (RLS), multiple World Champion, including
2018 World Champion.
• Applied to 20 highest ranked wrestlers in each style and weight class = 600 wrestlers
Risk
Individual Number of related to Average
Rank Gender Discipline Weight Name Country Country Risk
Risk (rank) Tests in 2018 the testing Risk
history
Carlos
1 M FS 125 RLS 2 3 2 3 2.67
ROY
1. Out-of-competition testing
- Registered Testing Pool (80 wrestlers)
- 3 out-of-competition tests per year
2. In-competition testing
- podium
- targeted tests (risk 3 athletes or based on other intelligence such as steroids passport or other
information received).
The number of tests have increased

since 2012. There was a peak in
2016. This was an Olympic year
where we have Olympic Games
qualfying events. With entry in
force in 2016 of WADA’s
International Standards for Testing
& Investigation, the number of tests
is less determinant than the quality
of tests. The idea is to have a
smarter testing program, with better
coordination between International
Federations and National Anti-
doping Organisations and more
tests based on intelligence.

Distribution between in-competition & out-of-competition tests:
In-competition Out-of-competition
We are also trying to have more balanced distribution between in-competition testing and out-of-competition
testing. Although the risk of doping in Wrestling is higher out-of-competition, it is difficult to have a balance
between in-competition and out-of-competition tests because of the large number of events across the season
and number of of categories. UWW allocates more pre-competition tests to also address the risk of abuse of
diuretics before competition.
Urine Tests / Blood Tests (collected by UWW)
Urine Blood
2016 2017 2018 2019 (1 OCT. 2019)
2% 5% 8% 10%
95% 92% 90%

98%

2018 - Adverse Analytical Findings (AAFs) – Countries
This is just indicative. No conclusions possible since depends on number of tests, priorities of NADOs,
calendar. Not only the Olympic Styles represented here. Also, Traditional styles. The only remark is that the
doping cases are discovered in every continent.
Non-analytical Anti-doping Rules violations

UWW AD rules / WADA Code:
Art.2.3 Evading, Refusing or Failing to Submit to Sample Collection
1x in 2018 (UWW) 1x in 2017 (NADO) 3x in 2016 (NADO)
Art. 2.4 Whereabouts Failures
2x in 2018 (NADO)
Art. 2.5 Tampering or Attempted Tampering with any part of Doping Control
Art. 2.6 Possession of a Prohibited Substance or Prohibited Method
Art. 2.7 Trafficking or Attempted Trafficking in any prohibited substance
Art. 2.8 Administration or Attempted Administration to any Athlete
Art. 2.9 Complicity
1x in 2018 (UWW)
Prohibited Methods!
• Tampering to alter the integrity of samples collected during doping control
• Intravenous infusions of more than 100 mL per 12 hours
Now with the steroid profile in ADAMS, it is possible to detect huge differences in an Athletes profile and to
request DNA analysis on an athlete’ s samples to show a possible manipulation. Regarding intravenous
infusions, this is more difficult to detect. To catch on the fact. –> Education needed.
Education
Coach Courses Level I
- Basics on anti-doping (prohibited substances, sanctions, TUEs, …)
More than Medals
- Basics for young Wrestlers (prohibited substances, sanctions, TUEs, Values of Clean sport)
Outreach campaigns
- Booths installed in several championships during the years
- Focus on Cadets Continental & World Championships + Junior World Championships
Online courses
- RTP Wrestlers, Coaches, Team Physician
- WADA Online Education tools

EFFECTS OF LOW MOBILITY OF THE SPINE IN YOUNG MALE AND
FEMALE WRESTLERS
Varvara Ioannidou, Evaggelia Makri & Ioannis Barbas
Democritus University of Thrace
ioannidou_b@yahoo.gr
INTRODUCTION
Male wrestling is an Olympic discipline with a long international background that has been present in the
modern Olympic Games since 1896. Female wrestling, has limited international experience compared to
male. It was first included in a World Championship organized by FILA in 1987 and was not included in the
Olympic program until Athens 2004.
Is a sport with enormous demands on the physical characteristics. It uses the upper and lower extremities,
including falls, locking joints, immobilizations and various gripping techniques. It is characterized by a high-
intensity intermittent effort lasting a total of 6 minutes (2 * 3-min bouts).
Physical and physiological characteristics
Wrestling as a sport demands several specific characteristics including:

Muscular Strength and Endurance
Aerobic-Anaerobic ability
Power
Speed
Flexibility
Mobility
Coordination/motor skills
Balance
Body composition
Depending on his/her age and sports level a successful athlete should have:
Technique
Agility
Analytical and Tactical skills
Motivation
Confidence
Perform under pressure
Little research has been done on the effects of flexibility, especially in the spine, but also shoulder and the
pelvic girdle and to what extent it affects wrestling. What is the role of these factors and posture in preventing
injuries and thus the overall performance of the athlete?
Pros
In both types of wrestling the possession of reasonable spinal curves might be an advantage as it
gives the competitor:
Low center of gravity
Stability
Mobility
Balance
Cons
Might be an important factor associated with increased kyphosis due to:
Extreme spinal flexion
Prolonged exercise
Psychological reasons
Stabilization of the spine

Spinal stabilization system consists of three elements:
Neuromuscular control
Passive(bones-ligaments)
Active(muscles)

Stabilization is not all about power. Adequate sensory input (proprioception receptors) is essential in order first
to alert the central nervous system about the interaction between the body and the environment and second
to interpret that in the appropriate motion.
Kyphosis in young wrestlers
The normal development of the

sagittal curvature of the spine is
dependent on the interaction
between heritable growth factors and
the mechanical environment in which
it grows.
It is believed that repetitive stress on

the adolescent spine, due to large
motions of the trunk in
flexion/extension during excessive
sports exercises can lead to juvenile
kyphosis.
Characteristics
Rounded back with greater thoracic
curve
Shoulders slouch forward
Scapula are in protraction because of
the shortening of the pectoralis minor
Internal arm rotation mainly because
of the shortening of the pectoralis
major
The head tilts forward because of short cervical extensors
Thoracic rigidity/stiffness (mainly in extension and rotation of the thoracic vertebrae)
What is normal?
Spinal posture and the resultant changes during the entire pubertal growth period (at the ages of 11, 12, 13,
14 and 22 years) have not been reported until 2005. M. Poussa (2005)
Αnother pilot study in children during their second growth phase (6-11 years old) measured a mean kyphotic
angle of 47.1° (SD±7.5) for all age groups. T.C Furian (2013)
Rajabi et al. (2010) reported the thoracic kyphosis for male wrestlers (15–24 years) at 41.77 degrees and for
the age range of 25–44 years at 42.80 degrees.
There is only one study that has examined the body posture in female wrestlers aged 15 to 20, before and
after specialized physical training. Sokolowski (2014)
Prehabilitation-Rehabilitation
Focus on:
• Core engagement
• Thoracic spine extention
• Scapula muscles activation
• Shoulder, pelvic, foot mobility
• Deep neck flexor muscle activation

REFERENCES
Betcsh, M. et al: Effects of Athletic Training on the Spinal Curvature in Child Athletes, Research in Sports
Medicine, 23:2, 190-202, 2015.
Chaabene, H.: Physical and physiological attributes of wrestlers: an update, Journal of Strength and
Conditioning Research, vol. 31, no 5, 2017.
E. Demirkan et al: Physical Fitness Differences between Freestyle and Greco-Roman Junior Wrestlers,
Journal of Human Kinetics volume 41/2014, 245-251.
Furian, T.C. et al: Spinal posture and pelvic position in three hundred forty-five elementary school children: a
raster stereographic pilot study, Orthopedic Reviews 2013, volume 5:e7.
Mirzaei, B. et al: Physiological profile of elite Iranian junior freestyle wrestlers, Journal of Strength and
Conditioning Research, 23(8): 2339–2344, 2009.
Muyor, J.M. et al: Spinal posture of thoracic and lumbar spine and pelvic tilt in highly trained cyclists, Journal
of Sports Science and Medicine (2011) 10, 355-361.
Poussa, M.S. et al: Development of spinal posture in a cohort of children from the age of 11 to 22 years, Eur
Spine J (2005) 14: 738–742.
Pallares, J.: Physical fitness factors to predict female Olympic wrestling performance and sex differences,
Journal of Strength and Conditioning Research vol.26, no. 3, 2012.
Rajabi, R. et al: Comparison of thoracic kyphosis in two groups of elite Greco-Roman and freestyle wrestlers
and a group of non-athletic participants, Br J Sports Med 2008;42:229–232.
Samakoush, H. et al: Prevalence of Postural Abnormalities of Spine and Shoulder Girdle in Sanda
Professionals, Annals of Applied Sport Science, vol. 5, no. 4, pp. 31-38, 2017.
Sokolowski, M. et al: Body posture in female wrestlers before and after specialized physical training, Med
Sport 2013; 66:473-84.
Wojtys, E.M. et al: The Association Between Athletic Training Time and the Sagittal Curvature of the
Immature Spine, The American Journal of Sports Medicine, Vol. 28, No. 4, 2000

INTRAVENOUS FLUID TRANSFUSION ISSUE FROM JUNIOR WORLD
CHAMPIONSHIPS 2019 TALLINN, ESTONIA 12.-18.08.2019
Mika Lehto, MD
mika.lehto@hus.fi
At 16th August from training/warming up area was found an empty infusion bottle of “RINGERS” with infusion
line and needle. It was found from a place that is not cleaned every day, so the date of the removal the
infusion system cannot be identified. The named place is not registered on surveillance camera.
It seems, that there has been an intravenous fluid transfusion issue during the competition, that is prohibited
according to the WADA-rules.

OVERTRAINING AND FATIGUE SYNDROME IN ELITE ATHLETES
Dr Amir Pakravan
a.pakravan@uos.ac.uk
Definitions
Overreaching:
Excessive Exercise volume or intensity → reduced sport-specific athletic performance
Temporary impairment
Supercompensation → Increased performance
Functional overreaching
Increased training load
Short term (days – weeks)
Good: Supercompensation
Non-functional overreaching
Intense training load
Long term (weeks – months): 6 weeks – 8 months
Other symptoms: psychologic, neurologic, endocrinologic
Bad: Symptoms, time out of training
Overtraining Syndrome (OTS)
Maladaptive response to excessive exercise without sufficient rest
Extreme non-functional overreaching?
More than 2 months: 2 years – no recovery
Severe varied symptoms
Bad: symptoms, time out of training, secondary complications, potential career ending
OTS
Continuum from non-functional overreaching?
Additional stressor?
Multi-factorial?
Individual and unique to each athlete?
Prevalence
Overreaching:
Common
Up to 60%
Overtraining: Unexpected and Paradoxical Deconditioning

Much less common
Approx. 15%
Mostly studied in endurance athletes
Less evidence in resistance athletes
Common in Wrestling
OTS: Signs & Symptoms

Underperformance & Fatigue
Multi-system & severe
Hormonal, immunologic, neurologic, and psychologic impairments
Other background risk factors and harmful behaviour:
Insufficient intake of Carbohydrate, Protein, Calorie
Poor sleep habits and quality
Excessive cognitive effort
Sympathetic (anaerobic sports):
Insomnia
Irritability
Agitation
Tachycardia
Hypertension
Restlessness
Parasympathetic (aerobic sports):

Fatigue
Depression
Bradycardia
Loss of motivation
Other:
Anorexia; Weight loss
Lack of mental Concentration
Frequent Muscles soreness
Anxiety
Unrefreshing sleep
OTS: Diagnosis
Challenging:
Retrospective and duration dependent by definition
No single diagnostic test or biomarker
Multi-factorial
Differential diagnosis
Detailed thorough history and physical examination
Training and competition load
Recovery: awareness, appropriate duration and techniques
Background harmful clinical behaviour
Past Medical History
Relevant systemic examination
OTS: Diagnostic tests

Screening for organic conditions
History and examination led
asthma, thyroid disease, primary mood disorder, adrenal disease, diabetes, iron deficiency, anemia,
infection, malnutrition, oncologic condition, rheumatologic condition, renal, liver disease, …
Tests to consider:
FBC, ESR, CRP, U&E, biochemistry and metabolic profile, Haematenics, CK, TFT, LFT, rheumatology
screening, ANA, serum and salivary immunoglobulins, vitamin D, vitamin B12, folate, serologies for viral
hepatitis, toxoplasmosis, cytomegalovirus/Epstein–Barr virus, …
 No definite biomarker
 Performance test (response to two maximal tests, 4 hours apart) + physiologic markers of
deconditioning: differentiate between OTS and Non-functional OR
 ↓ GH, cortisol and prolactin response to non-exercise stimulation tests  ↓ pace and performance
 ↓ testosterone  ↓ muscle mass
 ↑ oestradiol & ↓ testosterone / oestradiol  psychological and metabolic:
Depression, confusion, fatigue, reduced strength
Muscle catabolic state, lower metabolic rate, higher body fat,
Screening & Prevention

Multifactorial, Harmful behaviour and other Risk Factors
Unique to individual athlete
Principles of optimal load and monitoring
Regular monitoring
External load: quantify training and competition load
 hours of training, distance run, weight lifted, number of games played
 other: life events, daily hassles or travel
Internal load: physiological and psychological response

 RHR, Max HR, Rate of Perceived Exertion
 Well-being questionnaires, regular urinary hydration tests, body composition and
weight monitoring
Identify early signs:
abnormal body fat gain, paradoxical muscle loss, worse libido, mood
Summary
Functional and non-functional overreaching vs overtraining syndrome
Complex multi-factorial individual, not a single easy correlation with loading: unexpected paradoxical
deconditioning?
Diagnosis challenging, need to rule out possible organic causes
Role of screening and monitoring in prevention

SUCCESSFUL NON-OPERATIVE MANAGEMENT OF NEAR COMPLETE
HAMSTRING INJURY
Jason Crookham DO CCFP(SEM) Dip. Sport Med(CASEM)
Director, Sports Medicine Fellowship

University of British Columbia
medical@wrestling.ca
Subject
Danielle Lappage
25 y/o Wrestler 63 Kg 2016 Rio Olympics
2010 Junior World Champion
2013 Francophone Games Champion
2104 Commonwealth Games Champion
2014 Worlds Championships 5th
2014 R ACL Reconstruction
Injury
40 seconds into first round match – forced to abandon.
Eccentric contraction extended leg stepping forward
Sharp pain in buttock
Radiating to posterior thigh/ leg
Forced to abandon match at 40 seconds due to pain and
weakness
Near total disruption of hamstring tendon from attachment as
ischial tuberosity
Semimembranosus 1.7 cm
Semitendonosis ?
Biceps Femoris?
Crutches
2 weeks severe radicular pain sciatic nerve distribution
Classification – stretching type vs high speed type
Prognosis
Discussion Op vs Non Op
Note- MRI T2 Hip
Two Types of Hamstring Injuries

The high-speed running type is mainly located to the long head of
biceps femoris and typically involves the proximal muscle-tendon
junction.

The stretching-type is located close to the ischial tuberosity and
typically involves tendon tissue of the semimembranosus.
A general rule of thumb is, ‘the closer to the ischial tuberosity, the
longer the rehabilitation period’.
Inform the athlete that the rehabilitation period is likely to be prolonged,

Passive stretching and heavy load exercises appear to provoke the
stretching-type of injuries by increasing pain.
Chose Non-op Rehab

Avoid over-stretching
Pain free regenerative phase
8 weeks post injury Avulsion of Semimembranosis

Conjoint tendon intact
Reinjury
Coaching wrestling
Eccentric lunge mechanism
Pain at previous injury site
MRI
2.5cm SMT gap
British athletic muscle injury classification 3c
Platelet Rich Plasma Injection

low volume (2cc)
high concentration (45x baseline)
under US guidance
4 months post injury
6 months still at 50% strength
Return to Competition
Silver 2018 World Championships
Proximal hamstring injury has prolonged recovery.
Up to 40% career ending reported in some literature.
Operative management is controversial in part due to risk in sciatic
nerve injury.
Non-operative management is prolonged

Physio focus in strengthening and avoid stretching (especially early)
Role for PRP in late management of proximal injury Level 4
Role for PRP in early management of High Speed Running Type
injury (NFL Study shortens recovery a few days)

GENERAL HEALTH MANAGEMENT STRATEGIES IN WRESTLING
Dr Stevan Sikimic
sikimic@united-world-wrestling.org
Wrestling Characteristics
• Physically highly demanding one-to-one combat sport
• Involvement of whole-body muscle
• 3 sessions of 2 minutes each, 30 seconds break in-between
• Wrestling techniques: throws, takedowns, pins, grappling holds
• Reuse of wrestling techniques in other combat sports, military combat and self-defense
techniques
Benefits of Wrestling for Athletes

Physical Fitness
• Speed
• Agility
• Muscular endurance
• Stamina strength
• Flexibility
Mental Development
• Courage
• Persistence
• Self-control
• Sportsmanship
Health Management Strategy

Role of Sports Medicine
Key tasks of sports medicine:
• Managing the athlete’s health while optimizing the performance
• Protecting the athletes against the unnecessary risk
• Providing adequate illness and injury management
• Good sport-specific knowledge, in order to understand the athlete’s goals and challenges
•Adequate trainings •Accurate and timely

•Proper sporting gear •Individualization
•Good overall health •Effective anamneses
•Warm-up and stretching routines •Clinical and special
•Build hygiene habits examinations
•Personal and community hygiene Prevention Diagnosis
CONSEQUENCES FOR CAREER/LIFETIME
•Rehabilitation plan •Wound protection

Rehabilitation Treatment
•Patient-specific •Resting
•Injury-specific •Compression
•Pain management •Medication
•Return to sport •Self- or professional
•Continuous monitoring help
Health Management Strategy
Regular Health Special Examinations Individual treatment of Continuous monitoring &

Validations injury / illness / re-validation of health
psychological condition status
• Health Status • Diagnosis • Establishing best • Risk reduction

• Setting individual medical practice • Injury prevention
goals • Gathering sport-
specific competences

Optimization tools:
• Electronic medical records
• Power of social media for spreading information
Challenges of Health Management in Wrestling

• High sports injury rate
• Strong difference in medical care level and medical service around world
• Dependence of financial state of medical care system in the country
• Main challenges:
• Determine a common model for health management regardless of the country
• Optimize medical services for wrestlers
• Give recommendations to wrestling federations
•
Factors for Success in Wrestling
Physical and mental factors contributing to successful performance in wrestling:
• Fitness condition:
Muscular strength and endurance / Aerobic endurance / Strong neck muscles
Body composition
• Balanced nutrition and hydration
• Good training process
• Regular health examinations
• Adequate treatment of injuries and illnesses
Common Injuries and Medical Problems

• Skin infections
• Head and face injuries
• Upper body injuries
• Lower body injuries
Skin Infections
• Increased risk for injuries for wrestlers:
• Skin trauma – broken natural skin barrier for infections
• Prolonged exposure to potential infectious agents of the skin
• Infected areas:
• Head / neck / face due to maximum skin-to- skin contact
• Primary transmission of infections via skin (not mats and other environmental
sources)
• Infectious agents:
HSV, bacterial, fungal infections
Herpes Gladiatorum
MRSA infections
Tinea
Gladiatorum

Prevention:
• Education about symptoms
• Early detection of infections
• Exclusion of athletes from wrestling
• Clean equipment and mats
• Usage of common towels discouraged
• High hygienic level
Head and Face Injuries

• Common injuries
• Auricular hematoma
• Skin lacerations
• Epitaxis
• Cervical strain
Prevention-
Neck strengthening
• Dental fractures
• Bleeding
Lower Limb Injuries

• Common injuries
• Prepatellar bursitis
• Medial collateral ligament sprain (MCLS)

Prevention
Usage of adequate equipment (knee pads, bandages)
Floor mats
Upper Limb Injuries

Common injuries
• Shoulder subluxation / dislocation
• Elbow dislocation
• Finger dislocation
Prevention
• Shoulder flexibility / Rotator cuff strengthening
Summary
• Success in wrestling achieved through joint work of athletes, coaches and special personnel:
sport medicine doctors, nutritionists, physiotherapists and other professionals.
• Medical care should be personalized for each athlete
• The main goal: to achieve the best sport results with the lowest consequences for health of
the athlete.

VETERAN MEDICINE IN WRESTLING: EXAMINATIONS AND PREVENTION
Mika Lehto, MD, PhD
Specialist in internal medicine and cardiology

Helsinki University Hospital
Finnish Wrestling Federation
mika.lehto@hus.fi
BACKGROUND
Exercise increases physical and psychological wellbeing
Physical training is associated with healthy lifestyle
Sport provides social contacts
WRESTLING IS FUN!
Exercise and good physical condition are healthy!
Individuals with high level of physical activity have lower risk of CVD or death
Hållmarker
EHJ Qual
Care Clin
Outcomes,
2018
Better performance of push-ups is associated with lower risk of CV events
Yang JAMA Network

Open 2019

Physical activity is associated with survival in patients with coronary artery disease
Toukola Am J Cardiol 2018
Relative risk of MI associated with vigorous exertion according to habitual frequency of vigorous exertion
Thompson Circulation 2007
Cause of sudden cardiac death Canada, < 40y Arzamendi, Am Heart J 2011

Cause of sudden cardiac death, Canada - different age groups Arzamendi, Am Heart J 2011
Cause of sudden cardiac death - different age groups; USA Eckart JACC 2011
Sudden deaths among wrestlers in Iran during 1998- 2005
Kordi, Sports Health 2011

How to avoid coronary artery deaths in veteran wrestlers?
ECG screening works in young athletes
Corrado JAMA 2006
What about coronary artery disease screening in veteran athletes?

Studies of preparticipation screening of veteran athletes
Aagaard et al, Med Sci Sports Exerc Preparticipation Evaluation of Novice, Middle-Age, Long -Distance
Runners 2013
men age 45 yr and older
entry of first-time participation
153 of 265 eligible runners completed the study
medical history and physical examination
12-lead ECG, blood pressure, echocardiography, blood tests
estimation of the cardiovascular risk; SCORE
maximum exercise testing in high risk runners
BP > 180/110, ECG changes, SCORE ≥5%
The relatively high prevalence (14/153; 9 %) of abnormal findings was found

A physician examination with a 12-lead ECG is effective in identifying individuals in need for further diagnostic
workup. However, the detection of CAD was limited by the absence of a reliable screening tool.
Morrison, B.N. et al. Assessment of cardiovascular risk and preparticipation screening protocols in masters
athletes: the Masters Athlete Screening Study (MASS): a cross-sectional study
BMJ Open Sport Exerc Med 2018
Male and female recreational and competitive athletes

≥35 years old
PE activity at least 3 days per week over the preceding 3 months
798 athletes, 54.6 years

Farahani: Pre-participation Cardiovascular Screening of Elderly Wrestlers; Asian J Sports Med, 2010
63 Iranian elderly wrestlers Mean age 54 years
ECG: ischemic changes in 13.6%
premature atrial contractions and premature ventricular contractions in 11.4%
Echo: mild left ventricular systolic dysfunction 3.4%
valvular disease 32.3%, diastolic dysfunction 45.7%
LVH 16.9%
Exercise test: negative 70.4%, equivocal 15.8%, positive 5.2% and highly positive 8.6%
What to do? No evidence of benefits of screening of veteran athletes
Should we measure coronary artery calcification (CAC) with coronary CT? DeFina, JAMA Cardiol 2019
This is not informative!

Also, individuals with high CAC can safely continue to exercise!!

Borjesson, M. et al. (2011). Cardiovacular evaluation of middle-aged/senior individuals engaged in leisure-
time activities: position standfrom the ections of exercise physiology and sports cardiology of the European
Asociation of Cardiovascular Prevention and Rehabilitation. European Journal of Cardiovacular Prevention
and Rehabilitation
History
A heart attack
Heart surgery
Cardiac catherization
Coronary angioplasty (PCI)
Pacemaker/implantable cardiac defibrillator/rhythm disturbance
Heart valve disease
Heart failure
Heart transplantation
Congenital heart disease
Symptoms
Experience chest discomfort with exertion
Experience unreasonable breathlessness
Experience dizziness, fainting, blackouts
Heart medication
Cardiovascular Risk Factors

A man older than 45 years
Smoking
Blood pressure >140/90 or blood pressure not known
Hypertension
Cholesterol level is >6.2 mmol/l (240mg/dl) or cholesterol level not known
A close relative who had a heart attack before the age of 55 (father or brother) or 65 years (mother or
sister)
Diabetes mellitus
Physically inactive (<30min of physical activity at least 3 days/week)
>10 kg (20 pounds) overweight

Legal Issues
Who is responsible?
Athlete!
NOT:
Federation
Organizing committee
UWW
Conclusions
Physical exercise is healthy but vigorous activity increases risk of SCD
Veteran wrestlers should have (annual) checkup:
History!!
Physical examination
Blood pressure
Cholesterol
ECG >>>> Maximal exercise test in high risk individuals

KNEE LIGAMENT INJURIES IN WRESTLERS
Kohei Nakajima, MD１,2, Teppei Tanaka, M.D１,3, Naoka Fukuda, MD 2，Mika Hangai, MD 2
Yuki Ara, MD 2，Yusuke Nishida, MD2, Toru Okuwaki, MD２
１
Japan Wrestling Federation
２
Japan Institute of Sports Sciences
３
Tokyo Yamate Medical Center
kohei.nakajima@jpnsport.go.jp
Background
Objective: To clarify the rate of injuries for each ligament of the knee joint from clinical database of Japanese
top wrestlers.
Analyzed 938 (654 males and 284 females) clinical records at JISS clinic where all wrestlers. (2009 ~ 2013)
Reviewed
① Distribution
② Part of injury
③ Type of injury
④ Category of wrestling
Distribution

Injured Areas
Incidence ratio by style
Type of Injuries
to knee joint

Breakdown of Knee Ligament
Injuries n=102
Knee ligament Inj.

Free Style＞Greco-Roman Style
Conclusions:
It seems there is a characteristic knee injury in wrestling as compared to other sports.
But the further investigation is needed…i.e. the location of lesion, course of healing, and prevention program.

STUDY OF THE PEAK OXYGEN UPTAKE AND MAXIMAL HEART RATE IN
WRESTLERS
Daniela Cuadra M.D.
Head Team Physician

Chilean Sports Federation of Olympic Wrestling
daniela.cuadra@usach.cl
Background
Special Wrestling Fitness Test (SWFT) Is a specific test of wrestling to assess physical condition of athletes.
Comes from an adaptation of Special Judo Fitness Test (SJFT).
An important study indicates that this new test could be used to measure a more specific and valid physical
ability of the fighters without having to resort to laboratory tests, in which the movements and energy demands
are different from the specificity of wrestling (Martínez-Abellán, 2015).
Martínez-Abellán (2016) Special Wrestling Fitness Test: una prueba específica de lucha olímpica aplicada a
luchadores jóvenes. Sport TK-Revista Euroam. Ciencias del Deport. 5, 27
Karimi 2016, aimed to determine the validity of the special judo fitness test among Iranian male wrestlers and
published the Validity of Special Judo Fitness Test in Iranian Male Wrestlers. He compared the special judo
fitness test with Wingate test on a cycle ergometer. There was a significant correlation between the results of
HR changes and lactate concentration changes between the two tests.
The study concluded that the special judo fitness test is a valid field test to assess anaerobic fitness of male
wrestlers. The test can be used as a field test to evaluate anaerobic fitness in wrestling.
Karimi, M. (2016) ‘Validity of Special Judo Fitness Test in Iranian Male Wrestlers’, International Journal of
Wrestling Science. Routledge, 6(1), pp. 34–38.
SWFT has been positioned as the method to evaluate athletes’ performance and physiological parameters.
This physiological behaviour is still unclear.
Objective: Compare values of oxygen uptake in treadmill against SWFT by ergoespirometry (ERGO) analysis
in wrestling athletes.
Relative oxygen consumption (VO2/Kg) peak

Respiratory quotient (RER)
Oxygen pulse (VO2/HR)
Maximal heart rate (HRmax)
Design
Descriptive study of female and male cadets (n=10) of freestyle wrestling in pre-season at the Olympic
Training Centre.
VO2 treadmill (ERGO) test with the ACSM protocol for athletes and the SWFT.
SWFT:
3 bouts of wrestling activity (A: 15 seconds, B: 30 seconds and C: 30 seconds) with 10 seconds rest between
bouts.
Each test subject had to bring two other subjects were positioned at a 6-meter distance using the fireman
technique. SWFT Index = (Final HR + 1min HR)/Total Number of Throws

Results

Conclusion:
We observed that the peak VO2, HR, oxygen pulse are similar in treadmill and SWFT.

MEDICAL COVERAGE OF WRESTLING EVENTS; FROM A TO Z
Szabolcs Molnár
UWW Medical & Anti-Doping Commission
szabolcsmolnardr@gmail.com
Members of the Medical Service

Local Medical Team
Referees and UWW staff
Team Doctors / Physios
UWW Doctor
Local Staff
WADA
Local Medical Team BASIS OF THE SERVICE License to Practice in the Host Country
Beside the Mat
Back Office + ER
Ambulance + Hospital
Importance of the REFEREE

Referee – must know what is happening on the mat
Referee – in case of injury must be able to communicate with the medical staff
Team Doctors / Physios but In case of serious injury – the local Medical Service decide the treatment! Let
them work!
UWW Health Regulations

Article 15
A team doctor can accompany each competitor to assist mat doctors when necessary, but in case of
serious injury – the local Medical Service decide the treatment!
UWW Doctor Coordination / Decision
Role of the Local Medical Team in the Medical Service

They must be clear about the Sport Hall, the Wrestling Rules and the UWW staff.
Sport Hall: Senior World / Continental Championships and Olympic Games - 9 days on 4 mats
Sport Hall: Other (age) Championships - 7 days on 3 mats.
Back Office / Emergency Room – Medical Personnel (2) + other Ambulance Staff
Medical Examination: 4 boxes / rooms
4x (1 box = 1 doctor + 1 administrator + 1 body guard - entrance)
Referees and UWW staff - cleaners

Article 17 – Medical table
Each mat – one medical team.
Wide table with 2 chairs per each wrestling mat.
First aid material for most common minor injuries.
Basic life support equipment and standard first aid
materials for the most common minor injuries.
Each medical team should include one qualified medical doctor (mat doctor) with one assistant nurses
or technicians, arranged by the OC
Communication among the Members of the Medical Service

Local Medical Staff
Referees
Team Doctors / Physios
UWW Doctor
Local Staff
WADA Prerequisites

Everyone has to know his/her job perfectly!
Everyone has to know who is present on the mat and what kind of role / permission they have!
People must be able to communicate between one another.
Advised signs
Time out request
Stop the bout
Enter (the mat)
Medical Help request
Clean (the mat)
Malingering (simulation)
Wrestler is OK
Bout should be discontinued
Special Issues of Injuries

Taping and bandages – during the medical examination
or call room.
NOT ON THE MAT! not for tv and audience
To get medical approval otherwise do not use
taping!
Referee – role in preventing injuries
Injury
Neck – stabilize the neck
Teeth
Occlusion
Look for it: if swallowed – X-ray of the lungs
Special injuries
Rupture, distorsion
Fractures, dislocations
Shoulder: AC, GH, elbow
Knee cup
Fingers, ankle

Article 4-9
Medical certificate - validity: 1 year (adults)
 Licence includes
Additional Clearance Medical examination
 Medical Booklet / certificate
 3 days prior to Competition
 Highly advisable – not obligate
Medical Clearance
 Entry list – 1 hour before the weigh in
Article 5
The medical examination should include (valid for 1 year)
a. Medical history and past history
b. Family history
c. Complete clinical examination including
• Cardiopulmonary examination
• Orthopaedic examination
• Neuropsychiatric evaluation
• Dermatological examination
d. Routine laboratory examination (venereal disease and AIDS)
e. Functional and ergonomic evaluation

Medical examination - Article 8, 9, 16: UWW doctor + local staff
Entry list – 1 hour before the weigh in
Medical Examination: taping approval

Ask coaches to get medical approval otherwise do not
use taping.
Not acceptable taping

Article 14
Sports Hall must be well prepared with all the necessary
sanitary facilities
Article 16
3 or 4 large rooms are prepared for the medical
examination, equipped with tables and chairs and
adequate space for the pre-competition examination of
the competitors.
Article 18-19
Emergency room with equipment ATLS
Emergency specialist + sport medicine physician
Stretcher + ambulance
Article 21
Wrestling mat must be clean. After each session, mat must be cleaned. If a wrestling mat becomes
dirty during the course of the competition / bout, the referee must stop the competition / bout to allow
the mat to be cleaned and disinfected.
Article 21, 30
The bleeding competitor, the source of contamination, must be attended to immediately.
total injury time of four (4) minutes over the whole duration of the bout
Article 21
Nobody is authorized to step on the wrestling mat wearing ordinary shoes
Article 22
Nails
Beards not less than 5 mm in lenghth
Role of the UWW Doctor

Article 12
the technical delegate together with the appointed UWW doctor must inspect the conditions of
accommodation for competitors. the technical delegate together with the appointed UWW doctor must
inspect the conditions of accommodation for competitors, the food the conditions under which it is
prepared and distributed.
Article 29

If one of the competitors is injured, the UWW doctor on duty can request the officiating body and the
mat chairman to stop the bout.
Article 30
Upon request of the referee, the UWW doctor on duty is required to give an injured competitor
immediate medical assistance. Depending on the severity of the injury, the UWW doctor decides and
gives his opinion to the referee on the ability of the said competitor to continue the bout / competition.
Article 31
Injury report Submit to UWW (Athena)
Article 32
If, in the opinion of the UWW doctor on duty, an official seems physically or mentally unable to work or
if he is found to be under the influence of alcohol or drugs, he is obliged to inform the Technical
delegate and the head of the Officiating Department.

MOST FREQUENT SHOULDER INJURIES IN MEXICAN JUNIOR AND SENIOR
OLYMPIC WRESTLERS, DESCRIBED BY MUSCULOSKELETAL ULTRASOUND
Dr. Francisco Lee
dr.franciscolee@gmail.com
Material and Methods
Inclusion criteria:
 Olympic wrestling athletes with and
without shoulder pain
 Junior male and female athletes 18 to
20 years old and seniors 20 or older
Exclusion criteria:
 Athletes with prior surgical treatment
Elimination Criteria:
 Athletes who do not complete the
assessment tests
 Athletes who want to voluntarily
withdraw from the study.
Descriptive observational analytical study.
Athletes were interviewed to obtain

epidemiological data.
The Shoulder Pain and Disability Index

(SPADI), Spanish version, was evaluated.
Clinical maneuvers were performed for

shoulder examination.
Musculoskeletal ultrasound was performed

with their respective maneuvers.

Results
Discussion
 The most common injury was increased acromio-clavicular joint space
 2 incidental findings of winged scapulae
 With the SPADI Test, we observed that there was disability without pain and pain without disability
 The present study focused on the exploration of the rotator cuff

PRECOMPETITIVE ANTICIPATORY STRESS RESPONSE OF ELITE
WRESTLERS
Farkas Gábor, Dr. Bretz Éva, Dr. Barna Tibor, Dr. Bretz Károly
Testnevelési Egyetem
farkasg88@gmail.com
Goals
We investigated the Hungarian national wrestling team’s anticipatory stress response for highlighted
tournament in 2018 in October at the World Wrestling Championship in Budapest. We compared the results
with the baseline data's what we measured one month before the WC. At the day of the competition when the
wrestlers preparing for the fight it means that the vegetative nervous system’s sympathetic part is activating.
This is the Canon stress. The heart rate is higher and steady the muscular strength is increase thanks for the
stress. Why? Determinants of Sport Performance
Associated with the risk of Injury
Methods and hypotheses

One hour before their first match during the warming up process
Heart Rate analysis: 2 minutes rest EKG (Vicardio)
– Pulse: ↑
– Heart Rate Variability, HRV
• RR-intervals coefficient of variation (SDNN): ↓
• Rate of Low- and High frequency (LF/HF relation): ↑
– Special Vicardio parameters:
• State of heart: ?
• Stress index: ↑
Meassure of muscular strength:
– Strength of Right- and Left hand grip: ? The role of losing weight, conditional trainings,
stress?
Statistic: Two-sided t-test, p = 0,05
Participants
9 female and 22 male
10-10-10 Hungarian National Team
The final sample:
– Heart rate-examination: 4 female, 13 male
– Muscular strength-examination: 4 female, 11 male
The participants didn’t contribute to showing their results with their name.
ViCardio® system was utilized
Pulse

Heart rate
Heart rate (beats/min)
Heart rate (beats/min)
Preparation Tournament’s day Preparation Tournament’s day
RR-interval’s coefficient of variation
LF/HF relation
State of Heart

Stress Index
Strength (handgrip)
Discussion

• In case of female (n=4) only the pulse rate increase was significant
• The anticipatory hypotheses were validated by the results:
– Pulse: ↑ (female: +17/min, male: +25/min)
– SDNN: ↓
– LF/HF relation: ↑
– State of Heart: ↓
– Stress index: ↑
– Strength of hand grip: ↑ (male: +39 N)
• The special Vicardio parameters similar to the classic HRV numbers, there were well presented the
acute stress reaction effect to the heart. However, the average changes corresponded with
characteristics of the stress reaction, there were individual differences.
• The particular competitor’s physiology parameters changes in stress, supposedly has got relevant
effect to the wrestler’s final result.
• Measuring of these effects is not easy, because the result is effected by several other factors,
including technical knowledge, the preparedness of the opponent and the draw.
• Is there a correlation between the ASR and the results?

PREPARTICIPATION MEDICAL EVALUATION: WHY WHEN HOW
josealfredopadilha@uol.com.br
Preparticipation Sports Evaluation (PPE)

“The sports preparticipation physical (or preparticipation physical examination PPE) is a clinical examination
used to evaluate athletes for injuries, illnesses, or other conditions that might increase the risk of harm to
themselves or others when participating in sports.”
Source: British Medical Journal Best Practice, Sports preparticipation physical, last updated Oct. 30, 2017
“The goal of the PPE is to MAXIMIZE SAFE PARTICIPATION: … NOT to disqualify, but to INTERVENE”
Source: Scott Hall, MD: “The Preparticipation Physical Exam”)
Objectives of PPE
PRIMARY OBJECTIVES
• Detect potentially life-threatening or disabling conditions
• Detect conditions that may predispose the athlete or others to increased risk of injury or
illness (this includes evaluating the athlete for sport-specific fitness)
• Fulfill legal, administrative, and insurance requirements, which vary by context and
location.
SECONDARY OBJECTIVES
• Determine general health
• Serve as an entry point to the healthcare system for adolescents
• Provide opportunity to initiate discussion of health-related topics.
Source: British Medical Journal Best Practice, Sports preparticipation physical, last updated Oct. 30, 2017
PPE & High Intensity Sports

Sports are divided in categories according to Risk of Impact (and Educational background):
Impact expected
Impact may occur
Impact not expected
Wrestling figures among those sports with expected impact (comparable to American football, Ice hockey,
Lacrosse, Karate/Judo, Fencing and Boxing, Downhill skiing, Squash, Soccer, Basketball)
Source: “Eligibility and Disqualification. Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Preamble,
Principles, and General Considerations. A Scientific Statement From the American Heart Association and American College of
Cardiology. By: Barry J. Maron, MD, FACC, Co-Chair, Douglas P. Zipes, MD, FAHA, MACC, Co-Chair and Richard J. Kovacs, MD,
FAHA, FACC, Co-Chair. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY VOL. -, NO. -, 2015 ª 2015 BY THE
AMERICAN HEART ASSOCIATION, INC. AND THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 0735-1097
The 36th Bethesda Conference in 2005 elaborated eligibility recommendations for competitive athletes
with cardiovascular abnormalities. Together with the European Society of Cardiology consensus
documents, they form the 2 consensus documents physicians from different parts of the world rely upon.
UWW Medical Regulations Source: UWW Medical Regulations, Article 4

• Medical Examinations and Conditions for Participation in the Competition
• Medical examinations must take place once a year for the senior age group as well as for the junior
and cadet age groups at a medical institution approved and authorized by their respective Wrestling
Federations.
• These medical examinations must be carried out by a specialist in sports medicine or by a sports
medicine institution and are compulsory to obtain an international license delivered by UWW.
• In the veterans age group, special conditions apply regarding medical examinations. They are
described in the UWW General Regulations for the Veteran World Championship.
PPE & High-Performance Athletes

“The high-performance athlete is the athlete who competes on equal terms with the best in his category
and modality, regardless of the sport, dedicating his life to competitive performance. This includes rest,
specific nutrition, periodization and training, often giving up optimal health conditions for what needs to be
accomplished in a given period of preparation.“
Source: Pedro Gama Filho, UWW Bureau Member, CBW President, July 2019

PPE frequency: Once a year.
In high performance sport like professional wrestling, it is advised to conduct a PPE at least 6 weeks in
advance of the start of the competition season to detect any problem and to allow for further evaluation,
treatment, or rehabilitation as needed.
In case of specific diseases (e.g asthma, diabetes,...) the exams should be more frequent. (OBS: TUE)
Ensuring the health of the elite athlete is embedded in the Olympic Movement Medical Code
and pre-participation screening is, among others, recommended by the IOC.
Question: Should PPE be repeated?

No prospective studies shed light on the question whether the sports-medicine pre-participation
examination should be repeated, and, if so, when.
The current literature consistently recommends repeating the PPE as follows:
• every 2–3 years in persons under age 35
• every 1–2 years in persons over age 35, or who have more than one risk factor, or whose
examination reveals an abnormal finding (…)
• persons who have developed new symptoms or signs of disease should undergo an additional
short-term examination.
Source: “The Pre-Participation Examination for Leisure Time Physical Activity. General Medical and Cardiological Issues.” By:
Herbert Löllgen, Dieter Leyk, Jochen Hansel. In: Deutsches Ärzteblatt International | Dtsch Arztebl Int 2010; 107(42): 742–9
The medical examination shall include: (UWW Medical Regulations, Article 5)

• Medical history and past history
• Family history
• Complete clinical examination including:
cardiopulmonary examination
orthopedic examination
neuropsychiatric evaluation
dermatological examination
• Routine laboratory examination, as well as venereal disease and AIDS detection
• Functional and ergonomic evaluation
Suggestions for extra exams

Based on medical history:
Diseases transmissible by blood (such as hepatites C, ...)
Diseases susceptible to vaccination (hepatites B, yellow fever, measles,...)
Cat-scan/MRI post-concussion
AHA:14-ELEMENT SCREENING AMERICAN HEART ASSOCIATION (Maron BJ Circulation 2014)
Medical History
Personal history
1. Exertional chest pain/discomfort
2. Exertional syncope or near-syncope
3. Excessive exertional and unexplained fatigue and/or fatigue associated with exercise
4. Prior recognition of a heart murmur
5. Elevated systemic blood pressure
6. Prior restriction from participation in sports
7. Prior testing for the heart ordered by a physician
Family history
8. Premature death, sudden and unexpected, before age 50 years due to heart disease, in one or more
relatives
9. Disability from heart disease in a close relative < 50 years of age
10. Specific knowledge of certain cardiac conditions in family members: hypertrophic or dilated
cardiomyopathy, long QT-syndrome or other ion channelopathies, Marfan syndrome, or clinically
important arrhythmias
Physical exam
11. Heart Murmur-exam supine and standing or with valsalva, specifically to identify murmurs of
dynamic L ventricular outflow tract obstruction
12. Femoral pulses to exclude aortic stenosis
13. Physical stigmata of Marfan syndrome
14. Brachial artery blood pressure (sitting, preferably taken in both arms)

• Positive/abnormal screen warrants further investigation and 12-lead ECG
• AHA does NOT currently recommend routine 12-lead ECG
THE PHYSICAL EXAMINATION

(Source: British Medical Journal Best Practice, Sports preparticipation physical, last updated Oct. 30, 2017
The physical examination may include:

1. Injury identification: Orthopedic problems (dynamic instability of the shoulders, knees, and ankles),
chronic injuries to the fingers, wrists, feet, and toes and tell-tale scars (previous surgeries or injuries
that the athlete may not be aware of or may not wish to disclose).
2. Risk assessment of existing injury: The orthopedic exam should be focused towards the particular
demands of the athlete's sport as the impact a particular injury may have on an athlete will vary with
the sport involved.
3. Cardiac assessment: Auscultation for heart murmurs, simultaneous palpation of radial and femoral
pulses to evaluate for aortic coarctation, examination for the physical features of Marfansyndrome,
brachial artery blood pressure measurement (sitting position).
4. The AHA does not recommend routine augmented screening with ECG or other cardiovascular
testing as part of the PPE.
5. Dental assessment: Lack of access to routine dental care and lack of regular dental hygiene may
cause serious gingival and periodontal disease. Implications: poorly fitting or uncomfortable
mouthguards, pain, need for urgent dental procedures due to infection, abscess formation, and other
complications.
6. Absence of paired organ: (e.g. blindness in 1 eye, absent testicle
AGE-RELATED SPECIAL ATTENTION

YOUNG FIRST TIME WRESTLERS
Perform a preparticipation history and physical examination and identify children and adolescents
who may be at increased risk for morbidity or mortality from sport participation.
Source: “The Preparticipation Sports Evaluation”, Published in American Family Physician, September 1, 2015 – Volume 92,
Number 5, Table 1, page 373.Written by: Mark H. Mirabelli, MD, and Mathew J. Devine, DO, University of Rochester Medical
Center, Rochester, New York. Jaskaran Singh, MD Brampton, el Mendoza, MD, MPH, MS, University of Rochester Medical
Center, Rochester, New York.
ELDERLY WRESTLERS
Beside physical examination, pre-participation screening of elderly wrestling athletes with ECG and
exercise testing is feasible and recommended in the presence of coronary risk factors or cardiac
symptoms. Echocardiography can also be recommended to detect other relevant abnormalities when
there is a clue in the standard history, physical examination or ECG.
Source: “Pre-participation Cardiovascular Screening of Elderly Wrestlers” by Ali Vasheghani Farahani*1,2, MD; Hossein
Asheri1, MD; Saeed Alipour3, MD; Alireza Amirbeigloo2, MD.10 by Sports Medicine Research Center, Tehran University of
Medical Sciences
ELECTROCARDIOGRAM (ECG)
• The American Heart Association (AHA), the European Society of Cardiology (ESC) and SBMEE all
agree on recommending PPE to be performed on all professional athletes, but there is no general
consensus on recommending ECG.
• Examination in known cases should be requested but it will be a consensus for all PPE's
• Italy, Israel and Brazil mandate national ECG screening for competitive athletes.
• Only Israel, Italy and the US have mandatory national cardiovascular screening for athletes. (Japan
has them for all citizens)
• Denmark has specifically chosen not to mandate national ECG screening, due to perceived low risk.
• Up to 30% to 40% of potentially fatal cardiovascular diseases may have a negative/normal ECG, so
false negatives are a real problem.*
o Source: British Medical Journal Best Practice – Sports preparticipation physical; last updated Oct 30, 2017
• Examination in known cases should be requested but it will be a consensus for all PPE's
ECG + ECHOCARDIOGRAM (CARDIAC SCREENING) SWOT Analysis (strengths, weaknesses,

opportunities and threats)
POSITIVE
Strengths
• Italy has a national screening protocol for PPE of competitive athletes (history, physical exam
and 12-lead ECG), and was able to document a 89% reduction in the annual incidence of
SCD among this group

•
1/3 of the deaths are due to hypertrophic cardiomyopathy (hence the importance of
echocardiogram)
Opportunities
• Anticipate a treatable disease
• Avoid SCD
NEGATIVE
Weaknesses
• False positives*
• › False negatives*
• › Costs
*Obs: The rate of false positives and false negatives has decreased nowadays to levels deemed
acceptable.
*(Source: “Should Cardiac screening be compulsory in athletes”, Nathan Riding & Guido Pieles, in Aspetar Sports
Medicine Journal. September 2019
Threats
• Unnecessary treatment
• Unfair disqualification
• Generate false security
CONTRAINDICATIONS FOR SPORTS PARTICIPATION

 Active myocarditis or pericarditis
 Acute enlargement of spleen or liver
 Eating disorder in which athlete is not compliant with therapy and follow-up, or when there is
evidence of diminished performance or potential injury because of the eating disorder
 History of recent concussion and symptoms of post-concussion syndrome (no contact or collision
sports)
 Hypertrophic cardiomyopathy
 Long QT syndrome
 Poorly controlled convulsive disorder (no archery, riflery, swimming, weightlifting or powerlifting,
strength training, or sports involving heights)
 Recurrent episodes of burning upper-extremity pain or weakness, or episodes of transient
quadriplegia until stability of cervical spine can be assured (no contact or collision sports)
 Severe hypertension until controlled by therapy (static resistance activities, such as weightlifting,
are particularly contraindicated)
 Sickle cell disease (no high-exertion, contact, or collision sports)
 Suspected coronary artery disease until fully evaluated (patients with impaired resting left
ventricular systolic function less than 50%, 2000;61(9):2688
Source: “The Preparticipation Sports Evaluation”, Published in American Family Physician, September 1, 2015 – Volume 92, Number 5,
Table 1, page 373. Written by: Mark H. Mirabelli,
, University of Rochester Medical Center, Rochester, New York. Jaskaran Singh, MD Brampton, Ontario. Michael Mendoza, MD, MPH,
MS, University of edical Center, Rochester, New York.
SUDDEN DEATH
CAUSES OF SCD IN ATHLETES

Congenital/Genetic
Structurally Abnormal Heart
Hypertrophic cardiomyopathy
Arrhythmogenic right ventricular cardiomyopathy
Dilated cardiomyopathy
Congenital anomalies of coronary origin & course
Other cardiomyopathy (i.e., left ventricular noncompaction)
Aortopathy (i.e., Marfan syndrome & ascending aortic aneurysm/dissection)
Valvular heart disease (i.e., congenital aortic stenosis, mitral valveprolapse)

Structurally Normal Heart
Congenital long QT syndrome
Catecholaminergic polymorphic ventricular tachycardia
Wolf-Parkinson-White syndrome or other accessory pathway
Brugada syndrome
Other ion channelopathies
Acquired
Structurally Abnormal Heart
Atherosclerotic coronary artery disease
Kawasaki’s disease
Myocarditis
Structurally Normal Heart

Commotio cordis
Acquired long QT (i.e., drug-induced)
Other substance ingestion or environmental factors (i.e., hypo- or hyperthermia)
Source: “Table 2. Common cardiovascular conditions associated with sudden cardiac death (SCD) in athletes.” p.77. SUDDEN
CARDIAC DEATH IN ATHLETES; Meagan M. Wasfy, M.D.; Adolph M. Hutter, M.D.; Rory B. Weiner, M.D.; Massachusetts General
Hospital, Boston, Massachusetts; MDCVJ | XII (2) 2016
MOST COMMOM CAUSES OF SUDDEN DEATH IN ATHLETES
1. Hypertrophic Cardiomyopathy
2. Coronary Artery Anomalies
3. Commotio Cordis
4. Possible Hypertrophic Cardiomyopathy
5. Myocarditis
6. Arrhythmogenic right ventricular
cardiomyopathy (ARCV)
7. Other
Source: British Medical Journal Best

Practice –Sports preparticipation
physical; last updated ct 30, 2017

SUDDEN CARDIAC DEATH & PREVENTION
1. The value of any screening test is determined by the characteristics of the population to which it is applied.
As demonstrated above, the incidence and causes of SCD vary widely depending on the age, gender, race,
country, and sport of the athlete group. Therefore, it is unlikely that any single screening program will be
effective across all groups. Issues such as resource utilization and cost-effectiveness also must be
considered.
2. In summary, the role of the ECG in preparticipation athlete screening remains unclear, and athletic
programs should consider using ECG-inclusive screening based on the characteristics of their athlete
population, the local screening resources available, and access to expert ECG interpretation specific to
athletes.
3. It is critical that downstream testing, which can include cardiac imaging, exercise testing, and
electrophysiological evaluation, is delivered and interpreted by physicians (typically cardiologists) who
understand the cardiovascular adaptations to exercise training and resultant physiologic changes in the
heart’s structure and function—the so-called “athlete’s heart.”
Source: SUDDEN CARDIAC DEATH IN ATHLETES; Meagan M. Wasfy, M.D.; Adolph M. Hutter, M.D.; Rory B. Weiner, M.D.;
Massachusetts General Hospital, Boston, Massachusetts; MDCVJ | XII (2) 2016, p78.
Conclusion:
No method exists by itself. UWW rules should be followed and screening methods be added in case of
suspected need.
This evaluation should be based on geography, predisposition, good personal and family history, and
additional examination if the suspicion is founded.
CONTROVERSIES IN PPE
Source: British Medical Journal Best Practice – Sports preparticipation physical; last updated Oct
30, 2017
QUESTION: Do we need to include more exams for:
1. Cardiovascular testing?
• Data do not indicate that screening echo in the young athlete population is of demonstrated
• benefit. Other techniques have been shown not to be cost-effective for mass screening of young
• athletes.
• Certain cardiac abnormalities do not become phenotypically apparent until later in life. The
• potential danger of such a false negative result should not be underestimated.
• Despite the lack of beneficial data, it is possible that screening echo (like screening ECG) may
• become more commonplace in the future.
2. Anemia?
The usefulness of routine laboratory tests as part of the PPE has not been shown, but there are
data suggesting that screening for iron deficiency and anemia may be cost-effective in high-risk
athletes.
3. Sickle Cell?
Screening for sickle cell trait in high-risk populations has been associated with an increased risk
of lysis and sudden death during periods of intense exertion, especially in extreme environmental
conditions.

4. Prior concussions?
• Requirement for athlete with case of prior concussion(s) to present results of CT-scan, MRI, …
during next PPE.
• Use of bedside and formal neuropsychological testing to evaluate for persistent concussion-induced
deficits.
• Perform a baseline neurologic evaluation, including neuropsychological testing, as part of the PPE
in athletes at high risk for concussion (contact athletes, athletes with multiple prior head injuries).
THE CHALLENGE OF PPE

Unify the medical standard of PPE in countries with distinct cultures, economic conditions, social
realities, health systems, and support for wrestlers and a different local interpretation of sports
medicine.
185 different countries are affiliated to UWW.
 The mission of sports medicine is to care for and preserve the health of athletes, minimizing the risk
of sudden death that arises from causes that are detectable.The PPE is a very important instrument in
this process.
 UWW recommendations should be followed at all times.
 UWW could seize the opportunity and create a commission of UWW doctors to discuss and elaborate
a UWW standard for PPE for wrestling athletes that participate in UWW competitions.
 Special attention is needed to contagious blood diseases and prior concussions.
 It is important to educate health care professionals to correctly interpret screening results.

WRESTLING INJURIES; FACTS AND FIGURES, PAST, PRESENT &
FUTURE
Babak Shadgan, MD, PhD
President of UWW Medical, Prevention & Anti-Doping Commission
shadgan@gmail.com
INJURY; is a barrier for sport participation and development. Therefore, sport organizations need to
have a good understanding of nature, specifications, patterns, risk factors, and mechanisms of injuries in
order to prevent sport injuries, and promote the sport.
UWW Wrestling Injuries Surveillance Program

• Started at 2004 Athens Olympic Games
• By direct observation and recording all injuries during competitions
• UWW-MC cloud-based injury surveillance system started from 2016 Rio
Information
• severity, type, site, mechanism of Injury
• injury vs. style, sex, age, weight class, timing
Definitions:
Injury
Any musculoskeletal or soft tissue complaint incurred during the competitions, that required
medical attention regardless of the consequences with respect to absence from sport.
Injury Incidence
Number of new occurrences during competitions:
• number of injuries / 100 athletes
• number of injuries / 100 match
Injury Severity
• Mild Injuries fully treated on the mat.
• Moderate injuries treated primarily on the mat but needing more attention after the
competition, by which injured athletes were referred to the venue clinic.
• Severe injuries resulted in termination of the match; injured athletes were referred to the hospital.
2016 Rio Wrestling Competitions UWW-MC Injury Surveillance Study

Results
Overall incidence:
22 Injuries in 352 Athletes – 410 Matches
• 6.2 injuries per 100 athletes (6.2%)
• 5.4 injuries per 100 matches (5.4%)

Injuries vs. Styles
Women’s freestyle had the lowest injury
rate
Injury rate: 7.1% in men; 4.4% in women
Age vs. Injuries

Wrestlers between 24-28 years old
showed more injury.
Weight (kg) Injury#
48 2
58 1
59 1
Injuries vs. Weight-Class 65 1

More injuries were observed in the middle-weight categories.
66 2
69 1
74 4
75 4
85 1
86 1
97 2
98 2

Injury Types
The most common injury type was skin laceration and contusion
(54.5%) due to direct contact.
Injury Sites
The most common sites of injuries were the face and head
(72.8%) followed by shoulder and knee joints.
Injury Severity
54.5% of all injuries were classified as mild,
27.3% as moderate and 18.2% as severe.
• 4 matches were terminated

Injury Timing
45.5% of all injuries occurred at 1/8 final;
18.2% of injuries were recorded at the Final
matches.
WRESTLING INJURY RATES OVER LAST 4 OLYMPIC GAMES & IN COMPARISON WITH OTHER
SUMMER OLYMPIC SPORTS
Wrestling Injury Rates, 2004 – 2016 Olympic

Games

Conclusions
• No catastrophic injury was recorded during 2016 Rio Olympic wrestling competitions.
• Olympic wrestling injury rate shows a reducing trend.
• The rate of joint dislocations is still high.
• Wrestling compares favorably with other sports on the Olympic program.

MUSCULOSKELETAL INJURIES, MECHANISM, RESULTS &
PREVENTION
Dr. med. Loukas Konstantinou
Medical, Prevention, anti-Doping Commission UWW

Greek Wrestling Federation
Medical School University of Athens/GR
sportsclinics@hotmail.com
MUSCULOSKELETAL INJURIES
Multimodal aspect of the trauma
Complex modus
Movement/strength/balance/
technique/self-control/weight/age
Definition mild-severe injuries
Short term - long term results
Rehabilitation
Prevention
Wrestling, what are the common injuries?

Difference between what Wrestling professionals think and general public
Importance of the public work
Shoulder Neck
Elbow
knee
Head/face
Statistics, trying to get an overview

• the majority of the injuries are mild (88,5%)
• Short time therapy
• Mild skin injuries and contusions in the face and head area (58,8%).
In general
• the knee joint (12,9%)
• the elbow (6,7%)
• Αffected neighbour-joints
Example, possibility of a complex injury

- shoulder instability after multiple trauma
-recurrence of cervical pain
Main role the early training
Common injuries
Definition of the diseases
speaking about the same thing
• Contusion, ligament injury
• Distortion, ligament bone cartilage damage
• Skin injuries-Epistaxis (Taping, Pressing bandages)
Contusion
• A step before fracture?
• Haematoma
• Change of the microstructure of the bone
• Soft tissue edema
• Bone edema
• Aseptic bone necrosis after repeated trauma
• Influence on the blood supply of the bone

seldom severe injuries
• Severe affections maximal 11,5
%
– Joint luxation, reposition (patella, elbow, finger)
– Deep/wide face skin injury, stiches, wound care
– Ligament or tendon rupture
– Thorax contusion, rib fracture, x ray control, pneumothorax
– Contusion, severe pain knee, elbow
– Distortion ankle joint
Still low frequency of severe health affections

• Compared to other sports disciplines, which are classified as “not so dangerous” in common
language, is our sport Wrestling, especially through the body education from the early childhood
not a risky and dangerous sport discipline and indicated for every age.
Prevention 1
• Strength and Stabilization exercises in the most affected joints
– Medical doctors
– Physiotherapists
– nutritionists
Athens Cadet World Ch. 2017

57 (90,5%) non severe (frequent mechanism of affection)
– Head/face skin lac., epistaxis 31 (54%)
– Arm shoulder contusion 3 (5,2%)
– Wrist/hand distortion 3 (5,2%)
– Elbow contusion 5 (8,7%)
– Thorax contusion 3 (5,2%)
– Hip contusion 1 (1,7%)
– Knee distortion 5 (8,7%)
– Ankle distortion 3 (5,2%)
90.5% participation of affected areas with

non severe injuries-Athens
Athens Cadet World Ch. 2017

6 (9.5%) severe injuries incl.moderate
– Male: MCP/Dig III prox. phalanx Fracture, immo.
– Female: Luxation left elbow, reposition
– Male: distortion left ankle
– Male: Nausea
– Male: Anaphylactic reaction, iv therapy
– Male: wide face skin laceration, stiches
83.4% during competition 16.6% other

Athens Cadet World Ch. 2017-
Severe injuries
% Severe–non-severe injuries-Athens
Trnava Junior World Ch. 2018
87.7% participation of affected areas with

non-severe injuries-Trnava

Trnava Junior World Ch. 2018
Trnava Junior World Ch. 2018-Severe

injuries
% Severe – Non-severe injuries Trnava
Bucharest Senior European Ch. 2019

87.7% participation of affected areas with non-
severe injuries-Bucharest

Severe injuries
% Severe – Non-severe injuries Bucharest

2019

Injury during competition or training
Mostly male athletes became severe affected during competition or training

• Are female athletes more careful?
• Does weight or age play a role?
• What is the limits of permission to wrestle?
– An example (Veteran, man, final match BP 180/100, Pulse 88/min, allowed)
Past evidence
• Differences between statistics in injury reports
• Depending on School, College, Sportsclub
• Example study 2000
– Shoulder 24%
– Knee 17%
– Neck/spine 11%
– Foot/ankle 11%
– Hand/wrist 11%
– Head 8%
– Elbow 7%
– Leg/femur 3%
Necessary Prevention
Example shoulder
– Diagnostic steps, qualification med. Doctor, physiotherapist, trainer
– Flexibility
– Strength
– Shoulder neck area, neighbour muscle groups
– Coordination
– Endurance
Sec.example Junior Ch. 2004

(literature)
• Skin injuries 15%
• Contusio29%
• Muscle strain 11%
• Epistaxis 8%
• Luxation 5%
• Fracture 3%
Frequent affections of low severity

• Athens (Cadet)
– Face (lacerations, wounds, epistaxis) 54,4%
– Elbow (contusion) 8,8%
– Knee (distortion, contusion) 8,8%
• Trnava (Junior)
– Face (lacerations, wounds, epistaxis) 75%
– Knee (distortion, contusion) 14%
• Boucharest (Senior)
– Face (lacerations, wounds, epistaxis) 65,6%
– Elbow (contusion) 7,8%
– Knee (distortion, contusion) 10,9%

Frequent affections of low severity
similar results in Cadet, Junior, Senior
Championships
Epigenetic features: do they play a role to the

beginning of arthritis in sports?
ParadeigmataPalaiopathologyidiopathic predispositionto degenerativechanges in sports?
Skoliosis Predisposition
•Early diagnosis
•Muscle nerve disbalance
-dominant body side
-Bone Muscle assymetry
Tendency to develop musculoskeletal diseases like tendopathy, apophysitis, lower back pain, inguinal pain
Mostly non-surgical strategies necessary in competitive Wrestling

•Skin wound care, disinfection, bandaging
•Cold elements use
•Ligament injury Taping
•Analgesics, pharmaca
•Local injections mostly xylocaine
Lower frequent appear surgical therapies

skin laceration care, stitches
Reposition of luxated joints, elbow, fingers interphalangeal joints
operative Tendon reconstruction (Achilles tendon)
Low Number of Surgical intervention or hospital transfer in all three Championships

•Under 10% stitches
•3 transfers to the hospital
•One fracture finger
•One MCP I lux. and 2 elbow lux.
•One indication to surgery knee severe ligament injury junior female during competition
Wrestling is not a dangerous Sport

•Researching the tendencies concerning the art and frequency of sports injuries in wrestling
•Necessary long term comparisons to further results
•An example: 1995 Injury frequency
in wrestling in D. 0,71/1000
In Volleyball 29/1000
Prevention 2
•Excellent hygienic conditions on wrestling mates, athletes rooms and clothing
•Education
Prevention3
•controlled vaccination against infectious diseases like Hepatitis B
•Controversial discussion about vaccination
Interaction
•focused teaching of behavioural strategies for participants, athletes, trainers and referees
– wound contagiousness

•Hepatitis B , HIV
– controlling of aggression in play
Anthropological aspect
•Behavioural differences in acting reacting, consideration of the group or the public
•Aggression before, during, after the match
•Education regarding injury mechanisms and self-perception
•Learning to “hear the own body”
•Learn to respect the opposite athlete, group
Aggression self control in different disciplines

•Men
•Women
•Age groups
•Training
•Official Championship
•Retrospective and prospective interaction with trainer, referee
Morphology
•Morphognosy: study of certain features based on prepared schemata
•Typognosy: study of the whole phaenotypic picture of the person (statistic Typognosy)
Morpho diagnostic Methods Anthropological research

Morphologic Comparison, examples in the Forensic Anthropology
Diagnostic of body changes in diff. age groups
Human Ethology in sports

•Definition-Biology of the Human Behaviour (EIBL-EIBESFELDT
1984)
•Traditional physiology of behavioural characteristics
•Ecological, Genetic, Phylogenetic parameters
Research in Communication / Mimetic Individual-Social parameters (Observation/documentation)
Giving special Importance to certain points from the Doctor’s side

• Medical plan concerning equipment for National and international Championships
• Early inspection of the training rooms, medical control room, Hygienic status, cooperation with
local ambulance and local hospital.
• Interaction with the medical staff, concerning qualification, experience capacity, reliability
• Interaction with UWW members, referees

RISK OF BLOODBORNE INFECTION TRANSMISSION IN WRESTLING
Dr. Reza Naghavi MD FROM FHEA
Consultant in Occupational Medicine &

Honorary Senior Lecturer – Queen Mary University of London
Hamidreza_naghavi@yahoo.com
Risk to Health Care Worker

• Occupational exposure to HBV, HCV & HIV in healthcare workers:
• Percutaneous exposure: needlestick injury
• Mucocutaneous exposure: broken skin or mucous membranes e.g. eyes
• Other route of transmission e.g. sexual contact
Risk of transmission from patient to HCW after percutaneous injury:

• HBV Up to 30%
• HCV 1-3%
• HIV 0.3%
Lower risk after mucocutaneous exposure: for HIV 0.1%
Exposure to bloodborne viruses in athletes

• Risk of transmission from bleeding wound to broken skin or mucous membranes of other athlete
• Higher risk in contact sports e.g. boxing , wrestling (prolonged skin contact)
• Higher risk of transmission for HBV (more stable in the environment and can survive outside the body
for 7 days
What we know about wrestling?

JAMA. 1982 Jul 9;248(2):213-4.
An outbreak of hepatitis B in members of a high school sumo wrestling club. Kashiwagi S, Hayashi J,
Ikematsu H, Nishigori S, Ishihara K, Kaji M.
In a one-year period hepatitis B developed in five of ten members of a high school sumo wrestling club in
Japan. Source of infection was traced to a sumo wrestler with HBV, and the transmission of the virus was due
to skin contact while wrestling.
Br J Sports Med. 2007 May;41(5):306-10.

Risk of hepatitis B infections in Olympic wrestling.Bereket-Yücel, S.
• 9 (13%) of the wrestlers had OC‐HBV infection (HBV DNA in serum)
• 8 (11%) of the participants had HBV DNA in their sweat.
• In addition to bleeding wounds and mucous membranes, sweating may be another way of
transmitting HBV infections in contact sports.
• Recommendations:
An HBV test should be done and each wrestler should be vaccinated at the start of his career.
Hepatol Res. 2014 Oct;44(10):E267-72.

Sequential occurrence of acute hepatitis B among members of a high school Sumo wrestling club.
Bae SK1, Yatsuhashi H, Takahara I, Tamada Y, Hashimoto S, Motoyoshi Y, Ozawa E, Nagaoka S, Yanagi K,
Abiru S, Komori A, Ishibashi H.
- 2 cases of acute hepatitis B admitted to hospital
- Both Sumo wrestlers from the same club
- A coach was HBsAg+
Prevention strategies:
• Education
• Hepatitis B vaccination in contact sport
• Prompt detection and management of wounds
• Dressing of wounds, abrasions and cuts
• Clean blood contaminated wrestling mat (one part household bleach to 10 parts water). Gloves
should always be used when cleaning up any blood spills.
• Medical team should follow WHO standard precautions to prevent exposure to blood and body fluids.
https://www.who.int/csr/resources/publications/EPR_AM2_E7.pdf

SPINE INJURIES IN WRESTLING
Johann Klaus MD
ringerdocjohann@klaus-johann.com
Spine injuries in wrestling, overview and prevention

Anatomy
In this picture you see the bone structure of the spine. The sagittal alignment shows us an double S, which
helps to compensate shocks and give us more mobility.
• Cervical 7
• Thoracic 12
• Lumbar
Between two vertebra we have the disc, a shock absorber, Holden by the anterior and posterior ligament. the
passive and active dynamic stabilizer are the intervertebral ligaments and muscles, also the abdominal
muscles. The intervertebral joints control the movement. All structures secure the spinal cord.
Two vertebrae with disc and the part of spinal cord and the
nerve root such us the facet joint is called one motion
segment of “Junghanns”
This diagram shows us the possibility of three-dimensional motion with

extension, flexion torsion, also compression and distraction and lateral
bending.

You see here the load of compression directly of the spine, how strong the spine segment is, but if you flex by
eccentric compression, we can only stabilize an small part of this weight. This is the reason we need a good
formed musculature around the spine stabilizing forced power from all directions.
In Germany we see 1-1.5 million sport injuries per year. The part of peripheral nerve or spinal cord injuries
moves between 23 and 43%. Spinal cord injuries are distributed 42% vertical, 31% thoracic and 27% lumbar.
The newspaper Süddeutsche reports in 2015 1800 cases of cross section paralysis.
We have two big classification of fractures of the spine. The AO classification explains the type by grade of
stability with participation of the structures, also the direction of instability. This classification shows you the
formation of injury, so you can better comprehend, what can happen, in wrestling for example.
Takedowns with flexion can cause compression fractures ventral or ligament injuries dorsal.
Takedowns or throws with hyperextension can cause disc ruptures, vertebral fractures or in combination with
rotational load all of this with large dislocation and consequently with tear of spinal cord.
This picture shows you

the distribution of sport
injuries of the spine, 67%
concerning the
thoracolumbar area.
There are approximately
75% stable.
The literature distinguishes in various risk of sports. Gym, row, judo and wrestling are high risk sports.

Neck Injury
• takedown with driving in his Opponent
• Tearing on the head
• Stand up from headlock (Opponent)
• hyperextending
• Hyperflexion
The risk of injury on the neck is very variable. All throw
could be a risk, also standup from headlock as opponent,
all throw from down position.
Lumbar Spine injury

• 4- or 5-point Throws
• takedowns
• Hyperextension
• Hyperextension and twisting
• Hyperflexion
All throws with hyperflexion or hyperextensions are able
to tear the thoracic and lumbar spine, especially by
additional twisting the body.
Catastrophic Injuries to cervical Spine

• rotational
• axial blow
• Twisting the neck without resistance
Therapy
• Clinical examination (don‘t move)
• Testing pulse and peripheral motion (neurological deficit)
• Stabilization in place
• Transport to hospital
Most of minor injuries of the spine based on muscle or tendon strains. The therapy is symptomatic with cool,
compression, rest, analgesic drugs later physical therapy. Intervertebral blockade should be treated by
chirotherapy physiotherapy, injections or symptomatic analgesic drugs.
• Mostly minor injuries of Muscle and tendon
Symptomatic Therapy
• Often invertebrate blockade
Chirotherapy, injection

Stable fractures of the spine should be treated by rest, analgesic drugs, corset, later physiotherapy. Return to
wrestling maybe after 3 months. Unstable fractures need normally an operation with stabilization of the spine,
also by neurological deficit decompression of the spinal cord.
In a variety of prospective and retrospective epidemiological studies of wrestling injuries, neck injuries were
0.8–14.9% of the total number of Trunk and Spine. Low back injuries have comprised from 1.2 to 18.6% of
total wrestling injuries in prospective and retrospective studies.
Estwanik et al. [16] also noted that 25% of the wrestlers in his study presenting with back pain had
spondylolysis or spondylolisthesis; 58% of his patients were diagnosed with lumbar strain. Rossi and Dragoni
[36] reviewed the radiographs of 3,132 athletes aged 15–27 who were evaluated for low back pain over a 26-
year period. Wrestlers with back pain had a 29.8% prevalence of spondylolysis (17 of 67 wrestlers).
Prevention
•Referee? Recognizing dangerous situations in their making
•Equipment? small effect
•Mat
attenuation
elasticity
The best prevention to protect the spine is a good trained musculature of the problem areas
cervical. and lumbar spine. Neck muscles, trapezius altissimo, spinal erectors on the back side,
abdominal muscles in the front has to be stabilized. This could be with calisthenics, weight training,
core stabilization’s by sling trainer and more. Also necessary is the education of flexibility of the
spine with stretching, yoga, mobilization.
Case Studies
A young wrestler (15) complains neck pain. No x-ray, only mri would be primary done. Nothing found. By
constant pain x-ray shows a spondylolytic pars interarticularis. Dorsoventral stabilization had to be made. Only
100 cases of cervical spondylolysis have been presented in the literature.
Zentralbl Neurochir. 2008 May;69(2):96-8. Cervical spondylolisthesis C6-C7 in a young wrestler: case report.
Pitzen T, Johann K, Steudel WI, Fritsch E.
Disc Prolapse: Young female wrestler complained about neck pain after successfully European
championships with play and power deficit left hand. Disc prolapse was found. After stabilization and 8 weeks
of rest she returned to sport, after 12 weeks to wrestling
Avulsion of the rear longitudinal ligament After attack two legs by German youth championships a
young female wrestler complains about back pain and palsy in right leg. Prompt stop, clinical
examination and transport to hospital in fixed position. We see an avulsion of the rear ligament with
small spinal cord compression. By missing deficit of power conservative treatment with corset, rest,
and physiotherapy.
Conclusion
• 0.8-18% of injuries by wrestling
• Mostly minor injuries
• Fixed first aid therapy
• Prevention by stabilization of the spine and flexibility training needed

WORKSHOP: MAT-SIDE INJURY MANAGEMENT
Dr Amir Pakravan
Consultant in Sport, Exercise and Musculoskeletal Medicine
a.pakravan@uos.ac.uk
PURPOSE OF MAT-SIDE MEDICAL CARE

• Immediate medical care on FOP
• Identifying and acute management of serious issues
• Prioritisation of athlete safety
• Organising further care and hand-over
• Liaise with teams, referees, organizers, …
FOLLOW A BASIC STANDARD WELL-REHEARSED APPROACH
PRINCIPLES OF ORGANISATION
Medical plan in coordination with local hospitals and emergency services:
• Level of Service provided Mat-side and at the venue
• Procedures for extrication and transfer
• Local Emergency Services, Local contacts, Hospital services available, Routes
Medical Team members:

• Numbers, Qualifications, Experience, Role specific
• Dr(s), Physio, Paramedic, First aider, Stretcher Crew, …
• Others: Coaching and technical staff, Stewards, …
Preparations:
• Medical room
• Equipment and Medications
• Team Briefing & Practice of acute scenarios
• Liaise with participating teams, technical staff, organizers, …
PERSONAL CHARACTERISTICS
• Advanced Trauma and Resuscitation skills, and training
• Scope of practice and awareness of own limitations and capabilities
• Awareness of the team’s capabilities & appropriate delegation of roles
• Teamwork / leading qualities & Communication skills
CHALLENGES
• Focused and confident in Decision making under pressure:
• Life, death, serious disability, career defining
• Athlete’s safety over competition pressure, coaches and support staff
• Crowd, media, colleagues, …
• Documentation
“A© BCDEFG” APPROACH!

Mechanism of Injury (MOI)
• Airway: Assessment, Secure, Airway modalities
• C-Spine: MOI, Assessment, Immobilize and secure
• Breathing: Assessment incl pattern, O2, …
• Circulation: Assessment, Sources of bleed, stabilize,
• Disability: HI and LOC, Concussion,
• Exposure: limb injuries, secondary survey, pain management
• Don’t Ever Forget Glucose!
POSSIBLE SCENARIOS
MSK & limb injuries:
• Sprains and strains
• Cuts, lacerations
• Dislocations
• Bony injuries and fractures
Assess, Acute management, Immobilization, Pain management

POSSIBLE SCENARIOS
Spine injuries:
• Mechanism of Injury (MOI)
• Immediate immobilization (MILS).
• On mat assessment (if in doubt proceed to full immobilization)
• Log roll, full immobilization, safe transfer
Cardiac Arrest:
• Collapse without contact/Blunt chest trauma (Commotio Cordis)
• Immediate assessment
• Immediate resuscitation
• Early defibrillation (AED)
• Reversible causes? (4Ts & 4Hs)
Head Injury & Concussion

• Significant chest trauma, Tension Pneumothorax
• Long bone fracture, pelvic fractures
• Organ injury, retroperitoneal bleed
• Fitting, Severe Asthma Attack, Anaphylaxis, …
SPECIAL CONSIDERATIONS
“A© B C D E F G” Approach to organization, preparation, and management
• Airway kills First!
• Precedence over everything else
• O2 always helps
• Ask / Shout for HELP early!
• You are not on your own, use and mobilize other people
• Call for ambulance early
• Don’t be distracted by apparently more dramatic injuries
• Follow the steps
SPECIAL CONSIDERATIONS
Dynamic process
• Reassess progress after every intervention
• May need to go back to “A-B-C” again at any point
• If in doubt, choose the safest options
• MILS
• AED
• Communication
• Clear, Firm and Assertive
• Lead or assign a leader in advance
• Debrief the team afterwards and give yourself time to recover!
PRACTICAL WORKSHOP
• Overview of Airway assessment, Airway maneuvers, Airway Adjuncts, breathing assessment, Use of
Pocket Mask, Use of Bag Valve Mask
• Overview of BLS, Use of AED, principles of ALS
• Scenario Practice: Cervical Spine Injury; Cardiac Arrest; Limb Injury

SKIN CONDITIONS IN WRESTLING – HOW TO PREVENT
Krisztián Gáspár, MD, PhD
University of Debrecen Faculty of Medicine

Department of Dermatology
Debrecen, Hungary
nurk7@freemail.hu
Skin Barrier
Danger model:
”The basic function of immune system is not to distinct between self and non-self, but to recognize danger.”
In order to avoid or prevent a loss on the mat you need a good defense –The same is true for skin
(an active defense)
Polly Matzinger, PhD, Immunologist, NIH
Skin barrier functions

Physicochemical barrier and immunological barrier – in close morphological and functional connection.
Physicochemical barrier Stratum corneum:
corneocytes
• Stratum granulosum: keratinocytes
• Cornified envelop, structural proteins
(filaggrin)
• Lipid layer, proteases, protease
inhibitors, defensins
• Tight junctions, corneodesmosomes
Immunological barrier (SIS)
• Epidermis, dermis
• Keratinocytes, dendritic cells, T cells
• Defensins, cytokines, chemokines
Physicochemical barrier
Genetics
Environmental factors
• microbes (viruses, fungi, bacteria, parasites)
• physical factors (e.g. UV, humidity, scratching)
• chemicals (e.g. irritants)
• biological factors (allergens)

Elements of intact and impaired physicochemical barrier in the case of Atopic Dermatitis
Atopic Dermatitis
• Chronic, non-contagious inflammatory skin disease.
• Dry skin, pruritus, possible superinfections (>90% S. aureus colonization).
• Prevalence in Europe in children 15-25%, in adults 2-10%, continuously increasing.
Possible Prevention Techniques

• Avoidance mechanisms (specific and non-specific triggers, provocation factors) (?)
• Diet, probiotics
• Continuous emollient use
• Complex treatment in AD is unavoidable and inevitable in both acute and chronic form of disease.
• Helps in rehydration of skin, decreasing skin dryness.
• Replaces essential fatty acids locally.
• Increases skin elasticity. Decreases tension and itch of skin. Cleaning effect.
• Daily min. 2x in case of symptoms and 1x daily for preventive reasons
• Whole body use
Emollient therapy in AD
Emollients right after shower (~5 min; ~27 Celsius), after gentle drying (skin still moist).
• Long effect even without shower.
• Allergens in emollients must be avoided to prevent sensitization via skin.
• By its water-binding elements (e.g. urea, glycerol, hyaluronic acid) it hydrates stratum corneum
• Occlusive characters (lipid, fat, oil contain) TEWL decreases
• Further effects: changes microbiome and pH; increases AMP level; FLG and loricrin expression
• increases; T cell and DC infiltration decreases; antifungal, anti-pruritic, anti-inflammatory effects
Skin diseases in wrestling

• •Trauma
• •Eczema (contact dermatitis)
• •Infection (fungal, bacterial, viral, parasitic
Contact dermatitis
• Heterogeneous group
• Noninfectious inflammatory dermatoses in which the pathological changes in the epidermis and the
upper dermis produce distinctive clinical pictures
• Extremely common, 15-25% of patients with skin diseases
• Occupational dermatosis (No1)

Treatments in general
• Conventional medicine must be recommended and prescribed by physicians or health care
professionals.
• Wrestlers not reporting a skin condition/infection and using unusual and unhealthy treatments (e.g.
nail polish remover, bleach, salt, vinegar solutions) are causing unwanted adverse events (e.g.
suffocate or burn an infection, leaving extensive scars).
• ”Home remedies” – may be successful, but do not guarantee to kill the infection (only eliminating
visible symptoms temporarily). Thus, infections may not be symptomatic, but still remain
transmittable.
• Define etiology, classification
• Eliminate provoking factors
• Restore epidermal barrier function
• Moisturize
• Anti-inflammatories, immunosuppression (topical corticosteroids, topical calcineurin inhibitors)
Acronym: DERMA (skin)
SKIN INFECTIONS IN WRESTLING
Fungal
• Direct contact
• Indirect sources (mats, headgear, towel, uniform)
• In scalp may get deeper lesions
• Tinea corporis gladiatorum;
• Athletes foot; jock itch; ringworm
Treatment
• Topical – cream, ointment
Once a day; Do not cover;
7-10 days
• Systemic – tablets, capsules
- Extent forms of disease
- Scalp involvement
- Until total clearance (weeks)
• Combination
• In recurrent cases antifungal prevention may be possible
Bacterial
• Folliculitis, impetigo, erysipelas, cellulitis
• Streptococcus pyogenes; Staphylococcus, aureus; Pseudomonas
• Contagious (crust covered erosions)
• Itch
• Direct contact
• Predisposing factors (shaving, haircut, eczema), primary sites (head, extremities)

Folliculitis Impetigo
Treatment
- Topical antibiotics, disinfectants
- Once a day;
- Remove crust;
- Cover;
- 7-10 days
• Systemic – tablets, capsules
- Antibiotics (in prevention not possible – resistance)
- Extent forms or systemic symptoms
- 7-10 days
• Combination
Community Associated Methicillin Resistant Staph. Aureus (CA-MRSA)

• Looks identical to other forms of S. aureus, but different strains. Irresponsive to regular antibiotics
(e.g. Penicillin), but not multidrug-resistant
• Seen in community; believed due to antibiotic abuse/overuse for ear infection or viral infections
• Very invasive and destructive to skin and soft tissue
• Can spread to the lungs causing serious pneumonia
• Can only be diagnosed by culturing an infection
• When it occurs, usually seen as an abscess or boil (59%) vs cellulitis
(42%) or folliculitis (7%)
• Primarily seen in contact sports (wrestling, rugby)
• Clindamycin (4x300mg) for 10 days; incision and drainage
Viral – herpes
• Latent virus (cluster)
• Contagious (30% chance to contract)
• (vesicles, open sores, early crusts)
• HSV-1, HSV-2
• Painful
• Lips, body, genitals
• Recurrence (stress, immunocompromised)
• Secondary bacterial superinfection
Herpes gladiatorum
• Prevalence: 3-20% (varies in age groups)
• Primary outbreak: malaise, pharyngitis, fever, lymphadenopathy
• Primarily at ”lock-up” position: 70% head and face; 40% extremities; 30% trunk
• Skin-to-skin contact
• 3-8 days after contact, lasts for about 10 days
• All wrestlers in contact with it, should be isolated and monitored for 8 days. If no lesions develop,
return to competition
Treatment
 Not so effective
• Systemic – Acute
 Start within 3 days
 Acyclovir 5x200mg for 7-10 days (even longer)
• Systemic – Recurrence

 Min 3x in 6 months
 Acyclovir 2-3x200mg or 2x400mg for 6 months
• Preventative antiviral medication may be possible starting five days before the season and
continuing throughout the season. Prophylactic valacyclovir (QD 1g) for 1M in wrestlers resulted
in 85% decrease in the probability and 90% decrease in the incidence of outbreak.
Viral – wart, molluscum

• HPV; Pox virus
• Direct contact
• Contagious until removed
Treatment
• Topical – exfoliative
- Salicylic acid
• Topical – cytostatic
- Podophyllum
• Topical – immunomodulatory
- Imiquimod
• Surgical
- Liquid nitrogen
- Electrosurgery
- Curettage
- Laser (ablative)
-
Parasitic –scabies, lice
• Direct contact
• Intense pruritus
• Predilection areas (neck, hands, genitals)
• Contagious until treated (STI!)
• Eczema remains
• Possible superinfection
• Benzyl benzoate; Permethrin
• Appropriate treatment (3-5-14 days depending on the disease)
• No new lesions present (for 2-3 days)
• Proper bandage (cover)
Preventions in skin infections

• Utilize recommended procedures for cleaning and disinfection of surfaces. Clean workout gear,
clothes, towels for each practice. Mats must be cleaned before each practice with appropriate
disinfectant.
• Regular skin check (performed every day before practices) (visual enough no palpation necessary)
• Improve wrestlers’ hygiene practices
• Shave your face only (otherwise opportunity for infection)
• Wrestlers must shower immediately after practice (nearly 10% do not!)
• Coaches and trainers must be educated on skin infections
Skin examination and rules

• At wrestling meets, skin must be checked by medical experts or trained referees.
• Any skin condition must be stated non-infectious, adequately medicated and covered with bandage.
• Wrestlers must have developed no new lesions 72 hours prior to examination.
• Open wounds and infectious skin conditions that cannot be adequately protected are considered
grounds for disqualification (from both practice and competition).
• Wrestlers undergoing treatment must provide written documentation from a physician (diagnosis;
culture results - if possible; date therapy began; names of medications.
Conclusion – Take home message

• Skin infections may be significant problems in wrestling
• Look after your environment (clean equipment)! Protect yourself of harm/danger (danger model)!
• Keep the barrier intact! Prevention by moisturizing
• Prompt and proper diagnosis by specialist dermatologist inevitable in case of dermatological disorders
• Isolation and observation of individual
• Targeted treatment if necessary (avoid ”home remedies”)
• Importance of withdrawal of wrestler’s permission from competition

CAN I PROTECT THE WRESTLERS‘ SPINE FROM LONG-TERM
DAMAGE?
Dr. med. Eckart D. Diezemann
Orthopedic and Trauma Surgeon, Sports Medicine

Federation Doctor SBRV & Anti -Doping Officer
ARGE Baden-Württemberg, Germany
b-e.diezemann@t-online.de
INTRODUCTION
I received an email from my colleague, David Curby (Secretary of UWW Scientific Commission) in February
2018 who asked for my reaction to the following:
I am involved in a project to improve the neck and back health of wrestlers……….It began with a question
from a parent asking: “Is the wrestler’s bridge a safe exercise?”
A very simple question about an exercise that has been firmly entrenched in the training of wrestlers for
centuries, but upon closer investigation, there is not very much information available to provide a definitive
answer
Hence, this letter requesting your observations and recommendations for the creation and implementation of
an age-appropriate program of neck and back strength and flexibility development that is based on science
and medicine. Our intent is not to “ban” bridging exercises. The bridge and back arch, though they can be
seen as “extreme,” are fundamental positions employed in wrestling for both offense and defense.
Orthopaedic-traumatological sports medicine is not only based on the knowledge of the shape and function of
the musculoskeletal system, but must also deal with the mechanical stresses to the musculoskeletal system
caused by the sporting activities.
Biomechanics of the spine
Performance of the biological structures of the spine
Biomechanics is an interdisciplinary science that describes,

investigates and evaluates the movements generated by the
musculoskeletal system. It deals with interactions between
movements generated by the musculoskeletal system and the
resulting biological reactions in sporting activities
Reference: Brüggemann, G.-P.: Biomechanik. In: Klümper A.,
Sporttraumatologie, ecomed, Landsberg/Lech (04/01, III-2)1-60
The maximum forces causing fracture of a vertebral body clearly increase from the
cervical spine to the lumbar spine

The spine prefers to have the stress pressure exactly in the middle of the intervertebral
discs
The vertebral body takes over the main load
The lowest resistance is found at the

lateral edges of the posterior areas
The vertebral joint only takes over approx. 10%
Brüggemann, G.P.: Biomechanik. In: Klümper A., Sporttraumatologie, ecomed, Landsberg/Lech (04/01, III-2)1-60
Keller, T.S.; Hansson, T.H.; Abram, A.C.; Spengler, D.M.; Panjabi, M.M.: Regional variations in the compressive
properties of the lumbar vertebral trabeculae: effects of disc degeneration. Spine, 14 (1989) 1012 -1016
Hyperextensions combined with rotational loads may lead to premature

degenerative changes in the spine
Reference:
Schmitt H: Degenerative Gelenkerkrankungen nach Leistungssport.
Deutsche Zeitschrift für Sportmedizin 10 (2006) 248-254
The skeleton is held by the muscles. Wrestlers must be able to tolerate enormous
opponent forces. To prevent injuries, they need a powerful supporting and protective
muscular core.
References: Hartmann J., Tünnemann H.: Das große Buch der Kraft, Sportverlag Berlin (1990) 243
Rohlmann A., Wilke H.-J., Mellerowicz H. Graichen F., Bergmann G.: Loads on the spine in sports.
Deutsche Zeitschrift für Sportmedizin 52 (2001) 118-123
Reference: Tittel K.:

Beschreibende und
funktionelle Anatomie,
Urban & Fischer (2003)

Examples from everyday life
Mechanical stress of the spine in wrestling

“Knowledge of mechanical laws and detailed information on the physical activities and mechanical
movements occurring in wrestling and the loads on biological structures are a necessary requirement in order
to avoid possible over-stress and to identify and understand damage“
Reference: Brüggemann, G.-P.: Biomechanik. In: Klümper A., Sporttraumatologie, ecomed, Landsberg/Lech (04/01, III-2)1-60
Extension
Intervertebral disk
Nucleus pulposu

Flexion
Foramen Intevertebrate
Nucleus pulposus
Extension
Rotation
Nucleus Intervertebral disk

pulposus

What chronic damage do we observe on the spine? And
can I prevent this damage?

Do former wrestlers really have degenerative changes in the spine more often than the normal
population?
References:
Hellstrom M, Jacobson B, Sward L, Peterson L:
Radiologic abnormities of the thoraco-lumbar spine in athletes.
Acta radiological 31 (1990) 127-132
Lundin O, Hellstrom H, Nilsson I, Sward L:

Back pain and radiological changes in the thoracolumbar
spine of athletes. A long-term follow up.
Scand J Med Sci Sports 11 (2001) 103-109
Summery:
“In male wrestlers, radiologically degenerative
changes were found more frequently compared to
a control group particularly in the area of breast and
lumbar spine"
The goal of our sports medicine activities should be to accompany the athletes through their sporting
careers, keeping injuries and the risk of late damage as low as possible.
What options are there to prevent late damage in wrestling?

Wrestling-specifics parameters for late damage are:
Exogenous factors:
• Injuries
• Sport-specific stress on the spine
(Hyperextensions combined with rotational loads)
• Intensity of the sporting load
(Double load: Own body weight plus opponent's body weight, explosiveness)
• Duration of the sporting load
(Start of the wrestling career at about 6 years end often at over 30 years)
A German idiom says: “Constant dripping wears the stone”

Do the constant unfavorable loads in wrestling “hollow out” the spine over 30 years?
On which parameters do we as sport-physicians really have influence?

Endogenous factors:
Sports medical examination and subsequent
meeting with parents and responsible trainers
Exogenous factors:
Injuries (?)
Sport-specific stress
Competition (no!)
Training (?)
Slow adaptation of youngsters to wrestler-specific loads.

A trainer entrusted with youngsters also need basic knowledge of the shape and
function of the musculoskeletal system. He should consider the mechanical stresses
of the musculoskeletal system caused by sporting activities and their possible
consequences
Intensity and duration of the sporting load (no!)
Are these exercises still up-to-date? We should consider alternatives. What has been good for decades
does not always have to be so.
• Reduction of spine loads in training by alternative strength & flexibility training on suitable equipment
is necessary to develop strength of the musculature.
• Abnormal loads of the spine in wrestling should be reduced in light of the fact that this sport is
practiced for decades.

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International Journal of Wrestling Science

Volume 9, Number 2 2019

INTERNATIONAL NETWORK OF WRESTLING RESEARCHERS (INWR)

UIJW_I_7_1-2_COVER.indd 1 3/7/2018 9:44:54 AM

Mario Baić, PhD, Croatia Boris Podlivaev, PhD, Russia

https ://unitedworldwrestling.org http://inwr-wrestling.com

Volume 9, Number 2, 2019

1-8 TURKISH NATIONAL WRESTLERS AND HALAL FOOD-RELATED PROBLEMS IN

9-13 MODELING THE FORCE CHARACTERISTICS OF LIFTING ACTIONS BASED ON

14-18 MODEL CHARACTERISTICS OF SENSORIMOTOR REACTIONS AND SPECIFIC

20-26 PRINCIPLES OF MUSCULOSKELETAL INJURY PREVENTION IN WRESTLING

27-30 ASSESSMENT OF WRESTLING MATS TO PREVENT SPORTS INJURIES

31-32 BEACH WRESTLING: DOHA/QATAR 2019 – EXPERIENCES

33-34 CAULIFLOWER EAR AMONG FINNISH HIGH‐LEVEL MALE WRESTLERS AND

35-36 DOPING CONTROL RULES UPDATE & UWW TUE PROCESS

37-41 OVERVIEW ON DOPING RULES VIOLATIONS IN WRESTLING

47 INTRAVENOUS FLUID TRANSFUSION ISSUE FROM JUNIOR WORLD

51-52 SUCCESSFUL NON-OPERATIVE MANAGEMENT OF NEAR COMPLETE

53-55 GENERAL HEALTH MANAGEMENT STRATEGIES IN WRESTLING

56-62 VETERAN MEDICINE IN WRESTLING: EXAMINATIONS AND PREVENTION

63-65 KNEE LIGAMENT INJURIES IN WRESTLERS

69-72 MEDICAL COVERAGE OF WRESTLING EVENTS; FROM A TO Z

73-74 MOST FREQUENT SHOULDER INJURIES IN MEXICAN JUNIOR AND SENIOR

75-78 PRECOMPETITIVE ANTICIPATORY STRESS RESPONSE OF ELITE WRESTLERS

79-85 PREPARTICIPATION MEDICAL EVALUATION: WHY WHEN HOW

91-98 MUSCULOSKELETAL INJURIES, MECHANISM, RESULTS & PREVENTION

99 RISK OF BLOODBORNE INFECTION TRANSMISSION IN WRESTLING

100-103 SPINE INJURIES IN WRESTLING

104-105 WORKSHOP: MAT-SIDE INJURY MANAGEMENT

106-110 SKIN CONDITIONS IN WRESTLING – HOW TO PREVENT

111-117 CAN I PROTECT THE WRESTLERS‘ SPINE FROM LONG-TERM DAMAGE?

International Journal of Wrestling Science 2019; Vol 9 Issue 2 p. 1

p. 2 Official Journal of the International Network of Wrestling Researchers (INWR)

International Journal of Wrestling Science 2019; Vol 9 Issue 2 p. 3

Table 2. Response to question 1.

Table 3. Responses to questions 2, 3 and 4.

p. 4 Official Journal of the International Network of Wrestling Researchers (INWR)

Table 4. Responses to questions 5, 6, 7 and 8 with frequency and percentage

International Journal of Wrestling Science 2019; Vol 9 Issue 2 p. 5

p. 6 Official Journal of the International Network of Wrestling Researchers (INWR)

International Journal of Wrestling Science 2019; Vol 9 Issue 2 p. 7

p. 8 Official Journal of the International Network of Wrestling Researchers (INWR)

International Journal of Wrestling Science 2019; Vol 9 Issue 2 p. 9

p. 10 Official Journal of the International Network of Wrestling Researchers (INWR)

The second phase (2-6 s)

International Journal of Wrestling Science 2019; Vol 9 Issue 2 p. 11

p. 12 Official Journal of the International Network of Wrestling Researchers (INWR)

International Journal of Wrestling Science 2019; Vol 9 Issue 2 p. 13

1Kharkiv State Academy of Physical Culture. Ukraine

p. 14 Official Journal of the International Network of Wrestling Researchers (INWR)

International Journal of Wrestling Science 2019; Vol 9 Issue 2 p. 15

10 Line accuracy reproduction 0.42±0.02 0.45±0.03 0.50±0.07

Table 3. Reliability of differentiation indicators of sensorimotor reactions and specific perceptions

p. 16 Official Journal of the International Network of Wrestling Researchers (INWR)

t=-0.50; t=0.76; t=1.10;

t=0.53; t=0.30; t=-0.18;

International Journal of Wrestling Science 2019; Vol 9 Issue 2 p. 17

p. 18 Official Journal of the International Network of Wrestling Researchers (INWR)

International Journal of Wrestling Science 2019; Vol 9 Issue 2 p. 19

UWW Medical & Anti-Doping Commission

Importance of the topic

INJURY; is a barrier for sport participation and development

• in order to prevent sport injuries,

This requires establishing Injury Surveillance systems.