The Japanese Society of Clinical Sports Medicine and the Japanese Society for Athletic Training formed an expert working group in December 2020 to establish a set of recommendations to standardize sports injury and illness surveillance methods in Japan. The nominal group technique and Delphi method were used to determine key components of sports injury and illness surveillance. The feasibility of proposed recommendations was considered with the current Japanese collegiate sport context in mind. Experts agreed on eight recommendations that defined reporter and participant characteristics, a list of variables to be collected, methods of expressing data, and data management considerations.

During the Olympic Games and Paralympic Games, the delivery of medical services are required for all stakeholders associated with the Games inside the Games venues. In particular, medical services for athletes require appropriate emergency response at the Field of Play (FOP) or delivery of services to support athlete performance in addition to regular medical care. In Tokyo 2020, various medical profession cooperated as interdisciplinary team to provide these services and realized the holistic support for the athletes.

The Olympic Village Fitness Center at the Tokyo Olympics and Paralympics has made the following three efforts to realize “total conditioning support through medical cooperation.”

・Cooperation with polyclinic

・Training equipment selection and space design considering smooth total conditioning operation

・Athletes support by athletic trainer (AT) and strength coach (SC)

In this lecture, I will report on the activities of this initiative and describe the new professionalism of AT.

We describe the medical services provided at the Tokyo 2020 Olympic Basketball competition venue. 54 people participated in this tournament as medical trainer, and most of them belonged to the top leagues in Japan and had English skills and medical qualifications. The competition rules differed between the 5-player basketball and 3×3, and the roles required of medical staff, especially within the FOP. Therefore, in the 3×3 preparation stage, doctors and trainers constructed personnel and equipment allocation, emergency action plans, etc. while assuming various situations.

In this paper, we have discussed the medical services available for athletes and officials in the weightlifting event at the Tokyo 2020 Olympic Game and have described the preparations made for the event, in addition to the organization structure, staffing, venue facilities, medical equipment and materials. Although no serious injuries or emergency cases were reported during the events, we provided medical services to 132 athletes and event officials.

Prognosis from exertional heat stroke depends on the duration of exercise-induced hyperthermia above 40°C with impaired central nervous dysfunction. The prognosis is reported to worsen once the duration of symptomatic hyperthermia exceeds 30 minutes. Therefore, it is imperative to start the treatment of collapsed patient before hospital admission. However, it is extremely difficult to execute exertional heat stroke prehospital care in Japan due to its regulation on medical practice. Nevertheless, delivery of prehospital care for exertional heat stroke patients may be possible in mass sporting events where medical personnel are stationed at the venue. When there is a foreseeable risk of exertional heat stroke, one must consider developing a policy and procedure that allows for trained professionals to implement prehospital treatment.

This report summarized our supporting activities for National Women’s Handball Team performed before and during the Tokyo Olympics Paralympics games 2020. Due to the characteristics of handball as a contact sport, the maintenance of athletes’ conditioning and management of the acute injury were the issues. It was thought that the experience at the Tokyo Olympics Paralympics games 2020 would serve as a model case for future handball competition support.

The High Performance Support Project, which is commissioned by the Japan Sports Agency, targets athletes who are expected to win medals, and strategically and comprehensively provides specialized and high-level support from various fields. (1) Athlete support through the use of sports medicine, science, and information by specialized staff in various fields, including movement analysis, game analysis, information gathering, nutritional support, conditioning support, and psychological support at training camps and competitions, and (2) preparing a support system for the Olympic and Paralympic Games.

In addition, since para-athletes have various disabilities, it is necessary to understand not only the physical condition of the athletes, but also the characteristics of materials such as artificial legs and wheelchairs, and to create training program that match the athletes’ remaining functions to improve their performance.

The superior cleft sign and/or secondary cleft sign as MRI findings for groin pain was the only independent factor of the MRI findings associated with a delayed time to return-to-play. The purpose of this study was to examine usefulness of the pelvic mobility test as an assessment of clinical findings for groin pain with following three points, 1) the positive rate of the pelvic mobility test with or without cleft sign, 2) the laterality association between the positive side of the pelvic mobility and painful area, and 3) the effect of the pelvic mobility test positive on the time from the first visit to return-to-play. The inclusion criteria were 300 groin pain patients, all of whom were taken MRI ranging in age from 16 to 40 years old. Patients with hip-related groin pain was excluded. As a result, the positive rate of the pelvic mobility test was significantly higher in the cases with cleft sign more than no cleft sign (p<0.01). No association was found between the positive side of the pelvic mobility test and painful area. The cases with cleft sign and the pelvic mobility test positive significantly took longer time to return-to-play than the others: the cases with cleft sign and the pelvic mobility test negative, the cases with no cleft sign and the pelvic mobility test positive, and with no cleft sign and the pelvic mobility test negative (p<0.05, p<0.001, and p<0.01, respectively). The pelvic mobility test was demonstrated to be useful as an assessment of clinical findings for groin pain.

This study was performed to compare the effects of foam rolling (FR) with or without vibration stimulation to the ankle plantar flexor muscles on ankle dorsiflexion range of motion (ROM) in non-weight-bearing and weight-bearing positions and gastrocnemius muscle stiffness. Changes in muscle stiffness over time after the intervention were also investigated. The results showed that dorsiflexion ROM in weight-bearing positions was significantly higher after than before the 3-min FR intervention either with or without vibration stimulation (P<0.05), but dorsiflexion ROM in non-weight-bearing positions and muscle stiffness did not significantly change from before to after the intervention (P>0.05). In addition, there was no significant difference in any measurement between vibration and non-vibration FR conditions (P>0.05). This study suggests that FR to the ankle plantar flexor muscles is effective in improving dorsiflexion ROM in weight-bearing positions but that vibration stimulation during FR has no additional effect.

This study aimed to determine groin pain incidence and the distribution of groin pain in amateur male soccer players during a period of 37 weeks. A total of 39 players from two teams were recruited in this study and data were collected from January to October 2017. Overall, groin pain was reported in 17 players (43.5%), all of whom had a previous history of groin pain during their high school. On the other hand, players who had no history of groin pain did not report groin pain in this study. Recurrence of groin pain was reported in 58.8% (n＝10) of the players. Of a total of 50 cases of groin pains (4.36/1000 player hours), 27 pains (7.61/1000 player hours) occurred in the game phase and 23 pains (2.90/1000 player hours) occurred in the preparation phase; moreover, time loss groin pain was observed in 11 incidences (0.96/1000 player hours), and no time loss groin pain was observed in 39 incidences (3.40/1000 player hours). Regarding severity of groin pain, 40.7% of the players were classified as having moderate pain (1.39/1000 player hours) in the game phase, and 39.1% of the players reported minimal pain (2.54/1000 player hours) in the preparation phase. Groin pain was commonly adductor-related (52.0%), and the duration of pain was 11.3 days. The incidence of groin pain was highest in March (time loss: 0.26/1000 player hours, no time loss: 0.44/1000 player hours), which was the end of the first preparation phase, and August (no time loss: 1.41/1000 player hours), which was the start of the second game phase. The entire season showed groin pain with either time loss or no time loss. In conclusion, the incidence, location of pain, and prevalence of groin pain in amateur players were similar to those in professional players.

We are reporting on an emergency response case involving student trainers that occurred in the sports club of our university so that it can be used as reference material for AT education. A head injury accident between athletes occurred during club activities, and they were transported by ambulance in response to student trainers. At this time, it has been reaffirmed that guidelines and emergency action plans are important to protect athletes as well as student trainers.

In this study, we conducted an interview survey with medical institutions that employ full-time athletic trainers (ATs), certified by the Japan Sports Association. The purpose of this study was to clarify the ATs’ role in medical institutions and to consider the promotion of employment of ATs in medical institutions. The results showed that, ATs were in charge of rehabilitation assistants at all the medical institutions surveyed. In addition, it became clear that ATs’ work at medical institutions may include work at sports facilities attached to medical institutions and sports sites, in addition to in-clinic work. In order to promote ATs’ employment among medical institutions, it is important to strengthen the factors that contribute to their employment, improve on and reduce the hindering factors, and build a sustainable profit model.

This study aimed to analyze contents of publicly available resources on sports related concussion (SRC) for collegiate athletes in Japan. We identified eleven sport governing bodies that published SRC guidelines. Review of guidelines revealed information regarding SRC risk reduction strategies were particularly lacking in existing guidelines; therefore, further efforts in the improvement of SRC guidelines are warranted. Additionally, future SRC guidelines should be tailored to the rules and characteristics of each sport and more sport governing bodies should have means to distribute their guidelines to their membership and ensure latest evidence-based recommendations are delivered to stakeholders of the sport.