Abstract: Sailors are at risk of injury and an understanding of the risks and causes of injury are important in helping to reduce their frequency and severity. Injuries are specific to the class of sailing. In elite Olympic-class sailing the incidence of injury is approximately 0.2 injuries/athlete/year, with the lumbar and thoracic spine and the knee most commonly injured. Poor hiking technique and inadequate leg strength are thought to predispose the knee to injury. Injuries in novice and recreational sailing are predominantly acute in nature with contusions and abrasions typically occurring as a result of collisions with the boom or other equipment during manoeuvres. The only report of injuries in Paralympic-class sailing found a high rate of approximately 100 injuries/1000 days of sailing, likely due to severe sailing conditions. The majority of injuries were chronic in nature, predominantly sprains and strains of the upper extremity. The risk of windsurfing injury ranged from 1.1 to 2.0 injuries/person/year, with the majority of injuries being acute, typically due to impact with equipment. Severe injuries are frequent, with competitive male windsurfers often admitted to hospital for treatment. Chronic lower back injuries are also common in windsurfers and may be related to prolonged lordosis (lumbar extension) of the spine while 'pumping' the sail. In professional big-boat sailing, America's Cup studies have reported an incidence of approximately 2.2 injuries/1000 hours of sailing, with one study reporting a higher incidence of injury during fitness training sessions (8.6 injuries/1000 hours of fitness training). The main cause of injury seems to be non-specific overuse, with joint and ligament sprains and tendinopathies being the most common. Grinders and bowmen are at greatest risk of injury, with the repetitive nature of 'grinding' a contributing factor. In round-the-world offshore racing, 1.5 injuries/person/round-the-world race (amateur), and 3.2 injuries/person/race (professional) have been reported, with the majority being impact injuries (e.g. contusions, lacerations, fractures and sprains). Helmsmen experience mostly upper-limb overuse injuries as a result of 'steering', while mastmen and bowmen are at greater risk of acute injuries. Illnesses and non-injury-related complaints account for a large proportion of medical conditions in these events. Sailors of all classes and abilities seem to be at risk of injury, particularly from acute impacts with equipment that might be reduced by wearing protective clothing and more ergonomic boat design. High repetition activities, such as hiking, pumping, grinding and steering, are major causes of overuse injury in experienced sailors. Informed coaching of correct technique and appropriate progression of physical and technical developments are required. Competitive sailors should undergo regular health screening with specific strengthening of high-risk muscle groups, synergists and stabilizers. The scarcity of analytical studies of sailing injuries is a major concern, and there is a need for thorough prospective studies.

Abstract: Big-boat yacht racing is one of the only able bodied sporting activities where standing arm-cranking ('grinding') is the primary physical activity. However, the physiological capabilities of elite sailors for standing arm-cranking have been largely unreported. The purpose of the study was to assess aerobic parameters, VO(2peak) and onset of blood lactate (OBLA), and anaerobic performance, torque-crank velocity and power-crank velocity relationships and therefore peak power (P (max)) and optimum crank-velocity (omega(opt)), of America's Cup sailors during standing arm-cranking. Thirty-three elite professional sailors performed a step test to exhaustion, and a subset of ten grinders performed maximal 7 s isokinetic sprints at different crank velocities, using a standing arm-crank ergometer. VO(2peak) was 4.7 +/- 0.5 L/min (range 3.6-5.5 L/min) at a power output of 332 +/- 44 W (range 235-425 W). OBLA occurred at a power output of 202 +/- 31 W (61% of W(max)) and VO(2) of 3.3 +/- 0.4 L/min (71% of VO(2peak)). The torque-crank velocity relationship was linear for all participants (r = 0.9 +/- 0.1). P (max) was 1,420 +/- 37 W (range 1,192-1,617 W), and omega(opt) was 125 +/- 6 rpm. These data are among the highest upper-body anaerobic and aerobic power values reported. The unique nature of these athletes, with their high fat-free mass and specific selection and training for standing arm cranking, likely accounts for the high values. The influence of crank velocity on peak power implies that power production during on-board 'grinding' may be optimised through the use of appropriate gear-ratios and the development of efficient gear change mechanisms.

Abstract: Much of the prestige of the America�s Cup is that it boasts being the oldest competing trophy in modern sport, predating the modern Olympic Games by 45 years. The America�s Cup has predominantly been about the �boat�. It�s what goes on behind the closed door of the design studio that most often determines the success of a team. The team with the fastest boat, appendages and sails is almost guaranteed to win the Cup. But the success of version 5 of the International America�s Cup class rule had for the first time resulted in only small differences in boat speed between the challengers for the 32nd America�s Cup held in Valencia in July 2007. The result was an increase in the importance of the racing crew, the athletes. More than ever before, race tactics played a major role in the outcome of races. Consequently, the athletes� skill, experience, fitness and hunger to win have become paramount to success. As a result, teams have begun to realise the importance of sports science in search of increasing athletic performance. However, due to the confidentiality of the technical developments within America�s Cup teams, little has been published on athlete-preparation for this prestigious event. As with many other professional team sports, preparing to challenge for this coveted trophy requires cutting-edge sports science and sports medicine. America�s Cup athletes now rely on support teams of coaches, sports scientists and medical staff to meticulously aid in their technical, physical and mental preparation. Specialists in almost every area of human development are being consulted by teams to maximise and develop specific athletic talent and potential. Some teams have coaching staff consisting of head coaches, exercise physiologists (or strength and conditioning trainers), afterguard (tactical) coaches, video/manoeuvre advisors and rules coaches as well as medical teams consisting of nutritionists, physiotherapists, massage therapists, chiropractors, sports physicians and internal medicine specialists. Other teams have sports psychologists, boxing trainers, yoga and pilates instructors and corporate motivators. Many teams have their own fitness training centre and medical facility within their operation base, equipped with high-tech strength and conditioning apparatus and simulators. Fitness equipment manufacturer TECHNOGYM has worked closely with Team Luna Rossa and Team Alinghi to develop grinding simulators and other training equipment specific for the needs of America�s Cup athletes. The demands of each of the 17 athletes on-board the high performance racing yachts are role-specific. The traditional bodybuilding type training methods of heavy bench-presses and barbellcurls used by teams in the past have been replaced by more scientific and functional based conditioning programmes adapted to the specific demands of each position. For example, grinders provide the power for most manoeuvres and require a combination of explosive power and power endurance. Therefore much of their training comprises functional power exercises and high intensity interval training on arm ergometers. Other positions, such as bowmen require exceptional hand-eye coordination, visual depth perception, quick decision making and reaction speed, for which specific exercises are incorporated into their training programmes. For the most part though, fitness training not only serves the obvious physiological purpose, but equally, team cohesion, mental toughness and leadership are all encouraged within the training environment. A factor which differentiates the America�s Cup from other sailing events such as Olympic class sailing, is the team culture (similar to that of many other team sport environments), which many �rookie� America�s Cup sailors initially have difficulty in adjusting to. Chronic fatigue is common in the America�s Cup, as a result of the large volume of work that the athletes and support staff are often required to perform. This is particularly prevalent in the �smaller� teams where most athletes take on multiple roles within the team due to the limited number of support staff. Teams are generally driven by the technical developments of the boats and hardware, with most of the planning and scheduling determined by technical goals and deadlines and not necessarily by what is beneficial to athletic performance. Hence, America�s Cup campaigns are often referred to as �massive machines� where, if one is not able to keep up, they are rolled over and left behind. Athletes are required to spend as many as 10 to 14 h at work per day (~1.5 h strength & conditioning, ~7 h sailing, ~2 h meetings, ~2 h boat maintenance/preparation). For this reason, teams carefully monitor athletes training, sailing and overall work load. Apart from the standard logging of intensity, volume and frequency of each days sailing and training, athletes� cardiac output (heart rate variability and ECG) are regularly monitored for indicators of chronic stress and underlying fatigue. Daily subjective questionnaires and heart rate recovery protocols are also frequently used. In addition, blood and saliva samples are monitored regularly for immunological status (Neville et al.., 2008) and various methods of cryotherapy are commonly used to aid with recovery. A recent study on America�s Cup injuries (Neville et al.., 2006), showed that sailors are at a relatively high risk of injury, particularly grinders and bowmen, with the majority of severe injuries being related to overuse, mostly to the upper-limb, lumbar and cervical spine. Research is currently being conducted on the mechanisms and aetiology of the more severe injuries in order to determine appropriate injury prevention protocols. Most teams have two full crews, which allow for athletes in the more physically demanding roles to be rotated and rested. This was evident during the first two round robins of the 32nd America�s Cup, where two races were raced each day and an average of two athletes were rotated by each team for each race. The importance of hydration is often overlooked in sailing, partly because weight and space is often restricted. During an America�s Cup race an average athlete loses sweat at a rate of approximately one litre per hour (Neville et al.., 2007), which equates to a 5% loss in body weight for an average bowman during a two race day if fluid is not adequately replaced. This has important implications on performance, both cognitive and athletic. Furthermore, core body temperature of mid-bowmen has been shown to rise as high as 39.6 ºC during racing (Neville et al.., 2007), due to the high work load combined with the hot, humid conditions in the sewer (below the deck) while packing sails. In addition to impairing performance, this may result in serious health risk if combined with hypohydration. This has prompted research into the design of improved race clothing as well as regular monitoring of athletes hydration status. The America�s Cup class rule limits the total weight of the 17 person crew to 1,570 kg (92.4 kg per athlete), which is controlled by a oneoff official weigh-in, usually two to four days prior to each competition series. This has resulted in some athletes (and teams) employing rapid weight loss protocols prior to weigh-in, with some athletes losing as much as 6% body mass in the 48 h prior to weighin. For the most part though, the weight of each athlete is carefully monitored according to the demands of their position. Grinders and mastmen for example, require a high muscle mass due to the large forces which they are required to generate (Molloy et al.., 2005). Hence it is not surprising that the average weight of an America�s Cup grinder is 105 kg, with some weighing in excess of 120 kg. Other less physically demanding positions, such as the helmsman, tactician, navigator and trimmers benefit their teams by maintaining a lower body weight. Hence, in order to optimise performance of the crew, the objective is to maintain reasonably low levels of body fat for all athletes and increase muscle mass in the positions which have the greatest strength and power requirements. Dietary manipulation is the key to achieving these goals. During an average training and sailing day, an average grinder requires approximately 6,000 Kcal in order to maintain muscle mass (Bernardi et al.., 2007), which is almost three times that consumed by an average individual. With the athletes sailing between three and seven hours per day poses further logistical challenges, hence most teams have their own restaurants and nutritionists, in order to prepare specialised high energy �snack� meals according to the dietary needs of the athletes. High energy, low fat snacks are packed into portable insulated containers and transferred from the support boats onto the racing yachts during the sailing day. The unpredictable nature of the America�s Cup presents a set of unique challenges to sports science and medical support staff, with the hardware as opposed to the athlete directly being the centre of focus and the ever changing and uncontrollable sailing conditions being the environment by which all support is determined. However, there are also many similarities to other professional team sports and it is through applied practitioners sharing their experiences, challenges and successes that the true value of sports science and sports medicine can be appreciated and ultimately provide the athlete with the best opportunities and environment to excel

Abstract: The relationship between physiological and psychological stress and immune function is widely recognized; however, there is little evidence to confirm a direct link between depressed immune function and incidence of illness in athletes. PURPOSE: To examine the relationship between salivary immunoglobulin A (s-IgA) and upper respiratory infections (URI) in a cohort of professional athletes over a prolonged period. METHODS: Thirty-eight elite America's Cup yacht racing athletes were studied over 50 wk of training. Resting, unstimulated saliva samples were collected weekly (38 h after exercise, consistent time of day, fasted) together with clinically confirmed URI, training load, and perceived fatigue rating. RESULTS: s-IgA was highly variable within (coefficients of variation [CV] = 48%) and between subjects (CV = 71%). No significant correlation was found between absolute s-IgA concentration and the incidence of URI among athletes (r = 0.11). However, a significant (28%, P < 0.005) reduction in s-IgA occurred during the 3 wk before URI episodes and returned to baseline by 2 wk after a URI. When an athlete did not have, or was not recovering from URI, a s-IgA value lower than 40% of their mean healthy s-IgA concentration indicated a one in two chance of contracting an URI within 3 wk. CONCLUSION: On a group basis, relative s-IgA determined a substantial proportion of the variability in weekly URI incidence. The typical decline in an individual's relative s-IgA over the 3 wk before a URI appears to precede and contribute to URI risk, with the magnitude of the decrease related to the risk of URI, independent of the absolute s-IgA concentration. These findings have important implications for athletes and coaches in identifying periods of high URI risk.

Abstract: OBJECTIVES: To determine the incidence and severity of injuries and illnesses incurred by a professional America's Cup yacht racing crew during the preparation for and participation in the challenge for the 2003 America's Cup. METHODS: A prospective study design was used over 74 weeks of sailing and training. All injuries and illnesses sustained by the 35 professional male crew members requiring medical treatment were recorded, including the diagnosis, nature, location, and mechanism of injury. The volume of sailing and training were recorded, and the severity of incidents were determined by the number of days absent from both sailing and training. RESULTS: In total, 220 injuries and 119 illnesses were recorded, with an overall incidence of 8.8 incidents/1000 sailing and training hours (injuries, 5.7; illnesses, 3.1). The upper limb was the most commonly injured body segment (40%), followed by the spine and neck (30%). The most common injuries were joint/ligament sprains (27%) and tendinopathies (20%). The incidence of injury was significantly higher in training (8.6) than sailing (2.2). The most common activity or mechanism of injury was non-specific overuse (24%), followed by impact with boat hardware (15%) and weight training (13%). "Grinders" had the highest overall injury incidence (7.7), and "bowmen" had the highest incidence of sailing injuries (3.2). Most of the illnesses were upper respiratory tract infections (40%). CONCLUSIONS: The data from this study suggest that America's Cup crew members are at a similar risk of injury to athletes in other non-collision team sports. Prudent allocation of preventive and therapeutic resources, such as comprehensive health and medical care, well designed conditioning and nutritional programmes, and appropriate management of recovery should be adopted by America's Cup teams in order to reduce the risk of injury and illness.