Christopher Napier

Over the past decade, running shoes have undergone substantial innovation with the emergence of Advanced Footwear Technology (AFT). Shoes with AFT are typically characterized by highly compliant (deformable) and resilient (high energy return) midsole foams, embedded curved stiffening elements, low mass, and a rockered longitudinal geometry. This expert statement aims to synthesize established knowledge, remaining uncertainties and key directions for future research on AFT in middle‐ and long‐distance running. Current literature demonstrates robust improvements in running economy and performance with AFT, with reported metabolic savings of approximately 2%–4%, and corresponding performance improvements of 1%–3%. These benefits likely arise from a combination of “acute” and possibly “long‐term” mechanisms. Proposed acute mechanisms include decreased muscle force production due to higher positive work from energy‐returning foams, lower muscle force production to accommodate mechanical running demands due to compliant midsoles, and improved mechanical efficiency associated with greater longitudinal bending stiffness and curved geometry. Importantly, AFT features have a synergistic effect, with the relative importance of each mechanism differing depending on the context. Emerging evidence also suggests potential reductions in muscle damage/inflammation and soreness, which could support better physiological resilience, and higher training volumes/quality. From a biomechanical injury risk perspective, AFT can redistribute loading, potentially increasing metatarsal and tarsal stress while reducing tibia and possibly Achilles tendon loading. However, injury risk associated with AFT use remains equivocal, with limited high‐quality data. Notably, substantial inter‐individual variability has been observed, influencing both running economy and potential injury risk although the determinants of this variability remain unclear.

Ultramarathon performance reflects a complex interplay of physiological, biomechanical, and psychosocial factors, yet data from multi-day events remain lim

The ACTIVATE consensus aimed to develop recommendations for assessing, prescribing and promoting physical activity when healthcare professionals consult patients with non-communicable diseases in clinical practice. We developed the consensus through a comprehensive, multistep approach including 27 experts with professionally diverse backgrounds from 13 different countries, including three patient representatives. Initially, we conducted a survey at the World Congress for Sport Physical Therapy in 2022 to document the need for a consensus, which was followed up by development of a conceptual framework with guiding principles and research questions at a stakeholder meeting. We subsequently conducted three rapid umbrella reviews, covering the existing scientific literature to inform the statements for a Delphi survey. The Delphi survey involved two voting rounds (email survey) and one face-to-face (online) round. Finally, we identified recommendations on how to assess, prescribe and promote physical activity through consensus. We recommend routine physical activity assessments using quick and easy tools, documenting physical activity levels and providing tailored prescriptions for patients not meeting WHO guidelines for physical activity. Furthermore, the ACTIVATE consensus highlights the necessity for regular follow-ups to facilitate patients’ integration of physical activity into their daily routines, to enhance overall well-being and quality of life.

Sport and exercise medicine (SEM) has advanced substantially over recent decades. Developments in injury epidemiology, biomechanics, rehabilitation science and performance optimisation have translated into meaningful improvements in athlete care. Parallel to this, the Olympic and Paralympic movements have made visible strides in gender equity and inclusion. Yet, an important question remains: is SEM listening to the experiences of those it serves and letting these voices guide the research agenda?

Despite known sex and gender differences between males/men and females/women, most current running footwear is designed for and tested on males/men. This qualitative study aimed to explore the running footwear needs and preferences of recreational and competitive women runners and how these change across the lifespan. We conducted two semi-structured focus groups with women runners in Vancouver, Canada. Participants were purposively sampled for variation in age, running experience and running volume. Data analysis used an inductive reflective thematic approach. Twenty-one women runners (11 recreational, 10 competitive) of median (IQR) age 43 (20–70) years and median (IQR) running experience of 15 (6–58) years participated. Nine (43%) women had experience running during pregnancy or postpartum. Three main themes emerged regarding women’s running shoe needs and preferences: prioritising comfort and feel; the perceived contribution of the shoes to injury prevention; and the need for different shoes for different running contexts. Additionally, three main themes described how runners’ needs evolve across the lifespan: a shift from prioritising shoe style to comfort; increased shoe size and width during pregnancy/postpartum; and a growing preference for greater shoe stability and cushioning with age. Our results suggest that current running footwear does not fully meet the needs of women runners. Many women desired a wider toe box, a narrower heel cup and more cushioning, while competitive runners sought performance-enhancing features that did not compromise comfort. Women also strongly believed that footwear plays a critical role in injury prevention, highlighting the need for evidence-based education on this topic. These insights provide a foundation for the co-design of women-specific running shoes that better align with their unique biomechanical and performance needs. Future research should investigate whether sex-, gender- and life stage-specific shoe designs could enhance running performance, comfort and injury prevention for women across all levels of participation.

Field-based sport research involves studies that collect data from athletes and/or teams during competition and/or their daily training environments. Over the last decade, sport-specific field-based research projects have significantly increased in number and complexity, partially owing to the further development of more portable measurement equipment (e.g., indirect calorimetry, desktop blood/gas analyzers, portable laboratories, etc.) and/or wearable or consumable technologies (e.g., smart watches, sensors, core temp pills, etc.). However, given these rapid advances and novelty, challenges remain in the validity and applicability of these devices. Unfortunately, there are no global ethical or best-practice standards for the use of portable devices and/or wearables in sport; however, this review will outline various opportunities and challenges. Many decision trade-offs are required when designing field-based research studies to balance gold-standard scientific rigor and strict research control with highly applied, but less-controlled, “real-world” conditions. To our knowledge, there are no narrative reviews that take a wholistic view of the logistical and methodological considerations of field-based research in athletes. Accordingly, this review takes a multi-disciplinary methodological approach (physiological, nutritional/energetic, biomechanical, musculoskeletal, cognitive, and psychosocial factors), along with the logistical considerations involved in project planning, research design, and ethics of field-based research with elite athletes and/or teams. We also provide practical guidance for characterizing the extreme demands of elite training and competition to support research that ultimately catalyzes improved understanding of the limits of human capacity. We hope this review can serve as a practical guide for researchers undertaking elite athlete field-based research.