Between 17 October and 19 October 2024, the South African Sports Medicine Association (SASMA) will host the 20th Biennial SASMA Congress in Cape Town. The theme of the congress is ‘Breaking boundaries in Sports and Exercise Medicine and Science’. The conference will host an A-list of local and international speakers and include a range of topics from clinical cases, injury prevention and management, mental health and well-being, and sport and exercise for health. In line with the congress theme, the SASMA BJSM edition showcases work that is pushing the envelope in sport and exercise medicine (SEM).

The WHO Global Action Plan on Physical Activity 2018–2030 calls for the integration of physical activity teaching into the pre-service and in-service training of healthcare professionals.1 To achieve this integration, Dr Milton and colleagues share an infographic on what to talk about with patients to promote physical activity as part of routine healthcare ( see page 569 ). In line with the WHO Global Action Plan, Dr Zondi and other College of Sport and Exercise Medicine (South Africa) leaders explore the transformative potential of SEM in low-income and middle-income countries ( see page 517 ). The editorial features a brief history of SEM in South Africa, how it gained formal approval as a medical specialty and emphasises the role of SEM in fostering community engagement, advocating for equitable access to healthcare and driving policy changes to prioritise health equity. As SEM grows stronger as a medical specialty in South Africa, Dr Hendricks and colleagues outline the role of the chief medical officer at major sporting events and the need to include mass medicine training in SEM ( see page 528 ).

Whelan and colleagues studied the incidence rates of suicide from 2002 to 2022 among athletes from the National Collegiate Athletic Association (NCAA) and found that deaths by suicide among NCAA athletes increased in both males and females over the last 20 years, with suicide now the second most common cause of death in this population ( see page 531 ). In view of these data, Dr Burger and colleagues from the fields of psychiatry and SEM spotlight the emergence of sport and exercise psychiatry (SEP) on preventing, diagnosing and treating mental health conditions in both elite and recreational athletes, and how exercise can also be used as an intervention for mental health conditions in general.2 The authors also propose a model from South Africa to grow SEP in low-income and middle-income countries ( see page 519 ).

Cardiorespiratory fitness (CRF) is a physical trait that reflects the integrated function of numerous bodily systems, and higher CRF has shown to improve the prognosis in those with chronic conditions. To date, many systematic reviews have examined the prospective link between baseline CRF and health outcomes, but no study has compiled all the evidence to help identify important gaps in the literature. Dr Lang and colleagues set out to address this question, and conducted an overview of systematic reviews that represented 20.9 million observations from 199 unique cohorts ( see page 556 ). The authors found consistent evidence that high CRF is strongly associated with lower risk of a variety of mortality and incident chronic conditions in general and clinical populations. Muscle power declines substantially with ageing, impacting physical function and contributing to falls, disability and mortality.3 4 Power training to enhance muscle function in older adults however is generally overlooked and underused in practice.3 4 In an editorial, Professors Izquierdo and Cadore highlight the benefits of power training in older adults along with recommendations for practice ( see page 524 ). Dr Allison and colleagues also present results from the POWER randomised controlled trial investigating physiotherapist delivered diet program for knee osteoarthritis ( see page 538 ).

Padel is one of the fastest growing sports in South Africa and the world.5 Medial gastrocnemius injuries (calf injuries) are common in padel and other sports, and skills in ultrasound assessment can help correctly diagnose the injury to inform the return to play timeline, monitor progress and guide aspiration if needed. In an ‘Images in Sports Medicine’ article, Dr Pedret discusses the ultrasound imaging of a padel player with an acute calf injury after an abrupt forward step to accelerate while initially running back during a match ( see page 567 ). The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system is an approach that allows researchers to rate the certainty of evidence based on an analysis of the risk of bias, inconsistency, indirectness, imprecision and publication bias.6 In an editorial, Drs Calderon and García-Muñoz argue why using the (GRADE) is also important for SEM systematic reviews, and specifically reviews evaluating epidemiological studies ( see page 527 ). Moving beyond case studies and reviews, Dr Obërtinca and colleagues report the efficacy of a new multicomponent, exercise-based injury prevention programme (called FUNBALL) for youth football players ( see page 548 ). Beyond efficacy, Dr Hendricks and colleagues apply the Diffusion of Innovations Framework7 to the new tackle laws being implemented at the community level across all major rugby union playing nations and rugby league in the UK ( see page 521 ). To forecast the rate of adoption of the concussion prevention measure, Hendricks and colleagues explore their perceived attributes of the new tackle laws.

Enjoy this edition of BJSM, and join us for SASMA 2024 to engage in a high-quality sports medicine and science programme, as well as to explore the culturally diverse and picturesque Cape Town where food, adventure and scenery know no boundaries!

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