Swimming-induced pulmonary oedema (SIPO) has predominantly been reported in swimmers. However, to date, no review has specifically explored the scientific literature concerning the occurrence and characteristics of SIPO in triathletes. Therefore, this review aims to summarize and discuss the current evidence on SIPO in the context of triathlon.

We conducted a narrative review to summarize the current scientific literature on SIPO in triathletes. A structured search of two major databases—PubMed and Scopus—was conducted using free-text terms related to SIPO and triathlon. The search included articles published up to January 2025, with no language restrictions. After removing duplicates and excluding animal or in vitro studies, as well as unrelated articles based on title and abstract screening, a total of 48 relevant publications were included for analysis.

The reports on SIPO in triathletes are mainly case reports or case studies on a single athlete or a small number (case series) of triathletes. Most reported cases involved middle-aged women (30–60 years) participating in IRONMAN^® 70.3 and IRONMAN^® triathlons. The prevalence of SIPO in triathletes is reported to be less than 1.5%. Risk factors for SIPO in triathletes are female sex, age over 50 years, hypertension, fish oil consumption, highly trained individuals, competitive exercise, wet suit compression, longer race distances (i.e. IRONMAN^® 70.3 or IRONMAN^®) and a cold (water) environment. The symptoms and outcome are similar to those observed in swimmers and other aquatic athletes.

In summary, the results regarding the prevalence, symptoms and risk factors of SIPO in triathletes are comparable to those in other aquatic athletes. SIPO occurs only in IRONMAN^® 70.3 and IRONMAN^® races, but has not been reported in the Olympic distance triathlon or triathlons longer than the IRONMAN^® race distance.

Lifelong endurance exercise is generally associated with cardiovascular health benefits. However, recent studies suggest that prolonged high-volume training may contribute to coronary atherosclerosis, even in athletes with low traditional cardiovascular risk. This case report aims to explore the cardiovascular status of a master endurance athlete with an exceptionally high lifetime training volume, in light of recent concerns raised in the literature.

We present the case of a 60-year-old recreational male marathon runner with no history of cardiovascular disease, who completed over 500 marathons between the ages of 30 and 60 years, covering ~127000km running. In 2024 alone, he completed 60 marathons. Cardiovascular evaluation included clinical risk assessment and coronary computed tomography angiography (CTCA).

The runner was asymptomatic, had a low ESC-SCORE2 (3.3%), a favorable lipid profile, and normal levels of high-sensitivity C-reactive protein and lipoprotein (a). CTCA revealed no evidence of calcified, mixed, or non-calcified coronary plaques.

This case highlights that some master athletes may demonstrate resilience to coronary atherosclerosis despite decades of high training volume. In low-risk individuals, prolonged endurance training alone may not necessarily lead to coronary artery disease, emphasizing the need for individualized cardiovascular screening strategies.

Cupping therapy (CT), an ancient practice revived in modern sports medicine, offers potential benefits for athlete recovery and performance. Distinctions between wet CT (WCT) and dry CT (DCT) in sports science focus on their effects on recovery metrics, particularly how they influence sleep quality, perceived wellness, and athletic performance. Despite anecdotal evidence of its efficacy, rigorous comparative studies are scarce.

This study aimed to evaluates and compare the effects of WCT and DCT on endurance, perceived wellness, exertion levels, and sleep quality among young, active males, addressing the gap in the literature regarding CT's efficacy in sports performance and recovery.

Thirty-two amateur runners were randomly divided into two groups: one followed WCT sessions and the other followed DCT sessions. The study assessed the interventions' impacts on endurance performance (Yo-Yo intermittent recovery test), sleep quality (Pittsburgh Sleep Quality Index), and perceived exertion (Borg CR10 Scale). Heart rate was measured using a Polar H10 sensor to gauge physiological responses during physical tests.

Significant improvements were observed in the WCT group for sleep latency (% change ​= ​−82.31%; interaction group ​× ​time p ​= ​0.006; Cohen's d ​= ​0.74) and sleep disturbance (% change ​= ​−68.70%; interaction group ​× ​time p ​< ​0.001; Cohen's d ​= ​1.09), suggesting enhanced sleep quality (global score; % change ​= ​−52.81; interaction group ​× ​time p ​= ​0.004; Cohen's d ​= ​0.77). However, no significant differences were found in direct performance metrics (distance, maximal heart rate, maximal oxygen uptake) between WCT and DCT groups. These findings highlight WCT's potential as a recovery aid, particularly through improved sleep, without directly influencing endurance performance outcomes.

WCT may serve as an effective ergogenic aid for athletes by potentially improving sleep quality and reducing perceived exertion, thus contributing indirectly to performance through enhanced recovery.

The purpose of this study was to investigate the frequency of countries represented in the TOP20 long-distance elite runners ranking during 1997–2020, taking into account the countries’ Human Development Index (HDI), and to verify if the Matthew effect can be observed regarding countries’ representativeness in the raking alongside the years.

The sample comprised 1852 professional runner athletes, ranked in the Senior World TOP20 half-marathon (403 female and 487 male) and marathon (480 female and 482 male) races, between the years 1997–2020. Information about the countries’ HDI was included, and categorized as “low HDI”, “medium HDI”, “high HDI”, and “very-high HDI”. Athletes were categorized according to their ranking positions (1st–3rd; 4th–10th; > 10th), and the number of athletes per country/year was summed and categorized as “total number of athletes 1997–2000”; “total number of athletes 2001–2010”; and “total number of athletes 2011–2020”. The Chi-square test and Spearman correlation were used to verify potential associations and relationships between variables.

Most of the athletes were from countries with medium HDI, followed by low HDI and very-high HDI. Chi-square test results showed significant differences among females (χ² = 15.52; P = 0.017) and males (χ² = 9.03; P = 0.014), in half-marathon and marathon, respectively. No significant association was verified between HDI and the total number of athletes, but the association was found for the number of athletes alongside the years (1997–2000 to 2001–2010: r = 0.60; P < 0.001; 2001–2010 to –2011–2020: r = 0.29; P < 0.001).

Most of the athletes were from countries with medium HDI, followed by those with low HDI and very-high HDI. The Matthew effect was observed, but a generalization of the results should not be done.

The aims of this study were to propose an alternative method to assess an optimal performance improvement rate (PIR) that would be used as a tool for coaches and elite athletes willing to reach their personal best, mainly those seeking for national, continental or even world record (WR) in middle-distance events. We further compared the improvement rate of women vs. men of the top-10 ranked athletes in the IAAF running these middle-distance events

The top 10 athletes in the IAAF ranking of 800 m, 1500 m, and 3000 m events for each sex were assessed for their history of race times before achieving their personal record (PR). The difference between PR ('actual' season) and the best race time in the last season was defined as the 1st season improvement rate (1-SIR), whereas the average improvement rate in the last and preceding seasons was the multi-season improvement rate (M-SIR). 1-SIR and M-SIR were calculated for each athlete.

There were sex differences in the 1500 m with a large effect size (d = − 0.746) in 1-SIR (P = 0.001) and very large (d = − 2.249) in M-SIR (P = 0.001). Women improved more than men before the PR/WR achievements in the 800 m and 1500 m events (P = 0.001) and had similar improvement rates before performing PR/WR in 3000 m events (P = 0.533).

Women improve more before PR/WR achievement in 800 m and 1500 m races. However, in the 3000 m men and women have similar improvement rates in previous seasons before the PR/WR achievement.