Sport and Exercise Medicine (SEM) is a formal medical specialty in The Netherlands, with a 4-year full-time training programme for medical doctors. Currently, about 150 sports medicine specialists are actively practising in the country. It is interesting to note that almost one-third of all sports medicine specialists in The Netherlands have completed a PhD thesis, making SEM the specialty with the highest percentage of practitioners qualified as an MD with a PhD.

Military Medicine is a branch of Occupational Medicine attending to the medical risks and needs (both preventive and interventional) of soldiers, sailors and other service members. SEM in The Netherlands Armed Forces was recognised as an important medical specialty for service member selection, training and career fitness long before it evolved in the civilian sector. It was only a matter of time before the first civilian university with a full professor in Sports Medicine (University of Utrecht) and the Dutch Military Sports Medicine department, currently with a full professor in Military Medicine, formed an alliance. They both work in the same city!

Common themes of interest to both disciplines (and this Dutch-led issue of BJSM) are injuries of the knee/lower leg and female (combat) athletes. In The Netherlands (overuse) injuries of the knee and below have a high incidence and pose a major financial burden, both in civilian sports and the military.1 2 Female sports participation across the age groups is nearly equal to that of males but injury rate is not,3 especially in the military, where women consistently suffer more musculoskeletal injuries than men.4 Much more research is warranted to protect and treat the female athlete.

We are therefore delighted to present several articles in this issue aligned with two themes: (1) the female athlete; (2) knee and lower leg.

In an editorial contribution, Tsukahara et al draw attention to the prejudices and challenges female sports doctors face when working the sidelines during pregnancy and post partum and call for innovative research to support female sports doctors during these times (see page 1535) . For athletes, postpartum return to activity (RTA) and return to sports (RTS) may be challenging due to the significant physical, physiological and mental changes. Schulz et al performed a scoping review about current guidelines and recommendations for RTA and RTS (see page 1573) . Their research revealed the existence of only a few scientific based guidelines, mostly characterised by vague and inconsistent recommendations. Consequently, the authors plea for the development of future clinical practice guidelines.

The third manuscript addressing pregnancy and the postpartum period in athletes emphasises the experiences of coaches and healthcare providers for the development of evidence-informed policy and practices that support (elite) athletes through the perinatal period (see page 1559) .

Pelvic floor (PF) symptoms represent an under-recognised problem in female athletes, despite being responsible for interfering with exercise in 50% of Australian women experiencing these symptoms. The authors explored the reasons and, based on their results, they recommend a safe PF pre-exercise screening protocol including information and recommendations to deal with the PF inconveniences, to reduce the fallout from sports activities (see page 1539) . In line with this, Giagio et al developed an informative and practical infographic named ‘Ten naked truths about the pelvic floor in athletes’, indicating that PF symptoms also may occur in males (see page 1583) .

In an original research article, Clausen et al set out to determine the influence of treatment strategy, surgical or non-surgical, on structural knee joint changes and the later risk of knee osteoarthritis in young patients with meniscal tears. They found that after 2 years both treatment strategies yield similar outcomes in knee joint changes and patient-reported outcomes (see page 1566) . As ‘patient voices’, Le and Sleeswijk Visser, both working in healthcare, describe how they themselves would have liked to receive information on osteoarthritis prevention after a knee injury (see page 1579) . Della Villa and his group return to the basics of sports medicine injury prevention using detailed observation by video and advanced analytic epidemiology, in this case in football (see page 1550) . Other sports could benefit from this approach. Moisan et al take a stand in a debate that could be said to be ‘long-standing’: flat feet are not a deformity, but a healthy anatomical variant (see page 1536) . Finally, Carranza et al present a topic that is currently topical in the popular press: the influence of running shoe characteristics on physiology, biomechanics and running performance (see page 1581) . What do you think: does advanced footwear technology really help substantially? Read the article and be informed.

In line with these observations the annual scientific meeting of the Dutch Sports Medicine Association (VSG), to be held 30 November and 1 December 2023 in Vianen, will showcase several presentations on the female athlete and injuries of the knee and lower leg.

We hope you enjoy this VSG-inspired issue. May the articles in it contribute to your clinical and research efforts.

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