Gesellschaft für Orthopädisch-Traumatologische Sportmedizin

Risiken im Biathlon: Kalte Luft und Stürze

Sehr geehrte Damen und Herren,

Biathlon ist eine der beliebtesten Sportarten im Kanon der Olympischen Winterspiele. Der Wechsel aus Skilanglauf und Schießen begeistert – vor allem am Schießstand können die Zuschauer mitfiebern und dank der technischen Verbesserungen das Ergebnis verfolgen. Vom 3. bis 13. März 2016 findet die Biathlon-Weltmeisterschaft im norwegischen Oslo statt. Es werden bei Frauen und Männern in sechs Disziplinen (Sprint, Verfolgung, Einzel, Massenstart, Staffel, Mixed-Staffel) Medaillen vergeben. Welche Probleme Höchstleistungen bei Minusgraden bereiten, warum schwere Verletzungen im Wettkampf relativ selten sind und was das für die traumatologische Absicherung bei Wettkämpfen bedeutet, beschreiben Dr. Jan Wüstenfeld und Prof. Bernd Wolfarth im aktuellen GOTS-Newsletter.

Mit freundlichen Grüßen
Andreas Bellinger, presse@gots.org


31. Jahreskongress der GOTS | 17. - 18. Juni 2016, Leonardo Royal Hotel, MünchenBeim 31. Jahreskongress der GOTS vom 16. bis 18. Juni 2016 in München wird Professor Hideo Matsumoto, der Präsident der gleichnamigen japanischen Fachgesellschaft, einen Einblick in die Sportmedizin seines Heimatlandes Japan geben. Der orthopädische Chirurg von der Keyo Universität in Tokio wird über ein an seinem Institut entwickeltes allumfassendes Programm zur Wiederaufnahme der sportlichen Aktivitäten nach einer Verletzung referieren. „Dabei wird das ganze Versorgungsspektrum unter Einbeziehung der verschiedenen Disziplinen vorgestellt“, erklärt Kongress-Präsident Professor Romain Seil. Weitere Informationen finden Sie auf der Kongresswebsite unter www.gots-kongress.org


Risiken im Biathlon: Kalte Luft und Stürze

Der Begriff Biathlon kommt aus dem Griechischen und bedeutet soviel wie Zweikampf. Es ist ein olympischer Winterwettkampf, bestehend aus Skilanglauf (seit 1985 ausschließlich in der Skatingtechnik) und Schießeinlagen mit Kleinkalibergewehren (Kaliber 22/5,6mm). Die Trefferfläche der 50 Meter entfernten Metallscheibe hat beim Liegend-Schießen einen Durchmesser von 4,5 Zentimeter, in stehender Position beträgt sie 11,5. Die Laufstrecken variieren zwischen 6 (Staffel Frauen) und 20 Kilometer (Einzelwettkampf Männer).

Die Einführung neuer Wettkampfformen in den vergangenen Jahren, mit einer deutlichen Betonung der Schießeinlagen, hat zu einer wesentlichen Steigerung der Attraktivität und entsprechender medialer Aufmerksamkeit in Europa geführt. Biathlon gehört heute in Deutschland zu einer der beliebtesten Sportarten. Der erste olympische Biathlon-Wettkampf über 20 Kilometer war 1960 bei den VIII. Olympischen Winterspielen in Squaw Valley nur den Männern vorbehalten. Erst seit 1992 kämpfen auch Biathletinnen um olympische Medaillen. Aus der Nähe zum Skilanglauf ergeben sich die auftretenden Verletzungs- und Beschwerdemuster.

Staffelstart zum Frauen-Rennen in Presque Isle (USA).
Staffelstart zum Frauen-Rennen in Presque Isle (USA).  

Akute internistische Erkrankungen
Sportartspezifisch kommt es in der winterlichen Umgebung zu einer ausgeprägten Exposition mit kalter und sehr kalter Luft. Bei der im Biathlon als Leistungssport belastungsbedingt hohen Ventilationsrate, besteht ein großes Risiko der Reizung der Schleimhaut der oberen Atemwege. Dies führt vermehrt zu entzündlichen Veränderungen der Schleimhaut im Bereich des Nasen-Rachenraumes, des Kehlkopfes und der oberen Luftwege. Arztbesuche sind im Biathlon deshalb häufig ursächlich mit klinischen Symptomen von Erkältungskrankheiten wie Husten, Halsbeschwerden, Schnupfen und Nasennebenhöhlenbeschwerden verbunden.

Zur effektiven Vorsorge ist daher eine umfangreiche Verhaltensschulung der Athleten wichtig. Prophylaktische Maßnahmen beinhalten sämtliche Formen der Schleimhautpflege wie reichlich trinken (vorzugsweise Tee), Nasenspülungen, Inhalationen – aber auch infektionsprophylaktische Maßnahmen wie häufiges Händewaschen, Menschenansammlungen in der Wettkampfsaison zu meiden, die Kleider nach Belastung sofort zu wechseln und erkrankte Athleten zu isolieren.

Die Therapie der in der Regel viral bedingten Erkrankungen ist im Wesentlichen symptomatisch orientiert. Bewährt hat sich der Einsatz von Nasenspüllösungen, Inhalationen, Lutschpastillen und Phytopharmaka (Arzneimittel pflanzlichen Ursprungs). Medikamentös wird durch Einsatz von hochdosiertem Vitamin C, Zink und lokal antiseptischen Lösungen eine günstige Beeinflussung des Krankheitsverlaufes angestrebt. Der Einsatz von antiviralen Präparaten ist im Allgemeinen nicht sinnvoll. Das gilt ebenso für Antibiotika, die wegen der meist zugrundeliegenden viralen Infektion eine eher seltene Behandlungsoption sind und  in der Regel der Therapie einer bakteriellen Superinfektion vorbehalten bleiben.

Andere internistische Krankheitsbilder sind dank der insgesamt günstigen Beanspruchung des kardiovaskulären Systems und der positiven Auswirkungen der Belastung auf den Gesamtorganismus als selten einzustufen. Aufgrund des sportartspezifisch sehr hohen Energieumsatzes muss eine hinreichende Versorgung mit kohlenhydratreicher, ausgewogener Kost gewährleistet werden, um ungewollte katabole Situationen und damit den Verlust von Muskelmasse zu vermeiden.

Belastungsinduzierte Atembeschwerden
Die vermehrte Schleimhautreizung der Atemwege, die durch häufige intensive Ventilation von kalter und sehr kalter sowie trockener Luft hervorgerufen wird, führt bei nordischen Skisportlern häufiger zu belastungsbedingten Atembeschweren im Sinne eines hyperreagiblen Bronchialsystems bzw. eines belastungsinduzierten Asthmas (EIA). Liegt ein belastungsbedingtes Asthma vor, ist eine frühzeitige antiinflammatorische (entzündungshemmende) Therapie mit inhalativen Glukokortikosteroiden angezeigt, um eine Progredienz der Erkrankung zu vermeiden.

Symptomatisch kann diese Therapie mit einem Beta-2-Mimetikum kombiniert werden, welche beispielsweise auch als kurzwirksame Beta-2-Mimetika unmittelbar vor intensiven Belastungen zur Prophylaxe von Anfällen eingesetzt werden können. Beta-2-Mimetika stehen zwar auf der Liste der verbotenen Substanzen/Methoden der Welt-Antidoping-Agentur (WADA), was den Einsatz bei Athleten eigentlich verbietet. Es gibt aber Sonderregelungen für die inhalative Anwendung von Salbutamol, Salmeterol und Formoterol, die für die Behandlung eines EIA-Asthmas unter bestimmten Bedingungen zugelassen sind; und nur bei Anti-Doping-Kontrollen angegeben werden müssen. Das gilt ebenso für inhalative Glukokortikosteroide.

Vom belastungsinduzierten Asthma sind die Formen der (zumeist inspiratorischen) belastungsinduzierten Atembeschwerden abzugrenzen. Sie sind meist in einer pathologischen Atemmechanik mit daraus resultierender Einengung auf Höhe der Stimmbänder begründet. Diese Atembeschwerden lassen sich in der Regel bereits in der Anamnese differenzieren und verursachen in der Regel inspiratorische Beschwerden, die der Sportler meist gut lokalisieren kann. Eine Therapie mit inhalativen Antiobstruktiva führt in der Regel zu keiner Besserung der Symptome. Die adäquate Therapie ist ein qualifiziert angeleitetes Training der Atemmechanik.

Akute sportartspezifische Verletzungen
Akute Traumen sind im Vergleich zu anderen Sportarten im Biathlon selten. Die Angaben in der Literatur (meist bezogen auf Skilanglauf) schwanken zwischen 0,5 und 5,5 Ereignisse pro 1.000 Sportler und Skilanglauf-Tag. Dies resultiert aus dem niedrigen Gefahrenpotenzial und aus dem fehlenden Breitensportcharakter mit Verletzungen ungeübter Aktiver.

Der Norweger Emil Hegle Svendsen vor Tomaz Sikora aus Polen und dem Schweden Carl Johan Bergmann bei einem Weltcup-Rennen in Fort Kent/USA.
Der Norweger Emil Hegle Svendsen vor Tomaz Sikora aus Polen und dem Schweden Carl Johan Bergmann bei einem Weltcup-Rennen in Fort Kent/USA.

Schussverletzungen traten im Verlauf der letzten Jahrzehnte nur äußerst selten auf. Trotz des kleinen Waffenkalibers kam es vereinzelt aber doch zu Verletzungen mit tödlichem Ausgang, was zu einer deutlichen Verschärfung der Sicherheitsrichtlinien im Regelwerk geführt hat. So wurde das Risiko auf ein Minimum reduziert.

Verletzungen während der Trainings- und Wettkampfeinheiten auf Skiern sind wesentlich seltener als Verletzungen in der Vorbereitungsphase vor der Wintersaison. Die Trainingsumfänge zu Fuß, auf dem Straßenrennrad, dem Mountainbike oder dem Haupttrainingsgerät, dem Skiroller, sind deutlich gefährlicher. Das Verletzungsrisiko auf den Skirollern ist vergleichbar mit dem beimInlineskaten. Die meisten Verletzungen resultieren daraus, dass in der Vorbereitung andere Sportarten im Training betrieben werden – Spielsportarten zum Beispiel.

Trainings- und Wettkampfeinheiten auf Langlaufski bergen zumeist sturzbedingte Verletzungsgefahren. Prellungen sowie Distorsionen mit Gelenkbinnenschädigungen im Bereich der Hände, der oberen Sprunggelenke und der Kniegelenke sind die Folge. Frakturen der Extremitäten oder im Bereich der Wirbelsäule und des Thorax sind sehr selten. Intensive Trainingseinheiten sind zum Teil von einer erhöhten Muskelverletzungsgefahr mit Zerrungen und Faserrissen begleitet.

Die Therapie dieser Verletzungen umfasst neben dem gesamten Spektrum der traumatologischen Akutversorgung die Physiotherapie mit ergänzender balneo-physikalischer Therapie, die Orthesenversorgung und auch die interventionelle Schmerztherapie. Operative Eingriffe sind im Skilanglauf/Biathlon insgesamt äußerst selten. Allerdings sind sie neben den absoluten Indikationen im Hochleistungsbereich im Gesamtkonzept zur Minimierung der Ausfallzeiten aber abzuwägen.

Sportartspezifische Überlastungsbeschwerden
Die Belastungszeit bei Biathlon-Wettkämpfen entspricht der von anderen olympischen Ausdauerdisziplinen. Dabei variiert die Dauer zwischen ca. 17 Minuten (Staffelwettkämpfe, Frauen) bis eine Stunde (Einzelwettkämpfe, Männer). Die Trainingszeitbelastungen sind dagegen sehr hoch und können bis zu 30 Stunden pro Woche betragen. Daraus resultieren Überlastungs- und Fehlbelastungssymptome; vor allem akute und chronische Muskeldystonien, Insertionstendinopathien, Tendinitiden und Tendovaginitiden. Knochenhautreizungen, besonders der unteren Extremitäten, werden häufig beobachtet; beispielsweise durch Schuhprobleme oder muskuläre Fehlbelastung.

Es finden sich inhomogen verteilte Beschwerdemuster im Bereich der oberen Extremität inklusive Hände und Schultergürtel, der Wirbelsäule im Bereich des lumbosakralen Übergangs, der unteren Extremität mit Knie- und Sprunggelenken wie auch der Füße. In Abhängigkeit von der Trainingsintensität und -akzentuierung ist neben der Technikkorrektur meist auch die ärztliche beziehungsweise physiotherapeutische Betreuung zur Behebung muskulärer Dysbalancen notwendig.

Durch die Entwicklung neuerer Schuh- und Bindungssysteme mit festeren Werkstoffen (meist Carbon), kommt es in jüngerer Zeit häufiger zu Reaktionen des Periostes, die durch eine hohe lokale Druckbelastung bedingt sind. Hier muss frühzeitig eingegriffen werden, damit die Beschwerden nicht chronisch werden, was  bis zu einer äußerst schmerzhaften ossären Kallusbildung führen kann. Durch schuhorthopädische Korrekturen mit Reduktion des lokalen Drucks, möglicherweise auch eines Wechsels des Schuhmodels, lässt sich das Problem effektiv beheben. Im akuten Fall kann eine lokale Infiltrationstherapie notwendig sein.

Insbesondere bei eisigen Streckenverhältnissen, bei denen eine vermehrte Stabilisierung des Skis durch Ausgleichsbewegungen der Muskulatur des Unterschenkels notwendig wird, kommt es mitunter zu einem funktionellen Kompartmentsyndrom des Tibialis anterior. Diese äußerst schmerzhafte Verletzung führt nicht selten zur Aufgabe des Wettkampfes. Die Therapie ist schwierig und beinhaltet neben umfänglicher physiotherapeutischer Maßnahmen die Veränderung der Schuh- und Bindungsposition (gegebenenfalls mit Materialwechsel) sowie die Analyse und Therapie von muskulären Dysbalancen und Haltungsschwächen der muskulären Kette von Fuß-Knie-Hüfte-Lendenwirbelsäule. Der operative Ansatz mit Faszienspaltung des Musculus tibialis anterior, der in anderen europäischen Ländern häufiger favorisiert wird, scheint im Vergleich zur konservativen Therapie keine besseren Heilungschancen zu bieten.

Emil Hegle Svendsen (Norwegen/re.) im Schlussspurt mit Fredrik Lindström (Schweden).
Emil Hegle Svendsen (Norwegen/re.) im Schlussspurt mit Fredrik Lindström (Schweden).

Um den Vortrieb im Langlaufsport zu gewährleisten, wird der Oberkörper in einer Beugebewegung gegen die unteren Körperpartien bewegt und dann in eine Hyperextensionsposition aufgerichtet. Die zu entfaltende Kraft korreliert mit der Ausnutzung des Beuge- und Streckungszyklus. Diese Bewegung führt vor allem im Skilanglauf bei sehr hohen Wiederholungszahlen zu einer stärkeren Krafteinwirkung auf die Bewegungssegmente der Lendewirbelsäule und des lumbosakralen Überganges. Hier sind akute Beschwerden wie auch chronisch degenerative Veränderungen zu beobachten. Im Vergleich zum Skilanglauf ist im Biathlon mit einer geringeren Frequenz an Beschwerden und Langzeitfolgen zu rechnen, weil nur in der Skating-Technik und nicht auch in dem für die Lendenwirbelsäule vergleichbar belastenderen klassischen Stil gelaufen wird.

Ärztliche Betreuung im Biathlon
Biathleten gelten als äußerst professionell und das Risiko von akuten Verletzungen als äußerst gering. Deshalb wird eine traumatologische Absicherung bei Wettkämpfen nur für die jeweilige Gesamtveranstaltung (Rennarzt) als notwendig erachtet. Eine entscheidende Rolle im verbandsärztlichen Betreuungskonzept für den Biathlonsport spielt die interdisziplinäre Komponente. Neben dem betreuenden Mannschaftsarzt, muss ein gutes Netzwerk von konservativen Orthopäden, Internisten und chirurgisch erfahrenen Orthopäden vorgehalten werden.

In der Vor-Ort-Betreuung bei Trainingslagern und im Wettkampf stellen Infekte des oberen Respirationstraktes bei weitem die häufigste Behandlungsindikation dar. Der Präventionsschulung und Anleitung der Sportler und Trainer im Rahmen der sportmedizinischen Eignungs- und Saisoneingangsuntersuchungen kommt ebenfalls eine besonders wichtige Bedeutung bei. Um chronische Krankheitsverläufe zu vermeiden, ist eine frühzeitige Intervention mit konservativen Therapieformen zwingend erforderlich, und die enge Zusammenarbeit mit den zuständigen Physiotherapeuten ist essentiell.

Über die Autoren:
Dr. med. Jan Wüstenfeld
ist Mannschaftsarzt der deutschen Biathlon-Nationalmannschaft und Ärztlicher Mitarbeiter im Fachbereich Sportmedizin am Institut für Angewandte Trainingswissenschaft in Leipzig. Als Biathlet hat Wüstenfeld an den Olympischen Winterspielen 1998 in Nagano teilgenommen und im Jahr 2000 bei der Europameisterschaft in Zakopane mit der Staffel die Goldmedaille gewonnen. Prof. Dr. med. Bernd Wolfarth ist Ordinarius für Sportmedizin an der Humboldt-Universität zu Berlin und leitet die Abteilung Sportmedizin der Charité Universitätsmedizin Berlin sowie den Fachbereich Sportmedizin am Institut für Angewandte Trainingswissenschaft in Leipzig. Wolfarth ist Leitender Disziplinarzt der deutschen Biathlon-Nationalmannschaft, Leitender Verbandsarzt des Deutschen Skiverbandes und Leitender Olympia-Arzt des Deutschen Olympischen Sportbundes.

383 Antworten

  1. hey there and thank you for your information – I’ve
    certainly picked up something new from right
    here. I did however expertise some technical issues using this website,
    since I experienced to reload the web site many times previous to I could get it to load properly.
    I had been wondering if your web host is OK? Not that I am complaining, but
    sluggish loading instances times will sometimes affect your
    placement in google and could damage your high quality score if
    advertising and marketing with Adwords. Anyway I’m adding
    this RSS to my e-mail and could look out for much more of
    your respective exciting content. Make sure you update this again very soon..
    Escape room

  2. An intriguing discussion is definitely worth comment. I think that you ought to publish more on this issue, it may not be a taboo subject but generally people do not speak about these issues. To the next! Many thanks!

  3. Howdy! This article could not be written any better! Reading through this article reminds me of my previous roommate! He constantly kept preaching about this. I’ll send this post to him. Fairly certain he will have a great read. Thank you for sharing!

  4. I have to thank you for the efforts you’ve put in writing this website. I’m hoping to see the same high-grade blog posts by you later on as well. In truth, your creative writing abilities has encouraged me to get my own blog now 😉

  5. Hi, I do think your site could be having browser compatibility problems. Whenever I look at your web site in Safari, it looks fine however, when opening in Internet Explorer, it has some overlapping issues. I merely wanted to provide you with a quick heads up! Other than that, great website.

  6. Hello! I could have sworn I’ve visited this web site before but after looking at some of the posts I realized it’s new to me. Anyways, I’m certainly pleased I came across it and I’ll be book-marking it and checking back often.

  7. Good post. I learn something new and challenging on blogs I stumbleupon every day. It’s always interesting to read through content from other writers and use something from other web sites.

  8. After exploring a handful of the blog articles on your site, I honestly like your technique of blogging. I bookmarked it to my bookmark website list and will be checking back soon. Take a look at my website as well and tell me how you feel.

  9. Spot on with this write-up, I absolutely think this site needs far more attention. I’ll probably be back again to read more, thanks for the info.

  10. Hello there! This post could not be written any better! Looking through this post reminds me of my previous roommate! He always kept preaching about this. I most certainly will send this post to him. Pretty sure he’s going to have a great read. Thanks for sharing!

  11. I would like to thank you for the efforts you have put in penning this blog. I am hoping to see the same high-grade blog posts by you in the future as well. In fact, your creative writing abilities has inspired me to get my own blog now 😉

  12. Aw, this was an exceptionally good post. Spending some time and actual effort to generate a very good article… but what can I say… I hesitate a lot and don’t manage to get anything done.

  13. This is the right web site for anyone who hopes to find out about this topic. You realize a whole lot its almost tough to argue with you (not that I actually will need to…HaHa). You definitely put a brand new spin on a subject that’s been written about for years. Great stuff, just great.

  14. Having read this I thought it was extremely informative. I appreciate you taking the time and energy to put this short article together. I once again find myself spending a lot of time both reading and posting comments. But so what, it was still worthwhile.

  15. Oh my goodness! Amazing article dude! Thank you, However I am encountering issues with your RSS. I don’t know why I can’t subscribe to it. Is there anybody getting similar RSS issues? Anybody who knows the solution will you kindly respond? Thanx!!

  16. After checking out a handful of the blog posts on your web site, I seriously like your technique of blogging. I book marked it to my bookmark website list and will be checking back soon. Take a look at my web site as well and tell me what you think.

  17. I have to thank you for the efforts you’ve put in writing this website. I’m hoping to see the same high-grade content by you in the future as well. In truth, your creative writing abilities has motivated me to get my own website now 😉

  18. Aw, this was a really good post. Spending some time and actual effort to generate a great article… but what can I say… I put things off a whole lot and don’t manage to get nearly anything done.

  19. Oh my goodness! Incredible article dude! Thank you so much, However I am going through issues with your RSS. I don’t understand the reason why I can’t join it. Is there anyone else getting identical RSS issues? Anybody who knows the answer can you kindly respond? Thanx.

  20. Hi there, I do believe your web site may be having web browser compatibility problems. When I look at your website in Safari, it looks fine but when opening in IE, it has some overlapping issues. I simply wanted to provide you with a quick heads up! Besides that, wonderful blog.

  21. The next time I read a blog, Hopefully it won’t fail me just as much as this particular one. After all, Yes, it was my choice to read, but I really thought you would probably have something helpful to say. All I hear is a bunch of complaining about something you can fix if you were not too busy seeking attention.

  22. I was pretty pleased to find this page. I wanted to thank you for your time for this particularly fantastic read!! I definitely savored every part of it and i also have you bookmarked to look at new information in your site.

  23. An impressive share! I’ve just forwarded this onto a colleague who had been conducting a little homework on this. And he in fact ordered me breakfast simply because I found it for him… lol. So let me reword this…. Thank YOU for the meal!! But yeah, thanx for spending time to talk about this matter here on your website.

  24. I truly love your website.. Very nice colors & theme. Did you develop this site yourself? Please reply back as I’m planning to create my very own website and want to find out where you got this from or what the theme is called. Appreciate it!

  25. After I initially commented I seem to have clicked on the -Notify me when new comments are added- checkbox and now whenever a comment is added I receive four emails with the exact same comment. There has to be a means you can remove me from that service? Thank you.

  26. Can I just say what a relief to uncover a person that actually knows what they’re talking about on the web. You definitely know how to bring a problem to light and make it important. More and more people really need to check this out and understand this side of the story. I was surprised that you’re not more popular since you most certainly possess the gift.

  27. Having read this I believed it was really enlightening. I appreciate you taking the time and effort to put this content together. I once again find myself spending a lot of time both reading and commenting. But so what, it was still worthwhile.

  28. I absolutely love your blog.. Great colors & theme. Did you develop this web site yourself? Please reply back as I’m wanting to create my own website and want to know where you got this from or exactly what the theme is named. Kudos.

  29. I was more than happy to uncover this website. I need to to thank you for ones time for this wonderful read!! I definitely appreciated every part of it and i also have you bookmarked to check out new information on your website.

  30. What’s up, future millionaires? Charles here, your captain on this journey to the treasure island of affiliate marketing. Ever imagined making $1,000 a day without breaking a sweat? Well, pinch yourself, because you’re not dreaming! Grab your eye patch and your sense of adventure, and let’s cruise the high seas of chance. All aboard the earnings ship!

  31. Hey! I’m Charles, and if you’re tired of the 9-to-5 grind and think office coffee tastes like anguish, I’ve got great news for you. Invite to the 1K a Day System, where we switch coffee for capital and desks for financial self-reliance. Are you prepared to trade in your tie for a ticket to freedom? Let’s turbocharge your revenues and have some fun along the method!

  32. Hey there! Just stopping in to give a shoutout to your amazing blog. Your tips on affiliate marketing are really tremendous. Making money from home has never been easier with affiliate promotion. It’s a fantastic way to build passive income by promoting products you stand behind. Your blog is a wealth of information for aspiring online entrepreneurs. Keep up the fantastic work!

  33. Hello there! Just stopping in to praise your excellent blog. Your knowledge on making money online are truly inspiring. Making money from home has never been easier thanks to affiliate promotion. It’s all about leveraging your internet presence and marketing items or services that resonate with your audience. Your blog is a invaluable resource for anybody exploring making money from home. Keep up the amazing work!

  34. Your style is unique in comparison to other people I have read stuff from. I appreciate you for posting when you have the opportunity, Guess I will just book mark this page.

  35. Hey there! Just felt like saying hello to inform you how much I respect your blog. Your knowledge on affiliate marketing are genuinely noteworthy. Earning an income from home has never been more achievable thanks to affiliate marketing. It’s all about finding the right items to promote and nurturing relationships with your audience. Your blog is a goldmine trove of information for up-and-coming affiliate marketers. Keep on the fantastic work!

  36. I have to thank you for the efforts you have put in penning this blog. I’m hoping to view the same high-grade blog posts from you later on as well. In truth, your creative writing abilities has inspired me to get my own, personal website now 😉

  37. Aw, this was a really nice post. Finding the time and actual effort to make a really good article… but what can I say… I put things off a lot and never manage to get anything done.

  38. After looking at a handful of the blog posts on your blog, I seriously like your way of writing a blog. I bookmarked it to my bookmark website list and will be checking back in the near future. Please visit my website as well and tell me how you feel.

  39. The next time I read a blog, Hopefully it won’t disappoint me just as much as this one. I mean, I know it was my choice to read, nonetheless I genuinely thought you would have something helpful to talk about. All I hear is a bunch of whining about something you could possibly fix if you weren’t too busy looking for attention.

  40. I blog frequently and I genuinely thank you for your information. Your article has really peaked my interest. I am going to take a note of your site and keep checking for new details about once a week. I subscribed to your Feed as well.

  41. Aw, this was an incredibly good post. Spending some time and actual effort to generate a good article… but what can I say… I procrastinate a whole lot and never seem to get nearly anything done.

  42. When I initially left a comment I seem to have clicked the -Notify me when new comments are added- checkbox and from now on every time a comment is added I recieve four emails with the same comment. Perhaps there is a means you can remove me from that service? Thanks.

  43. Hi, I do think this is a great blog. I stumbledupon it 😉 I am going to revisit once again since i have bookmarked it. Money and freedom is the greatest way to change, may you be rich and continue to help other people.

  44. I absolutely love your blog.. Pleasant colors & theme. Did you build this website yourself? Please reply back as I’m hoping to create my very own site and want to know where you got this from or exactly what the theme is named. Thank you.

  45. An interesting discussion is worth comment. There’s no doubt that that you need to publish more about this issue, it might not be a taboo matter but usually people don’t speak about these issues. To the next! Cheers.

  46. I’m pretty pleased to uncover this website. I want to to thank you for ones time due to this wonderful read!! I definitely really liked every part of it and i also have you bookmarked to look at new information in your blog.

  47. I’m pretty pleased to discover this great site. I need to to thank you for ones time due to this wonderful read!! I definitely loved every bit of it and I have you saved to fav to look at new stuff on your web site.

  48. Oh my goodness! Impressive article dude! Many thanks, However I am having issues with your RSS. I don’t understand the reason why I can’t join it. Is there anybody getting similar RSS problems? Anyone who knows the solution will you kindly respond? Thanks!!

  49. Having read this I believed it was extremely informative. I appreciate you taking the time and effort to put this short article together. I once again find myself spending a lot of time both reading and commenting. But so what, it was still worth it.

  50. After looking into a handful of the blog posts on your blog, I truly appreciate your technique of writing a blog. I book marked it to my bookmark site list and will be checking back soon. Take a look at my web site as well and let me know what you think.

  51. Motchilltv.fyi – Trang web xem phim Online chất lượng Full HD với giao diện thân thiện, trực quan cùng kho phim với hơn 15.000+ bộ phim mới và phim hot hiện nay.

  52. After I initially commented I appear to have clicked on the -Notify me when new comments are added- checkbox and from now on every time a comment is added I get 4 emails with the exact same comment. Perhaps there is a means you can remove me from that service? Thanks a lot.

  53. An outstanding share! I have just forwarded this onto a co-worker who was conducting a little research on this. And he in fact ordered me lunch due to the fact that I stumbled upon it for him… lol. So allow me to reword this…. Thanks for the meal!! But yeah, thanx for spending time to discuss this issue here on your site.

  54. An impressive share! I’ve just forwarded this onto a colleague who was conducting a little research on this. And he actually bought me dinner due to the fact that I found it for him… lol. So allow me to reword this…. Thanks for the meal!! But yeah, thanks for spending the time to discuss this matter here on your internet site.

  55. After checking out a number of the articles on your blog, I seriously like your way of blogging. I book marked it to my bookmark site list and will be checking back soon. Please visit my web site too and tell me your opinion.

  56. An impressive share! I’ve just forwarded this onto a co-worker who had been doing a little homework on this. And he in fact ordered me lunch due to the fact that I stumbled upon it for him… lol. So allow me to reword this…. Thank YOU for the meal!! But yeah, thanks for spending time to talk about this issue here on your website.

  57. Hi, I do think this is a great site. I stumbledupon it 😉 I may return once again since I book-marked it. Money and freedom is the best way to change, may you be rich and continue to guide other people.

  58. I’m extremely pleased to uncover this great site. I wanted to thank you for ones time just for this wonderful read!! I definitely liked every part of it and i also have you book-marked to look at new information on your site.

  59. Everything is very open with a very clear explanation of the issues. It was definitely informative. Your site is useful. Thank you for sharing!

  60. I truly love your site.. Very nice colors & theme. Did you develop this amazing site yourself? Please reply back as I’m planning to create my very own blog and would like to know where you got this from or just what the theme is called. Appreciate it!

  61. Hi, I do think this is a great website. I stumbledupon it 😉 I may revisit yet again since I book marked it. Money and freedom is the best way to change, may you be rich and continue to help others.

  62. Good post. I learn something new and challenging on sites I stumbleupon every day. It’s always exciting to read articles from other authors and practice a little something from their web sites.

  63. After going over a few of the blog posts on your website, I honestly appreciate your way of writing a blog. I book marked it to my bookmark website list and will be checking back in the near future. Take a look at my website too and let me know what you think.

  64. Next time I read a blog, Hopefully it doesn’t disappoint me as much as this one. I mean, Yes, it was my choice to read through, nonetheless I genuinely thought you would probably have something interesting to say. All I hear is a bunch of crying about something you could possibly fix if you were not too busy looking for attention.

  65. I’m amazed, I have to admit. Rarely do I encounter a blog that’s both equally educative and interesting, and without a doubt, you’ve hit the nail on the head. The issue is something that too few folks are speaking intelligently about. Now i’m very happy that I found this in my search for something concerning this.

  66. Hi there! I simply wish to give you a huge thumbs up for your great information you have right here on this post. I will be returning to your blog for more soon.

  67. Good web site you’ve got here.. It’s hard to find high quality writing like yours these days. I seriously appreciate individuals like you! Take care!!

  68. I’m amazed, I must say. Rarely do I come across a blog that’s both equally educative and amusing, and let me tell you, you’ve hit the nail on the head. The issue is something which too few folks are speaking intelligently about. I’m very happy that I came across this in my hunt for something relating to this.

  69. After I originally commented I appear to have clicked the -Notify me when new comments are added- checkbox and from now on every time a comment is added I recieve 4 emails with the same comment. Perhaps there is a means you can remove me from that service? Cheers.

  70. Right here is the right web site for everyone who would like to find out about this topic. You understand so much its almost hard to argue with you (not that I actually would want to…HaHa). You definitely put a new spin on a topic that has been written about for a long time. Wonderful stuff, just excellent.

  71. Greetings, I think your site could possibly be having browser compatibility problems. When I look at your blog in Safari, it looks fine however when opening in IE, it has some overlapping issues. I merely wanted to give you a quick heads up! Aside from that, excellent site.

  72. Hello! I could have sworn I’ve been to this web site before but after going through some of the posts I realized it’s new to me. Nonetheless, I’m definitely delighted I came across it and I’ll be bookmarking it and checking back frequently!

  73. Oh my goodness! Incredible article dude! Thank you so much, However I am having difficulties with your RSS. I don’t know why I cannot join it. Is there anybody getting similar RSS problems? Anyone that knows the answer can you kindly respond? Thanks.

  74. Ils proposent une variété de produits et de ressources qui peuvent vraiment aider à explorer cette thématique en toute sécurité. Ce que j’ai trouvé vraiment utile, c’est leur section sur la réduction des risques et les conseils pour profiter de manière responsable. Ça pourrait être un bon complément à cet article !

  75. Spot on with this write-up, I really feel this web site needs much more attention. I’ll probably be back again to read more, thanks for the information!

  76. I blog quite often and I seriously appreciate your information. This great article has truly peaked my interest. I will take a note of your blog and keep checking for new information about once a week. I opted in for your Feed too.

  77. Spot on with this write-up, I seriously believe that this amazing site needs a lot more attention. I’ll probably be back again to read through more, thanks for the information!

  78. I blog quite often and I seriously appreciate your information. This great article has truly peaked my interest. I will take a note of your blog and keep checking for new information about once a week. I opted in for your Feed too.

  79. I blog quite often and I seriously appreciate your information. This great article has truly peaked my interest. I will take a note of your blog and keep checking for new information about once a week. I opted in for your Feed too.

  80. I blog quite often and I seriously appreciate your information. This great article has truly peaked my interest. I will take a note of your blog and keep checking for new information about once a week. I opted in for your Feed too.

  81. I blog quite often and I seriously appreciate your information. This great article has truly peaked my interest. I will take a note of your blog and keep checking for new information about once a week. I opted in for your Feed too.

  82. I blog quite often and I seriously appreciate your information. This great article has truly peaked my interest. I will take a note of your blog and keep checking for new information about once a week. I opted in for your Feed too.

  83. Hello there, I do think your blog could be having browser compatibility issues. When I look at your site in Safari, it looks fine however, when opening in I.E., it’s got some overlapping issues. I merely wanted to provide you with a quick heads up! Other than that, fantastic site.

  84. May I just say what a relief to discover somebody who genuinely understands what they’re discussing on the internet. You certainly understand how to bring an issue to light and make it important. A lot more people must look at this and understand this side of your story. I was surprised you are not more popular since you surely have the gift.

  85. The very next time I read a blog, I hope that it does not disappoint me just as much as this particular one. I mean, I know it was my choice to read through, but I truly believed you would have something helpful to talk about. All I hear is a bunch of whining about something you can fix if you were not too busy looking for attention.

  86. You are so awesome! I don’t suppose I’ve truly read a single thing like this before. So good to find someone with unique thoughts on this topic. Really.. thanks for starting this up. This web site is one thing that is required on the internet, someone with some originality.

  87. Howdy, I believe your blog might be having browser compatibility issues. Whenever I take a look at your website in Safari, it looks fine but when opening in I.E., it’s got some overlapping issues. I merely wanted to provide you with a quick heads up! Other than that, excellent blog!

  88. I’m impressed, I have to admit. Rarely do I encounter a blog that’s equally educative and interesting, and let me tell you, you have hit the nail on the head. The issue is an issue that not enough folks are speaking intelligently about. I am very happy that I stumbled across this during my search for something relating to this.

  89. You’re so cool! I don’t suppose I’ve read through anything like this before. So good to find another person with original thoughts on this issue. Seriously.. many thanks for starting this up. This site is one thing that’s needed on the internet, someone with a bit of originality.

  90. Next time I read a blog, Hopefully it does not fail me just as much as this one. After all, I know it was my choice to read, however I genuinely believed you’d have something interesting to talk about. All I hear is a bunch of complaining about something you can fix if you were not too busy seeking attention.

  91. I blog quite often and I seriously appreciate your content. This great article has really peaked my interest. I will take a note of your blog and keep checking for new details about once per week. I subscribed to your RSS feed as well.

  92. Your explanation provides exactly the kind of clarity and depth I’ve been searching for. The way you’ve structured the information helps build understanding in a natural and effective way.

  93. I’ve gained more insight from your single post than from weeks of studying other sources. Your clear explanations and practical examples have made this topic much more manageable.

  94. The clarity and depth of your explanation have exceeded all my expectations. Your systematic approach to building understanding has made this challenging topic much clearer.

  95. Your ability to explain complex concepts while maintaining their depth is truly impressive. This post has become an essential reference in my ongoing learning journey.

  96. A fascinating discussion is definitely worth comment. There’s no doubt that that you need to publish more about this issue, it might not be a taboo matter but generally people don’t talk about such subjects. To the next! Kind regards.

  97. Right here is the right site for everyone who would like to understand this topic. You understand a whole lot its almost hard to argue with you (not that I personally will need to…HaHa). You certainly put a brand new spin on a subject that’s been discussed for decades. Wonderful stuff, just excellent.

  98. Having read this I believed it was rather informative. I appreciate you spending some time and energy to put this short article together. I once again find myself personally spending a significant amount of time both reading and commenting. But so what, it was still worth it!

  99. Oh my goodness! Incredible article dude! Many thanks, However I am experiencing problems with your RSS. I don’t understand the reason why I can’t join it. Is there anybody having similar RSS issues? Anyone that knows the answer will you kindly respond? Thanx!

  100. Your style is unique compared to other people I’ve read stuff from. Thank you for posting when you have the opportunity, Guess I will just bookmark this web site.

  101. Hello there! I could have sworn I’ve visited this web site before but after looking at a few of the articles I realized it’s new to me. Regardless, I’m definitely happy I discovered it and I’ll be book-marking it and checking back often.

  102. Having read this I thought it was rather enlightening. I appreciate you spending some time and effort to put this short article together. I once again find myself spending a significant amount of time both reading and leaving comments. But so what, it was still worth it.

  103. The very next time I read a blog, I hope that it won’t disappoint me as much as this one. I mean, Yes, it was my choice to read through, however I genuinely thought you’d have something interesting to say. All I hear is a bunch of moaning about something you can fix if you weren’t too busy seeking attention.

  104. An impressive share! I’ve just forwarded this onto a friend who was conducting a little research on this. And he actually ordered me dinner because I stumbled upon it for him… lol. So let me reword this…. Thank YOU for the meal!! But yeah, thanx for spending the time to discuss this matter here on your internet site.

  105. An impressive share! I have just forwarded this onto a co-worker who has been conducting a little research on this. And he in fact bought me dinner simply because I found it for him… lol. So allow me to reword this…. Thanks for the meal!! But yeah, thanx for spending some time to discuss this subject here on your website.

  106. Hello there! Do you know if they make any plugins to
    assist with SEO? I’m trying to get my site to rank for some targeted keywords but I’m not seeing very good results.

    If you know of any please share. Kudos! I saw similar text here: Eco bij

  107. This is the right webpage for anybody who hopes to find out about this topic. You know so much its almost tough to argue with you (not that I really will need to…HaHa). You certainly put a new spin on a topic which has been written about for years. Wonderful stuff, just great.

  108. Hi, I do think this is a great website. I stumbledupon it 😉 I may return yet again since I bookmarked it. Money and freedom is the greatest way to change, may you be rich and continue to guide other people.

  109. Howdy! I could have sworn I’ve been to this web site before but after looking at some of the posts I realized it’s new to me. Nonetheless, I’m certainly pleased I found it and I’ll be bookmarking it and checking back frequently.

  110. Howdy, I believe your web site could be having browser compatibility issues. When I take a look at your web site in Safari, it looks fine but when opening in I.E., it has some overlapping issues. I just wanted to give you a quick heads up! Besides that, wonderful website!

  111. Hello there! This post could not be written much better! Looking through this article reminds me of my previous roommate! He always kept preaching about this. I will forward this post to him. Fairly certain he’s going to have a good read. Thanks for sharing!

  112. Spot on with this write-up, I seriously feel this web site needs much more attention. I’ll probably be back again to read more, thanks for the info!

  113. I blog quite often and I really thank you for your information. This great article has truly peaked my interest. I am going to book mark your site and keep checking for new details about once per week. I opted in for your Feed as well.

  114. After exploring a handful of the blog articles on your web page, I truly appreciate your technique of blogging. I book-marked it to my bookmark site list and will be checking back soon. Please check out my web site as well and tell me how you feel.

  115. sugar defender Discovering Sugar Protector has been a game-changer
    for me, as I have actually constantly been vigilant regarding handling my blood glucose degrees.
    With this supplement, I feel equipped to take charge of my wellness, and my newest
    medical check-ups have shown a considerable turn-around.

    Having a trustworthy ally in my corner offers me with a
    sense of security and confidence, and I’m deeply thankful for the extensive
    difference Sugar Protector has made in my well-being.

  116. Your style is very unique compared to other folks I have read stuff from. Thank you for posting when you’ve got the opportunity, Guess I will just book mark this web site.

  117. I’m very happy to find this page. I want to to thank you for your time for this fantastic read!! I definitely loved every part of it and i also have you saved to fav to see new things on your blog.

  118. Good post. I learn something new and challenging on websites I stumbleupon every day. It’s always interesting to read through content from other authors and practice something from other sites.

  119. This is the right website for everyone who hopes to understand this topic. You understand a whole lot its almost hard to argue with you (not that I personally would want to…HaHa). You definitely put a brand new spin on a subject that’s been written about for decades. Wonderful stuff, just wonderful.

  120. I would like to thank you for the efforts you have put in penning this website. I really hope to see the same high-grade content by you later on as well. In truth, your creative writing abilities has motivated me to get my own, personal website now 😉

  121. Hey there! Just popping by to praise your awesome blog. Your expertise on affiliate marketing are genuinely priceless. Making money from home has never been more accessible with affiliate marketing. It’s a fantastic way to build additional income by promoting goods you stand behind. Your blog is a goldmine of insights for budding online entrepreneurs. Keep up the good work!

  122. I’m amazed, I must say. Seldom do I come across a blog that’s both equally educative and entertaining, and let me tell you, you’ve hit the nail on the head. The issue is something not enough men and women are speaking intelligently about. I am very happy that I stumbled across this in my search for something regarding this.

  123. This is the perfect website for everyone who hopes to understand this topic. You realize so much its almost tough to argue with you (not that I actually will need to…HaHa). You definitely put a fresh spin on a subject that’s been discussed for many years. Great stuff, just great.

  124. You’re so awesome! I don’t believe I’ve read through something like this before. So good to find somebody with some unique thoughts on this topic. Really.. thank you for starting this up. This website is something that is needed on the internet, someone with some originality.

  125. An impressive share! I have just forwarded this onto a friend who was doing a little research on this. And he actually bought me dinner due to the fact that I discovered it for him… lol. So allow me to reword this…. Thanks for the meal!! But yeah, thanx for spending the time to discuss this issue here on your internet site.

  126. I blog quite often and I really appreciate your content. The article has truly peaked my interest. I am going to take a note of your website and keep checking for new information about once a week. I subscribed to your Feed as well.

  127. I was pretty pleased to find this great site. I want to to thank you for your time for this wonderful read!! I definitely appreciated every part of it and i also have you saved to fav to look at new stuff in your web site.

  128. I was more than happy to discover this site. I wanted to thank you for ones time just for this fantastic read!! I definitely liked every part of it and I have you saved to fav to check out new information in your website.

  129. After I originally commented I seem to have clicked the -Notify me when new comments are added- checkbox and now each time a comment is added I get four emails with the exact same comment. There has to be an easy method you can remove me from that service? Kudos.

  130. After checking out a number of the articles on your web site, I seriously appreciate your technique of blogging. I added it to my bookmark webpage list and will be checking back soon. Please check out my website too and let me know what you think.

  131. After I originally left a comment I seem to have clicked the -Notify me when new comments are added- checkbox and now every time a comment is added I recieve 4 emails with the exact same comment. Is there a way you can remove me from that service? Appreciate it.

  132. Howdy, I do think your site could be having internet browser compatibility issues. Whenever I take a look at your site in Safari, it looks fine however when opening in Internet Explorer, it has some overlapping issues. I merely wanted to provide you with a quick heads up! Other than that, fantastic blog!

Schreibe einen Kommentar

Deine E-Mail-Adresse wird nicht veröffentlicht. Erforderliche Felder sind mit * markiert