Download Sports Medicine

Sports Medicine
How does sports medicine
address the demands
of specific athletes?
Children and young athletes
• Almost half of admissions to hospital for
young people are sports-related.
• Issues such as
–
–
–
–
medical conditions,
overuse injuries,
thermoregulation and
appropriateness of resistance training
must be considered to ensure safe participation.
Medical conditions
• Asthma (is a chronic inflammatory condition of the airways, in
which the bronchioles (branches of the airways) contract and restrict
the amount of oxygen exchanged within the lungs.
– While asthma in children and young people has
decreased in Australia over time, it is still an
important and at times life-threatening health issue
that coaches need to address.
– The Australian Institute of Health and Welfare
reported that, in 2004–05, asthma was more
prevalent among males aged 0–14 years, but from
the age of 15 was more prevalent among females.
• People with asthma can still participate in
sport, but should have an Asthma Action Plan,
or management plan, that has been created
with their doctor to control and monitor asthma
episodes
• A child or young person may suddenly develop
asthma-like symptoms during physical activity.
– exercise-induced asthma.
• Endurance sports, such as long-distance
running, are more likely to trigger exerciseinduced asthma than stop/start sports such as
tennis.
– ventolin puffer
step 1
Sit the young person upright, remain calm
and provide reassurance. Do not leave them
alone
Give 4 puffs of a reliever puffer
(Airomir, Asmol, Epaq or Ventolin), one puff at
a time, preferably through a spacer device.
- take 4 breaths from the spacer after each
puff.
step 2
step 3
Wait 4 minutes.
step 4
If there is little or no
improvement,
repeat steps 2 and 3.
If there is still little or no
improvement, or the condition
suddenly deteriorates,or you become
concerned, call an ambulance
immediately (Dial 000).
Continue to repeat steps 2 and 3
while waiting for the ambulance.
Diabetes
• The incidence of diabetes among children
and young athletes has increased over time.
• Why?
• Type 1 diabetes is most common in children
and young people, and occurs when the body
is unable to produce insulin.
– type 2 diabetes has also increased significantly
due to obesity levels in children
• The body uses glucose to fuel working
muscles and if a person’s body is
unable to produce this glucose they
may start to feel unwell.
• If the sugar levels of a person with
diabetes are not maintained during
exercise, they may have a
hypoglycaemic episode, or a
hyperglycaemic episode.
• Either of these can lead to loss of
consciousness.
• A hypoglycaemic episode occurs when blood
glucose levels fall below their normal range.
• Symptoms:
–
–
–
–
–
–
increased heart rate
Sweating
shaking
anxiety and confusion
dizziness
possible altered state of consciousness.
• Treatment
– fast-acting carbohydrates, such as jelly beans,
fruit juice or a soft drink
– additional carbohydrates, such as a slice of bread,
banana or sweet biscuits.
• A hyperglycaemic episode occurs when blood
glucose levels are elevated above their
normal range. This happens slowly and is
usually hard to detect.
• Symptoms:
–
–
–
–
–
–
thirst
vomiting
excessive urination
rapid breathing
rapid but weak pulse
drowsiness.
• Management
– medical advice.
• Exercise can assist children and young
people to manage their diabetes.
• Exercise helps maintain blood glucose levels
and can help decrease the dosages of insulin
required.
• A long-term benefit of exercise is weight loss,
which can lead to a reduced risk of type 2
diabetes.
• Children and young athletes with diabetes
can participate successfully in physical
activity, providing they have taken extra
measures to ensure their blood glucose
levels are maintained.
Epilepsy
• When normal electrochemical activity in the
brain is disturbed, a seizure (sometimes
known also as a fit) occurs.
• Children and young people with epilepsy can
participate in physical activity, as the modern
medications available reduce the likelihood of
seizures.
• Management
– Do not try and restrain the person.
– Let the seizure occur, but move any
objects away that may cause more harm.
– Once the seizure has finished, place the
person in the lateral position
– Loosen any tight clothing and reassure the
person that everything will be fine.
– If the seizure lasts longer than 5 minutes,
call an ambulance.
Overuse injuries
• Overuse injuries are on the increase in
children and young athletes, and occur when
repetitive stress is placed on a body part
(bone, tendon or muscle) without enough
recovery time for the body to heal and repair.
• These types of injuries can be related to
improper technique, poorly fitted protective
equipment, training errors, limited recovery
time, and muscle weakness and imbalance.
–
–
–
–
shin splints,
stress fractures,
tendonitis
tennis elbow.
• Stress fractures
– caused by repeated stress on a bone due
to an activity such as continual running.
– develop due to a sudden increase in
intensity of training, when the body is
unable to cope with the repeated stress on
the bone.
How are they avoided?
Thermoregulation
• The process that allows the body to
maintain its temperature.
• Children and young athletes are at
greater risk of heat illnesses.
• Because their bodies’ physiological
structures are still growing, they are not
as efficient at regulating body
temperature as adults.
• Young athletes have:
– a greater surface area to body ratio than adults,
which makes them more susceptible to gaining heat
from the environment or when exercising
– higher thresholds before sweating due to immature
sweat glands, therefore holding in heat longer
– slow acclimatisation to hot weather, therefore holding
heat in for longer the capacity to become dehydrated
very quickly
– a core body temperature that increases faster than
that of adults.
• Children and young athletes should not
participate in physical activity if the temperature
exceeds 34 degrees Celsius.
• Management
– encourage athletes to drink small amounts
of water regularly to replace fluid lost
through perspiration
– ensure suitable and appropriate clothing is
worn for the weather conditions, such as
hats during hot weather and polo fleeces
during cold weather
– provide adequate rest breaks in shaded
areas to reduce fluid loss.
Appropriateness of resistance training
• Resistance training, when combined with
aerobic training, can enhance a young athlete’s
sporting performance.
• When supervised with correct instructions,
resistance training is both safe and beneficial.
• An athlete’s physical and emotional wellbeing
can be enhanced through resistance training,
with improvements in:
–
–
–
–
–
strength
motor performance
injury protection
self-esteem
body image
• Young athletes should use their own
body weight for resistance training; over
time, they can progress to weights.
• Exercises such as push-ups, chin-ups,
tricep dips and planks where using own
body weight can provide a good
foundation for weight training.
• Designing a resistance program
– start with light loads and high repetitions.
– Increasing the number of sets performed
and the number of exercises in the workout
will enable strength development.
– The size and type of weights used can be
changed to further develop overall
strength.
– specifically for each individual athlete, to
ensure there is no risk of injury.
– Specific to the athlete’s sport, and relevant
to the overall training program.
Adult and aged athletes
• As Australia’s population continues to age,
coaches need to the address the specific needs of
adult and aged athletes, enabling these athletes
to participate safely in physical activity.
• Adult and aged athletes can continue being
physically active throughout their life span,
providing due care is taken.
• Research suggests that physical activity for older
people increases muscle capacity, stamina,
balance, joint mobility, flexibility, agility and overall
physical coordination.
• Regular vigorous exercise decreases the riskof
cardiovascular disease, osteoporosis, diabetes
and some forms of cancer.
• Guidelines for adult and aged athletes:
– Assess the medical history of an older athlete.
– Evaluate the reasons why the athlete is
participating in the sport.
– Adults and aged athletes participate for different
reasons than do younger athletes.
– Ensure longer warm-up and cool-down sessions.
– Monitor and adjust intensity levels for workout
sessions.
– Provide longer recovery periods after each
activity.
– Encourage athletes to continually improve their
fitness levels safely.
• Heart conditions
– As people age, the efficiency of their cardiovascular
system declines.
– A variety of heart conditions are more prevalent in older
people, such as heart attacks, strokes and high blood
pressure.
– As the cardiovascular system becomes less efficient, its
ability to pump blood from the heart is reduced.
– The amount of oxygen transported around the body
therefore decreases, which makes exercising a lot
harder. The narrowing and increasing inflexibility of
blood vessels place an added resistance on blood flow,
and can raise blood pressure.
– Lung tissue becomes less elastic, decreasing the body’s
ability to take in the oxygen needed for working muscles.
• Fractures/bone density
– As people age, so too do their bones. Bones lose some
of their density and become brittle (osteoporosis), so
older people have a higher risk of a fracture if they fall.
– Osteoporosis is more common in women, which is linked
to changes in their hormone levels.
– Weight training or weight bearing exercise such as
walking increases bone density, particularly in older
women.
– Exercise also improves agility, balance and coordination,
which all contribute to the prevention of falls.
– People with low bone density should avoid contact
sports where any knock or fall could increase the risk of
injury.
– Activities such as cycling, light weights, climbing stairs
and gardening are safe and beneficial.
• Flexibility/joint mobility
– Those who participate in physical activity can help
prevent their joints from seizing up, and maintain good
flexibility for daily functioning.
– reduced mobility can restrict participation in physical
activity.
– Keeping active and mobile will increase quality of life
and reduce injuries.
• Flexibility exercises for people who are mobile
could include:
•
•
•
•
•
low-impact exercises
yoga
stretching
pilates
dance.
Female athletes
• When coaching female athletes, there
are various factors that need to be
taken into consideration to ensure that
they participate safely.
• The physiological changes that occur to
the female body during the life span put
them at greater risk of iron and calcium
deficiency.
Eating disorders
• When participating in physical activity, female
athletes need to be aware of special dietary
considerations.
• Any athlete needs to ensure they consume
adequate food to meet the increased energy
demands on their body.
• Sports such as gymnastics, dance, and beach
volleyball may add extra pressure on females to
look a certain way, be a certain weight or have a
desired physique.
• In order to obtain this physique, some female
athletes take extreme dietary measures, restricting
their food intake as they view themselves as being
overweight (anorexia nervosa).
• Causing a range of serious health risks,
including:
– loss of energy
– irregular menstrual cycles which can lead to
amenorrhea
– weak bones which can lead to osteoporosis
– abnormal heart rhythm
– dehydration
– starvation.
• If an athlete does not restrict their food
intake, but still seeks a certain body shape
for a sport, they may choose to overeat or
binge-eat, and then purge (vomit) or over
exercise to lose the weight (bulimia).
• Causing several serious health risks, such
as:
– loss of energy
– dental erosion
– damage to the oesophagus
– low blood pressure
– malnutrition.
• Management
– seek medical assistance
– educating female athletes on healthy
eating, particularly iron, calcium and
energy needs
– effectively dealing with athletic
performance stress
– developing positive self-esteem and selfimage
– encouraging personal best, rather than
perfection.
Iron deficiency
• Iron is an essential mineral needed for the
formation of red blood cells that carry oxygen
to working muscles
• However, female athletes—and endurance
athletes in particular— have an increased risk
of having low iron levels due to training.
• When iron stores are depleted, haemoglobin
levels drop, and oxygen is unable to be
transported around the body - anaemia.
• This lack of oxygen to working tissues results
in fatigue, tiredness and breathlessness,
• The recommended dietary intake (RDI) of iron for
an female aged 14–18 years is 15 milligrams per
day; for women aged 19–50 years, it is 18
milligrams per day.
• A higher intake of iron is recommended for an
active female.
• The following foods are rich in iron and will help
with iron intake:
•
•
•
•
•
•
•
red meat (once or twice a week)
liver
tuna
dark green leafy vegetables, e.g. spinach, broccoli
beans
lentils
foods rich in vitamin C - to assist in greater iron absorption.
Bone density
• Calcium plays a crucial role in the functioning
of the female body.
• It is responsible for muscle contractions,
blood clotting, activating enzymes,
transporting nutrients in and out of cells,
regulating energy metabolism and building
strong bones.
• The strength of a person’s bones is linked to
their calcium intake, exercise and diet.
• The recommended dietary intake (RDI) for
calcium for a female aged 14–18 years is
1300 milligrams per day; for women aged 19–
50 years, it is 1000 milligrams.
• To meet this RDI, females should consider
including calcium-rich foods in their diets
such as:
–
–
–
–
–
skim milk
salmon
yoghurt
tofu.
cheese
• Maximum bone density occurs by the age of 30
years, and most of this bone mass is achieved
during puberty.
• Since the body cannot produce calcium itself, it
is essential that the RDI of calcium is consumed
at each life stage.
• If insufficient calcium is consumed, bones
become frail and brittle, leading to osteoporosis
• Exercise can positively affect bone density
levels. Weight-bearing or strength bearing
exercises such as climbing stairs, weightlifting
or walking can assist in the restructuring and
strengthening of bone.
Pregnancy
• Participation in physical activity during
pregnancy has raised issues that coaches
and players need to consider.
• If a female has not been active before their
pregnancy and would like to participate in
physical activity, it is important they consult
with their health professional before they
begin.
• Research suggests that physical activity
during pregnancy is beneficial, not only for
the mother but also the developing baby.
• Benefits of exercise include:
– reducing the risk of cardiovascular disease
• reducing the risk of type 2 or gestational
diabetes
• reducing the risk of excessive weight gain
• improving self-esteem, self-image and
wellbeing
• improving physiological functioning, which
will meet the increase
• demand of oxygen and energy required by
the developing baby.
• There are various sports which present a higher risk
for female athletes during pregnancy,
• Non-contact sports (i.e. any sport where there is no
contact with another person).
– In most cases, it is safe for pregnant woman to participate
in non-contact sports for the duration of their pregnancy,
e.g. swimming, walking.
• Minimal contact sports (i.e. any sport where
there is a small amount of contact with
another person).
– In most cases, these sports (e.g. doubles tennis,
netball) are considered safe in the first trimester of
pregnancy, however advice from a health
professional is recommended if participation
continues into the second trimester.
• Contact and collision sports (i.e. any sport
where two players have the possibility of
colliding).
– In most cases, these sports (e.g. football, hockey)
are considered safe only in the first trimester.
• Pregnant females need to be particularly
careful in hot and humid weather to ensure
they do not overheat.
• They also need to take care of their
muscles, as the hormonal changes during
pregnancy lead to the ligaments becoming
more relaxed.
• The increase in weight and the growing
belly can also lead to an increased risk of
injuries to pregnant females participating in
physical activity.