Download Chapter 29: Additional Health Conditions

Chapter 23: Additional Health
Concerns and General Medical
Conditions
Skin Infections
Viral Infections

Virus

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
Small organism that can live only in a cell
Upon entering cell it may immediately
trigger a disease (influenza) or remain
dormant (herpes)
Can damage host cell by blocking normal
function and using metabolism for own
reproduction
Virus ultimately destroys cell
Herpes

Cause of Condition

Herpes simplex – viral infection that
tends to occur in the same location
(mucous membranes)


Type I (cold sore)
Type II (genitals)
Herpes zoster
Appears in specific pattern on body
(innervated by specific nerve root)
 Re-appearance of chicken pox virus


Signs of Condition
Early indication = tingling or hypersensitivity
in an infected area 24 hours prior to
appearance of lesions
 Local swelling followed by outbreak of
vesicles
 Heal in generally 10-14 days


Care
If an athlete has an outbreak they should be
disqualified from competition due to
contagious nature of condition
 Utilize universal precautions when dealing
with herpes virus
 Use of antiviral drugs can reduce recurrence
and shorten course of outbreak

Verruca Virus and Warts

Variety of forms exist

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Different types of human papilloma
virus have been identified

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verruca plana (flat wart), verruca
plantaris (plantar wart), and condyloma
acuminatum (venereal wart)
Uses epidermal layer of skin to
reproduce and grow
Wart enters through lesion in skin

Signs of Condition
Small, round, elevated
lesion with rough, dry
surfaces
 Painful if pressure is
applied
 May be subject to
secondary bacterial
infection


Care
If vulnerable, they should
be protected until treated
by a physician
 Use of electrocautery,
topical salicylic acid or
liquid nitrogen are
common means of
managing this condition

Bacterial Infections

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Bacteria are single celled microorganisms
Disease development


Bacterial pathogen enters host, growth of
bacteria and production of toxic substances
occurs and host attempts to fight infection
Two types
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Staphylococcus
Streptococcus

Furuncle (Boils)
Infection of hair follicle that results in pustule
formation
 Generally the result of a staph infection
 Become large and painful

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Folliculitis
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Inflammation of hair follicle around face/neck
or in the groin
Impetigo Contagiosa
Caused by streptococci
 Spread through close contact

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Symptoms of Condition
Mild itching and soreness followed by
eruption of small vesicles and pustules that
rupture and crust
 Exhibits signs of inflammation

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Tenderness, warmth, redness and swelling
Care
Cleansing and topical antibacterial agents
 Systemic antibiotics
 Pus filled lesions should be drained
 Minimize the chances of the infection to
spread to others

Fungal Infections

Cause of Condition

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Ringworm fungi (tinea)
Cause of most skin, nail and hair fungal
infections
Tinea of the Groin (tinea cruris)

Signs and Symptoms
Mild to moderate itching and found bilaterally
 Brownish or reddish lesion resembling outline
of butterfly in groin

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Care
Treat until cured
 Will respond to many of the non-prescription
medications
 Medications that mask symptoms should be
avoided
 Failure to respond to normal management
may suggest a non-fungal problem (such as
bacteria) and should be referred to a
physician
 May require additional topical medications
and oral prescriptions
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Athlete’s Foot (tinea pedis)

Cause of Condition
Most common form of superficial fungal
infection
 Webs of toes may become infected by a
combination of yeast and dermatophytes
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Signs of Condition
Extreme itching on soles of feet, between
and on top of toes
 Appears as dry scaling patch or inflammatory
scaling red papules forming larger plaques
 May develop secondary infection from itching
and bacteria
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Care

Topical antifungal agents and good foot
hygiene
Respiratory Conditions

The Common Cold

Cause of Condition
Attributed to filterable virus that produces
infection in upper respiratory tract in
susceptible individual
 Susceptible individual

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Physical debilitation from overwork or lack of
sleep
Chronic inflammation from local infection
Inflammation of nasal mucosa from allergy
or from breathing in foreign substance
Sensitivity to stress

Sign of Condition
Begins w/ scratchy, sore throat, stuffy nose,
watery discharge and sneezing
 Some may experience a fever
 Various aches and pains
 Nasal discharge becomes thick and
discolored from inflammation
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Care
Symptomatic treatment (may last 5-10 days)
 Non-prescription cold medications
 Eat a balanced diet, consume 64 oz. of water
 Avoid emotional stress and extreme fatigue
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Influenza (Flu)

Cause of condition
Occurs in various forms as an annual epidemic
 Caused by a virus
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Symptoms of Condition
Fever (102-103oF), chills, cough, headache,
malaise, and inflamed respiratory mucous
membrane w/ non-productive cough, watery
eyes
 General aches and pains, headache becomes
worse
 Weakness, sweating, fatigue may persist for
many days

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Care
Bed rest and supportive care
 Steam inhalation, cough medicines, and gargles
 Flu prevention – avoid contact with someone
that has it
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Acute Bronchitis

Cause of Condition
Infectious winter disease that follows common
cold or viral infection
 Fatigue, malnutrition or becoming chilled could be
predisposing factors

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Sign of Condition
Upper respiratory infection, nasal inflammation
and profuse discharge, slight fever, sore throat
and back muscle pains
 Fever lasts 3-5 days while cough can last 2-3
weeks
 Yellow mucus indicates infection
 Pneumonia can complicate condition

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Care
Avoid sleeping in cold environment, avoid exercise
in extreme cold w/out protection
 Rest until fever subsides, drink 3-4 quarts of
water daily, ingest antipyretic analgesic, cough
suppressant, and antibiotic
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Bronchial Asthma

Cause of Condition
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Caused by viral respiratory tract infection,
emotional upset, changes in barometric
pressure or temperature, exercise, inhalation
of noxious odor or exposure to specific
allergen
Sign of Condition
Spasm of smooth bronchial musculature,
edema, inflammation of mucus membrane
 Difficulty breathing, may cause
hyperventilation resulting in dizziness,
coughing, wheezing, shortness of breath and
fatigue
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Care
Prevention – determine causative factors
 Use of prescribed inhalers are effective in
acute cases
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Exercise-Induced Bronchial
Obstruction (Asthma)
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Cause of Condition

Brought on by exercise w/ exact cause
unknown
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Loss of heat and water (airway reaction), eating
certain foods, sinusitis may also trigger
Sign of Condition
Airway narrowing due to spasm and excess
mucus production
 Tight chest, breathlessness, coughing,
wheezing, nausea, hypertension, fatigue,
headache, and redness of skin
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EIA (continued)

Care
Regular exercise, appropriate warm-up and
cool down, w/ intensity graduated
 Inhaled bronchodilators may be useful
 Exercise in warm, humid environment
 Coaches should be sure to remind athletes to
have inhaler with them at all times
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Other Conditions That Can Affect the
Athlete
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Infectious Mononucleosis

Cause of Condition
Virus that has incubation period of 4-6 weeks
 Transmitted through saliva
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Signs and Symptoms
First 3-5 days -severe fatigue, headache,
loss of appetite and myalgia
 Days 5-15 - fever, swollen lymph nodes and
sore throat (50% will experience enlarged
spleen)
 Possible jaundice, skin rash, puffy eyelids
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Care
Supportive symptomatic treatment
 Acetaminophen for headache, fever and
malaise
 Resume training after 3 weeks after onset if
spleen not markedly enlarged/painful, athlete
is afebrile, liver function is normal, and
pharyngitis is resolved
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Iron Deficiency Anemia
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Cause of Condition
Prevalent in menstruating women and males age
7-14
 Three things occur during anemia
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Small erythrocytes
Decreased hemoglobin
Low ferritin concentration (compound that contains
23% iron)
GI loss of iron in runners is common
 Aspirin and NSAID’s may cause GI bleeding and
iron loss
 Menstruation accounts for most iron lost in
women
 Vegetarian athletes may also be deficient in
intake relative to iron loss

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Sign of Condition
First stage of deficiency, performance
declines
 Athlete may feel burning thighs and nausea
from becoming anaerobic
 May display some mild impairments in
maximum performance

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Care
Eat a proper diet including more red meat or
dark poultry; avoid coffee and tea (hamper
iron absorption)
 Consume vitamin C (enhance absorption)
 Take supplements (dependent on degree of
anemia)
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Sickle-Cell Anemia
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Cause of Condition
Hereditary hemolytic anemia - RBC’s are sickle
or crescent shaped (irregular hemoglobin)
 Less ability to carry oxygen, limited ability to
pass through vessels, causing clustering and
clogging of vessels (thrombi)

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Signs of Condition
Fever, pallor, muscle weakness, pain in limbs
 Pain in upper right quadrant indicating possible
splenic infarction
 Headaches and convulsions are also possible
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Care

Provide anticoagulants and analgesics for pain
Diabetes Mellitus
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Most common forms are Type I
(insulin-dependent diabetes mellitus)
and Type II (non-insulin-dependent
diabetes mellitus)
Cause of Condition
Result of interaction between physical and
environmental factors
 Involves a complete or partial decrease in
insulin secretion
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Insulin Shock
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Cause of Condition

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Occurs when the body has too much insulin
and too little blood sugar
Sign and Symptoms
Tingling in mouth, hands, or other parts of
the body, physical weakness, headaches,
abdominal pain
 Normal or shallow respiration, rapid heart
rate, tremors along with irritability and
drowsiness

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Care
Adhere to a carefully planned diet including
snacks before exercise
 Must determine food and insulin intake
during questioning
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Diabetic Coma
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Cause of Condition
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Sign and Symptoms
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Loss of sodium, potassium and ketone bodies
through excessive urination (ketoacidosis)
Labored breathing, fruity smelling breath
(due to acetone), nausea, vomiting, thirst,
dry mucous membranes, flushed skin, mental
confusion or unconsciousness followed by
coma
Care
Early detection is critical as this is a lifethreatening condition
 Insulin injections may help to prevent coma

Epilepsy
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Disordered cerebral function characterized
by periods of altered consciousness,
motor activity, sensory phenomena or
inappropriate behavior caused by
abnormal cerebral neuron discharge
Not a disease

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Symptom manifested by a large number of
underlying disorders
Cause of Condition
For some forms of epilepsy there is genetic
predisposition
 Brain injury or altered brain metabolism
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Sign of Condition
Periods of altered consciousness, motor
activity, sensory phenomena or inappropriate
behavior
 May last 5-15 seconds (petit mal seizure) or
longer (grand mal seizure)
 Include unconsciousness and uncontrolled
tonic-clonic muscle contractions
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Care
Individuals that experience daily or weekly
seizures should be prohibited from
participating in collision sports (blow
resulting in unconsciousness could result in
serious injury)
 Must be careful with activities involving
changes in pressure
 Can be managed with medication
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Care (continued)
Athlete may experience undesirable side
effects – care giver must be aware
 Be sure to have individual sit or lie down
 Remain composed
 Try to cushion athlete’s fall
 Keep athlete away from surrounding objects
that could cause injury
 Loosen restrictive clothing
 Do not force anything between the athlete’s
teeth

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Meningitis

Cause of Condition
Inflammation of meninges surrounding spinal
cord and brain
 Caused by infection brought on by
meningococcus bacteria

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Sign and Symptoms
High fever, stiff neck, intense headache,
sensitivity to light and sound
 Progress to vomiting, convulsions and coma
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Meningitis (continued)

Care
Cerebrospinal fluid must be analyzed for
bacteria and WBC’s
 If bacteria is found isolation is necessary for
24 hours (very contagious), antibiotics must
be administered immediately
 Monitored closely in intensive care unit

Substance Abuse Among Athletes
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Substance abuse has no place in
athletics
Use and abuse of substances can
have a profound effect on
performance

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Both positive and negative
Use of performance enhancing and
street drug use occurs throughout
athletics, on various levels
Performance Enhancing Drugs
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Drug use designed to improve
performance is known as doping
Doping

“Administration or use of substances in
any form alien to the body, or of
physiological substances in abnormal
amounts and with abnormal methods
by healthy persons with the exclusive
aim of attaining an artificial and unfair
increase in performance in sports.”
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Stimulants
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Used to increase alertness, reduce fatigue,
increase competitiveness and hostility
Some respond with loss of judgment that
may lead to personal injury or injury to
others
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Amphetamines
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Extremely potent and dangerous
Injected, inhaled, taken as tablets
Most widely used for performance
enhancement
Can produce euphoria w/ heightened
mental status until fatigue sets in,
accompanied by nervousness, insomnia,
and anorexia
In high doses, will reduce mental activity
and decrease performance
Athlete may become irrational

chronic use causing individual to become
“hung up” in state of repetitious behavioral
sequences

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Can lead to amphetamine psychosis,
manifesting in auditory and visual
hallucinations and delusions
Physiologically, high doses can cause
abnormal pupil dilation, increased blood
pressure, hyperreflexia and hyperthermia

Anabolic Steroids
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Synthetic chemical (structure resembles
sex hormone, testosterone)
Androgenic effects
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Growth, development and maintenance of
reproductive tissues, masculinization
Anabolic effects
Protein synthesis - causing increased muscle
mass and weight, general growth and bone
maturation
 Goal is to maximize this effect

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Can have deleterious and irreversible
effects causing major threats to health
Use most commonly seen in sports that
involve strength and power

In prepubescent boys
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Ingestion by females
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Decrease in ultimate height, cessation of long
bone growth, acne, deepening of the voice
(hirsutism), and swelling of the breasts
(gynecomastia)
Hirsutism
Increases in duration and dose increases
the likelihood of androgen effects
Abuse may lead to liver and prostate
cancer and heart disease

Human Growth Hormone (HGH)
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Produced by anterior pituitary and
released into circulatory system
Amount released varies with age
Can be produced synthetically
Results in increases muscle mass, skin
thickness, connective tissue in muscle,
organ weight
Can produce lax muscles and ligaments
during periods of growth and alterations in
bone growth

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Can cause premature closing of growth
plates, acromegaly which may also result
in diabetes mellitus, cardiovascular
disease, goiter, menstrual disorders,
decreased sexual desire and impotence
No proof that increased HGH and weight
training contributes to strength and
muscle hypertrophy

Androstenedione

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Weak androgen produced primarily in
testes and in lesser amounts by adrenal
cortex and ovaries
Increases testosterone in men and
particularly women
Effects last a few hours
No scientific evidence to support or
rebuke efficacy or safety of using this
ergogenic aid

Creatine Supplementation



Naturally occurring in the body
synthesized by kidneys, liver and
pancreas
Can also be obtained from ingestion of
fish and meat
Positive physiological effects

Increase workout intensity, prolong ability to
perform maximal effort, improves exercise
recovery, stimulates protein synthesis,
decreases total cholesterol and triglycerides
and increases fat free mass

Side effects



Weight gain
No apparent long term side effects
May enhance muscular performance
during high intensity resistance training

Blood Reinjection (Blood Doping,
Packing or Boosting)

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
Endurance, acclimatization and altitude
make increased metabolic demands for
the body, requiring increased blood
volume and RBC’s
Can replicate physiological responses by
removing 900 ml of blood and reinfusing
is after 6 weeks (allows time to replenish
supply)
Can significantly improve performance
While unethical, it can also prove to be
dangerous
Risks involve allergic reactions, kidney
damage, fever, jaundice, infectious
disease, blood overload (circulatory or
metabolic shock)
Recreational Substance Abuse
Among Athletes



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It occurs among athletes
Desire to experiment, temporarily
escape, be part of the group
Can be abused and habit forming
Drug used for non-medical reasons
with the intent of getting high, or
altering mood or behavior

Psychological vs. Physical Dependence


Psychological dependence is the drive to
repeat the ingestion to produce pleasure
or avoid discomfort
Physical dependence is the state of drug
adaptation that manifests self in form of
tolerance


When cease consumption abruptly
unpleasant withdrawal occurs
Tobacco Use
Cigarettes, cigars & pipes are increasingly
rare in athletics
 Smokeless tobacco and passive exposure to
others continues to be an ongoing problem

Smokeless Tobacco


Loose leaf, moist, dry powder, and compressed
Posses serious health risk

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Major substance ingested is nitrosonornicotine


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Bad breath
Stained teeth
Tooth sensitivity to heat and cold
Cavities and gum recession
Tooth bone loss
Leukoplakia
Oral and throat cancer
Absorbed through mucous membranes
More addictive habit w/out exposure to tar and carbon
monoxide
Will increase heart rate but does not impact reaction
time
Coaches, athletic trainers and professional athletes
should avoid use in order to present a positive role
model
Alcohol

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Most widely used and abused substance
with athletes
Depresses CNS
Absorbed from digestive tract into
bloodstream
Does not improve mental or physical
abilities and should be avoided by athletes
Consumption on a large scale can result in
development of a moderate degree of
tolerance
No place in sports participation
Marijuana





Formerly most abused drug in Western
society
Similar components and cellular changes
as tobacco
Can lead to respiratory disease, asthma,
bronchitis, lowered sperm count and
testosterone levels, limited immune
functioning and cell metabolism
Causes increased pulse rate and can
cause decrease in strength
Psychologically causes diminution of selfawareness and judgment, slower thinking
and short attention span


Has also been found to alter the
anatomical structures suggesting
irreversible brain damage
Contains cannabinoids (can store like fat
cells)

May remain in the body and brain for weeks
and months resulting in cumulative
deleterious effects
Drug Testing in Athletics


NCAA and USOC have established banned
substances lists and testing programs
Banned substances list have not been set
at the high school level



Choice is left up to the individual schools
Testing at the high school level is on the rise
Program screens for some and leaves out
several commonly used substances (alcohol,
tobacco and steroids)
The Female Athlete Triad

Cause of Condition
Relationship between disordered eating,
amenorrhea and osteoporosis
 Driven to meet standards of sport or to meet
a specific athletic image to attain goals


Sign and Symptoms
Disordered eating - bulimia and anorexia
 Osteoporosis - premature bone loss in young
women, inadequate bone development


Care

Prevention is key; identify and educate