CQ 2

• How sports medicine addresses the demands of specific athletes


  • children and young athletes
  • medical conditions (asthma, diabetes, epilepsy)
  • overuse injuries (stress fractures)
  • thermoregulation
  • appropriateness of resistance training
• Medical conditions


  • Asthma
  • Diabetes
  • Epilepsy
• Asthma


  Respiratory condition characterised by severe spasms of the airway causing difficulty breathing
• Asthma


  • Condition where the airways swell and become narrower when activated by triggers such as dust, pollen, animals, colds, cigarette smoke, and different temperatures
  • Should not be an excuse to avoid participation in sports
• Exercise Induced Asthma (EIA)


  Strenuous activity can trigger asthma attacks
• Exercise Induced Asthma (EIA)


  • Some activities provoke attacks more than others
  • Many asthmatic children are encouraged to swim for deep breathing and increases lung capacity
  • Exercise intensity needs to be steady and adequate water is to be consumed
  • Opportunities for rest need to be provided and a gradual warm and cool down help lower the risk of an attack
• Diabetes


  Complex hereditary or developmental disease where the supply of insulin is reduced or completely severed
• Types of Diabetes


  • Type 1 - born with it
  • Type 2 - later developed
• Diabetic athletes


  • Must balance insulin by injections, food intake and exercise for optimal performance
  • Symptoms include; dizziness, drowsiness, confusion, rapid breathing, and pulse rate when experiencing HYPOGLYCEMIA (low blood sugar levels)
  • Well balanced diet, complex carbs (release energy slowly) to allow insulin to break it down easily
  • Exercise increases the utilisation of sugar, pre-game meal required to raise blood sugar levels and hourly glucose supplementation (a banana) if exercise is protracted
• Epilepsy


  • Caused due to fatigue, extremes of temperature, over stimulation
  • Disruptions to brain function, messages to the body from brain interruption
  • Causes a brief alteration to the level of consciousness and resulting in seizures or fits
• Epilepsy


  • Generally believed that, if seizures occur on a daily or weekly basis, collision sports should be avoided
  • If controlled through medication or occurs only during sleep, epilepsy should not prevent participation in a wide range of sporting activities
  • The circumstances of each individual should be assessed and they should be guided by their doctor
  • Some activities (swimming alone, scuba diving, rock climbing) must be completely avoided, as a seizure may go unnoticed or cause loss of control, leading to serious injury or death
  • No contact, individual/solo sports
  • Be aware of problems, treatment, safety considerations (swimming, etc)
• Overuse injuries


  • Injuries often related to growth imbalances in muscles, tendons, bones
  • Growth plates injured
  • Bones grow faster than muscles, tendons causing painful inflammation
  • Possible fractures due to lack of coordination through fatigue
• Overuse injuries


  • Children are most susceptible because of different growth rates in bone and soft tissue
  • Examples include swimmer's shoulder, runner's knee, stress fractures
  • The most common causes are; High training volume and intensity, High training frequency (number of times a week), Inadequate warm-ups, Biomechanical problems leading to stress on particular parts of the body, Unsuitable equipment such as running shoes that do not provide proper support, Poor technique or changes in techniques leading to joint stress, Strength and flexibility imbalances leading to poor body alignment
• Avoiding overuse injuries


  1. Have days of non-training

  2. Monitor the volume and intensity of exercise activities

  3. Ensure appropriate condition and stretching

  4. Duration of training, correct gear, rule changes (big gears not allowed on kids bikes in races)

  5. Avoid overusing body parts - vary sports, positions

  6. Rules to restrict repetition (cricket, baseball limit number of ovals/balls pitched)

  7. Use appropriate equipment - modified
• Thermoregulation


  Maintenance of a stable core body temperature
• Thermoregulation in children


  • Larger surface area - more opportunity to lose fluids
  • Sweat less, and could become overheated
  • Less muscle - decreased heat generation, increased risk of becoming cold
  • Do not have the same ability to lose heat through evaporation at the same rate as adults
  • Sweat glands release fluids more slowly and are less responsive to temperature change
  • Rely more on radiation and convection to lose heat
  • Have shorter tolerance time in extreme heat, increasing the possibility of dehydration
  • Have a higher chance of developing hypothermia from exposure to cold compared to adults
• Maintaining thermoregulation in children


  1. Reduce length bouts of activity

  2. Avoid extremes of weather

  3. Encourage frequent replacement of fluids

  4. Wear appropriate clothing
• Resistance training for young athletes

  When supervised with correct instructions, resistance training for young athletes is both safe and beneficial
• Resistance training program for children


  • Must be an integral part of an overall program designed to improve skill and fitness
  • Should not be competitive
  • Strength specialisation (focusing on power/absolute strength) should be avoided, as this can lead to imbalance between muscle groups and contribute to injury
  • Can improve strength mainly through improved neural capacity, coordination
  • Training should begin with weight exercises, instruct proper technique, allowing appropriate rest, not lead excessively, have slower accurate movements with relatively light loads, work large muscle groups, not be competitive - keep actively enjoyable
• Sports participation options for aged people with medical conditions


  • Heart conditions
  • Fractures/bone density
  • Flexibility/joint mobility
• Heart conditions


  Include individuals who suffer from high blood pressure, have experienced a heart attack or other heart problems, or have a bypass surgery
• Exercise for people with heart conditions


  • Prescreening must occur
  • Prescribed exercise conveys considerable benefit with little risk
  • Reduces blood pressure in mandatory hypertension patients by an average of 11 systolic and nine diabolic points
  • To gain maximum benefit, exercise needs to be combined with a balanced diet with low fat and salt intake
  • People with existing heart conditions should obtain medical clearance before starting an exercise program
  • Aerobic (walking, cycling, jogging, swimming) exercise presents the best options for people who have not been active for a period of time
  • The 'steady state' heart rate is considered safe as long as it is 10 or more beats per minute lower than trigger abnormal signs/symptoms (nausea, shortness of breath, dizziness, abnormal heart rhythm, chest pain)
  • Levels can be determined by stress tests which show the limit of one's heart rate (what they can not go over during exercise)
• Key principles for sports participation for people with heart conditions


  • Initially, they require medical clearance
  • The program should be tailored to individual tastes
  • Activity needs to be of moderate intensity
  • Progress must be gradual
• Osteoporosis


  Musculoskeletal condition in which there is deterioration in the bone structure - the bones become thin and weak, leading to an increased risk of bone fracture
• Exercise for people with osteoporosis


  • Exercise is particularly important to older women because it contributes significantly to delaying postmenopausal bone density loss
  • Inactivity should be avoided as this encourages calcium discharge from bone, making it weaker
  • Exercise programs should focus on improved fitness, balance, strength, coordination, aerobic capacity, flexibility
  • Aims to develop postural retraining - to teach safe ways of performing movements (lifting) and to avoid further fraction
• Exercise and sports options for people with osteoporosis


  • Endurance activities - walking, cycling, swimming
  • Low impact and balance activities - aerobics
  • Low range strengthening exercises focus on the limbs, trunk and back
• Exercise for people with flexibility/joint mobility issues


  • Exercise has a positive effect
  • Programs should increase balance and stability and aim to reduce fractures caused by falls
  • Programs need to be low impact, be specific to a person's physical limitations, and consider existing medical conditions that might limit movement
• Exercise and sports options for people with flexibility/joint mobility issues


  • Walking
  • Cycling
  • Swimming
  • Flexibility classes
  • Aqua-aerobic
  • Tai chi
• Special dietary conditions for female athletes


  • Anorexia nervosa
  • Bulimia nervosa
• Eating disorders in female athletes


  • Twice the risk of developing eating disorders
  • Exposure to peer influence, magazines, televisions and other forms of media that make athletes susceptible to the pressures of weight loss
  • Exposure to social expectations to be thin within the athletic subculture (desire for 'athletic shape')
  • The need to conform to an ideal sporting image that overvalues ideal body shapes, size, wright and low body fat
• Preventing eating disorders in female athletes


  1. Expect their athletes to do their best and not focus solely on winning

  2. Be better educated to detect signs of eating disorders and use nutrition experts and counsellors to program and advise in these areas

  3. Observe training routines and social practices (eating) and take action when suspicious behaviours are disguised or turn into an obsession

  4. Invite parents to training sessions to observe coaches to endure that excessive pressure is not placed on athletes to meet unreasonable dietary ot body size demands
• Iron deficiency


  • Causes anaemia - a condition in which there is an abnormally low level of haemoglobin, resulting in less oxygen being available to tissues
  • Without sufficient iron, the number of red blood cells is reduced, limiting the oxygen-carrying capacity of the blood and the degree to which the athlete is able to participate in sport
• Iron deficiency in female athletes


  • More evident in females as they consume less red meat and can lose from 5 to 40mg of iron during menstruation
  • Recommended daily intake is 15mg, but many women do not consume this level of iron
  • Supplementation benefits people whose intake is below recommended levels, but is of no benefit to those whose intake is satisfactory
  • Indiscriminate use of iron tablets can cause iron levels to reach toxic amounts and contribute to liver disease, diabetes, heart problems and joint damage
• Bone density


  • Directly related to the quantity of calcium in the bones
  • Bones that lack calcium are susceptible to fractures and structural weakening
• Bone density


  • Bone is strongest when a person is in their twenties, with deterioration beginning in the mid-thirties
  • Following menopause, women lose calcium faster than men and some may require a form of oestrogen therapy
  • For women with osteoporosis it is important that activity includes a warm-up, progress to stretching and that ice is used on inflamed or arthritic joints to prevent swelling and soreness
• Pregnancy


  Most research shows now that sustained, moderate exercise creates no more stress to previously active, healthy women than the stress of weight gain
• Exercise during pregnancy


  • Exercise regularly performed improves cardiovascular fitness
  • Moderation is the key, particularly if there is restricted placental blood flow that could place the foetus at risk
  • Pregnant women should exercise in the cool of the day and consume adequate water to avoid thermal stress, which can affect foetal development (overheat, loss of fluid)
  • In an uncomplicated pregnancy, regular moderate exercise can have considerable benefits, include; Maintenance of fitness and general well-being, Improved muscle tone, Weight control in later stages of pregnancy, Strong core allows the birthing process (theoretically) to be easier, Weight control - can lose excess weight quicker if they used to exercise before/during pregnancy, Gestational Diabetes - Only occurs when pregnant, Good way to relieve stress