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2012-05-08 20:42:24

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  1. Proper nutrition can positively contribute to:
    • Strength
    • Flexibility
    • Cardiorespiratory Endurance
  2. Diet
    • does not always mean losing weight
    • Refers to a person�s usual food selection
  3. Nutrition
    Science of certain food substances (nutrients) and what they do in the body
  4. Nutrients have 3 roles
    • Grow, maintain and repair all body cells
    • Regulate body processes
    • Supply energy for cells
  5. Nutrition Basics
    • Science of substances found in food that are essential to life
    • Carbohydrates (CHO)
    • Protein
    • Fat
    • Vitamins
    • Minerals
    • Water
  6. Roles of nutrients
    • Growth, repair & tissue maintenance
    • Regulation of body processes
    • Production of energy
  7. Carbohydrate
    • Body�s most efficient energy source
    • Accounts for 55-70% of total caloric intake
    • Sugars
    • -Simple (sugars) and complex (starch and fiber)
    • -Monosaccharides
    • --single sugars (fruits, syrup and honey)
    • --glucose
    • -Disaccharides
    • --2 sugars combined (milk sugar, table sugar)
    • -Should account for <15% of caloric intake
  8. Starches
    • Complex CHO
    • Long chain glucose units
    • Rice, potatoes, breads
  9. Body cannot use starch directly
    • Broken down in simple sugars
    • Unused starches and sugars are stored as glycogen to be used by the body later
    • Inadequate CHO intake results in protein utilization for energy
    • Protein sparing action of glucose occurs if adequate CHO in the system
  10. Fats
    • Most concentrated source of energy
    • Serves to make food flavorable and contain fat soluble vitamins
    • Essential for normal growth and development (<25% of caloric intake)
  11. Saturated vs. unsaturated fat
    • Saturated - fatty acids derived from animal products (10% or less of total caloric intake)
    • Unsaturated - plant derivatives - liquid at room temperature
  12. Proteins
    • Required for growth, maintenance, and repair of the body
    • Aid with enzyme, hormone, and enzyme production
    • Should encompass 12-15% of daily caloric intake
  13. Amino Acids
    • Basic units that compose protein
    • 20 amino acids compose the majority of body protein
    • Most can be produced by the body while others (essential) must be consumed
    • Animal products contain all essential amino acids
    • Incomplete sources (i.e. plants sources) do not contain all essential amino acids
  14. Vitamins
    Vitamins (13) serve as regulators in many body processes
  15. Fat soluble vitamins
    • Vitamins A, D, E, K
    • Found in fatty portion of foods and oils
  16. Water soluble Vitamins
    • Vitamin C, B-complex vitamins
    • Help to regulate metabolism but cannot be stored
    • Each serves a series of roles
  17. Anitoxidants
    • May prevent premature aging, cancers, heart disease and other health problems
    • Help protect cells from free radicals
    • Include vitamins A, C, E
    • Found in a number of dark green, deep yellow and orange fruits and vegetables
  18. Supplements
    • Vitamin Deficiencies
    • Illness that results from a deficit in a particular vitamin/mineral
    • Are avoidable if an adequate diet is consumed
  19. Minerals
    • 20 minerals have essential roles in the body
    • Many are stored in liver and bones
    • -Examples
    • --Iron (energy metabolism and oxygen transport)
    • --Magnesium(energy supplying reactions)
    • --Calcium (bone formation, clotting, muscle contractions)
    • --Sodium and Potassium (nerve conduction)
  20. Water
    • Most essential nutrient and most abundant in body (60% of body weight)
    • Essential for all chemical processes
    • Lack of water (dehydration) can lead to illness and death
    • Body has mechanisms to maintain homeostatic levels of hydration (kidneys and solute accumulation)
  21. Electrolyte Requirements
    • Involve minerals of the body - must maintain adequate levels for optimal functioning
    • Excess sweating can lead to depletion of these electrolytes
    • Help to maintain levels of hydration
    • Can generally maintain through proper diet, however, additional salts may need to be added periodically
  22. Production of Energy From Foodstuffs
    • Energy is produced when cells breakdown CHO, fat or protein to release energy stored in compounds
    • CHO � major portion of energy for short-term, high-intensity muscular contractions
    • Prolonged activity = % of CHO and fat is similar
    • Generally protein provides <5% of energy
    • Endurance athletes may receive 10-15% of energy
  23. Nutrient Requirements and Recommendations
    • Amount of nutrient required to prevent deficiency diseases
    • Vary by individuals and across populations
  24. Requirements vs. Recommendations
    RDA (Recommended Daily Allowance) vs. DRI (Dietary Reference Intake)
  25. Food Labels
    Aids consumers in determining levels of nutrients in foods
  26. Nutrient dense food
    Contains considerable amount of vitamins, minerals, and proteins in relation to caloric content
  27. Junk foods
    • Cookies, candies, doughnuts, chips
    • Everything in moderation
    • Avoid substituting junk food for nutrient dense foods
  28. Nutrition and Physical Activity
    Activity increases need for energy not necessarily all vitamins, minerals and nutrients
  29. Vitamin Supplementation
    • Athletes believe large doses can lead to superior health and performance
    • Coaches should avoid distributing nutritional supplements
    • If not eating a balanced diet, supplementation may be beneficial
  30. Mineral Supplementation
    • Calcium and iron tend to be low and diets may need to be modified
    • Need to be certain additional minerals are necessary in diet prior to purchase (save money)
  31. Calcium Deficiency
    • Most abundant mineral in body
    • Over time additional levels of calcium are required for bone maintenance
    • Without, bones become weak and brittle resulting in osteoporosis
    • Young adult requires 1000mg/day
    • Females tend not to get enough calcium in diet
    • While exercise helps bones to retain calcium, extreme levels of exercise, causing hormonal imbalances, can disrupt calcium retention
    • Supplementing with calcium carbonate or citrate is advisable
    • Milk products are the most reliable source of calcium
    • May be lactose intolerant and lack the enzyme lactase (lactase deficient)--an supplement with lactase (scientifically produced)
  32. Iron Deficiency
    • Common in females
    • Results in iron-deficiency anemia, limiting oxygen carrying capacity of blood
    • Athlete feels tired and weak due to muscles� inability to generate energy
  33. Protein Supplementation
    • Approximately 1-1.5g/kg body weight of protein should be consumed for increasing muscle mass
    • Often times exceeded with normal diet and supplementation is not necessary
  34. Creatine Supplementation
    • Naturally occurring substance in body produced by kidneys, pancreas and liver
    • Found in meat and fish
    • Role in metabolism
    • Two types (free creatine and phosphocreatine)
  35. Phosphocreatine is stored in skeletal muscle and works to re-synthesize ATP during activity
    • -Positive effects
    • --increase intensity of workouts
    • --lactic acid buffer
    • --stimulates protein synthesis
    • --decreases total cholesterol and total triglycerides and improves HDL-LDL ratio
    • --increases fat free mass
    • -Negative effects
    • --weight gain
    • --muscle cramping
    • --gastrointestinal disturbances and renal dysfunction
    • Not a banned substance, however, distribution by NCAA institutions is banned
  36. Sugar and Performance
    • Ingesting large quantities of sugar prior to activity increases glucose in the blood
    • Release of insulin is stimulated allowing cells to utilize free circulating glucose, sparing blood glucose
    • Positive effect on performance
    • However, some athletes are sensitive to high CHO feedings and have problems with increased levels of insulin
  37. Caffeine
    • Central nervous system stimulant found in carbonated beverages, coffee, tea (chocolate contains compounds related to caffeine)
    • Increase alertness and decrease fatigue
    • Too much causes nervousness, irritability, increased heart rate and headaches
    • Headaches may result when ceasing caffeine use (withdrawal)
    • Not detrimental to performance
    • Enhances fat utilization and endurance performance
    • Makes calcium more available allowing muscles to work more effectively
    • May cause slight headaches
  38. Alcohol
    • Provides energy for the body
    • Little nutritional value
    • Central nervous system depressant
    • decreases coordination, slows reaction time, decreases mental alertness
    • increases urine production (diuretic effect)
  39. Organic, Natural, and Health Foods
    • Claim to be safer and nutritionally superior due to absence of pesticides and fertilizers
    • All foods are organic due to presence of carbon
    • Grown w/out synthetic fertilizers or pesticides
    • More expensive; no increased benefit physiologically
    • Processing (preservatives) helps to maintain nutritional value
  40. Herbs
    • Trend - natural alternatives to drugs and medications
    • Safe to ingest as natural medicines with few side effects (occasional allergic reaction)
    • Offer nutrients that nourish brain, glands, and hormones
    • Don�t need to consume with food - contain own digestive enzymes
    • Work with the body�s functions (whole body balancers)
    • Caution must be exercised as there is no governmental control or regulation
  41. Ephedrine
    • Stimulant used in diet pills, illegal recreation drugs and legitimate OTC medications
    • Similar to amphetamine
    • Potential dangers associated with use and has been known to cause numerous problems
    • --Heart attack, stroke, tachycardia
    • --Paranoid psychosis, depression, convulsions, coma
    • --Fever, vomiting, palpitations, hypertension
    • --Hypertension and respiratory depression
  42. Vegetarianism
    • Utilize plants to form foundation of diet - animal foods are either excluded or included in a variety of eating patterns
    • Economic, philosophical, religious, cultural, or health reasons
    • While practiced intelligently (not a fad) a vegetarian diet can result in deficiencies
    • Diet must be carefully planned
  43. Pre-event Nutrition
    • Importance and content pre-event meal vs. traditional rewarding that may hamper performance
    • Traditional steak and eggs
    • --Long term food consumption is more important than immediate consumption
    • --Purpose should be to provide competitor with nutrients/energy and fluids for competitions (taking digestibility into consideration)
  44. Encourage athletes to be conscious of diet
    • Diets are also individual to each athlete
    • Individual is the best judge of what should or should not be consumed
    • What is the individual comfortable with?
  45. Fast Foods
    • Way of life in America --world of fast food junkies
    • Often meal of choice during travel
    • Big concern is the amount of fat (40-50% of calories from fat)
  46. Glycogen Supercompensation
    • Increase muscle and liver glycogen stores prior to major event by altering eating and training habits
    • Decrease training at least 48 hours prior to event
    • Increase CHO loading to increase glycogen stores and positively impact muscle glycogen and muscle endurance
    • Six-day period
    • --Phase I (Days 1-2): hard training with reduced CHO intake
    • --Phase II (Days 3-5): decrease training and increase CHO (potentially increasing glycogen stores 50-100%)
    • --Phase III (Days 6-7): resume normal diet
    • Not clearly demonstrated as being beneficial in endurance activities
    • Do not perform more than 2-3 times per year
    • Ideal for prolonged duration events
  47. Fat Loading
    • Fat loading vs. carbohydrate loading
    • Intent = better energy source
    • Negative side effects
    • --cardiac protein and potassium depletion
    • --development of arrhythmias, increased serum and cholesterol
  48. Weight Control and Body Composition
    • Gains and loss of weight in athletes can be problematic
    • Intelligent and conscientious approach involves some knowledge of what is involved on the part of the athlete, coach and athletic trainer
    • Results in athlete displaying discipline relative to types and quantities of food
  49. Body Composition
    • Ideal body weight = age-related height/weight chart
    • Inaccurate due to broad ranges and failure to take individual body types into consideration
    • Health and performance may be best indicators
    • Fat vs. nonfat components of body = body composition
  50. Non-fat or lean tissue (lean body weight)
    bone, muscle, tendon, connective tissue
  51. Body Comp. Averages
    • Female 20-25% body weight = fat
    • Male 12-15% body weight = fat
    • Should not fall below 3% and 12 % for males and female respectively
    • --Results in loss of essential fat padding for organs
  52. Assessing Body Composition
    • Several methods
    • --Hydrostatic, bioelectrical impedance, skinfold thickness measures
    • --Skinfolds based on the fact that 50% of body fat is subcutaneous
    • Utilize skin fold calipers
    • Relatively low accuracy but is easy to learn and utilize
    • Error is + 3-5%
  53. Assessing Caloric Balance
    • Caloric balance = Calories consumed - calories expended
    • Positive caloric balance results in weight gain and vice versa for negative caloric balance
    • Can be calculated through accurate record keeping of calories consumed and expended relative to metabolic and activity needs
  54. Calories are expended through:
    • basal metabolism (calories expended at rest)
    • work (activity that requires more energy than sleeping)
    • excretion
  55. College athletes consume
    2000-5000 calories/day
  56. Endurance athletes may consume as many as
    7000 calories
  57. Methods of Weight Loss
    • Exercise or dieting alone is ineffective over the long run
    • Dieting alone results in lean body tissue loss
    • Should not drop below 1000-1200 calories for women and 1200-1400 for men
    • Exercising, while resulting in loss of fat mass, will also enhance strength, cardiorespiratory endurance, and flexibility
    • The key is moderation--A negative energy balance must be achieved
    • Loss of 1.5-2.0 pounds per week is adequate
    • Weight loss of more than 4-5 pounds per week can be attributed to dehydration
    • It takes time to put weight on and also takes time to take it off
  58. Methods of Weight Gain
    • Aim should be to increase lean body mass
    • Increased physical activity (muscle work) and dietary modifications
    • Approximately 2500 calories is required per pound of lean body mass, an increase of 500-1000 calories per day
    • A 1-2 pound per week gain is adequate
  59. Eating Disorders
    • Epidemic in our society, especially in sports
    • 1 out of 200 girls age 12-18 will develop some pattern of eating disorder (1-2% of population)
  60. Bulimia
    • Commonly females - ranging in age from adolescence to middle age
    • Periods of starvation, bingeing (thousands of calories) and purging through vomiting, fasting, and laxatives/diuretics
    • Characteristics
    • Typically bulimic athletes are white, middle to upper-middle class
    • Perfectionist, obedient, overcompliant, highly motivated, successful academically, well-liked, and a good athlete
    • gymnastics, track, dance
    • occasionally seen in male gymnasts and wrestlers
    • Bingeing and purging can result in stomach rupture, heart rhythm, liver damage, tooth decay from acids, chronically inflamed mucous lining of mouth and throat
  61. Anorexia Nervosa
    • 30-50% of anorexics also suffer from bulimia
    • Characterized by distorted body image and constant concern about weight gain
    • Impacts mostly females
    • Starts often with adolescents and can be life threatening
    • While the athlete tends to be too thin they continue to feel fat
    • Deny hunger and are hyperactive
    • Highly secretive
    • Early intervention is critical with eating disorders--Empathy is a must
    • Psychological counseling is key
    • Must have athlete recognize the problem, accept the benefits of assistance and must voluntarily accept help for treatment to work
  62. Environmental stress
    can adversely impact an athlete�s performance and pose serious health threats
  63. Areas of concern in Environmental factors
    • Hyperthermia
    • Hypothermia
    • Lightening storms
    • Overexposure to the sun
  64. Hyperthermia
    • Athletic trainers require knowledge and information concerning temperature, humidity and weather to adequately make decisions regarding environmental dangers
    • Has caused a number of deaths over the years
    • Must manage heat stress appropriately
    • Hyperthermia = increase in body temperature
  65. Heat Stress
    • Extreme caution should be used when training in the heat (overexposure could result heat stress)
    • It is preventable
    • Athletes who train under these extreme conditions are at risk
    • Physiologically the body will continue to function if body temperature is maintained
    • Body must dissipate heat to maintain homeostasis
  66. Heat can be dissipated from the body through 4 mechanisms
    • Conduction (direct contact)
    • Convection (contact with cool air or water mass)
    • Radiation (heat generated from metabolism)
    • Evaporation (sweat evaporating from the skin)
    • --Majority of body heat is dissipated through evaporation
    • --Heat can also be gained via these four mechanisms
  67. Evaporative Heat Loss
    • Sweat glands allow water transport to surface
    • Evaporation of water takes heat with it
    • When radiant heat and environment temperature are higher than body temperature, loss of heat through evaporation is key
    • Lose 1 quart of water per hour for up to 2 hours
    • Air must be relatively water-free for evaporation to occur
    • --relative humidity of 65% impairs evaporation
    • --relative humidity of 75% stops evaporation
    • Heat illness can still occur in cold environment if body is unable to dissipate heat
    • --Caused by dehydration and inability to sweat
  68. Monitoring Heat Index
    • Heat, sunshine and humidity must be monitored closely
    • Wet bulb globe temperature index (WBGT) provides objective measure for determining precautions concerning participation in heat
    • WGBT incorporates different thermometer readings
    • Dry bulb (standard mercury temperature)
    • Wet bulb (thermometer with wet gauze that is swung around in air)
    • Black bulb (black casing that measures radiant heat)
    • Formula yields WBGT index
  69. DBT and WBT can be measured with psychrometer (combines both thermometers)
    • Wet bulb will be lower due to evaporation of water
    • Drier air = greater depression of wet bulb temperature due to evaporation
    • Ventilation is provided by whirling thermometer (sling psychrometer) or suction fan (aspiration psychrometer)
    • Newer models utilize digital sensors
  70. Heat Illnesses
    • Heat Syncope (heat collapse)
    • Associated with rapid fatigue and overexposure, standing in heat for long periods of time
    • Caused by peripheral vasodilation, or pooling of blood in extremities resulting in dizziness and fainting
    • Treat by placing athlete in cool environment, consuming fluids and laying down
  71. Heat Cramps
    • Painful muscle spasms (calf, abdominal) due to excessive water loss and electrolyte imbalance
    • Occurs in individuals in good shape who overexert themselves
    • Treatment
    • Prevent by consuming extra fluids and maintaining electrolyte balance
    • Treat with fluid ingestion, light stretching with ice massage
    • Return to play unlikely due to continued cramping
  72. Heat Exhaustion
    • Result of inadequate fluid replacement
    • Will exhibit signs of profuse sweating, pale skin, mildly elevated temperature, dizziness, hyperventilation and rapid pulse
    • May develop heat cramps or become faint/dizzy
    • Core temperature will be ~102o
    • Performance may decrease
    • Immediate treatment includes fluid ingestion (intravenous replacement, ultimately), place in cool environment
  73. Heatstroke
    • Serious life-threatening condition, with unknown specific cause
    • Characterized by sudden onset - sudden collapse, LOC, flushed hot skin, minimal sweating, shallow breathing, strong rapid pulse, and core temperature of > 104o F
    • Temperature must be lowered within 45 minutes
  74. Drastic measures must be taken to cool athlete
    • Strip clothing
    • Sponge with cool water
    • Do not immerse in water
    • Transport to hospital immediately
  75. Preventing Heat Illness
    • Common sense and precaution
    • Consume fluids and stay cool
    • Fluid and Electrolyte Replacement
    • --Single most important step taken by a coach to minimize the chance of heat illnesses
    • Continual re-hydration is critically important
    • Generally only 50% of fluid is ever replaced and should therefore be replaced before, during, and after exercise
  76. Fluid replacement should match sweat loss
    • Most effectively replaced at regular intervals (15 minutes)
    • Time of stomach emptying is critical
    • Water is absorbed rapidly from intestine
    • Drink with 6% CHO is eliminated at the same rate if the individual is hydrated
    • Cold drinks tend to empty rapidly and will not induce cramping or put heart at risk
    • Drinks with caffeine and alcohol will promote dehydration
    • Hydration levels can be monitored via urine color and volume
    • Appropriate hydration = clear urine at normal or above-normal output level 60 minutes following exercise
  77. Using Sports Drinks
    • More effective than just replacing fluids with water
    • Flavoring results in increased desire to consume
    • Replaces fluids and electrolytes
    • Water alone can prematurely stop thirst response and initiate fluid removal by kidneys
    • Small amounts of sodium help in retention of water
    • Different drinks have different nutrient levels
    • Optimal CHO level is 14g per 8 ounces of water
    • More CHO results in slower absorption
    • Effective for both short term and endurance activities
  78. Gradual Acclimatization
    • Most effective method of avoiding heat stress
    • Involves becoming accustomed to heat and exercising in heat
    • Early pre-season training and graded intensity changes are recommended with progressive exposure over 7-10 day period
    • 80% of acclimatization can be achieved during first 5-6 days with 2 hour morning and afternoon practice sessions
  79. Identifying Susceptible Individuals
    • Athletes with large muscle mass
    • Overweight athletes
    • Athlete with increased fluid loss
    • While slight differences exist, precautionary measures apply to both males and females
    • Athletes consuming medications or supplements may have impaired sweating and may predispose them to injury
  80. Uniform Selection
    • Base on temperature and humidity
    • Dress for the weather and temperature
    • Avoid rubberized suits
  81. Weight Records
    • Keep track of before and after measures for first two weeks
    • If increase in temperature and humidity occurs during the season, weights should again be recorded
    • A loss of 3-5% = reduced blood volume and could be a health threat
  82. Hypothermia
    • Cold weather vs. nature of particular sport
    • Most activity allows for adequate heat production (increased metabolism) and dissipation, allowing for sufficient functioning
    • Impact on warm-up and �down time�
    • Temperature in conjunction with wind chill and dampness or wetness can increase chances of hypothermia
    • With muscular fatigue, in cold weather, rate of exercise begins to drop and rate of heat loss relative to heat production may shift
    • Results in impaired neuromuscular responses and exhaustion
    • Drop in core stimulates shivering but stops after temp drops below 85-90oF
    • Death is imminent when temp falls below 77-85oF.
  83. Cold Disorders
    • Fluid replacement is critical even under colder environmental conditions
    • Dehydration = decreased blood volume = less fluid available for tissue warming
    • May be useful to monitor weight of athletes training in cold temperatures
    • While less common, injury/illness due to the cold still occur, particularly in endurance type activities, winter sports and swimming in cold water
  84. Frost nip
    • Involves, ears, nose, chin, fingers, and toes
    • Occurs with high wind and/or severe cold
    • Skin appears firm with cold painless areas that may peel and blister (24-72 hours)
    • Treat with firm pressure, blowing warm air or hands in armpits (if fingers involved)
    • Do not rub
  85. Frostbite
    • Superficial Frostbite involves only skin and subcutaneous tissue
    • Appears pale, hard, cold and waxy
    • When re-warming, the area will feel numb, then sting and burn
    • It may blister and be painful for several weeks
    • Deep Frostbite indicates frozen skin requiring hospitalization
    • Rapid re-warming is necessary (100-110oF)
    • Tissue will become blotchy red, swollen, painful and may become gangrenous
  86. Prevention of Frostbite
    • Apparel geared for weather to provide semitropical microclimate for body and prevent chilling
    • Waterproof and windproof fabrics that allow passage of heat and sweat, and allow movement
    • Layers and adjusting them are key to maintaining body temperature (during period of (in)activity)
    • Inadequate clothing, improper warm-up and chill factor can lead to injury, frostbite, and/or minor respiratory problems
  87. Overexposure to Sun
    • Precautions must be taken to protect athletes, coaches, athletic trainers and support staff
    • Long Term Effects on Skin
    • Premature aging and skin cancer due to ultraviolet exposure
    • Premature aging is characterized by dryness, cracking and inelasticity of the skin
    • Skin cancer is the most common malignant tumor found in humans
  88. Using Sunscreen
    • Can help prevent damaging effects of UV radiation
    • Sunscreen effectiveness is expressed as SPF (sun protection factor)
    • Indicates how many times longer an individual can be exposed to the sun with vs. without sunscreen before skin turns red.
    • The greater the susceptibility, the higher the SPF that should be used
    • Should be worn by athletes, coaches, and athletic trainers who are outside a considerable amount, and/or have fair complexion, light hair, blue eyes, or skin that burns easily
    • Sunscreen use is at its highest March - November but should be used year round (particularly between the hours of 10am-4pm)
    • It should be applied 15-30 minutes before exposure and re-applied after exposure to water, excess sweating, rubbing skin with clothing or a towel
  89. Safety in Lightening and Thunderstorms
    • #2 cause of death by weather phenomena
    • Emergency action plans must be set for this type of event
    • Involving chain of command, monitoring of weather service, decision-making regarding removal and return to field
    • In the event of a storm, shelter indoors should be obtained
    • Avoid large trees, flag/light poles, standing water, telephones, pools, showers, and metal objects (bleachers, equipment, umbrellas)
    • Last resorts: find car, ravine, ditch or valley for safety
    • If hair stands up on hand you are in imminent danger and should get down on the ground but not flat as that increases surface area
    • NATA and National Weather Service recommend returning to the field 30 minutes following the last clap of thunder or lightening strike
  90. Flash-to-bang method
    • Estimates distance away for the storm
    • From time lightening is sighted to the clap of thunder count, divide by 5 to calculate the number of mile away
    • Count of 30 indicates inherent danger
    • Count of 15 seconds everyone should leave the field
  91. Lightening Detectors
    • Hand-held instrument with electronic system to detect presence and distance of lightening/thunderstorm activity (w/in 40 miles)
    • Can determine level of activity and direction of movement
    • Provides audible and visual warning signals
    • Inexpensive alternative to contracting weather services
  92. Athletes Psychological Response to Injury
    • Athletes deal with injury differently
    • Viewed as disastrous, use as an excuse for poor performance, or exhibit courage
  93. Severity of injury and length of rehab
    • Short term (<4 weeks)
    • Long term (>4 weeks)
    • Chronic (recurring)
    • Terminating (career ending)
  94. No matter the length of time, three reactive phases to the injury process occur
    • Reaction to injury
    • Reaction to rehabilitation
    • Reaction to return to play or termination of career
  95. Other matters that must be considered
    • Past history, coping skills, social support and personal traits
    • Injury may impact a number of factors socially and personally
    • Be aware of possible self-esteem issues
  96. Dr. Kubler-Ross 5 Stages of Grief
    • 1. Denial and Isolation
    • 2. Anger
    • 3. Bargaining
    • 4.Depression
    • 5. Acceptance
  97. Predictors of Injury
    • Some psychological traits may predispose athlete to injury
    • No one personality-type
    • Risk takers, reserved, detached or tender-minded players, apprehensive, over-protective or easily distracted
    • Lack ability to cope with stress associated risks
  98. Injury prevention is physiological and psychological
    • Athlete under stress emotionally is prone to injury compared to one that is adjusted emotionally
    • Skill and coordination could be sacrificed resulting in injury that may have been avoided
  99. Stress and Risk of Injury
    • Stress is defined as positive and negative forces that can disrupt the body�s equilibrium
    • A number of studies have indicated negative impact of stress on injury particularly in high intensity sports
    • Results in decreased attentional focus, create muscle tension (reduces flexibility, coordination, & movement efficiency)
  100. Sports can serve as stress to athlete.
    • Athlete will walk a fine line between reaching and maintaining performance
    • Must be able to handle peripheral stressors imposed
    • Expectations
    • Stress from school, family, and work can also lead to emotional stress.
  101. Overtraining
    • Result of imbalances between physical load being placed on athlete and his/her coping capacity
    • Physiological and psychological factors underlie overtraining
    • Can lead to staleness and eventually burnout
  102. Recognition and early intervention is key of overtraining
    • Implement short interruption in training
    • Should lower workload but maintain training intensity until athlete shows signs of recovery
    • Follow with gradual return to same workload
    • Should be removed from competition during this time period
  103. Staleness
    • Numerous reasons including, training too long and hard w/out rest
    • Attributed to emotional problems stemming from daily worries and fears
    • Anxiety (nondescript fear, sense of apprehension, and restlessness)
    • Athlete may feel inadequate but unable to say why
    • May cause heart palpitations, shortness of breath, sweaty palms, constriction of throat, and headaches
    • Minimal positive reinforcement may make athlete prone to staleness
  104. Symptoms of Staleness
    • Deterioration in usual standard of performance, chronic fatigue, apathy, loss of appetite, indigestion, weight loss, and inability to sleep or rest
    • Stale athletes become irritable and restless
    • Increased risk for acute and overuse injuries and infections
  105. Burnout
    • Syndrome related to physical and emotional exhaustion leading to negative concept of self, job and sports attitudes, and loss of concern for feeling of others
    • Burnout stems from overwork and can effect athlete and coach
    • Can impact health
    • Headaches, GI disturbances, sleeplessness, chronic fatigue
    • Feel depersonalization, increased emotional exhaustion, reduced sense of accomplishment, cynicism and depressed mood
  106. Goal Setting as a Motivator to Compliance
    • Effective motivator for compliance in rehab and for reaching goals
    • Athletic performance based on working towards and achieving goals
    • With athletic rehabilitation, athletes are aware of the goal and what must be done to accomplish
    • Goals must be personal and internally satisfying and jointly agreed upon
  107. To enhance goal attainment the following must be involved
    • Positive reinforcement, time management for incorporating goals into lifestyle, feeling of social support, feelings of self-efficacy,
    • Goals can be daily, weekly, monthly, and/or yearly
  108. Viral Infections
    • Virus
    • Herpes
    • Verruca and Warts
  109. Virus
    • 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
  110. 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
  111. Verruca Virus and Warts
    • Variety of forms exist
    • verruca plana (flat wart), verruca plantaris (plantar wart), and condyloma acuminatum (venereal wart)
    • Different types of human papilloma virus have been identified
    • 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
  112. Bacterial Infections
    • Bacteria are single celled micro-organisms
    • Disease development
    • Bacterial pathogen enters host, growth of bacteria and production of toxic substances occurs and host attempts to fight infection
  113. Two types of bacteria
    • Staphylococcus
    • Streptococcus
  114. Impetigo Contagiosa
    • Caused by streptococci
    • Spread through close contact
  115. Furuncle (Boils)
    • Infection of hair follicle that results in pustule formation
    • Generally the result of a staphy. Infection
    • Become large and painful
  116. Folliculitis
    Inflammation of hair follicle around face/neck or in the groin
  117. Bacterial Infections
    • Symptoms of Condition
    • Mild itching and soreness followed by eruption of small vesicles and pustules that rupture and crust
    • Exhibits signs of inflammation
    • --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
  118. Fungal Infections--Cause of Condition
    • Ringworm fungi (tinea)
    • Cause of most skin, nail and hair fungal infections
  119. 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
    • 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
  120. 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
    • 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
    • Care
    • -Topical antifungal agents and good foot hygiene
  121. Bronchial Asthma
    • Cause of Condition
    • -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
    • Care
    • -Prevention � determine causative factors
    • -Use of prescribed inhalers are effective in acute cases
  122. Exercise-Induced Bronchial Obstruction (Asthma)
    • Cause of Condition
    • -Brought on by exercise w/ exact cause unknown
    • -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
    • 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
  123. Gastrointestinal Bleeding
    • Cause of Condition
    • -Distance running, gastritis, iron-deficiency anemia, ingestion of aspirin or NSAID�s, stress, bowel irritation, colitis
    • Care
    • -Refer to physician is bleeding is occurring
    • -Other Conditions That Can Affect the Athlete
  124. Infectious Mononucleosis
    • Cause of Condition
    • -Virus that has incubation period of 4-6 weeks
    • -Transmitted through saliva
    • Sign 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
    • 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
  125. Iron Deficiency Anemia--Cause of Condition
    • Prevalent in menstruating women and males age 7-14
    • Three things occur during anemia
    • --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
  126. Iron Deficiency Anemia--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
  127. Iron Deficiency Anemia--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)
  128. Sickle-Cell Anemia
    • 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)
    • 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
    • Care
    • -Provide anticoagulants and analgesics for pain
  129. Marfan�s Syndrome
    • Abnormality of the connective tissue resulitng in weakening of the aorta and cardiac valves.
    • Signs
    • -Athlete have abnormally large wingspan
    • -Long fingers and long toes
    • -Causes sudden cardiac death in atheltes
  130. Diabetes Mellitus
    • 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
  131. Insulin Shock
    • Cause of Condition
    • -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
    • Care
    • -Adhere to a carefully planned diet including snacks before exercise
    • -Must determine food and insulin intake during questioning
  132. Diabetic Coma
    • Cause of Condition
    • -Loss of sodium, potassium and ketone bodies through excessive urination (ketoacidosis)
    • Sign and Symptoms
    • -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 life-threatening condition
    • -Insulin injections may help to prevent coma
  133. Epilepsy
    • Defined as recurrent paroxysmal disorder of cerebral function characterized by periods of altered consciousness, motor activity, sensory phenomena or inappropriate behavior caused by abnormal cerebral neuron discharge
    • Not a disease
    • 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
    • Sign of Condition
    • -Periods of altered consciousness, motor activity, sensory phenomena or inappropriate behavior caused
    • -May last 5-15 seconds (petit mal seizure) or longer (grand mal seizure)
    • -Include unconsciousness and uncontrolled tonic-clonic muscle contractions
  134. Epilepsy--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
    • 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
  135. Common Contagious Viral Diseases
    • Athlete exhibiting infectious disease should be referred to physician for treatment
    • Coach should be aware of certain signs
  136. Substance Abuse Among Athletes
    • Substance abuse has no place in athletics
    • Use and abuse of substances can have a profound effect on performance
    • Both positive and negative
    • Use of performance enhancing and street drug use occurs throughout athletics, on various levels
  137. Recreational Substance Abuse Among Athletes
    • 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
  138. 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
  139. Menstrual Cycle Irregularities
    • Strenuous training may alter cycle (25-38 day long cycles)
    • Amenorrhea � absence of menses
    • Oligomenorrhea - diminished flow (refers to fewer than 3-6 cycles per year)
    • Dysmenorrhea � painful menses
    • Menorrhagia - excessive menstruation
    • Polymenorrhea - abnormally frequent menstruation
    • Irregular periods
    • Any combination of these
  140. Dysmenorrhea
    • Cause of Condition
    • Painful menstruation prevalent in active women
    • May be caused by hormonal imbalance, ischemia of the pelvic organs, endometriosis
    • Most common menstrual disorder
    • Sign and Symptoms
    • Cramps, nausea, lower abdominal pain, headache, occasionally emotional lability
    • Management
    • Mild to vigorous exercise that helps to ameliorate dysmenorrhea are usually prescribed
    • Continued activity as long as performance levels do not drop
  141. 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