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Proper nutrition can positively contribute to:
- Strength
- Flexibility
- Cardiorespiratory Endurance
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Diet
- does not always mean losing weight
- Refers to a person�s usual food selection
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Nutrition
Science of certain food substances (nutrients) and what they do in the body
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Nutrients have 3 roles
- Grow, maintain and repair all body cells
- Regulate body processes
- Supply energy for cells
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Nutrition Basics
- Science of substances found in food that are essential to life
- Carbohydrates (CHO)
- Protein
- Fat
- Vitamins
- Minerals
- Water
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Roles of nutrients
- Growth, repair & tissue maintenance
- Regulation of body processes
- Production of energy
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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
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Starches
- Complex CHO
- Long chain glucose units
- Rice, potatoes, breads
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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
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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)
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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
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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
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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
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Vitamins
Vitamins (13) serve as regulators in many body processes
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Fat soluble vitamins
- Vitamins A, D, E, K
- Found in fatty portion of foods and oils
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Water soluble Vitamins
- Vitamin C, B-complex vitamins
- Help to regulate metabolism but cannot be stored
- Each serves a series of roles
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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
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Supplements
- Vitamin Deficiencies
- Illness that results from a deficit in a particular vitamin/mineral
- Are avoidable if an adequate diet is consumed
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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)
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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)
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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
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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
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Nutrient Requirements and Recommendations
- Amount of nutrient required to prevent deficiency diseases
- Vary by individuals and across populations
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Requirements vs. Recommendations
RDA (Recommended Daily Allowance) vs. DRI (Dietary Reference Intake)
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Food Labels
Aids consumers in determining levels of nutrients in foods
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Nutrient dense food
Contains considerable amount of vitamins, minerals, and proteins in relation to caloric content
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Junk foods
- Cookies, candies, doughnuts, chips
- Everything in moderation
- Avoid substituting junk food for nutrient dense foods
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Nutrition and Physical Activity
Activity increases need for energy not necessarily all vitamins, minerals and nutrients
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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
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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)
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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)
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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
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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
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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)
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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
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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
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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
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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)
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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
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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
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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
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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
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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)
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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?
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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)
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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
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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
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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
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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
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Non-fat or lean tissue (lean body weight)
bone, muscle, tendon, connective tissue
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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
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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%
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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
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Calories are expended through:
- basal metabolism (calories expended at rest)
- work (activity that requires more energy than sleeping)
- excretion
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College athletes consume
2000-5000 calories/day
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Endurance athletes may consume as many as
7000 calories
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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
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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
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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)
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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
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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
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Environmental stress
can adversely impact an athlete�s performance and pose serious health threats
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Areas of concern in Environmental factors
- Hyperthermia
- Hypothermia
- Lightening storms
- Overexposure to the sun
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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Drastic measures must be taken to cool athlete
- Strip clothing
- Sponge with cool water
- Do not immerse in water
- Transport to hospital immediately
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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
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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
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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
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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
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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
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Uniform Selection
- Base on temperature and humidity
- Dress for the weather and temperature
- Avoid rubberized suits
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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
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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.
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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
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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
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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
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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
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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
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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
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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
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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
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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
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Athletes Psychological Response to Injury
- Athletes deal with injury differently
- Viewed as disastrous, use as an excuse for poor performance, or exhibit courage
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Severity of injury and length of rehab
- Short term (<4 weeks)
- Long term (>4 weeks)
- Chronic (recurring)
- Terminating (career ending)
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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
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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
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Dr. Kubler-Ross 5 Stages of Grief
- 1. Denial and Isolation
- 2. Anger
- 3. Bargaining
- 4.Depression
- 5. Acceptance
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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
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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
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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)
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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.
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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
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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
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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
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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
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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
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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
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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
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Viral Infections
- Virus
- Herpes
- Verruca and Warts
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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
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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
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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
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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
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Two types of bacteria
- Staphylococcus
- Streptococcus
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Impetigo Contagiosa
- Caused by streptococci
- Spread through close contact
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Furuncle (Boils)
- Infection of hair follicle that results in pustule formation
- Generally the result of a staphy. Infection
- Become large and painful
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Folliculitis
Inflammation of hair follicle around face/neck or in the groin
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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
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Fungal Infections--Cause of Condition
- Ringworm fungi (tinea)
- Cause of most skin, nail and hair fungal infections
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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
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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
- 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
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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
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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
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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
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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
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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
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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
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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)
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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
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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
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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
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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
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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
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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
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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
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Common Contagious Viral Diseases
- Athlete exhibiting infectious disease should be referred to physician for treatment
- Coach should be aware of certain signs
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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
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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
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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
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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
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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
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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
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