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Sports Medicine UNIT - 3 HO
Sports Medicine UNIT - 3 HO
Sports
Medicine
1
Conditioning in sports
Psychological
Physical Environmental
• Remove fatigue and recovery • Heat balance etc.
• Sleep
• Nutrition
• Find and treat illness
Condition
Overreaching Overtraining
Undertraining Overload
Overwork
Staleness
2
Urbanization and Heat Illness
Heat Balance
Ambient Hyperthyroidism,
temperature obesity, exercise
3
Skin and Sweat grand
• Sweat glands
• 2-3 million sweat glands
• Active sweat glands: about 1/3
• Eccrine and apocrine glands Sebaceous
• Constituents gland
• Water Epidermis
• Na chloride: about 0.65%
• Urea: 0.08%
• Lactic acid: 0.03% Subcutaneo
us tissue Sweat
• Sweating: Exercise causes gland
profuse sweating in short time.
• Like sea water, sweat contains Hair root Adipose tissue
not only water but also Nerve
minerals such as salt, iron, zinc,
and others. Structure of Subcutaneous
• 100ml sweat secretion = -1 deg. Tissue
body temperature
4
Climate and Heat Illness
Saitama
Chiba
• 32℃〜 : Cancellation of the event
• WBGT:Wet bulb globe
23 wards of
Tokyo
illness prevention
Yokohama
Kawasaki
• Outdoors:
• 0.7 × wet bulb temp. +
0.2 × black bulb temp. +
Daily maximum temperature (°C) 0.1 × dry bulb temp.
http://www.nies.go.jp/health/HeatStroke/
• Indoors:
• 0.7 × wet bulb temp. +
0.3 × black temp.
Days
Septembe
June July August
r
Number of emergency cases due to heat illness: Fire and Disaster Management Agency
(figures indicate the number of deaths [2013]), WBGT: Ministry of Environment
10
5
Age Distribution of Heat Illness
• 4 peaks
• Infants
Daily living, work, exercise
• Adolescents
Females
Males • Middle age
• Elderly
Deaths by heat illness
11
Ambient
Temperature WBGT Exercise Guidelines for the Prevention of Heat Illness
(typical case)
12
6
Sports and heat illness Number of Participants Rate per year per 1
(data from Australia) cases in 2 (×1000 persons) million people
years (excluding those aged
under 15)
13
14
7
Number of Cases of
Heat Illness by
Sports Discipline
Japan, 1970-2005
Otsuka Pharmaceutical website
Baseball 65 23
Mountaineering 29 0
Marathon race 26 26
Running 21 21
Rugby 20 2
School event, summer camp, sports day, etc. 18 0
Soccer 17 7
Opening ceremony of Inter-high and other games 16 0
Judo 16 6
Kendo 14 2
Golf 12 1
Tennis 10 2
Volleyball 6 3
American football, basketball, softball 5 each 3
Boat, wrestling 4 each 2
Training, drilling, handball, table tennis 3 each 3
Gateballl, judo, sumo, physical education class 2 each 2
Aikido, cheerleading, triathlon, hockey 1 each 4
Total 315 107
15
16
8
Type of Sports discipline
Individuals Environment
and form of exercise
Indoor / Outdoor
Age, sex
Temperature
Individual / Team
Rules
Humidity
competitive level
Weight Control
17
Heat Exhaustion
6.4
21.1 Heatstroke
40.4
(sunstroke)
Heat syncope
32.1 Other
18
9
Management Strategy of Heat Illness in Sports
Assessment of
severity
Prevention •Level of
•Education consciousness
Transporting
•Wearing •Pulse, blood
appropriate pressure •Cool area
clothing •Body temperature •Ventilation
Checking Cooling,
environmental drinking water
condition •Sodium
•WBGT supplementation
•Heat index
19
20
10
Hypothermia
Digestive
Rectal temperature Consciousness Shivering Heart rate ECG
tract
35 - 33°C
Normal (+) Normal Normal Normal
(mild)
33 - 30°C Elongated
Indifference (-) Slight decrease Ileus
(moderate) waveform
30 - 25°C Confusion, Marked
(-) Osborn-J wave Ileus
(severe) hallucination decrease
25 - 20°C Coma, Muscle Marked Atrial
Ileus
(critical) apparent death rigidity decrease fibrillation
Less than 20°C Almost Muscle Atrial
Lost Ileus
(extreme) certainly dead rigidity fibrillation
21
22
11
Age-related Changes in Sex Hormones
(Free) Testosterone
Estradiol
10 15 30 40 50 Age
23
Effect of Estrogens
Its role: Prepare the body for Pregnancy and Childbirth
Femal
Male
e
Q-angle
24
12
Development of the genital system
(primary sex characteristics) … begins around age 10
Vagina
Fallopian
tube
Uterus
Uterus
Ovary
Birth Birth
Age Age
25
Menstruation
Purpose of menstruation:
Ovulation and pregnancy Follicle-stimulating hormone
Luteinizing hormone
26
13
Changes during Menstrual Cycle
Basal body
temperature
Hypothalamus
Cycle of Central
Nervous System Pituitary
gland
17OH-progesterone
Ovarian hormone
Estradiol
Ovarian Cycle
Progesterone
Ovarian
follicle
Endometriu
Uterine/Vaginal m (stratum
functionale)
Cycle
27
First Menstruation
Weight (kg)
Height (cm)
All All
cases cases
Age Age at Age at
menarche menarche
28
14
Normal Ranges for Menstruation
Cycle period
• 25-38 days
• Luteal phase: about 14 days
Duration of menstruation
• 3-7 days
Menarche
• 12 years old in average
Menopause
• 50 years old in average
Ammenorhea
• Primaly: 18 y.o.<
• Secondaly: interval 90 days <
29
Early week 1
Bad
Early week 2
Good
Mid-cycle
Late week 1
Menstrual
phase
Unrelated
30
15
Athletes and Eating Disorders
Weight loss for body appearance or
participation in a sport
→ Strict food restrictions → Habituation
Abnormal Eating Behavior (%)
Degree of obesity
Subjects
(%) Binge
Self-induced vomiting Laxatives, diuretics
eating
31
• References:
• Birch K. BMJ. 330(7485):244-246, 2005.
• Torstveit MK, Sundgot-Borgen J. Br J Sports Med. 39(3):141-147, 2005.
32
16
Sexuality
Aspects of sexuality Male Female
4) Sex of mind ?
33
Femininity Test
(Sex Check)
34
17
Unequal separation of Sex Chromosomes
(Ovum) (Spermatozoa)
Normal
Nondisjunction
35
Assignment 3
Please summarize characteristic and difference of
heat illness between youth and elderly.
Please discuss about the gender problem in sports.
36
18