SPORTS MEDICINE

Sports Medicine is one of the disciplines of clinical medicine. Sports Medicine includes:
medical control, sports pathology, athletes’ hygienic regimen, sanitary inspection of sports
facilities and equipment.
Medical Control studies three main aspects of physical condition of athletes: overall
health condition, physical development and functional capacity. The health condition is
determined by means of taking history and inspection (somatoscopy). Assessment of physical
development of athletes includes measurements of height, weight, muscle strength, vital capacity
of lungs and etc (anthropometry). Investigation of functional condition gives an idea about
adaptation of different organ systems to sports activities.
Physical training is defined as planned and goal-oriented muscular activity. Sports
training includes technical, tactical, psychological, general and special preparation of athletes.
During physical preparation great attention has to be paid to continuity of systematic training and
gradual increase of exertion.
Exercises can be divided in speed, strength, endurance and flexibility exercises. Speed
exercises are performed in a relatively short period of time and they can be local (e.g. playing the
piano) and general (e.g. running 60, 100, 200 meters (sprint), swimming 25 meters). Strength
exercises use strong and strenuous contraction of muscles. These kinds of exercises are used in
gymnastics, wrestling, weight-lifting and etc. Strength exercises should be conducted correctly,
because in some cases they may have negative influence on the organism, especially on the
cardiovascular system. Endurance exercises are needed for almost any sport and they increase
adaptational capacity of the body. By developing endurance, athletes can maintain high working
capacity for a long time. Speed and strength are decreased with aging, but endurance is relatively
unaffected. Flexibility exercises involve very exact and coordinated movement skills. Flexibility
is the capacity of a joint to move smoothly though it’s full range of motion. Lack of flexibility is
associated with musculoskeletal injuries. Flexibility is progressively decreased with aging
because of changes of elasticity of the soft tissues.
Exercises can be performed with maximal, submaximal and moderate intensity. Exercise
with maximal intensity is usually performed in short period of time, for example during less than
20 seconds. Oxygen consumption is very high, about 87-94% and period of resting lasts 30-40
min. This kind of exercise is called anaerobic exercise. Exercise with submaximal intensity is
performed from 30 sec. to 5 min. Oxygen consumption is 53-89% and resting lasts 1-2 hours.
This kind of exercise is called aerobic exercise. Exercise with average intensity lasts 30 min and
more oxygen consumption is low, about 50%.
Gravitational shock may develop during physical activity with maximal intensity, which
means that if a person abruptly stops moving after the maximal exertion, he may fall down
because the loss of consciousness. Gravitational shock has the following mechanism: at the
moment of ceasing muscular activity, the tone of skeletal muscles decreases immediately, the
tone of peripheral blood vessels decreases and blood vessels are rapidly widening in abdominal
cavity, while during physical exertion they are usually contracted. As a result, smaller quantity of
blood reaches the heart, systolic volume decreases, which causes decrease of arterial blood
pressure and development of brain ischemia; therefore the person can lose consciousness. This
kind of reaction should be always taken into consideration and advice should be given to never
stop exercise immediately after maximal exertion. Movement has to be continued for several
minutes in cool-down regimen.
During physical exercise with submaximal intensity, a so called “dead point” condition
can develop, which afterwards is followed by so called “second breathing”. In the “dead point”
condition an athlete may feel strong fatigue, unpleasant sensation in chest, tachycardia (200 beats
per minutes), difficulty breathing and feeling of asphyxiation. The athlete may have a strong
desire to stop moving completely. Usually this condition lasts 40 seconds, than it is replaced by
“second breathing” and all these negative feelings disappear. The athletes should know about this
“dead point” condition and simply decrease physical exertion in such cases, for example
decrease speed and intensity during running.
 Some peculiarities of athlete’s organism

The process of exercise training greatly influences the locomotors apparatus. Long bones
of athletes are increased about 2-8 mm in thickness. The mass of skeletal muscles is gradually
increased by the intensity of plastic processes in the muscles. It’s called muscles working
hypertrophy. If untrained muscle’s weight is usually 35-40% of whole body weight. Trained
muscle’s eight could be 50%. The increase in muscle mass may also be caused by hyperplasia,
which is an increase in the number of muscle fibers. One of the major changes in skeletal muscle
with exercise training is an increase in the number of capillaries around each muscle fiber. The
increase in capillary allows for greater exchange of gases, nutrients, waste products and heat
between the blood and active muscle tissue.
As a result of endurance training, heart weight and volume increase. Like skeletal muscle,
cardiac muscle undergoes hypertrophy and it’s called physiological (working) hypertrophy. The
increasing of chamber size allows for a greater end diastolic volume and increasing in chamber
filling places a greater stretch on the cardiac muscle fibers and this in conjunction with an
increasing in ventricular wall thickness will result in enhance of contractility that can be
generated by heart during systole.
Resting heart rate decreases markedly as a result of endurance training. Heart rate of the
sedentary individuals is between 70-80 beats/min. Highly conditioned endurance athletes often
have 30-60 beats/min restingheart rate. One of the reason of decreasing of heart rate –
bradycardia is the increasing of stroke volume. Resting stroke volume of untrained persons
ranges from 55to 75 ml and maximal stroke volume from 80 to 110 ml. After training, resting
and maximal stroke volume may increase 40-60%. Exceptionally well-trained individuals have
been reported to have resting stroke volumes 100-120 ml and maximal strike volumes of 160-
220 ml. The increasing of stroke volume is due to increase in ventricular filling and force of
contraction. With the reduction in heart rate under this condition, cardiac output is maintained by
an increase in stroke volume. Maximal cardiac output ranges from 15 to 20 l/min in untrained
people, 20-30 l/min in trained people, and as much as 40 l/min or more in large highly trained
endurance athletes. The increasing in VO2max is directly related to the increase in cardiac output.
Athletes often have physiological hypotonia. It could be explained by the increasing of
elasticity of blood vessels. Athlete’s systolic blood pressure could be low than 100 mmHg and it
could be considered as normal. The blood pressure response to the same absolute rate of energy
expenditure is determined by the amount of muscle mass being used. The greater the muscle
mass involved the lower the blood pressure, or the less the muscle mass used, the greater the
blood pressure.
Athletes respiration becomes deeper and more rare about 4-14 breath/min instead of 16-
22. It’s called bradypnoe. If healthy, in trained person usually absorbs only 40% of oxygen from
1 liter breathed in air, trained person absorbs 55-65% of oxygen.
 Hypodynamia

Hypodynamia means long-term limitation of physical activities, or lack of motion. If

physical labor in human social activities amounted 96% one hundred years ago, nowadays it
hardly amounts 1%. Though these activities, as well as migration processes all over the world,
can hardly be called physical strain of muscles.
Hypodynamia negatively affects above all the heart function. Only a few sportsmen of
modern society managed to match the physical abilities of their ancestors only thanks to constant
conscious efforts. Any break in training quickly destroys the achieved results of long hard work.
The rest of us must resign oneself to death from heart diseases as a punishment for a lifetime of
worries pushing buttons and turning on switches. In other words, we have a “syndrome of a non
trained heart”, meaning above all clerks who are engaged in intensive “paper work”, but who
don’t go in for physical activity of any kind at all.
Intensive muscular activity controls not just the heart’s contractile force, but the size of
coronary arteries lumen, which means, that it controls the amount of blood, flowing into the
heart’s muscular cells. They tend to extent with physical activity, which is a result of
catecholamine ejaculation into the blood flow. However if the system is “not trained”, sharp
intensification of muscular activity might lead to serious consequences.
Muscular activity is necessary for intensification of metabolism in the organism as a
whole and in the heart in particular. If the metabolic system is not trained well enough, a great
number of catecholamine is ejaculated into the blood, which along their selective absorption by
the heart, result in the fact that the oxygen as well as blood , supplied to the myocardium, is fully
processed before they reach the terminal branching of coronal arteries. Microfocal necrosis of
myocardium is often a result of this process. Metabolic disorders may cause atherosclerosis,
which is the reason of myocardial infarction, kidney disease, stroke and etc.
The center for disease Control has reported that lack of adequate exercise is the most
prevalent risk factor for coronary heart disease. It’s fact that disease of cardiovascular system
mostly are found among mental workers, approximately three times more than among physical
workers.
Aerobic exercises increase high density lipoprotein decrease blood pressure, normalize
blood glucose. Some of the lesser known benefits of long-term endurance training are an
increase in fibrinolysis and red blood cells deformability, which may be prevent coronary
ischemic events.
Muscular activity favorably affects the respiratory system and via it – other organs,
including the heart. In case of hypodynamia the oxygen’s partial pressure in blood becomes
lower, which leads to reducing the level of its delivery to the myocardium.
Skeleton muscles (the more so lower extremities’ muscles) are known to constitute a
certain “peripheral heart”, which encourage pumping the blood through veins against gravity.
Prolonged hypodynamia and lack of physical activities during office work inevitably result in
congestion in the lower part of the torso, which in its turn lead to lower extremities vessels’ and
small pelvis organs diseases. Strength of heart’s systole is extremely decreased after 40 days of
lying.
Hypodynamic condition provokes degenerative changes in different systems, which cause
different diseases. An experiment was conducted on a group of people, who were put in cast till
waist for 7 weeks. Nevertheless they put on weight during this time, they lost such important
substance as protein, about two kilos. This fact confirms that moving is important to keep protein
in the organism. Another experiment was carried out, in which a group of young healthy people
(20-22 ages) were laid in bad during 2 month. After three days most of them felt pain in the low
back and lower extremities. After 20 days sleep disorders, loosing appetite and apain in muscles
were developed. Other disorders were: tachycardia and bradycardia, dropping of arterial blood
pressure, a balance disorders and etc.
Long term limitation of physical activity causes metabolic disorders, which is very
dangerous for the organism. As it’s known atherosclerosis is developed after fatty metabolism
disorders, which causes deposition of cholesterol on blood vessels lining. This becomes the
reason of vessels contraction and organs undernourishment, which may cause e.g. myocardial
infarction, kidney diseases, blood circulation disorders in brain.
Nourishment factor is also very important. If a person usually takes more calories than
he can spend, he could gain the weight. A man spends only 110-120 kcal during usual walking of
4-5 km per hour, but he can restore it with only 50 g. white bread. Modern life conditions limit
human’s physical activity. Besides we should remember that according to a human’s nature, he
must move as much as possible.
 Medical control
Medical Control studies three main parts of physical condition of people being trained.
There are health condition, physical development and functional condition. The aim of medical
control is to study athlete’s morphological and functional status. All basic clinical and
physiological methods could be used in Sports Medicine. The studying of athletes’ organs
systems condition should be conducted at rest, as well as at during physical exertion.
In Sports Medicine the following methods are used: medical history, collection of data,
somatoskopy (external observation), clinical and laboratory investigation, the study and
estimation of physical development, the study of functional condition of different organs systems
by testing methods. These collected information has to be entered in the special blank and than
the estimation has to be done.
Medical history includes general and sports histories. General history includes past
diseases (infections and other diseases), current diseases and etc. Sports history includes traumas
or other sports injuries, resting and training regimens, bad habits and etc.
In research of human’s physical development we mean the estimation of body’s morpho-
functional characteristics. It is divided into Somatoscopy and Anthropometry.Somatoscopy
means external observation of human’s body. At fist a color of the skin and it’s surface should be
observed, than accumulation of the fat tissues, which might be expressed well, average and
mildly. After that a muscle development is checked. If muscles relief is expressed well they are
considered to be well developed. Muscles development are average when intercostal cavities are
filled. If the intercostal cavities aren’t filled, it means that muscles are weakly developed. Forms
of chest might be normal and pathological. The form of normal chest is symmetric. The
pathological form of the chest could be flat, also it could be so called hen’s chest, which is
originated from rachitic. There exists funnel chest, emphysematosical chest is when forms of the
chest is dilated, costal arch is raised and have horizontal position.
During the inspection of the back attention should be paid to vertebra, shoulder blades.
Among the defects of the back round back are most often met. Curvature of the spine might be in
sagittal (kyphosis, lordosis) and in frontal (different forms of scoliosis) flatness. The forms of the
legs are straight, resembling to 0 and resembling to X. The form of the foot is also important. It
might be normal, with the arch, half flat, and flat. In case of the flat foot the body weight doesn’t
distribute evenly on low extremities, also the foot spring function is extremely decreased. People
with flat foot shouldn’t train for a long time and with great intensity.
Anthropometry means the study of human’s physical development by means of
measuring. At first a person’s weight and height should be determined. The weight is the most
stable sig of athletic fitness level. The height is measured in standing as well as in sitting
position, which is impotent to calculate the coefficient of proportionality. The chest
circumference is determined by the tape. It is measured during the deep inspiration and the deep
expiration and during the pause. In the moment of pause the chest mustn’t move. The respiratory
excursion is the thorax difference between inspiration and expirations and it reflects best of all
functional condition of thorax. The thorax excursion is about 6-8cm among men and 3-6cm
among women, but could be 12-15 cm among athletes.
Vital capacity of the lungs is a volume of air which comes out from lungs by maximum
deep and slow expiration and it’s determined by spirometer.
The strength of the hands is measured by dynamometer. It’s mostly reflects the strength
of the hand muscles and partially back extensors. Strength of the hand is about 40-45 kg among
men and 30-35kg among women. The strength of the waist is measured by waist-back
dynamometer, which shows the strength of big extensors of the back and abdominal muscles. If
these muscles are well developed the data would be 80-90 kg among women and 130-150 kg
among men.
Functional tests of cardiovascular system
Different test are widely used in order to study functional condition of an athlete’s body systems, The
functional tests helps to clarify how the athlete’s organism adjusts to different kinds of physical loading
(What is it adaptation capacity to muscle working) and which type of reaction it respond to that.

The functional test of cardiovascular and respiratory system is based on qualitative and quantitative
analysis. Qualitative analysis means studying the reactions of hemodynamic readings like pulse rate ,
arterial blood pressure at rest after doses physical loading , Quantitative analysis means studying these
reactions during muscle working process. For common researches the functional tests, which are based
on quantative analysis are more informative, From qualitative tests , Martine Kushelevski one moment
functional test with standard dosed physical loading is the most of all used . A person being examined
sits on the left side of a physician and pulse rate and blood pressure are checked out. After that the
person makes 20 squatting during 30 sec and immediately after finishing during 10 sec of first minute
pulse rate is checked and in last 50 sec arterial blood pressure is measured, the checking of pulse and BP
should be repeated in three times during three minutes of recovery period.

The reaction of cardiovascular system should be estimated by changes of pulse rate and BP as positive ,
mean and negative reactions, In case of positive reaction systolic pressure rises about 15-30 mmHg
(average 20) and diastolic pressure decreases about 5-15 mmHg (Average 10, Pulse pressure
moderately increases, pulse rate becomes frequent for about 50-60% . All these reading return to the
initial figures at the end of the third minutes. During mean reaction pulse pressure insignificantly rises
basically due to the increase of systolic pressure , During negative reaction pulse pressure decreases due
to decreases of systolic pressure and increases of diastolic pressure , Pulse becomes frequent not than
60% and these readings don’t return their initial figures during three minutes.

This functional test could be used with untrained persons, patients, children and not with high
qualification athletes. Because this kind of loading is too light for them.

For study of athlete’s functional condition combined functional test with the three moments by Letunov
is used. In the first moment standard dose loading ( 20 squatting during 30 seconds ) is conducted. In
the second moment, The athlete performs quick running at place( exercise for speed ) during 15 sec. ,
after finishing a recovery period last 4 minutes. In the third moment the athlete performs running at
place during 3 minutes ( exercise for endurance ) with 180 step a minute . The recovery period last 5
minutes. After this test the following reaction could be observed. Positive or Normotonic and negative
or non typical ( hypotonic , hypertonic and dystonic reactions . During Normotonic reaction pulse rate
increases till 100-120 %, systolic pressure rises about 40-60 mmHg , diastolic pressure decreases about
20 – 40 mmHg . The recovery period lasts 5 mins. During hypotonic or asthenic reaction pulse rate
becomes more frequent in comparison with Normotonic reaction maximal pressure insignificantly rise
and minimal pressure either rises insignificantly or doesn’t change at all, it means that pulse pressure
insignificantly increases . Pulse rate becomes frequent about 120- 150 %. Recovery period is longer than
5 min. Hypertonic reaction is characterized with visible increase of maximal pressure till 200 mmHg and
minimal pressure is also increased. Pulse rate undergoes severe increase. Hypertonic reaction is caused
by increasing of peripheral resistance or arterial spasm. Recovery period is longer than 5 min.
Hypertonic reaction is characteristic for people who have an inclination for hypertonic disease.
Hypertonic reaction is noted among atheletes during chronic fatigue. In case of step reaction, maximal
pressure increases during the recovery period at second and at third minutes, while it should decrease
gradually. Recovery period is longer than 5 min. This reaction shows weak adaptation capacity of
cardiovascular system with respect to muscle working . Such reaction is mostly noted among untrained
person or athlete with chronic fatigue during dystonic reaction systolic pressure increases significantly
but diastolic pressure drops till 0. It is called zero level pressure. Pulse rate become visibly frequent and
recovery period is longer than 5 min.

For functional research of professional athlete‘s cardiovascular system one moment combines
functional test by Svanishvili is used ( exercise for speed endurance) . Like all qualitative functional tests.
During this test pulse and blood pressure are checked. After that the athlete performs combined dosed
physical loading running at place. 180 steps per min during 2 min and 45 sec and after getting of signs,
he starts quick running at place during remained 15 sec, Then during 2 min pulse rate is counted and BP
is measured. This functional test is estimated by before mentioned reactions.

One of the wide used functional test based on quantitative analysis is determination by physical working
capacity. This test has great importance for modern clinical and sports medicine. Physical working
capacity is connected with endurance of human organism. However it is widely conception and gives an
idea about body’s physical condition.

Physical condition could be studied by different way. But mostly by heart rate. It is fact that certain
direct connection exist between heart rate and muscle working intensity. This connection is maintained
till heart rate reached 170 beats per minute during muscle working ( 100-170) because in condition
cardiac output doesn’t decrease and cardiovascular and respiratory systems optimally function. When
during muscle working heart rate becomes more than 170 beats per min , this direct connection
between heart rate muscle work up intensity destroys. From this moment cardiac output decreases and
heart works uneconomically. A functional test by which physical working capacity could be determined
was based on this fact. The test was created by Scandinavian scientist Siostrand in 1947 and Volund in
1948 . They called the test PWC which means physical working capacity and 170 beats per minute is
characteristic for the healthy person and it is optimal figure of pulse during this sub maximal loading.

A person being examined performance must be working on a cycloergometre during 5 min. This time is
necessary to obtain optimal heart functioning and the quantity of pedaling should be 60 rounds per
min(50-75) . For determination of PWC two loadings with different intensity are performed. At interval
between them is 3 min for athletes and 5 min for non athletes. Heart rate is checked during last 30 sec
of 5 min loading by electrocardiogram (R-R interval). Heart rate of healthy person should be 100-120
beats after first loading and 140 – 160 beats after second one. The first intensity is picked up gy physical
preparation of the subject and the second intensity is up from obtained reactions (Pulse after the first
loading. For healthy non trained people first intensity is 400km/min, second 500-800 km /min m for
athletes first loading 500-600 km/min .By special formula physical working capacity could be determined
.
PWC 170 = N1+ (N2-N1) x 170-fi
f2-f1
N1 and N2 are working intensity during first and second loading

f1 and f2 are heart rate , the figure 170 is constant.

PWC 170 of healthy, nontrained women is 580 km/min, of men – 1064 km/ min. For athlete women are
780 km/ min. For men 1500 km /min (by Karpman), for athlete men – 1460km/min (by Svanishvili).

Physical working capacity is directly proportional to weight therefore PWC is equalized to weight . For
non trained people it is 15-19 km/min/kg. For athletes 15- 29 km/min/kg.

For estimation of athlete’s body functional condition the determination of maximal body consumption is
( Vo2Max) has great importance.

More simple step test was created at the university of Havard in 1942 . The person being examined on a
special box ( 50 cm high ) 10 times during 4-5 mins . One move includes 4 steps . on the first………….. He
puts leg on the box , on the second he gets on the box, on the third he get down on one leg on the floor
and one the fourth he stands with both foots . If during performing this test the person is tired , he stops
moving and doe determination could be used only that time during which he had performed the
loading . After that he sits on the chair pulse is checked during 30 sec of 2,3,4 th minutes of recovery
period. Also arterial blood pressure is measured and electrocardiogram is taken on first and fifth min of
recovery period.

J= t x 100/(f1+ f2+f3) x 2
F1 is pulse rate in 30 sec of second min of recovery period

F2 is pulse rate in 30 sec of third min

F3 is pulse rate in 30 sec of fourth min

t is performed move

If J is less than 50 it indicates to weak working capacity , between 50-80 is average and more than 80 is
good working capacity.
 Sports pathology
Professional sports are engaged with risk of traumatic inuries and other sports pathology.
Overload training can acuse at first functional and than organic pathological changes. Usually
atheletes are in high tension and under some external factors such as low temperature or other
factors their cases too much training causes tissues and cells damage for eg – cardiac muscle
damage.

To make diagnosis in sports pathology is very difficult, because very often athletes are in good
shape but latent pathological changes takes place in their organism. It’s important to
remember, that recuperation should be full after injury and over exertion. In sports pathology
chronic infections should be paid special attention. First of all there are caries, chronic
tonsillitis, cholecystitis, otitis, bronchitis and etc. the more intensive muscle working, the worse
the chronic infections manifest. It could be explained by intensive physical loading reinforce
blood and lymph circulation, which cause infections diffusion through whole organism. This
process doesn’t take place in non athletes organism.

Among chronic infections tonsillitis is especially dangerous, it may cause tonsil cardiac
syndrome, which means cardiac muscle local and diffuse damage. During this pathology
sometimes sports of angina doesn’t occur and only heart pain is a complaint, which complicate
to make correct diagnose. After tonsillectomy ECG is normalized among 80percent of athletes.

During the examination of athletes a physician can expose such pathological changes in athletes
cvs such as heart defects ( AORTIC , BICUSPID, TRICUSPID VALVES). These kinds of heart defects
are characterized by good compensation. but after several time health condition can be
worsening and the athletes with heart defects should stop training. For eg- to make diagnose of
aortic valve anomaly is very difficult because at the first time athletes may be in good shape and
they don’t have any complaints. One of the first sign of decompensation is the decrease of
diastolic pressure till zero. In this case athletes should show decrease loading and the they
should change it to rehabilitation exercises.

In fact that among athletes physiological hypertrophy of cardiac muscle frequently take place,
but sometimes for reason of excessive training pathological hypertrophy could be develop.
Athletes heart volume can be achieved about 1000 to 1200ml ( an athlete had 1700ml heart
volume), but more than 1200ml volume may change in pathological, which means that in
increased heart muscle sufficient blood vessels doesn’t occur and there by muscles nutrition

isn’t enough. Also athletes heart rhythm should be paid attention, distributing of which may
depend on heart muscle damage. If arrhythmias systematically take place during training
process ECG studying with dosing physical loading should be conducted. Very intensive training
may cause cardiac muscle overstrains, which could be acute or chronic. Among athletes left
ventricle overstrain often happens. Low physical working capacity, negative reactions of heart
rate ad bp ( hypertonic or hypotonic reactions) heart pain characterize overstrain heart. If
atheletes decrease physical loading all these complaints could be disappeared, but if overstrain
heart condition lasts long time the functional changes gradually turn into organic changes,
which means dystrophic damages and needs rest and treatment.

If the athelete has high bp at rest, in future hypertension may develop. Amog atheletes low
systolic bp as 80 to 90 mmhg often meet, but this fact has to be always take into consideration,
because for the different reasos the physiological hypotonia may change in pathological
hypotonia.

Atheletes respiratory disease also exist in sports medicine practice but more rare ( 3times rae
than amog non atheletes), especially acute upper respiratory infections.

After intensive physical loading proteins and blood cells can appear in athelets urine , but it
could be considered as abnormal only if it lasts more than one day.

Intensive muscle working disturbs GIT secretory and motoric functions, there by during training
process atheletes should to keep strictly feed and rest regimes. Sometimes muscle working can
cause pain in right upper quadrant of the abdominal cavity and its called liver syndrome which
is caused by stasis in liver ad bile duct, liver becomes bigger and it cause pain.

If such condition last for a long time it may cause damage of liver cells. Irrational physical
training sometimes causes egative influence on atheletes organism and it exposes as fatigue
and as overstrain. The reason of fatigue and overstrain could be different changes in CNS the
overdosed muscle working cause decrease of process of excitation in definite cells of cerebrum
and feeling of early fatigue , reluctance of training , decrease of cordiation and muscle strength,
sisposition to sleep could be developed. Fatigue may develop in athletes with good shape , but
after several days of adequate rest it usually disappear.

Overstrain causes more grave disorders. It characterizes to the athletes is good shape as well as
in bed shape. During overstrain nervousness develops which is functional disorder of central
nervous system and means losing balance between the process of excitation and inhibition
during overstrain fast loosing of weight, decrease of vital capacity of lung , frequent breathing
and frequent pulse rate could be exposed, blood pressure could decreases or increases, and
also negative reactions nervous system could develop. These complex changes negatively affect
on organs system. The reasons of overstrain could be very intensive physical loading ,
shortening of rest time, disturbing of rest and train regimen or when athletes take place in
competition after severe illness without carrying out of good rehabilitation program. Three
stages of overstrain are exist. First stage is when athletes physical activity decreases, early
fatigue, loosing of appetite, sleeping disorders are developed. At the second stage all these
signs are exposed in more grave forms with adding of heart pain and disposition of sweat. At
the third stage (very rare) athletes must stop training progress and they have to be treated by
cardiac drugs and by rehabilitative methods.