Sports Medicine CQ 2 - How does sports medicine address the demands of specific athletes?

1. Children and young athletes

1.1. medical conditions (asthma, diabetes, epilepsy)

1.1.1. Asthma is a medical condition that affects the airways. It is characterised by inflammation of the airways leading to contraction of the bronchioles (airway branches) limiting the air flow both into and out of the lungs. The medical condition, asthma, has various possible triggers including: dust, pollen, pollution and exercise

1.1.1.1. Implications

1.1.1.1.1. Asthma is not an excuse not to play sport

1.1.1.1.2. Make sure coaches and teachers know about the condition and how to respond.

1.1.1.1.3. Long distance activities e.g running, require closer monitoring

1.1.1.1.4. Choose suitable sports like swimming and indoor activities,

1.1.1.1.5. Pre-exercise preparation such as ventolin will help prepare for the activity.

1.1.2. Management Strategies:

1.1.2.1. Asthma management Plan/Action Plan for coaches, teachers and managers is required and understood by all parties.

1.1.2.2. Aviod activities in severe cold and dry environments - Humid, moist air is preferred.

1.1.2.3. Swimming is recommended for children with asthma

1.1.2.4. Allow for warm ups and cool downs as well as rest breaks when participating in long aerobic activities - monitor symptoms

1.1.2.5. Avoid triggers - playing sports when there is smoke or high pollution or pollen in the air - try and move the activity indoors

1.1.2.6. 4:4:4 - 4 puffs, 4 breaths, 4 minutes

1.1.2.7. Coach & player have ventolin puffer on hand

1.2. overuse injuries (stress fractures)

1.3. Thermoregulation

1.4. appropriatness of resistance training

2. Epilepsy is a neurological condition where children experience recurring, unprovoked seizures due to abnormal electrical activity in the brain. Seizures vary in type and can range from brief lapses in attention to convulsions. Triggers may include fatigue, stress, or environmental factors like flashing lights, which can impact participation in certain sports. Sports and exercise can offer positive physiological and psychological changes which may improve seizure control through improved overall health and wellbeing.

2.1. Implications

2.1.1. Selecting suitable sports such as non-contact sports and sports with supervision eg diving and swimming, horse and bike riding are recommended

2.1.2. Make sure the athlete has proper hydration, rest and aviod known triggers such as blinking lights etc

2.1.3. Coaches & players are aware of the athletes triggers and can respond safely to a seizure

2.2. Management strategies

2.2.1. Medication adherance (make sure the athlete/child has been taking their medication)

2.2.2. Seizure Action Plan

2.2.3. Supervised participation

3. Overuse Injuries

3.1. Overuse injuries result from repetitive movements placing repetitive stress upon the body parts involved, such as: bones, muscles, tendons and ligaments.

3.1.1. Implications

3.1.1.1. Balanced training - not specialising in specific positions of a sport or one particular sport - allows variety of movements, holistic and balanced growth

3.1.1.2. Allow sufficient rest days

3.1.1.3. Make sure they are fully recovered from minor and/or major injuries

3.1.2. Management

3.1.2.1. Rest and recovery

3.1.2.2. RICER

3.1.2.3. Ice & Compression

3.1.2.4. Gradual return to play under the supervision of a GP/Physiotherapist etc

3.2. Example: a stress fracture to the shin of a child or young athlete, is an overuse injury usually caused by excessive running, particularly on concrete. This young athlete would be required to stop running until cleared by their health professional and GP.

3.3. Overuse injuries can be caused by: - poor recovery - high stress loads - poor technique - poor muscular strength or imbalance - ill-fitted protective equipment

3.4. Common overuse injuries in children and young athletes are: - shin splints - stress fractures - tendonitis (golfers or tennis elbow)

3.5. Children and young athletes are particularly susceptible to overuse injuries as their bodies are growing and developing.

4. Thermoregulation

4.1. Is the maintenance of a stable core body temperature. Thermoregulation is vital for every athlete as maintaining a safe body temperature avoids conditions such as hyperthermia and hypothermia. A child's body will overheat 3 -5 times faster than an adult

4.2. Implications

4.2.1. Children and young athletes have underdeveloped sweat glands, which means they sweat less that adults and therefore, are more affected by their surrounding environments. In addition to this, children and young athletes have a small body mass to surface area ratio. This means that they have a large surface area (skin) compared to their body mass (weight).

4.3. Management Considerations

4.3.1. - Appropriate clothing, - time of day the sport is played, - availability of shade, and - access to fluid need to be addressed to ensure the safety of children and young athletes during the sport. For example, a game of football (soccer) played on a hot day: - Can be broken into quarters to improve access to fluids - Can be played in the early morning to avoid the heat of the day, and - Children should have sunscreen applied and wear clothing that allows for greater air flow

4.3.2. Heat Exhaustion - Hyperthermia treatment

4.3.2.1. lie the person in a cool place with circulating air remove unnecessary clothing sponge with cool water give cool water to drink seek medical aid Heatstroke is an emergency situation and is managed by: - DRSABCD - lie the person in a cool place with circulating air - remove unnecessary clothing - apply cold packs or ice - cover with a wet sheet - ensure 000 has been called - give water

4.3.3. Hypothermia

4.3.3.1. Hypothermia is a cold-induced condition and is managed by: - DRSABCD - lie the person in a warm dry place avoid wind, rain, sleet, cold, and - wet grounds - remove wet clothing - warm the athlete with a blanket, - head cover and warm drinks - ensure 000 has been called

5. Appropriateness of Resistance Training

5.1. Resistance training involves exercises that improve muscular strength and endurance by working against a force, such as weights, resistance bands, or body weight. When appropriately tailored, it can be safe and beneficial for children, helping to enhance physical fitness and support healthy growth.

5.2. Management

5.2.1. - Age-Appropriate Programming: Designing programs that are suitable for the child's age, maturity level, and physical abilities, focusing on proper technique over heavy weights. -

5.2.2. Supervision: Ensuring trained adults supervise sessions to provide guidance and ensure safety.

5.2.3. - Incorporating Variety: Including a mix of exercises to promote balanced muscle development and prevent overuse injuries.

5.2.4. children should be mature enough to follow direction and appreciate the benefits and risks of resistance training, usually age 6. - 1 RM should be avoided - technique should be taught and mastered before increasing resistance - Intensity should be fairly low: x 6-9 year olds 15+ RM x 9-12 year olds 10-15 RM x 12-15 year olds 8-15 RM x 15-18 year olds 6-15 RM - Frequency should be 2-3 times per week [2]

5.3. Implications

5.3.1. The key to safe participation in resistance training is to provide qualified supervision, age-specific instruction and a safe training environment following established training guidelines.

5.3.2. Resistance training provides increases in muscular size, strength, power and speed. Resistance training increases bone strength and help prevent injury.

6. Diabetes is a metabolic disorder where the body either doesn’t produce enough insulin (Type 1) or cannot use insulin effectively (Type 2), leading to high blood glucose levels. Type 1 diabetes is more common in children and requires careful blood sugar monitoring and insulin management to prevent symptoms like fatigue, irritability, and, in severe cases, seizures or unconsciousness.

6.1. Implications

6.1.1. Long duration activities will cause a reduction in BGL due to glucose demands of the muscles, which could result in hypoglycemia - Low BGL

6.1.2. Regular physical activity helps manage both types of diabetes and can prevent hyperglycemia

6.1.3. Will need frequent breaks to re-fuel

6.2. Management strategies

6.2.1. Make sure you test the athletes BGL before starting any activity and have fast acting glucose on hand e.g jelly beans and juice poppers

6.2.2. Sit players out if they are hypo (below 4) Hyper (above 8 )

6.2.3. Signs of Hyperglycemic - thirsty, vomiting, weak pulse - Call 000

6.2.4. Signs of Hypoglycemia - fatigue, shaking, sweating, rapid HR

6.2.5. Action Plan - for coaches, teachers etc developed by GP - education sessions

6.2.6. Monitor performance, if you see signs of fatigue or decline in performance bring them off, test BGL and offer rest and glucose