Special Considerations in Athletes

1. Special Considerations in Athletes Chapter 25

2. Special Considerations in Athletics • Training staff needs to be aware of any medical condition an athlete has so they can be prepared if an emergency should arise • Information could be found on physical and should be on emergency medical cards • Environmental Considerations • Skin Conditions • Diabetes • Seizure Disorders • Insect Stings or Bites • Female Athlete Triad

3. Heat Stress • A condition that occurs when the body cannot maintain homeostasis and the body temperature begins to rise (hyperthermia). • The hypothalamus of the brain is in control of regulating body temperature

4. Assessing the Risk • There are certain risks that increase the chance of suffering from heat stress • Athletes need to be well hydrated, rested and in good physical condition for temperature regulation work properly • Poor condition causes the body to work harder, putting more strain on the hypothalamus • The heat index combines temperature and humidity to provide a reference point for various levels of risk associated with exercise under hot and humid conditions • The greater the head index, the more moisture in the air. • The body progressively loses its ability to adequately evaporate moisture • These risks can cause potentially dangerous increases to core temperature

5. General Care of Heat Illnesses • There are varying degrees of heat-illnesses but even the milder ones can become life threatening if not properly treated or managed • Methods of Treatment • Reduce body temperature • Moving victim to cool location, removing unnecessary clothing, pouring cool water over extremities • Fanning the victim • Increases air circulation and evaporation • Immerse victim in cool water • Extremities should be massaged to promote circulation of cool blood

6. Avoiding Heat-related Illnesses • Keys to avoid heat-related illnesses • Prevention • Addressing the environment • Acclimatization • Proper Hydration • Heat-related illness include • Dehydration • Sunburns • Heat cramps • Heat Syncope • Heat Exhaustion • Heat Stroke

7. Dehydration • Dehydration in athletics is usually due to the increased demand for water during exercise, which can be lost by the body at a rate of 1 – 2 liters per hours during vigorous exercise. • Symptoms are very subtle at first • Light yellow urine • Mild headache • Fatigue • Reduced endurance and oxygen uptake • Feelings of thirst • Serious dehydration • Disorientation • Irritability • Rapid pulse • Complete exhaustion

8. Dehydration (cont’d) • There are 3 levels of dehydration • Mild • Mucous membranes drying out • Normal Pulse • Yellow Urine • Mild Thirst • Moderate • Extremely dry mucous membranes • Weak and rapid pulse • Very dark urine (apple juice) • Very thirsty feeling • Severe • Completely dry mucous membranes • Disorientation • Drowsiness • No urine output • Inability to form tears • Beginning stages of shock • Rapid weak pulse, Rapid breathing pale skin

9. Treatment for Dehydration • The best treatment is prevention • Athlete’s recommendations • 17 to 20 oz. 2 – 3 hours before activity • 7 to 10 oz. after warm-up • 28-49 oz. every hour of play • 20 to 24 oz afterward for every pound of body weight lost of sweat • Water vs. Sports Drinks • The use of sports drinks vs. water has been debated for a while • Sports drinks do contain carbohydrates and electrolytes that the body may need • Especially endurance athletes

10. Sunburns • Caused by overexposure to UV light from the sun • Can lead to premature aging and skin cancer • Medical attention should be sought if the burn is severe enough to cause blistering • Treatment • Cold washcloth • Use of over-the-counter pain medication • Petroleum or products containing benzocaine should be avoided • Moisturizing lotion or aloe vera gel can help relieve itching and provide moisture • Prevention • Use of sunscreen on exposed skin • Sun Protection Factor (SPF) of 15 or greater

11. Heat Cramps • Heat cramps are very common and should not be overlooked because they can be the first stage of heat illness • Caused by rapid water and electrolyte loss through to perspiration • Occur in various muscles • Calf (most common) • Quadriceps • Hamstrings • Abdominals • Treatment • Slow passive stretching with ice • Immediate fluid and electrolyte replacement

12. Heat Syncope • Occurs when the body tries to cool itself through the dilation of blood vessels • Also called fainting • Symptoms • Lightheadedness • Dizziness • Headache • Nausea • Vomiting • Treatment • Drinking fluids • Stop activity

13. Heat Exhaustion • A condition of near-total body collapse, where the athlete experiences difficulty dissipating the heat. • Symptoms • Skin is cool, moist and pale • Generalized weakness • Dizziness • Nausea • Rapid breathing • Pulse • May progress to heat stroke if not treated • Treatment • Moving the athlete to the shade • Immediate fluid replacement • Cooling the body • Use ice towels if necessary

14. Heat Stroke • The most severe heat-related condition, where the body’s heat regulation breaks down • Symptoms • Dry, hot skin • Strong, rapid pulse • Possible mental confusion • Unconsciousness • Treatment • Move the athlete to shade • Cool immediately by removing unnecessary clothing • Icing with towels with ice packs in axilla and groin areas • Misting and fanning the skin • Heatstroke is a medical emergency and requires immediate transport to an emergency room by EMS

15. Cold Stress • There are 5 ways that the body loses heat • Respiration • Evaporation • Conduction • Radiation • Convection • Contributing factors • Cold temperatures • High or cold winds • Dampness • Cold water • The body has to work harder to maintain its temperature

16. Respiration Evaporation • Evaporation of perspiration and other moisture from skin causes body to lose heat • Rids the body of heat with every expiration

17. Conduction • When the body is in direct contact with a cooler object. Heat from the body flows to the cooler object • Ex. Sitting on cool ground or standing/swimming in cool water

18. Radiation • Transfer of head by infrared rays. • Just as the body gains head from infrared rays of the sun, it can lose heat by infrared rays to a cooler environment.

19. Convection • Occurs when heat near the body’s surface is removed by moving air • Wind, cool breeze

20. Wind Chill • Describes the rate of heat loss on the human body resulting from the combined effects of low temperature and wind • Wind-chill temperature is a measure of relative discomfort due to combined cold and wind • Developed in 1941 and revised in 2001 to make use of advances in science and technology • The factors of wind chill • Amount of clothing • Other protection worn • Age • Health • Body characteristics • Wind-chill temperatures near or below 0 degrees F indicate a risk of frostbite to expose flesh

22. Hypothermia • When heat from the body is lost (from being in a cold environment) faster than it can be replaced • Symptoms • Begin when body temp drops to 95 • Shivering • Stomping feet • As body temp continues to drop • Slurred speech • Lack of coordination • Memory loss • Unconsciousness after body temp reaches 85 • Death may occur around 78

23. Hypothermia (cont’d) • People who have experienced trauma often go into shock and begin to shiver • Warming sign for hypothermia • Physical or mental trauma limits body’s capability to regulate its own temperature • As a core body temperature decreases, severe hypothermia sets in

24. Frostbite • When skin tissues and blood vessels are damaged from exposure to temperatures below 32 degrees F • Commonly affects toes, fingers, earlobes, chin, cheeks, and nose

25. 3 Stages of Frostbite • Stage 1 – Frostnip • pins-and-needles sensation • skin turns very white and soft • Stage 2 - Superficial frostbite • May show blistering • Skin is numb, waxy, and frozen • Ice crystal form in the skin • Stage 3 – Deep Frostbite • Freezing of blood vessels, muscles, tendons, nerves, and bone. • Can lead to permanent damage, blood clots, gangrene • No feeling in the affected area • Usually no blistering • Serious infection and loss of limb is frequent • Medical attention is needed as soon as possible

26. Treatment of Frostbite • Emergency care should be provided. If it is not possible to immediately transport to a hospital, the following steps will help • Bring the individual indoors as soon as possible • Apply warm towels or immerse the area in circulating lukewarm water or 20 minutes. Leave any blisters • Do not use hot water or hold the affected area near fire • Offer warm fluids to the athlete, but never alcohol, which causes the blood to cool quickly • Keep the affected areas raised.

27. Diabetes • A disorder in which the body does not produce or properly use insulin • Hormone that causes body cells to absorb sugar from the body for use within the cell • 2 types of Diabetes • Type I: Insulin dependant • Affects 10-15% of people with this disorder • Type II: Non-insulin dependant • Affects 85-90% of people with this disorder

28. Types of Diabetes • Type I • Results from the body’s failure to produce any insulin • First appears in childhood to young adults • Insulin is normally produced by beta cells within the pancreas • Management • Possible through frequent monitoring of blood sugar levels • Insulin injections • May require the use of a pump • Type II • Can usually be controlled with diet and exercise • Body still produces insulin but in insufficient amounts or poorly functioning

29. Diabetic Emergencies • Insulin reaction • Happens when there is way too much insulin in the body, rapidly reducing the sugar level in the blood causing brain cells to suffer • Causes • Taking too much medication • Failing to eat • Heavy exercise • Emotional factors • Symptoms • Fast breathing and pulse • Dizziness • Weakness • Change in level of consciousness • Vision difficulties • Sweating • Headache • Numb hands or feet • Hunger • Treatment • Giving the athlete sugar if conscious

30. Diabetic Coma • Occurs when the sugar levels are too high and too little insulin in the blood • Causes • Eating too much sugar • Not taking prescribed meds • Stress • Infection • Symptoms • Drowsiness • Confusion • Deep and fast breathing • Thirst • Dehydration • Fever • Change in the level of consciousness • Peculiar, sweet-or-fruity smelling breath • Monitor carefully and seek professional help

31. Seizure Disorders • Seizures are caused by disruption of normal brain activity • Epilepsy is a condition in which seizures occur regularly • No clear cause • Other causes • Infection • High fever • Brain tumors • Drugs • Strokes • Bleeding in the brain • Trauma to the brain • Low blood glucose, sodium, or calcium

32. Types of Epileptic Seizures • Simple partial seizure • When jerking beings in one area of the body, arm, leg, or face • Victims may hear things that are not there, or feel unexplained fear, sadness, anger or joy • No first aid is necessary, unless the seizure becomes convulsive • Generalized tonic-clonic seizure • Also called grand mal seizure • Characterized by sudden cry, falling, and rigidity • Followed by muscles jerks, shallow breathing, or temporarily suspended breathing, bluish skin, and possible loss of bladder or bowel control • After a couple of minutes, normal breathing resumes, though there may be confusion and/or fatigue

33. Managing “grand mal” seizures • Look for medical identification • Protect the victim from nearby hazards • Loosed ties or shirt collars • Protect the head from injury • Turn the victim on side, unless injury exists • To keep airway clear • If there are multiple seizures, or if they last more than 5 minutes, call 911

34. Insect Bites and Stings • Severity and duration of the reaction can vary from person to person • If multiple stings are received or if allergic reactions occur, the situation can be life threatening • Local Reaction • Characterized by pain, swelling, redness, itching, and a whelp surrounding the wound • Systemic Reaction • If it occurs, happens within a few minutes of a sting • May include • Skin flushing • Itchy rash • Chest wheezing • Nausea • Vomiting • Abdominal pains • Palpitations • Faintness • Falling blood pressure • death

35. Treatment for Insect Bites/Stings • Notifying a companion in cases assistance is necessary • Immediately removing the sting apparatus by scraping it out of the skin • Applying ice to reduce the pain and swelling • Seeking medical assistance if a serious reaction is suspected • For systemic reaction • Epinephrine by injection is the only effective, immediate treatment • Epipen is an automatically injecting syringe, designed to inject a premeasured, single dose of epinephrine. • Its administered if the front part of the leg through the clothing. • Effects will last 15-20 minutes • EMS must be activated

36. Female Athlete Triad • Involves a combination of 3 conditions • Disordered Eating • conditions such as anorexia and bulimia that result in malnutrition • When muscles that lack sufficient and proper fuel, performance is impaired • Amenorrhea • The loss of menstrual periods • A certain % of body fat in females is necessary for proper functioning of the menstrual cycle • IF the body fat % gets too low, hormonal balance and the menstrual cycle are affected • Osteoporosis • The loss of bone, most commonly among women after menopause, whose menstrual cycle also stops functioning • Amenorrhea can lead to osteoporosis in female athletes just like it can in postmenopausal women • Stress fractures become more common and repair is slow.

37. Warning signs of Female Athlete Triad • Frequent or unexplained injuries, stress fractures • Excessive or compulsive exercise • Change in performance • Loss of endurance, speed and/or strength • Impaired concentration • Absent or irregular menstrual periods • Restrictive eating masked as a “performance-enhancing” meal plan • Use of weight loss products or supplements

38. Prevention of Female Athlete Triad • Choosing an activity that complements an individuals natural body strengths. • Realizing health is more important that competitive success. • Avoiding frequent weigh-ins, weight comments and punitive consequences for weight gain. • Appreciating a healthy, active body. Optimal weight for health and performance is different for everyone. • Realizing that the thinnest athletes are not necessarily the fastest or the strongest. • Thinking of fuel as the ultimate performance enhancer. • Not starving the bones. Part of the fuel mix should include several servings of good calcium sources. • Being a role model with words and actions. Take a positive attitude about fueling and enjoying foods.