EXERCISE FOR GIRLS & WOMEN

1. EXERCISE FOR GIRLS & WOMEN

2. Historical Attitudes Towards Women • 1875: Hutchingson: • Women have a sum total of nervous force equivalent to man • Women have more organs • Nervous force is weakened in each organ • Resistance to disease is weakened • Women are more sensitive and more liable to derangement

3. 1875 Dr. King, Obstetrics & Gynecology Women menstruate because of a failure to conceive Menstruate occurs because the organ was not used for it’s intended purpose When an organ is not used = atrophy & disease Therefore, once reaching puberty a woman should be encouraged to marry and immediately impregnated Continuously impregnated as not to menstruate

4. Beigel, Physician: 10-14 days of Bed Rest for Each Menstrual Cycle

5. International Olympic Committee: Circa 1900 Women should not engage in any activity which they cannot wear a long dress

6. Heart Rate Response to Running 540 Yard Run Wearing Corsets Heart Rate (/min) Without Seargent

7. Fashion allowed more exercise

8. 1928 Modern Olympics 11 women First 800 m Race • 5 collapsed during the Run • 5 collapsed at the Finish • Winner collapsed in the Dressing Room

11. EXERCISE & GYNECOLOGY

12. AGE OF MENARCHE High School Olympic College Sport Ballet

13. MATURATION AND SPORT Does sport delay maturation? Is maturation unsuccessful for sport?

14. AGE OF MENARCHE High School Olympic College Sport Ballet

15. FEWER COMPAINTS IN MENOPAUSE LATER AGE OF MENARCHE Jazman, Frontiers of Hormone Research 2:22, 1973.

16. ….AS A YOUNG WOMAN…

17. FEMALE ATHLETE TRIAD OSTEOPOROSIS EATING DISORDERS AMENORRHEA

18. INCIDENCE OF ANOREXIA & BULIMA Percent of Athletes Specific Sports College HS

19. AMENORRHEA Athletes Percent of Population (%) General

20. OSTEOPOROSIS Incidence of Bone Fractures (%) Active Amenorrhic Active Regular Cycling Control Marcus eat al, Ann Int Med 102:158-163, 1985

21. ACSM RECOMMENDATIONS • Serious Syndrome • Unrealistic pressures to lose weight in athletics. • Sports Medicine Professionals need more education • Screening programs should be developed. • Develop prevention strategies • Educate parents to have reasonable goals for children. • Educate the girls • More research.

22. EXERCISE IN PREGNANCY

23. PREGNANCY EXERCISE • SKELETAL • METABOLISM • RESPIRATORY • CARDIOVASCULAR • ENDOCRINE • THERMOREGULATION

25. EXERCISE IN PREGNANCY • Safe for mother? • Safe for fetus • Affect on pregnancy outcome?

27. WEIGHT GAIN DURING PREGANACY Weight (kg) Weeks of Gestation (wks)

28. Increased anterior flexion of cervical spine Forward displacement of the center of gravity Lumbar Lordosis Forward rotation of Pelvis & Femur SKELETAL SYSTEM

29. SKELETAL SYSTEM PREGNANCY EXERCISE • Lumbar Lordosis • Cervical Spine • Pelvis & Femur • Center of Gravity • Lumbrosacral Pain • Compression Syndromes • Carpal Tunnel • Ulnar Nerve • Posterior Tibial • Perennial 5. Overextension Injury 5. Increased joint mobility

30. METABOLISM

31. METABOLISM PREGNANCY EXERCISE • Increased Resting Metabolism • 80,000 cal • 300 cal/day • Increased metabolism at submaximal work 2. Glucose = primary fuel 2. Hypoglycemia

32. RESPIRATORY SYSTEM • Chest cavity increases transverse diameter • Raised diaphragm

33. PULMONARY FUNCTIONS Insp Res Tidal Vol. Volume (ml) Exp Res RV

34. RESPIRATORY SYSTEM PREGNANCY EXERCISE • Pulmonary Functions • Increased tidal volume • Decreased Residual Vol 2. Metabolism & Pulmonary Functions 3. 40% increase in Resting Minute Ventilation (VE)

35. RESTING HEART RATE Heart Rate (/min) Gestation (wks) Wilson et al., Am J Med 68:97, 1980.

36. CARDIOVASCULAR SYSTEM Cardiac Output Percent Increase (%) Blood Volume Gestation (wks)

37. CARDIOVASCULAR SYSTEM PREGNANCY EXERCISE • Cardiac Output • Heart Rate • Stroke Volume • Decreased Physical Work Capacity • Increased Sub-maximal work • Heart Rate • Stroke Volume • Cardiac Output

38. CARDIOVASCULAR SYSTEM Heart Rate (/min) Workrate (kpm/min)

39. CARDIOVASCULAR SYSTEM Stroke Volume (cc) Workrate (kpm/min)

40. CARDIOVASCULAR SYSTEM Cardiac Output (L/min) Workrate (kpm/min)

41. CARDIOVASCULAR SYSTEM C(a-v)O2 (ml/L) Workrate (kpm/min)

42. PHYSICAL WORK CAPACITY • Lowest PWC in First Trimester • Highest PWC in Second Trimester • Decreases as Body Weight Increases in Third Trimester

43. ENDOCRINE SYSTEM HCG Concentration (iu/1000ml urine) Gestation (days)

44. ENDOCRINE SYSTEM PREGNANCY EXERCISE • Hormone Changes • Physical Work Capacity • Joint Injury • Gestational Diabetes

45. THERMOREGULATION PREGNANCY EXERCISE • Increased Sweat Gland Activity • Shunt blood to Periphery • Fetus >1oC • Dehydration • Heat Related Injury • Spinal Cord Growth Retardation (1st trimester)

46. EXERCISE IN PREGNANCY • Safe for mother? • Safe for fetus • Affect on pregnancy outcome?

49. FOR THE MOTHER? Exercise Training during Pregnancy • Physical Work Capacity • Increases during pregnancy • Not above Pre-Pregnant Values • Lower Exercise Heart Rates* • At same workrate • Increased Heart Volume* * Not all studies agree

50. FOR THE MOTHER? • Skinfold thickness • Maternal Weight Gain • Resting Heart Rate • Maximal Heart Rate • Exercising Heart Rates* • Cardiac Output at Submax • Stroke Volume at Submax • Resting & Orthostatic Blood Pressures • VO2 at submax • Resting Metabolism • VEmax • VEsubmax