Female Athlete Flashcards
What are the MS and physiological differences between genders?
- prepubertal body fat differences - greater % total body and subcutaneous body fat and smaller vertebral cross-sectional dimension of parasminal mm in girls
- testosterone increases lean body mass, estrogen increases fat deposition, breast development and widening of hips
- lowest fat the body can tolerate without potential widespread adverse effects is 8-12%; decr in fat = decr in estrogen levels - Adolescent - peak height velocity occurs 2 years earlier in girls (10.5-13 years); peak weight 6 months after peak height
- Skeletal maturity - Females 18 years; Males 22 years (4’’ taller, 29 lbs heavier)
- Strength differences - women’s mm cross section 60-85% of males; peak strength occurs 14 mos after peak height; no incr in puberty, as with boys, after 15 yrs; women have higher proportion Type I fibers; 5-10% lower resting metabolic rate
- no differences in response to strength and CV training
What qualifies as osteopenia in for children and adolescents 5-19yrs?
Z-score below -2.0 SD from means that are age, sex, and ethnic specific (ISD)
T-score below -1.0 to -2.5 SD below mean of young, normal, adults (WHO)
Z scores between -1.0 to -2.0 SD I the presence of secondary clinical risk factors (nutritional deficiency, low estrogen levels, stress fx, etc.) (ACSM)
- declines in bone density are directly proportional to the number of missed periods, indicating the severity and length of time that amenorrhea is present directly impacts bone health
What needs to be addressed to prevent injury?
- HS/quad ratio
- core strength
- postural training
What MS injuries are more common in women?
- patellofemoral pain
- ACL injury - females 2-8x risk; NM mechanism
- Shoulder pain - trauma, over use; higher incidence in females in UE/LE combo sports; hyper mobility common
- LBP - No difference between athletes/non-athletes or males/females for acute disk herniation; Spondylolysis and Spondylolisthesis - Incidence 63% diving, 32% gymnastics
What intrinsic and extrinsic factors contribute to ACL injury in females?
- Intrinsic risk factors - Intercondylar notch size/shape, malalignment, physiological laxity, HS flexibility, posture, proprioception, hormone levels
- Extrinsic risk factors - Training, conditioning, coaching, muscular activation patterns, jumping/landing characteristics, knee stiffness
- Other female risk factors for knee injury: shortened quad, altered VMO reflex response time, decreased explosive strength, hypermobile patella, Q angle differences
- Clinical features: anterior, lateral anteriomedial pain, tenderness with palpation; crepitus, movie-goers sign, pain with stairs
Where do stress fractures occur most commonly?
tibia 34% > Fibula 24% > Metatarsals 20% > Femur 14% > Pelvis 6%
- Stress fx = mild, mod, severe local pain; Mod to severe local tenderness; x-ray may show fx after 10-14 days
- Stress rxn = mild to mod local pain; Mild to mod local tenderness; x-ray normal
- Bone strain = nil local pain; nil local tenderness; x-ray normal
What are the 3 parts that make up the female athlete triad?
- disordered eating - anorexia, bulimia, EDNOS
- menstrual dysfuntion
- low BMD
- low energy availability (decr in leptin) = dcr GnRH from hypothalamus –> decr LH, FSH from pituitary –> menstural dysfunction
What are S and S of anorexia nervosa?
Cold intolerance, amenorrhea, lightheadedness, constipation, abdominal bloating, fatigue, decreases concentration, dry skin/hair/nails, hypothermia, bradycardia, lanugo
What are S and S of bulimia nervosa?
Fatigue, constipation/diarrhea, irregular menses, sore throat, bloating/abdominal pain, peripheral edema, erosion of dental enamel, orthostatic BP changes, problems related to fluid loss
What are nutritional recommendations?
- Fluids - important to hydrate prior to exercise
- General guideline is 14-23 cal/lb body weight
- nutritional needs - electrolytes and carb replenishment helps in high intensity exercise
- leptin
What is the avg age onset of mensuration?
Avg age onset 12.8 + 1.2 years
- Normal cycle length 28 days
- Ovarian function depends on secretion of hypothalamic GnRH. Disturbance of GnRH pulse generator which leads to hypoestrogenic state. Stimulates release of FSH and LH from pituitary
- Energy availability affected LH more than stress (Loucks et al). Dietary energy not enough for both reproduction and locomotion
What is the avg age onset of mensuration?
Avg age onset 12.8 + 1.2 years
- Normal cycle length 28 days
- Ovarian function depends on secretion of hypothalamic GnRH. Disturbance of GnRH pulse generator which leads to hypoestrogenic state. Stimulates release of FSH and LH from pituitary
- Energy availability affected LH more than stress (Loucks et al). Dietary energy not enough for both reproduction and locomotion
What are the phases of the menstrual cycle?
Menses to ovulation:
- Follicular phase - FSH/ LH secreted causing growth in follicle (ovarian cycle)
- Proliferative phase - Incr levels of estrogen cause endometrium to develop (endometrial cycle)
Ovulation to menses:
- Luteal phase - release of egg; 14 days in length; estrogen/ progesterone case decrease FSH/ LH (ovarian cycle)
- Secretory phase - proliferation of endometrium occurs (endometrial cycle)
What causes the luteal phase to shorten during luteal phase deficiency?
decrease in progesterone
- infertility may occur, still menstruate
- an ovulation = decr progesterone causes ovulation to stop
- hypoestrogenic amenorrhea = eventually with low prog. levels and lack of ovulation, estrogen level drop causing amenorrhea
- lab studies related = blood count for anemia, electrolytes, creatinine, albumin, TSH, pregnancy test
What is primary amenorrhea?
- No menstruation by age 14 without secondary sex characteristics
OR - Normal growth/development without menstruation by age 16
