Week 6 - Common medical conditions and impact on sport

Question 1

Discuss asthma

Answer 1

May affect sport as trouble breathing, exacerbated by pollen/cold weather, more surceptible to URTI/LRTI

Epidemiology:
Most common medical condition affecting olympic athletes
Increased risk in summer endurance sports, winter sports, speed skating
Triggers eg cold, pollen, pollutants, respiratory infections, NSAIDs/beta blockers could be taken into account

Aetiology:
Uncertain
Hyperventilation causes airway drying, can cause bronchoconstriction, post exercise rearming can also cause bronchoconstriction, air pollution

Non pharmacological management:
Regular exercise programmes increases tolerance. Consider facemask etc

Pharmacological:
Effective management and appropriate TUEs, note daily dosing for salbutamol (SABA) has been reduced under 2022 WADA change
Note glucocorticoid change eg budesonide remain permitted, its injections that are now not

Avoid - scuba diving in those with chronic asthma due to combo of physical exertion, inhalation of dry air with increased risk of barotrauma and pneumothorax, or even PE

Question 2

Discuss diabetes

Answer 2

(Hornsby and Chetlin 2005)
- Careful management needed in line with athlete goals, safe participation and changes in glucose uptake

• Note alterations based on training type/time of 20-50% reduction of insulin needed at beginning of training sessions, consider basal change needed. Insulin should be injected 60 mins prior. Not over muscles contracting as would increase insulin uptake.
• Important to educate about hyper/hypo and risky behaviours eg diabulimi

Question 3

Discuss epilepsy

Answer 3

Concussive convulsion occur within seconds of impacts - phase of brief tonic stiffening followed by myoclonic jerking which can last up to 3 months but not associated with structural and permanent brain injury.

Post traumatic epilepsy - risk factors prolonged unconsciousness, skull fracture, intracerebral haematomas, haemorrhoagic cerebral contusion, FNS signs

Exercise does not increase seizure frequency, affect anti epileptic drug level

Consider triggers - lack of sleep, stress, dehydration.
Careful of sports with heights or machinery
Effects of drugs

Question 4

Discuss allergies

Answer 4

Consider epipen, in date, this around know how to give it
Make catering aware etc

Question 5

Discuss osteoporosis

Answer 5

Peak bone pass achieved early adulthood.

Bone requires sex hormone levels, vit D, weight bearing exercise. Need a balance between osteoblastic and osteoclastic activity to ensure bone formation and breakdown happens within an appropriate balance

Oestrogen helps with bone resorption, therefore an absence weakens bones