Sport & Health
Week 1 – Exercise is medicine
Physical activity recommendations
- Adults:
o 150 minutes per week mild/heavy exercise divided over different days
o Muscle and bone strengthening exercises (and balance for elderly), 2 times a
week
o Prevent sedentary behaviour
o 44% of adults (18+) meet the recommendations
- Children:
o At least 1 hour a day mild/heavy exercise
o Muscle and bone strengthening exercises, 3 times a week
o Prevent sedentary behaviour
o 55% of children between 4 and 11 y/o meet the recommendations
o 28% of children between 12 and 17 y/o meet the recommendations
Benefits of exercise:
- Improves sleep
- Maintaining healthy weight
- Stress management
- Improving quality of life
- -40% change of diabetes type 2
- -35% change of cardiovascular disease
- -30% change of depression
- -30% change of falling
- -25% change of joint and back pain
- -20% change of (colon and breast)cancer
Misconceptions about sports physicians
- Only for elite athletes
- Magician who runs into the pitch during a game
- Doping
Goals of a sports physician
- Prevention and management of injuries and disease
- For both athletes and people who (start to) exercise
- Promote exercises because of health benefits
- Reduce sport and exercise relates problems
,Sport & Health
Tasks of a sports physician
- Consultations
o Sport injuries
o Exercise related problems
o Prescribe exercise as medicine
- Pre-participation physical exam
o Is it safe to exercise?
o Individual exercise prescription
- Team physician
o Acute medical care
o ‘General practitioner’
o Case manager: help injured athletes with their treatment/recovery plan
o Advice staff
o Diets and fluids
o Vaccinations
o Jet lag
Sports injuries
- There are 3.7 million sport and exercise related injuries each year. 1/3 needs medical
treatment. In reality the number is a lot higher since a lot of overuse/chronic injuries
are unreported.
- Predispositions + external factors susceptible athlete + event injurie
- Sudden cardiac arrest is a very uncommon event that can happen during sport
participation.
o <35 years: mostly because of congenital abnormalities of the heart that can
cause heart muscle diseases like hypertrophic cardiomyopathy (thickening of
the heart muscle)
o >35 years: mostly because of coronary artery disease blockages of the
arteries (caused by cholesterol)
, Sport & Health
o Screening:
Medical history, symptoms, risk factors, glucose/cholesterol levels,
physical examination, ECG, exercise testing (combined with ECG)
ECG in athletes is often abnormal because of the high amounts
of exercise. This doesn’t directly mean that there is a heart
problem
Spiro-ergometry
To measure heart, lungs and muscles during exercise
Ventilatory threshold (VO2max)
o Normal: 40-50 ml/kg/min
o Athlete: 70-80 ml/kg/min
o Pathologic: 15-20 ml/kg/min
o The outcome (whether you are prone to be an athlete) is
influenced (70%) by your genes
- Acute injuries are often caused by atraumatic event such as a fall or a hit. They need
immediate medical treatment. Damage is often found in the:
o Bones (fractures)
o Cartilage
o Ligaments
Traumatic ankle injury
Rupture of the ligaments
39% still has symptoms after 6.5 years
Can cause cartilage damage
Unhappy triad: ACL rupture + medial collateral ligament rupture +
meniscus rupture
o Muscles
o Tendons
- Chronic/overuse injuries are caused by repetitive
microtrauma to the tissue. It is often difficult to
treat and prevent these injuries.
o Usually there is a homeostasis in load and
loading capacity. The right training causes
an improvement of loading capacity and
therefor the amount of load/performance.
Loading capacity depends on:
Intrinsic factors
Anthropometric factors: gender,
weight, leg differences, x-/o-
knees, flat foot, high arched foot
Age
Psychological status
Extrinsic factors
Week 1 – Exercise is medicine
Physical activity recommendations
- Adults:
o 150 minutes per week mild/heavy exercise divided over different days
o Muscle and bone strengthening exercises (and balance for elderly), 2 times a
week
o Prevent sedentary behaviour
o 44% of adults (18+) meet the recommendations
- Children:
o At least 1 hour a day mild/heavy exercise
o Muscle and bone strengthening exercises, 3 times a week
o Prevent sedentary behaviour
o 55% of children between 4 and 11 y/o meet the recommendations
o 28% of children between 12 and 17 y/o meet the recommendations
Benefits of exercise:
- Improves sleep
- Maintaining healthy weight
- Stress management
- Improving quality of life
- -40% change of diabetes type 2
- -35% change of cardiovascular disease
- -30% change of depression
- -30% change of falling
- -25% change of joint and back pain
- -20% change of (colon and breast)cancer
Misconceptions about sports physicians
- Only for elite athletes
- Magician who runs into the pitch during a game
- Doping
Goals of a sports physician
- Prevention and management of injuries and disease
- For both athletes and people who (start to) exercise
- Promote exercises because of health benefits
- Reduce sport and exercise relates problems
,Sport & Health
Tasks of a sports physician
- Consultations
o Sport injuries
o Exercise related problems
o Prescribe exercise as medicine
- Pre-participation physical exam
o Is it safe to exercise?
o Individual exercise prescription
- Team physician
o Acute medical care
o ‘General practitioner’
o Case manager: help injured athletes with their treatment/recovery plan
o Advice staff
o Diets and fluids
o Vaccinations
o Jet lag
Sports injuries
- There are 3.7 million sport and exercise related injuries each year. 1/3 needs medical
treatment. In reality the number is a lot higher since a lot of overuse/chronic injuries
are unreported.
- Predispositions + external factors susceptible athlete + event injurie
- Sudden cardiac arrest is a very uncommon event that can happen during sport
participation.
o <35 years: mostly because of congenital abnormalities of the heart that can
cause heart muscle diseases like hypertrophic cardiomyopathy (thickening of
the heart muscle)
o >35 years: mostly because of coronary artery disease blockages of the
arteries (caused by cholesterol)
, Sport & Health
o Screening:
Medical history, symptoms, risk factors, glucose/cholesterol levels,
physical examination, ECG, exercise testing (combined with ECG)
ECG in athletes is often abnormal because of the high amounts
of exercise. This doesn’t directly mean that there is a heart
problem
Spiro-ergometry
To measure heart, lungs and muscles during exercise
Ventilatory threshold (VO2max)
o Normal: 40-50 ml/kg/min
o Athlete: 70-80 ml/kg/min
o Pathologic: 15-20 ml/kg/min
o The outcome (whether you are prone to be an athlete) is
influenced (70%) by your genes
- Acute injuries are often caused by atraumatic event such as a fall or a hit. They need
immediate medical treatment. Damage is often found in the:
o Bones (fractures)
o Cartilage
o Ligaments
Traumatic ankle injury
Rupture of the ligaments
39% still has symptoms after 6.5 years
Can cause cartilage damage
Unhappy triad: ACL rupture + medial collateral ligament rupture +
meniscus rupture
o Muscles
o Tendons
- Chronic/overuse injuries are caused by repetitive
microtrauma to the tissue. It is often difficult to
treat and prevent these injuries.
o Usually there is a homeostasis in load and
loading capacity. The right training causes
an improvement of loading capacity and
therefor the amount of load/performance.
Loading capacity depends on:
Intrinsic factors
Anthropometric factors: gender,
weight, leg differences, x-/o-
knees, flat foot, high arched foot
Age
Psychological status
Extrinsic factors
