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Endurance Sports Medicine - A Clinical Guide
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Endurance Sports Medicine - A Clinical Guide
von: Timothy L Miller
Springer-Verlag, 2016
ISBN: 9783319329826
336 Seiten, Download: 22760 KB
 
Format:  PDF
geeignet für: Apple iPad, Android Tablet PC's Online-Lesen PC, MAC, Laptop

Typ: B (paralleler Zugriff)

 

 
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Inhaltsverzeichnis

  Dedication 6  
  Preface 8  
  Contents 10  
  Contributors 12  
  Part I: Medical Conditions 15  
     1: Cardiovascular Evaluation and Treatment of the Endurance Athlete 16  
         Introduction 16  
            Overview of Normal Physiological Adaptations to Endurance Training 16  
         Left Ventricular Adaptations to Endurance Exercise 17  
         Right Ventricular Adaptations to Endurance Exercise 19  
         Atrial Adaptation to Endurance Exercise 19  
         Variability of Exercise-Induced Cardiac Remodeling 19  
         Clinical Implications of Remodeling 20  
         Electrical Remodeling 21  
         Evaluation of the Symptomatic Endurance Athlete 22  
         Chest Pain 22  
         Syncope 24  
         Palpitations 26  
         Atrial Arrhythmias 27  
         Long-Term Effect of Chronic Endurance Training 27  
         Sudden Death During Endurance Competition 28  
         Conclusion 28  
        References 30  
     2: Exercise-Induced Bronchoconstriction and Vocal Cord Dysfunction 33  
         Vocal Cord Dysfunction 36  
        References 39  
     3: Evaluation and Treatment of Heat- and Altitude-Related Illness 42  
        References 51  
     4: Pregnancy and the Endurance Athlete 53  
         Introduction 53  
            Pregnancy Physiology 53  
            Endurance Physiology 55  
         Physiological Concerns of Exercise During Pregnancy 55  
            Maternal Physiologic Concerns 56  
            Fetal Physiological Concerns 56  
            Risks/Benefits of Exercise During Pregnancy 57  
            Physical Activity in Pregnancy 58  
            Exercise Prescriptions 59  
         Exercise Prescription During Pregnancy 61  
            The Sedentary or Non-exercising Patient 61  
            The Regular Exercising Patient 61  
            The Elite Athlete 62  
         Conclusion 63  
        References 63  
     5: Gender Differences: Considerations for the Female Endurance Athlete 65  
         Historical Perspective 65  
         Anatomical and Physiological Differences in the Female Endurance Athlete 66  
            VO2max 66  
            Other Sex Differences 67  
         Medical Conditions in the Female Endurance Athlete 67  
            Iron Deficiency Anemia and Iron Depletion 68  
            Stress Urinary Incontinence 69  
            Overtraining Syndrome 70  
            Exercise-Associated Collapse and Hyponatremia 71  
         The Female Athlete Triad and the Relative Energy Deficiency in Sport 72  
            Energy Availability 73  
            Menstrual Dysfunction 75  
            Poor Bone Health 75  
            Stress Fractures 77  
        References 77  
     6: Considerations for the Pediatric Endurance Athlete 81  
         Background 81  
         Is Long-Distance Running Safe? 81  
         Endurance Training Physiology 82  
         Growth 83  
         Training 83  
         Cardiac Changes 83  
        References 84  
  Part II: Musculoskeletal Conditions 86  
     7: Treatment of Stress Fractures 87  
         Pathophysiology 87  
         Risk Factors for Stress Fractures 88  
         Intrinsic Factors 88  
         Extrinsic Factors 89  
         Clinical Presentation 89  
         Imaging Evaluation 89  
            Radiography 89  
            Bone Scintigraphy 90  
            Ultrasound 90  
            SPECT Scan 91  
            Computed Tomography 91  
            MRI 91  
            Classification/Grading 92  
         High-Risk Stress Fractures Versus Low-Risk Stress Fractures 93  
         Rib and Upper Extremity Stress Fractures 93  
         General Treatment Principles 94  
         Management of High-Risk Stress Fractures 94  
         Return to Sports Participation 95  
         Prevention of Stress Injuries 96  
         Summary 96  
        References 97  
     8: Evaluation and Treatment of Soft Tissue Overuse Injuries 100  
         Achilles Tendinosis 100  
            Introduction 100  
            Terminology 100  
            Anatomy 100  
            Pathophysiology of Tendinosis 101  
            Epidemiology 101  
            Etiology 101  
            Physical Exam 102  
               Imaging 102  
         Treatment 103  
         Medications 103  
         Rehabilitation 103  
         Extracorporeal Shock Wave Therapy (ESWT) 104  
            Injection Therapies 104  
         Topical Treatment 105  
         Surgery 105  
         Patellar Tendinosis 106  
            Introduction 106  
            Terminology 106  
            Anatomy 106  
            Epidemiology 106  
               Risk Factors 107  
         History and Physical Exam 107  
         Workup 107  
         Imaging 107  
         Treatment 108  
            Medication 108  
         Rehabilitation 108  
         Extracorporeal Shock Wave Therapy (ESWT) 109  
            Injections 110  
         Greater Trochanteric Pain Syndrome (GTPS) or Gluteal Tendinopathy 111  
            Definition 111  
            Epidemiology 111  
            Anatomy 111  
         Risk Factors/History 112  
         Physical Examination 112  
         Laboratory Studies 114  
         Radiographic Workup 114  
         Management 115  
            Medications 115  
         Physical Therapy 115  
         Injection Therapy 115  
         Extracorporeal Shock Wave Therapy (ESWT) 115  
         Surgical Intervention 116  
         Newer Considerations 116  
        References 116  
     9: Chronic Exertional Compartment Syndrome 119  
         Introduction 119  
         Epidemiology 120  
         Anatomy/Physiology 120  
         Diagnosis 123  
         Differential Diagnosis 125  
         Treatment 126  
            Two-Incision Technique 127  
         Outcomes 128  
         Complications 129  
         Recovery/Return to Sport 129  
         Summary 129  
        References 130  
     10: Shoulder Injuries and Conditions in Swimmers 132  
         Background 132  
         Epidemiology 132  
         Pathophysiology 133  
            Training Factors 133  
            Scapular Dyskinesis 133  
            Shoulder Instability and Range of Motion Deficits 134  
            Muscle Imbalance 135  
            Muscle Fatigue 136  
            Intrinsic Tendon Degeneration 136  
         Diagnosis, Evaluation, and Management 137  
            Core Strength, Impaired Posture, and Scapular Dyskinesis 137  
            Tight Posterior Capsule 138  
            Rotator Cuff Strength 139  
            Glenohumeral Instability 139  
         Shoulder-Specific Conditions 139  
            Subacromial Impingement 139  
            Internal Impingement 140  
            Multidirectional Instability 141  
            Exam/Imaging 141  
            Treatment 141  
        References 141  
     11: Common Injuries and Conditions in Rowers 144  
         Introduction 144  
         Brief History 144  
         Basic Technique and Biomechanics 144  
         Mechanisms of Injury and Initial Assessment 145  
         Common Injuries and Treatment 146  
            Lower Back 146  
               Spondylolysis 146  
               Spondylolisthesis 146  
               Disk Injuries/Herniation 146  
               Sacroiliac Joint Dysfunction (SIJD) 147  
            Knee 147  
               Iliotibial Band Friction Syndrome 147  
               Patellofemoral Syndrome 147  
            Rib 148  
               Rib Stress Fractures 148  
               Costochondritis 148  
            Wrist and Forearm 148  
               Intersection Syndrome (“Oarsmen’s Wrist”) 148  
               Tenosynovitis 149  
               Exertional Compartment Syndrome 149  
            Dermatology and Skin Conditions 149  
               Blisters 149  
               Abrasions 149  
         Conclusion 150  
        References 150  
     12: Common Injuries and Conditions in Crossfit Participation 152  
         Introduction 152  
         Weight lifting 153  
         Endurance 157  
         Gymnastics 158  
         Other 160  
         Conclusion 162  
        References 162  
     13: Hip Injuries in the Endurance Athlete 164  
         Introduction 164  
         Anatomy 164  
            Layer I 165  
            Layer II 165  
            Layer III 168  
            Layer IV 170  
         History 170  
         Physical Examination 172  
            Inspection 173  
            Palpation 173  
            Motion, Strength, and Special Testing 173  
         Imaging Evaluation 176  
         Differential Diagnosis Evaluation 177  
         Treatment 180  
         Conclusions 181  
         Location of Investigation 183  
         Source of Funding 183  
         Statement of Originality 183  
         Disclosures 183  
        References 183  
     14: Exercise and Osteoarthritis: The Effect of Running with Aging in the Masters-Level Athlete 187  
         Introduction 187  
         Pathophysiology of Disease, At-Risk Populations, and the Modifiable Lifestyle Factors 188  
         Evaluation of Masters Athlete with Lower Extremity/Knee Pain Associated with Running 190  
         Treatment of Masters Athlete: Nonoperative vs. Operative Management 192  
         Conclusion (Summary of Evaluation and Treatment, “Barefoot” Running, Role of Diet, and Cross-Training for Healthy Running) 196  
        References 198  
  Part III: Special Considerations 202  
     15: Clinical Aspects of Running Gait Analysis 203  
         Introduction 203  
         Getting Started 203  
         Patient Setup and Video Capture 204  
         Analysis of the Recorded Video 205  
            Sagittal Plane 205  
            Initial Contact 205  
            Mid Stance 209  
            Additional Sagittal Measures 210  
            Frontal Plane 211  
            Mid Stance 211  
            Other Variables 213  
         Summary 214  
         Disclosure 214  
        References 214  
     16: Clinical Considerations of Bike Fitting for the Triathlete 216  
         Introduction 216  
         Injury Considerations in the Triathlete 217  
         Triathlon Bike Anatomy 217  
         Clinical Considerations of Cycling Mechanics 217  
         Getting Started: Basic Fit Setup and Equipment 219  
         The Bike: Fit Window 220  
            Seat Tube Angle (STA) (Fig. 16.5) 221  
            Seat/Saddle Height (Fig. 16.5) 222  
            Cleat Position (Fig. 16.6) 222  
            Hip Angle (Fig. 16.7) 223  
            Shoulder Angle (Fig. 16.8) 223  
            Arm Pad Stack/Drop and Reach (Fig. 16.9) 225  
            Armrest Width (Fig. 16.2a) 225  
            Crank Length (Fig. 16.1b) 225  
            Saddle Position 226  
            Helmets/Sunglasses 226  
         Other Fit Considerations for Different Triathlon Distances 226  
         Summary 227  
        References 227  
     17: Evaluation and Treatment of the Swimming Athlete 229  
         Introduction 229  
         The Four Competitive Strokes 229  
         Freestyle Biomechanics 230  
            Freestyle Upper Extremity Movement 230  
            Freestyle Lower Extremity Movement 231  
            Freestyle Stroke Mechanics: General Notes 231  
         Backstroke Biomechanics 232  
            Backstroke Upper Extremity Movement 232  
            Backstroke: Lower Extremity Movement 232  
            Backstroke Mechanics: General Notes 232  
         Butterfly Biomechanics 232  
            Butterfly Upper Extremity Movement 233  
            Butterfly Lower Extremity Movement 233  
            Butterfly Stroke Mechanics: General Notes 233  
         Breaststroke Biomechanics 233  
            Breaststroke Upper Extremity Movement 234  
            Breaststroke Lower Extremity Movement 234  
            Breaststroke Stroke Mechanics: General Notes 234  
         Common Stroke Technique Error 235  
         Freestyle Errors 235  
            Common Errors in Freestyle Are Found Below (% Prevalence in Subjects Tested) [21] 235  
            Injury Prevalence and Incidence 238  
         Performance Considerations 239  
         The Pediatric Swimmer 239  
         The Masters Swimmer 240  
         Common Injuries 241  
            Shoulder 241  
            Knee 243  
            Spine 244  
            Hip 244  
            Ankle 245  
         Swimming Injury Conclusion 246  
         Unique Pulmonary Considerations in Swimmers 246  
            Thoracic Outlet and Paget-Schroetter Syndrome 246  
            Swimming-Induced Pulmonary Edema 246  
            Rehabilitation 247  
            Breathing 247  
            Breath Control/Pulmonary Function 248  
         Spine 249  
            Cervical 249  
            Lumbar 249  
            Hip 250  
            Knee 251  
            Ankle 251  
            Shoulder 252  
            Mobility 255  
            Elastic Therapeutic Taping 256  
            Return to Sport Considerations 256  
            Return to Swimming Protocol 257  
         Training Considerations 262  
            Equipment Considerations 262  
            Coach/Trainer Resistance Training Expertise 263  
            Efficacy of Dryland Strength Training 263  
            Efficacy of Swim Training Regimen 263  
            Training Effort and Communication with Coaches 265  
            Altitude Training 265  
         Injury Prevention 266  
            Video Analysis 266  
            Feedback 267  
            A Proposed Injury Screen 267  
            A Proposed Dynamic Warm-Up 267  
         Appendix A: General Rehab—Neck Pain for Swimmers [86] 268  
         Appendix B: General Rehab—Trunk Program (Lumbar and Hip) [119, 121, 122] 269  
         Appendix C: General Rehab—Shoulder Program [99, 114, 133] 270  
         Appendix D: Part 1—Dynamic Shoulder, Spine, Hip, Knee, and Ankle Warm-Up (All 2 × 15 Reps) [186, 187] 271  
         Appendix E: Part 2—Strength/Plyometric/Balance/Reaction Time Progression [186] 273  
         Appendix F: Part 3—Aquatic Swimming-Specific Drills [186, 187] 275  
        References 276  
     18: Mental Skills for Endurance Sports 283  
         Introduction 283  
         Motivation 284  
         Goal Setting 284  
         Energy Management 285  
         Self-Talk 286  
         Concentration 287  
         Imagery 288  
         Performance Routines 289  
         Mindfulness 290  
         Balanced Exercise 291  
         Conclusion 292  
        References 292  
     19: Optimizing Nutrition for Endurance Training 295  
         Important Nutrition Components and Current Recommendations 295  
         The Macro Mixture 296  
         Hydration 299  
         Common Micronutrient Issues 299  
         Summary 301  
        References 301  
     20: Endurance Medicine: Medical Coverage for Mass Sporting Events 304  
         Overview 304  
         Anticipated Encounters 304  
         Medical Staff and Volunteer Management 305  
         Equipment, Supplies, and Logistics 308  
         Weather Monitoring and Alerts 309  
         Event-Day Communication 311  
         Event Security 312  
         Conclusion 314  
        References 314  
     21: Return to Sport Decision-Making for Endurance Athletes 315  
         Identification and Correction of Predisposing Factors 315  
            Biomechanics and Equipment 315  
               Running 315  
               Biking 316  
               Swimming 316  
               Rowing 316  
            Training 316  
            Nutrition 317  
         Restoration of Function 318  
            Range of Motion 318  
            Strength 318  
            Neuromuscular Training 319  
            Sport-Specific Training 319  
            Returning to Competition 319  
         Managing Challenges During Rehabilitation 319  
            Maintaining Fitness Level 320  
            Dietary Changes 320  
            Psychological Challenges 321  
         Integrating the Treatment Team 322  
            Physical Therapy 323  
            Exercise Physiology 323  
            Coaching Staff 323  
            Nutrition 324  
            Sport Psychology 324  
            Sports Medicine Physicians and Surgeons 324  
        References 325  
  Index 328  


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