Classifying Sports Injuries

Ways To Classify Sports Injuries

• Direct injuries are caused by an external force applied to the body at the point of impact.
• An example of a direct injury is a shoulder dislocation from a rugby tackle.
• Indirect injuries are caused by an intrinsic force within the body.
• Causes of indirect injuries include inadequate warm-up, ballistic movement, poor skill execution, and excessive strain.
• An example of an indirect injury is a sprinter tearing a hamstring.
• Soft tissue injuries affect all tissue besides bones and teeth, usually including cartilage.
• Examples of soft tissue injuries include tears, contusions (bruises), and subluxation (partial dislocation).
• Hard tissue injuries include bones and teeth.
• Examples of hard tissue injuries are fractured bones and dislodged teeth.
• Overuse injuries result from continuous or repetitive movements of specific body regions over long periods.
• Incorrect technique can also provoke overuse injuries.
• Overuse injuries occur when tissue cannot handle the repetitive load, leading to microtrauma and potentially more serious conditions.
• Examples of overuse injuries are tendonitis and stress fractures.
• Acute injuries occur suddenly, and are the opposite of overuse injuries.

Soft Tissue Injuries

Tears, Sprains, Abrasions

• A tear occurs when tissue is excessively stretched or severed.
• A sprain is the stretching or tearing of a ligament caused by moving beyond the normal range of motion (ROM).
• Sprains heal slowly due to a relatively poor blood supply.
• A strain is the stretching or tearing of a muscle or tendon.
• Tears are classified according to their severity: Grade 1 (less than half the fibers torn), Grade 2 (more than half the fibers torn), and Grade 3 (all fibers torn).
• Symptoms of tears include swelling, loss of power, bruising, pain, and inability to perform normal joint movement.

Contusions/Bruise

• Contusions, or bruises, are muscle damage caused by a sudden blow.
• Contusions result in damaged blood vessels, leading to discoloration.
• Contusions range from superficial to deep, with some causing bruising to the bone.

Skin Abrasions, Lacerations, Blisters

• Abrasions are damage to the superficial surface of the skin from scraping along a surface, causing pain and shallow bleeding.
• Treatment for abrasions involves gentle cleansing, sterilization, and a wound pad to prevent infection.
• Lacerations are wounds where flesh has incurred an irregular tear or cut into tissue.
• Lacerations often occur on the scalp or in the mouth (lips or tongue).
• Immediate treatment for lacerations includes applying pressure, gentle sterilization/cleaning with antiseptic, and applying a sterile gauze pad.
• Lacerations longer than 1cm should be referred to medical professionals.
• Blisters are caused by friction, resulting in a collection of fluid below or within the epidermal layer of skin.
• Blisters may contain clear fluid or blood if a vessel has ruptured.
• Blisters occur when equipment (racquets, clubs, bats) or shoes have been used for an extended period.
• Management of blisters includes 24 hours of rest.
• Blisters may need surgical removal and a donut pad applied.
• If a blister has torn, the area should be washed with antiseptic.

The Inflammatory Response

• The inflammatory response is the body's reaction to a soft tissue injury
• Increases blood flow enriched with inflammatory mediators.
• The inflammatory process is often excessive and can lead to longer recovery time, and therefore RICER is applied.
• The three stages of the inflammatory response are inflammation, repair/maintenance, and remodeling.
  • The inflammatory stage lasts 48-72 hours, characterized by redness, warmth, pain, swelling, limited movement, and the formation of blood vessels to promote healing.
  • The repair/maintenance stage lasts from 3 days to 6 weeks, characterized by lower inflammation, collagen replacing damaged tissue (unorganized at this stage), debris elimination, new fiber formation, and scar tissue production.
  • The remodeling stage can last from 6 weeks to many months, characterized by increased scar tissue production, collagen organization, reduced swelling.
  • During the remodeling stage, the replacement tissue strengthens and develops in the direction that force is applied.
  • The type of remodeling varies according to the timing and degree of mobilization of the injury, with excessive exercise too early causing further damage and too little exercise allowing large quantities of scar tissue to form.

Phases Of Tissue Repair

• Acute phase: blood clot formed, tissue disruption.
• Sub-acute phase: clots shrink, new fibrous tissue formed.
• Chronic phase: tissue fibers become organized.
• Fiber regeneration limited, but remodeling continues.

RICER - Management Of Soft Tissue Injuries

• RICER leads to a reduction of pain and minimal formation of scar tissue, allowing for optimal return of movement and strength.
• Rest reduces bleeding into the injury and prevents further injury.
  • Rest is applied by placing the injured site in a comfortable position with support.
  • Rest should be maintained until the beginning of a program of careful mobilization.
• Ice reduces pain, swelling, spasm, enzyme activity, and the tissue demand for oxygen.
  • Reduced swelling allows for more regular blood flow.
  • Ice is applied using crushed ice in a wet paper towel, frozen gel packs wrapped in a wet towel, or immersion in a bucket of ice water.
  • Ice should be applied for 20 minutes every hour for up to 4 days.
• Compression decreases bleeding, reduces swelling, and provides support to the injured area.
  • Compression is applied by wrapping the injured area in an elastic bandage.
  • You should check for blood flow by color and pressure test
  • Compression should be applied at the time of injury and reapplied every 24 hours.
• Elevation decreases bleeding and reduces swelling and throbbing.
  • The injured area should be raised above the level of the heart by placing a support under the injury.
  • Elevation should be done whenever possible during the day and for the following 2-3 nights.
• Referral is necessary to understand the nature and extent of the injury and to seek guidance in a program of rehabilitation.
  • Referral involves making an appointment with a doctor or physiotherapist.
  • Referral should be done as soon as possible following injury.
• After a soft tissue injury, avoid heat, alcohol, running, and massage, as these cause blood vessels to dilate and increase bleeding in the area, which is detrimental to the repair process due to increased swelling.

Hard Tissue Injuries

Fractures

• Fractures are any disruption to the continuity of the outer surface of the bone (periosteum).
  • A simple fracture is when the bone is broken but does not go through the skin.
  • A compound fracture is when the bone is broken and pierces the surface of the skin, causing an open wound.
  • A complicated fracture is when the bone is broken and causes damage to nerves, organs, or blood vessels.
• Examples of fractures include greenstick, comminuted, depressed, oblique, and displaced (moved from the original position, needing to be reset).
• Symptoms of fractures include intense pain, possible cracking sound, loss of function, swelling and deformity, bruising, and discoloration.

Assessing Fractures

• Initially, the DRSABCD protocol should be considered, as fractures can sometimes be life-threatening.
• Once the degree of severity is established:
  • Minor fractures still need to be attended to by medical professionals, but immobilization and required transport are not necessary.
  • For severe fractures, the patient should not be moved, limb immobilization with packing and continuous monitoring of vitals should occur.

Dislocation

• Dislocation is the displacement of the bone at the joint where the bone momentarily pops out.
• When it goes straight back in, it is called a subluxation.
• Dislocations are designated as hard tissue injuries but stretch ligaments and cause additional soft tissue damage.
• Symptoms of dislocations include pain, swelling, deformity, and loss of function.

Managing Dislocations

• The DRSABCD protocol, STOP, and RICER for any soft tissue damage should be applied if possible.
• Don't attempt to relocate, immobilize, seek medical attention
• Hard tissue injuries require immobilization to minimize the amount of damage and decrease the level of pain and decrease the chance of entering shock.
• Splints, "buddying of fingers," slings, aluminum, packing around the joint, and makeshift items may be used.

####Teeth

• Caused by direct injuries
• Symptoms: bleeding from mouth, tooth dislodged.
• Management: DRSABCD, STOP, TOTAPS, wash tooth with milk/saline/saliva, immobilize tooth in socket using aluminum foil, seek medical attention

Assessment Of Injuries

TOTAPS

• TOTAPS is used to determine the nature and extent of an injury immediately after it occurs.
• Correctly assessing injuries increases the chances of sound rehabilitation and quick recovery.
  • Talk - Ask "What happened? Where does it hurt? What type of pain are you experiencing? On a scale of 1-10, how much pain is there?"
  • Observe - Look for swelling, discoloration, and deformity. Compare the injured site to the uninjured site. Also, note the emotional or mental state. If it is clear that there is a break in the bone, do not continue to "touch."
  • Touch - Gently feel for tenderness, heat, and abnormality. Start wide and work your way toward the site with gentle touches toward the thumbs.
  • Active movement - Ask the patient to move the injured area themselves, noting the difficulty and range of motion. If pain is present, stop immediately and skip the next two steps.
  • Passive movement - Move the patient's injured area for them. Move over the full Range of motion to test for stability. Only perform if there is no pain in movement.
  • Skills test - Get the athlete to perform game-specific skills (e.g., throwing, dodging, squats). If there is no pain, allow play to continue.
• If, at any point, it is clear that further testing or participation will be detrimental, play should stop and treatment should begin.

Children And Young Athletes

Medical Conditions (Asthma, Diabetes, Epilepsy)

• Asthma is a respiratory condition characterized by difficulty in breathing due to a reduction in the width of the airways.
• Narrowing may be brought about by acute narrowing from spasm, swelling of the airway lining, or secretion of mucus in airways.
• Symptoms of asthma include a dry irritating cough (often at night and morning or with exercise), chest tightness, wheezing and shortness of breath, and, in severe cases, blueness around the lips and tongue and inability to speak.
• Beneficial activities for asthmatics include swimming (particularly indoors with moist, warm air), yoga, and learning coping skills and relaxation techniques.
• Management of asthma includes sitting the victim upright, reassuring them, giving four separate puffs of Ventolin via a spacer, waiting four minutes, and repeating. Call 000 if still no improvement.
• Implications for participation in sports include considering environmental factors (cold air, pollen, pollution), ensuring easy access to medication and emergency support, developing an asthma plan with a GP, and gradual warm-up and cool-down.
• Epilepsy: a disruption to brain function caused by excessive neuronal activity, leading to strange sensations, emotions, behaviours, seizures and fits.
• Symptoms: May collapse, muscle spasm occur and frothing from mouth, may turn blue in face (cyanosis) and may lose control of their bladder
• Management: Some infantile forms of epilepsy can be controlled with a high fat diet or by vitamin B supplements.
  • Need plenty of sleep. Medication helps up to 80% of sufferers. During seizure: protect from external dangers (move objects away), time the seizure, do not try to restrain, comfort and monitor when seizure stops. Call 000 if its the first time, over 5 mins long, patient in water
• Implications: Avoid activities that have possibility of significant metabolic imbalances e.g. Scuba diving, high altitude climbing , most sports are okay to play, but avoid overexertion, dehydration and hypoglycemia, coaches/carers should be aware of the extent of condition, including players and staff

Overuse Injuries (Stress Fractures)

• Overuse injuries occur due to repeated use of a body part, causing tissue damage and discomfort.
• Overuse injuries develop over a period of time and may reoccur following brief periods of rest.
• Examples of overuse injuries include stress fractures, Achilles tendonitis, and swimmer's shoulder.
• Overuse Injuries should avoid overtraining/excessive parent pressure, obesity, poor technique/footwear/equipment, and hard surfaces
• Management of overuse injuries includes varying sports to reduce repetitive strain, correcting footwear and surface selection, and implementing proper warm-up and cool-down routines.

Thermoregulation

• Thermoregulation is the maintenance of a stable internal temperature independent of the temperature of the environment.
• Children acclimatize slower to heat and therefore retain heat longer, causing overheating on warm days or dehydration.
• Children also have a higher risk of hypothermia due to less body mass, dehydration, and heat exhaustion.
• Children have a greater lower sweating rate, higher peripheral blood flow in the heart, and a greater extent of vasoconstriction in the cold.
• Management of thermoregulation includes avoiding playing in temperatures over 34 degrees, having regular drink breaks for hydration, and wearing appropriate clothing for conditions.
• Sports policies may ensure more breaks in the heat, such as quarter times instead of half times.

Appropriateness To Resistance Training

• Correct resistance training can benefit strength, motor performance, general health, self-esteem, and prevent injuries.
• Several factors should be considered, including the child's training base, ability to learn new techniques, stage of growth and development, and quality of supervision.
• Implications include using the principle of "progressive overload" for all ages and only using body weight for beginners and those 9 and under.
• Training should be sport-specific, with low resistance and high reps.
• No maximal lifts should be performed until age 18+.
• Supervision should be provided at all times.
• The epiphyseal plate is the main site of longitudinal growth in long bones.
• Resistance training increases the risk of plate injury when executed incorrectly, which may close early and stunt limb growth.

Adult And Aged Athletes

Heart Conditions

• As people age, the heart works less efficiently, and heart walls lose elasticity.
• People with heart conditions include those with a heart attack history, high blood pressure, or recent bypass surgery.
• Heart conditions can cause problems for older athletes competing at high intensity.
• However, regular aerobic exercise will reduce blood pressure and decrease heart risks.
• Athletes must seek advice from a health professional before participation in sports.
• General rules include low resistance, low impact, gradual building of fitness, avoiding weight lifting, and frequent monitoring of heart rate.
• Exercise should be done for 30 minutes a day, 3-4 times per week
• Activities could include walking, cycling, swimming, or water aerobics.

Fractures/Bone Density

• Bone density is a measure of the strength of a bone by determining the amount of minerals (calcium) in relation to the amount of bone.
• Bone density peaks at 35-40 and declines after this, thus older athletes are more susceptible to broken bones.
• Prevention strategies include weight-bearing exercises (walking, dancing, resistance training), avoiding high-impact activities, and ensuring calcium and vitamin D intake.
• Osteoporosis is a condition in which bones become fragile and brittle, leading to a higher risk of fracture.
• Osteoporosis occurs when bones lose minerals like calcium more quickly than it is replaced, leading to loss of thickness and becoming porous.
• Osteoporosis has no symptoms before a fracture but commonly occurs in the hip, spine, wrist, ribs, and pelvis.
• Exercise will reduce the onset of osteoporosis.

Flexibility/Joint Mobility

• Ageing leads to reduced flexibility due to muscle tightening and joint stiffness and an increase in the risk of arthritis.
• Arthritis is joint inflammation and refers to a group of over 100 rheumatic diseases that can cause pain, stiffness, and swelling at the joints.
• Prevention strategies include stretching exercises to improve flexibility (yoga, Pilates, tai chi) and low-impact activities (swimming, walking).
• There are master events for athletes 35 and over in track and field or cross-country running.

Female Athletes

Eating Disorders

• Eating disorders are characterized by behaviors such as purging, binge eating, and starving.
• Eating disorders may arise from social media, weight restrictions within sports, specific sports subcultures, and stress from competition.
• Female athletes have twice the risk of developing eating disorders compared to non-athletes.

Anorexia Nervosa

• Anorexia nervosa is characterized by a refusal to maintain a healthy body weight and an obsessive fear of gaining weight due to distorted self-image.
• Anorexia involves self-induced starvation and is classed as a mental illness with the highest mortality of any psychiatric disorder.
• Symptoms of anorexia include rapid weight loss, increased hair on the face and body, frequent exercise, wearing baggy clothes, a fear of gaining weight, and rituals such as cutting food into tiny pieces and not eating around others.
• Treatment for anorexia includes restoring the person to a healthy weight range, treatment for psychological disorders related to the illness, and reducing or eliminating behaviors or thoughts that lead to the disorder.
• Prevention methods include expecting athletes to do their best (not solely focusing on winning), educating on the early detection of eating disorder signs and symptoms, observing training routines and any changes or suspicious behaviors, and maintaining contact amongst parents, coaches, and athletes.

Bulimia Nervosa

• Bulimia nervosa includes cycles of uncontrollable eating followed by periods of purging which may include self-induced vomiting, use of laxatives and diuretics, and compulsive exercise to rid the body of calories.
• Athletes may binge and then not eat for days due to the guilt of calories they have consumed.
• Signs/symptoms of bulimia include depression, disappearing after eating, excessive use of the bathroom, excessive exercise, dental and gum problems, calluses or abrasions on the back of the hand from vomiting, dehydration, and menstrual irregularities.
• Affects on sports participation include low food intake leading to a lack of energy, therefore athletes not performing at peak levels. Muscle atrophy occurs, leading to loss of strength and increased injury risk. Organs may shut down from a lack of nutrients. There is an increased risk of dehydration, decreasing endurance, speed, and coordination levels. Athletes will fatigue beyond normal expectations, making endurance sports hard. Poor sleep patterns lead to an inability to perform at optimal levels.

Iron Deficiency

• Iron levels may be depleted by intense physical training and menstruation.
• Most common in sports with high physical demand like gymnastics, diving, and dancing.
• Iron deficiency causes anemia (a condition in which there is an abnormally low level of hemoglobin, resulting in less oxygen being available to tissues).
• Symptoms of iron deficiency include fatigue, dizziness, and decreased endurance.
• Effects on performance include reduced energy levels with lower intensity of training, an increased risk of injury due to muscle weakness, and poor concentration and motivation.
• Prevention and treatment include a diet rich in iron (red meat, leafy greens, fortified cereals).
• Caffeine and calcium can have a detrimental effect, and iron supplementation may be necessary if required.
• Regular monitoring of iron levels is important.

Bone Density

• Directly related to the quantity of calcium in bones, affecting strength and resistance to fractures.
• Following menopause, women lose calcium faster than men.
• Estrogen specifically promotes the activity of osteoblasts, responsible for building new bone.
• After menopause, estrogen drops, accelerating bone loss.
• Effects on performance include a higher risk of stress fractures, decreased ability to recover from injuries, and long-term health complications if not addressed early.

Pregnancy

• The body demands much more blood when pregnant, needing to supply enlarging organs like the uterus.
• Heartbeat also increases to move blood through the body.
• Ligaments soften during pregnancy due to an increase in relaxin, especially in the pelvic area to accommodate the fetus.
• Early pregnancy increases urine production, and pressure from the fetus also causes a need to urinate.
• Some lose weight due to nausea and vomiting early in pregnancy, and later there is weight gain due to an increase in the uterus, breast, blood volume, and water retention.
• A woman's ability to maintain fitness and an exercise program depends on several factors, including existing level of fitness, morning sickness, weight gain, blood pressure, and environmental conditions.
• Sports participation during pregnancy requires prolonged cool-downs to prevent sudden changes in blood pressure.
• Pregnant women should not do high-intensity exercise, as the heart rate is already high.
• Pregnant women should avoid overeating, as the fetus cannot regulate heat.
• Pregnant women should stretch gently and include pelvic floor muscle exercises Maintain a good diet and stay hydrated These concerns are critical for female athletes to manage to sustain long-term performance and well-being.

Physical Preparation

• Most sports require a degree of physical preparation and development of the required components of fitness, for both performance and prevention of sports injuries.

Pre-Screening

• Before starting a training program, subjects at risk should be pre-screened to tailor the program.
• Assess the health status of a person based on age, gender, health status, and previous experience.
• For adult athletes, it is important to identify potential risks to participation from heart conditions or otherwise a risk of adverse effects during physical activity.
• Pre-screening is essential for males 40+, females 50+, asthmatics, smokers/obese/high blood pressure, and those with a family history of heart conditions.
• Questionnaires may be used to identify people at high risk of cardiovascular problems who must then obtain medical clearance.
• Pre-screening highlights limitations and enables an exercise prescription to be developed.
• An exercise prescription specifies what needs to be done to achieve a desired level of fitness (FITT principle).

Skill And Technique

• Skill and technique refer to the proficiency and efficiency with which people perform required activities.
• Skilful players perform difficult movements with ease and precision and display a high degree of temporal patterning (smaller parts of the movement), pacing (precisely timed), and control.
• Skills are acquired through effort and practice.
• Essential to prevent injury
• E.g. Correct tackling technique in rugby league otherwise at risk every tackle. In basketball landing after going up for rebound can place undue stress on knees.
• Skill and technique are important for improving performance and preventing injury.

Physical Fitness

• Ensure the level of fitness required by the sport is present before participation.
• E.g. Rugby requires high levels of CV fitness, strength, power, speed, endurance, agility. Gymnastics requires less CV fitness and more flexibility, coordination and balance.
• Lack of development of the appropriate level of fitness for a particular sport is a major contributing factor to injury.
• Coaches need to be aware of what is required for their sport and ensure that these needs are developed within their athletes.
• Specific areas of training may involve CV fitness, strength, flexibility, power, speed, etc.

Warm-Up, Stretching, And Cool-Down

• The warm-up should be sport-specific and last 20 minutes.
• Sports requiring explosive movements demand a longer warm-up compared to endurance-based sports.
• Warming up redistributes blood flow to muscles from organs, increasing muscle temperature for flexibility, improved joint mobility, enhanced reflexes, and activating sweating for effective body cooling.
  • A proper warm-up consists of a general body warm-up (jogging and skipping to increase blood flow), stretching (dynamic stretches followed by PNF), calisthenics (push-ups, sit-ups, half squats, star jumps to strengthen muscles and redirect blood flow from internal organs to skeletal muscles), and skill rehearsal (drills and routines).

Stretching

• Stretching is vital for flexibility and injury prevention.
• Recommended to stretch 4-5 times per week, more for athletes.
• Muscles must be stretched beyond their required range before performance.
• Stretching should be sports-specific.
• E.g. A high jumper should stretch all major muscle groups, with a focus on calves and thighs.

Stretching methods

• Static: holding for 30 seconds, gradually going beyond normal range.
• Dynamic: controlled movements to prepare muscles.
• PNF: a combination of static and isometric contractions, repeated to achieve desired flexibility.

Cool down

• Cool-down helps the body recover by gradually reducing body temperature, circulation, and respiratory rates to a pre-exercise state.
• Should reverse the warm-up but with less intensity, incorporating stretching for at least 10 minutes and finishing with a light jog or swim
• Incorporates static stretches, lengthens muscles that have shortened during exercise, disperses lactic acid through gentle exercise, allows psychological wind-down, and prevents blood pooling by maintaining circulation and aiding the "muscle pump" effect.

Sports And Sports Environments

Rules Of Sports and Activities

• Assist flow of play and prevent injury, provide a level playing field (i.e., age, ability).
• Enforced on the field by a referee.
• Codes have well-defined rules, as illegal movements have detrimental affects, including disability
• E.g. high head tackle in league. Also, regulations and suspensions/fines for dangerous play
• Some sports with no contact have certain rules to ensure safe participation (e.g., marathon runners must consume fluid to prevent heatstroke, softball catchers must wear face guards and shinpads.

Modified rules for children

• Lowering backboards and rims in basketball/netball; smaller fields in soccer; using a t-ball stand in softball; rewards for achievements (McDonald's vouchers).
• Changes cater to improving skill development and reducing injury.

Matching Of Opponents

• Even competition is desirable in all sports, especially junior ones.
• Consider size, gender, and skill.
• In junior sports, taking away winning as the focus may help in creating equal competition where all players receive the same reward and are thus encouraged to simply match their own skills against opponents of similar ability and enjoy competition.
• Creates equal competition, promotes skill development, prevents injury, allows players to be pushed, and increases confidence.

Use Of Protective Equipment

• Essential to prevent injury. Should protect the wearer and others, allow freedom of movement, and be comfortable/allow airflow.
• Examples include mouthguards in rugby, helmets in cricket, padding on goal posts, wetsuits in surfing, and sunglasses.
• May be optional, highly recommended, or compulsory.
• More expensive equipment tends to be safer.
• Soccer boots enable sidestepping; basketball shoes enable grip and cushioning.
• Important to wear appropriate shoes.
• Consider shoes that aren't too tight, don't cramp toes, are flexible where toes bend, have a supportive heel and arch support, and have a non-slip sole. High heels support the Achilles tendon

Safe Grounds, Equipment, Facilities

• Player safety is paramount.
• Guidelines put in place by SMA (Sports Medicine Aus) for clubs and officials.
• Rules include having a reasonable playing surface (no holes, sprinkler valves), removing rubbish, padding permanent fixtures (netball posts), adequate lighting, and perimeter fences well back from the playing area.
• Playing equipment should be suited to the size and ability of the child, regularly maintained, in sufficient number, and properly constructed.

Environmental Considerations

Temperature Regulation

• The human body will not work properly above or below 37 degrees.
  • Elevated core temperature = risk of hyperthermia
  • Lowered core temperature = risk of hypothermia
• Convection occurs when air moves across the skin surface, and heat is transferred away from the body.
• An example of convection is feeling a wind or fan.
• Conduction occurs when heat is transferred away from the body to an object through direct contact.
• Radiation is the transfer of heat through space with no physical contact.
• Evaporation is the transfer of heat into liquid sweat, which is then evaporated and heat is taken with it.
• Body temperature is controlled by the hypothalamus in the brain.

Climatic Conditions

• Temperature climates impact performance
• Vasoconstriction is the shrinking of blood vessels to preserve heat when cold
• Vasodilation is an increase in blood vessel size to dissipate heat.
• Specific performance strategies
  • Adequate hydration
  • Clothing (sweat-wicking fibers)
  • Higher levels of subcutaneous fat will lose heat slower.
  • Heat loss is more rapid in cold water (radiation and convection reduces temperature 4x faster in water than air).

Humidity

• A measure of the amount of moisture in the air.
• Sweat doesn't evaporate readily in humidity, which leads to heat exhaustion and vasodilation.
• Wind increases heat loss by convection.
• Westerly winds are warmer and may increase body temperature.
• The body responds to cold via shivering and vasoconstriction.
• Wear light clothing covering lots of surface area, preventing wind chill e.g. Wetsuits, skins, face goggles, etc

Rain

• Affects Visibility & traction
• Heat loss may be amplified
• Wear waterproof jackets
• May involve event modifications e.g changing course.

Altitude

• Effects endurance events more as less O2 available, harder for body to supply demand.
• Solar radiation can be stronger

Pollution

• Air pollution a safety hazard for asthmatics and CV problems, reducing O2 capacity
• Carbon monoxide is the most dangerous pollutant, causing nausea, eye irritants and respiratory problems
• Do not exercise in bad air quality

Combinations

• The combination of heat and humidity or cold and wind increases the likelihood of hyperthermia and hypothermia, respectively.

Fluid Intake

• 57% of weight is water.
• Essential for maintaining blood volume, regulating body temperature, and allowing muscle contractions to take place.
• Less water lowers plasma levels and affects the delivery of red blood cells, nutrients, CO2/waste, and hormones.
• Viscosity of blood thickens, so the heart must pump harder.
• Dehydration on performance may include loss of coordination, impaired decision-making, increased exertion, and an increased risk of heat stroke.
• Exercise accelerates water loss as fluids are lost in sweat.
• As dehydration increases, there is a gradual reduction in physical and mental performance, an increase in heart rate and body temperature.
  • 1% loss of water = thirst
  • 5% loss = discomfort and a decrease in aerobic effect
  • 10% loss = breakdown in coordination