© 2007 McGraw-Hill Higher Education. All Rights Reserved. Presentation revised and updated by Brian B. Parr, Ph.D. University of South Carolina Aiken Chapter 22 Training for the Female Athlete, Children, and Special Populations EXERCISE PHYSIOLOGY Theory and Application to Fitness and Performance, 6th edition Scott K. Powers & Edward T. Howley

© 2007 McGraw-Hill Higher Education. All Rights Reserved. Objectives 1.Describe the incidence of amenorrhea in female athletes versus the general population. 2.List those factors thought to contribute to “athletic” amenorrhea. 3.Discuss the general recommendations for training during menstruation. 4.List the general guidelines for exercise during pregnancy. 5.Define the term female athlete triad.

© 2007 McGraw-Hill Higher Education. All Rights Reserved. Objectives 6.Discuss the possibility that chronic exercise presents a danger to: (1) the cardiopulmonary system or (2) the musculoskeletal system of children. 7.List those conditions in Type I diabetics that might limit their participation in a vigorous training program. 8.Explain the rationale for the selection of an insulin injection site for Type 1 diabetics prior to a training session. 9.List the precautions that asthmatics should take during a training session. 10.Discuss the question “Does exercise promote seizures in epileptics?”

© 2007 McGraw-Hill Higher Education. All Rights Reserved. Factors Important to Women Involved in Vigorous Training  Responses of females to training are similar to males –Thermoregulation impaired during luteal phase of menstrual cycle  Concerns for female athletes: –Exercise and the menstrual cycle –Eating disorders –Bone mineral density –Exercise during pregnancy

© 2007 McGraw-Hill Higher Education. All Rights Reserved. Exercise and Menstrual Disorders  Amenorrhea –Cessation of menstruation –Incidence higher in distance runners and ballet dancers –Due to multiple factors Amount of training Psychological stress Body composition  Training and menstruation –No reason to limit training during menstruation –Dysmenorrhea Painful menstruation May limit training due to discomfort

© 2007 McGraw-Hill Higher Education. All Rights Reserved. Relationship Between Training Distance and the Incidence of Amenorrhea Figure 22.1

© 2007 McGraw-Hill Higher Education. All Rights Reserved. The Female Athlete and Eating Disorders  Eating disorders affect both male and female athletes  Anorexia nervosa –Extreme steps to reduce body weight Starvation, exercise, laxative use –Effects: Excessive weight loss, amenorrhea, death  Bulimia nervosa –Pattern of overeating (binging) followed by vomiting (purging) –Effects: Damage to teeth and esophagus

© 2007 McGraw-Hill Higher Education. All Rights Reserved. Warning Signs for Anorexia Nervosa Figure 22.2

© 2007 McGraw-Hill Higher Education. All Rights Reserved. Warning Signs for Bulimia Figure 22.3

© 2007 McGraw-Hill Higher Education. All Rights Reserved. Bone Mineral Disorders  Osteoporosis –Loss of bone mineral content  Major causes: –Estrogen deficiency due to amenorrhea –Inadequate calcium intake due to eating disorders

© 2007 McGraw-Hill Higher Education. All Rights Reserved. The Female Athlete Triad  Interrelated health problems –Amenorrhea –Eating disorders –Bone mineral loss  Eating disorder can lead to: –Diminished intake of calcium and vitamin D –Amenorrhea and low blood levels of estrogen –Both can lead to low bone mineral density

© 2007 McGraw-Hill Higher Education. All Rights Reserved. The Three Components of the Female Athlete Triad Figure 22.4

© 2007 McGraw-Hill Higher Education. All Rights Reserved. Risk of Knee Injury in Female Athletes  Female athletes are at higher risk of certain knee injuries compared to men –ACL injury  Reasons –Fluctuation in hormones during menstrual cycle May influence ACL structure –Knee anatomy May be due to greater joint laxity –Dynamic neuromuscular imbalance Imbalanced strength, proprioception, and landing biomechanics

© 2007 McGraw-Hill Higher Education. All Rights Reserved. Training During Pregnancy  Short-term, low-intensity exercise appears to be safe during pregnancy –Aquatic exercise may be a good choice  Long-duration, high-intensity exercise should be avoided –May reduce uterine blood flow and fetal weight at term

© 2007 McGraw-Hill Higher Education. All Rights Reserved. Sports Conditioning for Children  Training and the cardiopulmonary system –Improvements in VO 2max similar to that of adults –No risk of permanent cardiovascular damage as a result of training  Musculoskeletal system –Training may optimize growth in children –Concerns of damage to cartilage Articular cartilage and epiphyseal growth plate Too much training can retard growth –Injuries can be avoided by attention to proper technique

© 2007 McGraw-Hill Higher Education. All Rights Reserved. Location of the Growth Plate Figure 22.5

© 2007 McGraw-Hill Higher Education. All Rights Reserved. Competitive Training for Diabetics  Type 1 diabetics who are free from complications should not be limited in type or quantity of exercise  Safe participation depends on ability to avoid hypoglycemia –Combination of exercise, diet, and insulin for optimal blood glucose control –Have carbohydrate snack available during exercise  Insulin injection site –Should be away from working muscle to prevent increased rate of uptake and hypoglycemia

© 2007 McGraw-Hill Higher Education. All Rights Reserved. Training for Asthmatics  Asthmatics may safely participate in all sports –Provided that exercise-induced bronchospasm is controlled –Should keep a bronchodilator inhaler handy during exercise  Asthmatics and SCUBA diving –May be safe for those who have normal airways at rest and do not exhibit exercise-induced bronchospasm

© 2007 McGraw-Hill Higher Education. All Rights Reserved. Epilepsy and Physical Training  Epilepsy is characterized by seizures –Loss of consciousness, muscle tremor, and sensory disturbances  Mixed opinions on whether exercise induces seizures  Concern about injury –Blow to head causing a seizure –Injury during a seizure  Participation in exercise should be determined on a case-by-case basis –Depending on type of epilepsy and sport considered