Sports Medicine Study Notes

Classifying and Managing Sports Injuries

  • Sports injuries are classified based on:
    • Cause of injury:
      • Direct
      • Indirect
      • Overuse
    • Type of body tissue damaged:
      • Hard Tissue
      • Soft Tissue

Classification According to Cause

  • Direct Injuries:
    • Caused by an external blow or force.
    • Examples:
      • Collision with another person (e.g., rugby tackle).
      • Being struck by an object (e.g., cricket ball, hockey stick).
    • Resulting injuries:
      • Bruises
      • Joint and ligament damage
      • Dislocations
      • Bone fractures
  • Indirect Injuries:
    • Caused by intrinsic (internal) forces within the body.
    • Examples:
      • Ankle sprain in soccer.
      • Hamstring tear in sprinting.
    • Can result from:
      • Inadequate warm-up.
      • Ballistic movements.
      • Excessive movement.
      • Faulty skill execution.
  • Overuse Injuries:
    • Caused by excessive and/or repetitive force on bones, joints, tendons, and muscles.
    • Can result from:
      • Changes in training practices (increased frequency or intensity).
      • Poorly planned training schedules à insufficient recovery time à overtraining.
      • Poor technique and equipment à extra stress on the body.
    • Examples:
      • Elbow injury from poor backhand technique or heavy racquet in tennis.
      • Ankle/knee pain from inappropriate running style or footwear.
    • Resulting injuries:
      • Stress fractures (small cracks in the bone).
      • Tendonitis (inflammation of a tendon).
      • Shin splints.

Soft Tissue Injuries

  • Most common injuries from sports participation.
  • Involve damage to tissues other than bones and teeth.
  • Examples:
    • Muscle, tendons, ligaments, cartilage, skin, blood vessels, organs, and nerves.
  • Can be acute (sudden) or chronic (prolonged).
  • Examples:
    • Sprains, strains, dislocations, subluxations, torn cartilage, contusions, and abrasions.
  • Muscle or Tendon (Strain):
    • Overstretching or tearing of muscle or tendon fibres.
    • Occurs when a muscle is used too quickly or stretched too far.
    • Grades:
      • Grade I: Small number of fibres torn, mild pain, no loss of strength.
      • Grade II: More fibres torn, pain and some loss of function.
      • Grade III: Complete tear, severe pain, and major loss of function.
  • Ligament Tear (Sprain):
    • Stretching or tearing of a ligament.
    • Ligaments connect bone to bone for joint stability.
    • Causes pain, swelling, and limited movement.
    • Severity depends on the number of fibres torn.
    • Ligaments heal slowly due to poor blood supply.
    • Classified into Grades I to III, like strains.
  • Contusion (Bruise):
    • Bleeding under the skin caused by a direct blow.
    • Damages small blood vessels, causing bruising and tenderness.
    • Caused by contact with a person, object, or equipment.
  • Abrasions (Scrapes):
    • Superficial damage to the skin surface.
    • Involves damage to small capillaries, causing minor bleeding.
    • Wound may contain dirt, gravel, or foreign material.
    • Common in sports like cycling and athletics.
    • Management: Clean thoroughly to prevent infection; cover with a sterile dressing.
  • Lacerations (Cuts):
    • Skin is cut or torn open, varying in depth and severity.
    • May involve deeper tissues depending on the force or object causing the cut.
    • Often caused by collisions with sharp equipment or an opponent’s gear.
    • Management: Control bleeding, clean the wound, and apply a sterile dressing; stitches may be needed for deep lacerations.
  • Blisters:
    • Caused by friction or rubbing.
    • One layer of skin separates from another, forming a fluid-filled pocket.
    • Common causes: Poorly fitting shoes or equipment, callus build-up, increased training loads, or recommencement of training after a rest period.
    • Management: Avoid popping unless necessary; protect with padding or blister plasters.

RICER (Managing Soft Tissue Injuries)

  • Rest: Avoid activities causing pain; rest the injured area until the beginning of rehab to prevent further injury.
  • Ice: Apply an ice-pack (20 minutes every hour) using insulating material to protect the skin; ↓pain.
  • Compression: Wrap a compression bandage over the injured area for 3 days; ↓ swelling.
  • Elevation: Raise the injured area above the heart; ↓ bleeding, swelling, and throbbing.
  • Referral: Appointment with doctor/physio ASAP after injury to determine the nature and extent of injury and to create a rehabilitation program.

Immediate Treatment of Skin Injuries

  • Main concerns:
    • Control blood loss
    • Minimise the risk of infection
    • Promote healing
  • Management Steps:
    • Wear gloves to reduce the chances of cross-infection.
    • Control bleeding with rest, pressure, and elevation.
    • Assess the severity of the wound.
    • Clean the wound using clean water, saline solution, or a diluted antiseptic.
    • Apply an antiseptic to the wound (EG, Betadine) after ensuring that the person is not allergic to the antiseptic to be used.
    • Dress the wound with a sterile pad and bandage.
    • If necessary, refer the person to medical attention.

Inflammatory Response

  • The inflammatory response is the body’s natural reaction to soft tissue damage, aimed at initiating healing.
  • It occurs immediately after injury and consists of three overlapping stages.
  • Functions:
    • Defend the body against harmful substances.
    • Dispose of dead or dying tissue.
    • Promote the renewal of normal tissue.
  • When tissue is damaged, the body increases blood flow to the area, bringing inflammatory mediators to begin healing. However, this response can be excessive.
    • Increased swelling and discomfort.
    • Slowed healing due to irritation of the surrounding tissues.
Phases of the Inflammatory Response
  • Phase 1: Inflammatory Stage
    • Timeframe: 48–72 hours after injury
    • Characteristics:
      • Pain – due to chemicals released by damaged cells.
      • Redness – caused by vasodilation (widening of blood vessels).
      • Heat – due to increased blood flow.
      • Swelling – caused by fluid entering the damaged area.
      • Loss of function/mobility – from pain and swelling.
      • Damage to cells and surrounding tissue.
      • New blood vessels begin to form to aid healing.
      • RICER should be used during this phase to reduce excessive swelling and pain.
  • Phase 2: Repair and Regenerative Stage
    • Timeframe: 3 days to 6 weeks
    • Characteristics:
      • Inflammation decreases.
      • New capillaries form to support healing.
      • Collagen fibres (strong protein) replace damaged tissue.
      • Collagen is laid randomly, possibly impairing function.
      • Debris (dead/damaged cells) is removed.
      • New fibres and scar tissue begin to form.
      • Scar tissue = dense, inelastic, fibrous tissue.
  • Phase 3: Remodelling Stage
    • Timeframe: 6 weeks to several months (can last up to 2 years)
    • Characteristics:
      • Scar tissue strengthens and matures.
      • Collagen production slows.
      • Collagen fibres hypertrophy (increase in size) and align in the direction of applied force (e.g., during rehab).
      • Tissue continues to strengthen.
    • Balance in rehabilitation is crucial:
      • Too much exercise too soon = risk of re-injury.
      • Too little exercise = poor healing and weak scar tissue formation.

Hard-Tissue Injury

  • Includes damage to the bones and teeth.
  • Ranges from severe fractures and joint dislocations to bruising of the bone and a dislodged tooth.
  • Fractures
    • A crack, chip, or break in a bone.
    • Causes:
      • Direct force (e.g., a direct blow to the bone).
      • Indirect force (e.g., falling on an outstretched hand, breaking the collarbone).
      • Repetitive stress or impact (e.g., stress fractures from overuse).
    • Types of Fractures
      • Closed (Simple) Fracture: Bone is broken but does not pierce the skin.
      • Open (Compound) Fracture: Broken bone pierces the skin, increasing the risk of infection.
      • Complicated Fracture: A Broken bone causes damage to organs, nerves, or major blood vessels.
    • Signs and Symptoms
      • Pain at the site of injury
      • Inability to move or loss of function
      • Unnatural movement
      • Visible deformity
      • Swelling and discolouration
      • Grating sensation (bone ends rubbing together)
    • Treatment of Fractures
      • Follow DRSABCD (Danger, Response, Send for help, Airway, Breathing, CPR, Defibrillation)
      • Control any bleeding
      • Reassure the injured person
      • Immobilise and support the injured area using a splint or sling
      • Seek immediate medical attention
      • Use RICER (Rest, Ice, Compression, Elevation, Referral) only if it does not increase pain
  • Dislocations
    • Displacement of bones at a joint, resulting from trauma or congenital conditions (weak ligaments or repeated previous dislocations).
    • Can damage surrounding muscles, tendons, and ligaments.
    • Commonly Affected Joints
      • Shoulder
      • Elbow
      • Fingers
      • Hip
      • Kneecap
    • Signs and Symptoms
      • Loss of movement at the joint
      • Obvious deformity
      • Swelling and tenderness
      • Pain at the site
    • Treatment of Dislocations
      • Follow DRSABCD
      • Control any bleeding
      • Reassure the injured person
      • Immobilise the joint using a splint or bandage
      • Apply RICER if tolerated
      • Do not attempt to relocate the joint
      • Seek immediate medical attention

Examples of Injury, Cause, Type

  • Broken arm (fracture)
    • Cause: Falling onto an outstretched hand while running or during contact sports like football
    • Type: Hard tissue
  • Greenstick fracture (child)
    • Cause: Minor fall or impact while playing – common in playground accidents
    • Type: Hard tissue
  • Comminuted fracture (shattered bone)
    • Cause: Car crash or a high-speed tackle in rugby causes the bone to break into multiple pieces
    • Type: Hard tissue
  • Stress fracture (shin/foot)
    • Cause: Repetitive impact from long-distance running without proper rest or footwear
    • Type: Hard tissue
  • Dislocated shoulder
    • Cause: Falling awkwardly or being tackled hard during rugby, AFL, or basketball
    • Type: Hard tissue
  • Dislocated finger
    • Cause: Jamming a finger against a ball or surface (e.g. in basketball, netball, or cricket)
    • Type: Hard tissue
  • Subluxed kneecap
    • Cause: Sudden twist while changing direction during netball or soccer
    • Type: Hard tissue
  • Corked thigh (deep contusion)
    • Cause: Collision with another player’s knee during a tackle in rugby or soccer
    • Type: Soft tissue
  • Sprained ankle (rolled ankle)
    • Cause: Landing awkwardly after jumping in basketball or stepping on uneven ground while running
    • Type: Soft tissue
  • Torn ACL (knee ligament tear)
    • Cause: Quick stop, sidestep, or twist during sports like netball, soccer, or skiing
    • Type: Soft tissue
  • Hamstring strain
    • Cause: Sprinting too fast without a warm-up or overstretching during a kick
    • Type: Soft tissue
  • Calf strain
    • Cause: Taking off explosively from a standing start, especially in sprinting or jumping
    • Type: Soft tissue
  • Achilles tendonitis
    • Cause: Repetitive jumping or running uphill without proper rest or stretching
    • Type: Soft tissue
  • Tennis elbow
    • Cause: Overuse of the forearm in racquet sports like tennis or repetitive lifting in manual work
    • Type: Soft tissue
  • Shin splints
    • Cause: Running long distances on hard surfaces or poor shoes, especially in new training phases
    • Type: Soft tissue
  • Abrasion (scraped knee)
    • Cause: Sliding on a netball or basketball court, or falling off a bike or skateboard
    • Type: Soft tissue
  • Laceration (cut from glass)
    • Cause: Falling on sharp objects or contact with broken equipment or the environment (e.g. fencing or glass)
    • Type: Soft tissue
  • Blister (on heel or palm)
    • Cause: Repetitive rubbing from ill-fitting shoes or constant gripping of sports equipment like bats/sticks
    • Type: Soft tissue

Assessment of Injuries (TOTAPS)

  • Firstly, the DRSABCD procedure should be followed.
  • After ensuring the person is conscious and there are no life-threatening conditions (using DRSABCD), the TOTAPS method is used to assess the extent of a musculoskeletal injury (like sprains, strains, or impact injuries) on the field.
  • This method helps determine:
    • The severity of the injury
    • If the player is fit to continue or should be removed from play
    • Whether the injury requires referral to professional medical care
  • TOTAPS stands for:
    • T – Talk: Ask the injured person what happened. Listen for details about how the injury occurred and where it hurts.
    • O – Observe: Look for any obvious signs of injury, such as swelling, bruising, or deformity. Compare the injured side to the uninjured side.
    • T – Touch: Gently feel the injured area to identify any pain, tenderness, or unusual movement. This helps pinpoint the exact site of injury.
    • A – Active Movement: Ask the player to move the injured part themselves. If they can’t move it through a normal range of motion, the injury may be serious.
    • P – Passive Movement: The assessor gently moves the injured area to test for pain and range of motion. Pain during passive movement suggests a more severe injury.
    • S – Skills Test: If the player has passed all previous steps, they attempt to perform a skill related to their sport (e.g. jogging, jumping, throwing). If they feel pain or instability, they should not return to play.

How Does Sports Medicine Address the Demands of Specific Athletes?

  • Considerations for young athletes include:
    • Medical conditions (asthma/diabetes/epilepsy)
    • Overuse injuries (stress fractures)
    • Thermoregulation
    • Appropriateness of resistance training
Three Medical Conditions
  • Asthma
  • Diabetes
  • Epilepsy
Asthma
  • Chronic respiratory condition where the airways become narrow and inflamed, making it difficult to breathe.
  • Causes of Asthma Symptoms (3 Main Reasons):
    • Inflammation/Swelling of the airway lining
    • Excess mucus production
    • Constriction of muscles around the airways (bronchoconstriction)
  • Signs & Symptoms:
    • Wheezing
    • Shortness of breath
    • Tight chest
    • Coughing (especially at night or early morning)
  • Asthma Management – “4 x 4 x 4 Method”
    • Reassure the person and help them sit upright.
    • Give 4 separate puffs of reliever medication (e.g. Ventolin) using a spacer: 1 puff → 4 breaths from spacer Repeat until 4 puffs have been taken Wait 4 minutes. If no improvement, repeat 4 puffs using same method. Seek medical help if symptoms continue.
  • Implications for Sports Participation:
    • Use a gradual warm-up and cool-down.
    • Do not allow play during an asthma attack.
    • Be aware of the athlete’s limits and Asthma Management Plan.
    • Provide opportunities to rest (e.g. substitutions).
    • Encourage hydration.
    • Avoid training during cold/dry weather or when athlete has a respiratory infection.
    • Avoid training in cold mornings or late evenings, especially in winter.
    • Allow/preventative medication use before exercise if prescribed.
  • Key Considerations for Coaches/Teachers:
    • Know who has asthma and keep their reliever nearby.
    • Monitor environmental conditions (pollen, cold air).
    • Encourage open communication about symptoms.
    • Promote a supportive environment.
Diabetes
  • Chronic condition where there is too much glucose (sugar) in the blood.
  • This occurs because the pancreas either: Cannot produce insulin, or Produces insufficient insulin, or The insulin does not work properly.
  • Insulin is a hormone that allows glucose to enter body cells to be used for energy.
  • Types of Diabetes:
    • Type 1: Body does not produce insulin. Usually diagnosed in childhood.
    • Type 2: Body becomes resistant to insulin or doesn’t produce enough. Often lifestyle-related.
    • (Gestational Diabetes: Occurs during pregnancy – not a focus for sports.)
  • Hypoglycaemia (Low Blood Sugar):
    • Sudden onset with symptoms such as: Rapid heart rate, Sweating, Shaking, Anxiety, Dizziness, Possible unconsciousness
    • Management: Provide quick-acting sugar: jelly bean, Juice or soft drink After symptoms improve, provide more substantial food If unconscious: Apply DRSABCD, Call 000
  • Hyperglycaemia (High Blood Sugar):
    • Slow onset with symptoms such as: Thirst, Vomiting, Weak, rapid pulse, Rapid breathing, Drowsiness
    • Management: Apply DRSABCD. Do not give food or drink. If conscious: Allow the person to administer insulin Seek medical help
  • Implications for Sports Participation:
    • Ensure the athlete eats well before physical activity.
    • Make teammates aware of the condition (with consent)
    • Use player rotations or adjust positions to prevent overexertion.
    • Keep glucose supplements nearby (e.g. lollies).
    • Regularly monitor blood glucose levels.
    • Be aware of the athlete’s physical limits.
    • Ensure medication is taken correctly before/during activity.
    • Provide close supervision throughout the activity.
Epilepsy
  • Neurological condition where there is a disruption to normal brain function, causing seizures or fits.
  • This leads to a temporary change in consciousness or behaviour.
  • Characteristics of Seizures:
    • May involve convulsions (shaking), staring, or brief loss of awareness.
    • Duration is usually short.
    • Can vary in type and severity depending on the individual.
  • Management of a Seizure:
    • Ensure safety: Clear the area of hard or sharp objects. Do NOT: Restrain the person. Put anything in their mouth. After the seizure: Reassure and comfort the person. Seek medical help. If the person becomes unconscious: Apply DRSABCD. Call 000 and stay with the person.
  • Implications for Sports Participation:
    • Be aware of: The child’s seizure triggers (e.g. stress, flashing lights). Type and severity of seizures. Any activity restrictions or recommendations.
    • Provide close supervision during activity.
    • Avoid high-risk sports (e.g. swimming, contact sports) unless properly managed.
    • Ensure the child’s medication is taken as prescribed.
    • Be prepared to respond to a seizure.
  • Key Considerations:
    • Create a supportive and inclusive environment.
    • Develop and follow an Epilepsy Management Plan.
    • Maintain open communication with parents/guardians and the child.
Overuse Injuries
  • Occur due to repeated use of a body part, leading to tissue damage and discomfort over time.
  • They develop gradually and are often subtle in onset.
  • Causes of Overuse Injuries in Young Athletes:
    • Growth spurts – body parts (bones, tendons, muscles) develop at different rates.
    • Muscle imbalance – uneven strength vs flexibility.
    • Inadequate warm-up.
    • Excessive training – increased intensity, duration, or frequency.
    • Playing multiple sports without rest.
    • Poor technique or biomechanical imbalances.
    • Unsuitable equipment – e.g. incorrect footwear.
    • Lack of base fitness or recovery time.
  • Common Examples of Overuse Injuries (Children/Adolescents):
    • Stress fractures
    • Osgood-Schlatter’s disease
    • Tennis elbow
    • Shin splints
    • Tendonitis
    • Swimmer’s shoulder
    • Rotator cuff injuries
  • Signs & Symptoms:
    • Gradual onset of pain
    • Increasing pain with continued activity
    • Local swelling
    • Tenderness at the injury site
    • Reduced performance
  • Management of Overuse Injuries:
    • RICER (Rest, Ice, Compression, Elevation, Referral) +
    • Rest – usually 4 to 6 weeks, depending on severity
    • Use anti-inflammatory medication (under medical advice)
    • Maintain general fitness with low-impact alternatives (e.g. swimming, cycling)
    • Use of corrective devices (e.g. orthotics, braces) and rehabilitative exercises
    • Address biomechanical issues (e.g. technique correction)
  • Implications for Sports Participation:
    • Modify the technique to reduce stress on the injured area
    • Use correct and well-fitted equipment
    • Balance strength and flexibility through targeted programs
    • Include variety in training to avoid repetitive strain
    • Schedule regular rest periods and recovery
    • Closely monitor athletes, especially during growth spurts
    • Rotate playing positions to reduce strain on specific body parts
Thermoregulation
  • Definition: The body’s ability to maintain a stable internal temperature despite changes in the external environment.
  • Involves balancing heat gain and heat loss.
  • Children and Thermoregulation
    • Kids have less developed sweat glands, so they:
      • Can’t cool down as efficiently through evaporation (sweating).
      • Are slower to acclimatise to heat.
      • Have shorter tolerance to heat.
      • Are at greater risk of hyperthermia (overheating).
  • Heat-Related Conditions
    • Hyperthermia
      • Symptoms may include: dizziness, confusion, dry skin, rapid pulse
      • First Aid: DRSABCD Move the person to a cool area Remove unnecessary clothing Sponge with cool water Apply ice packs Offer cool water Seek medical help
    • Hypothermia
      • Symptoms may include: shivering, slurred speech, drowsiness
      • First Aid: DRSABCD Movethe person to a warm, dry place Avoid wind, rain, cold or wet surfaces Remove wet clothing Use blankets and warm drinks Cover the head to reduce heat loss
  • Implications for Sports Participation
    • To protect athletes from temperature extremes:
      • Regular water breaks
      • Cooling strategies (shade, fans, cold towels)
      • Appropriate clothing (light, breathable, or warm layers as needed)
      • Provide shelter from the sun/rain
      • Avoid vigorous activity in extreme heat or cold
      • Modify the environment (e.g. indoor training if needed)
      • Choose suitable sports for the weather
      • Train at cooler times of day (e.g. early morning)
      • Ensure a proper warm-up and cool-down
Appropriateness of Resistance Training
  • Definition
    • Refers to how suitable and safe resistance (weight) training is for young athletes, considering age, intensity, and technique.
  • Key Principles
    • Use low resistance with high repetitions
    • Go through a full range of motion (ROM)
    • The technique must be taught before any weight is added
    • Under age 14–16, use body weight only
    • Avoid strength specialisation (e.g., powerlifting) – can lead to muscle imbalances and injuries
    • Focus should be on general strength, coordination, and fun
  • Best Practices for Young Athletes
    • Use your own body weight for resistance
    • Ensure correct supervision
    • Emphasise proper form over lifting heavy
    • Make training fun and varied
    • Include peer interaction and group activities
  • Implications for Sports Participation
    • Always warm up properly
    • Ensure qualified supervision
    • Focus on light weights and proper technique
    • Encourage high reps, low resistance
    • Avoid competitive lifting or max effort sets
    • Make sessions engaging and enjoyable
  • Examples of Safe Bodyweight Resistance Exercises
    • Plank
    • Push-ups
    • Chin-ups
    • Tricep dips
    • Wall sits
    • Squats/lunges without weights

Adult and Aged Athletes

  • Adult Athletes = Aged 30+
  • Aged Athletes = Aged 60+
  • Importance of Physical Activity for Older Athletes
    • As athletes age, physical activity becomes essential for maintaining:
      • Cardiovascular fitness → supports heart and lung health
      • Muscular strength & endurance → helps with everyday tasks and injury prevention
      • Flexibility → improves range of motion and reduces stiffness
      • Coordination & balance → lowers the risk of falls and accidents
    • Physical activity helps to:
      • Reduce the risk of lifestyle diseases (e.g. type 2 diabetes, obesity, cardiovascular disease)
      • Improve mental health (reduces depression and anxiety)
      • Increase social interaction (group exercise, community programs)
      • Enhance quality of life and independence
      • Delay the effects of ageing on the body and mind
  • Common Health Concerns in Older Adults
    • Older athletes are more likely to experience:
      • Coronary Heart Disease (CHD) – narrowed arteries affecting heart function
      • High Blood Pressure (HBP) increases risk of stroke/heart attack
      • Cancer – risk increases with age, but exercise can help reduce risk and aid recovery
      • Mental disorders – e.g. depression, anxiety, dementia
      • Osteoarthritis – joint inflammation and pain, especially in the knees, hips, hands
      • Osteoporosis – bone weakening; increases fracture risk
      • Vision and hearing problems may affect balance and coordination
      • These must be managed carefully when designing fitness programs.
  • Safety and Medical Considerations
    • Always get medical clearance before starting exercise, especially after a long period of inactivity.
    • Monitor heart rate, breathing, pain, and fatigue.
    • Programs should be:
      • Tailored to individual needs
      • Low-risk and gradually progressive
      • Safe and enjoyable
  • Recommended Exercise Guidelines (For Aged Athletes)
    • 30–40 minutes
    • Moderate intensity
    • At least 3–4 times per week
    • Include:
      • Aerobic exercise (cardio)
      • Resistance training (light weights or bands)
      • Balance & flexibility training
  • Suitable Activities for Older Adults
    • Low-impact, joint-friendly, and safe exercises:
      • Walking improves cardio and can be done anywhere
      • Cycling – gentle on joints, builds leg strength
      • Swimming or water aerobics – great for joints and overall fitness
      • Light resistance training maintains muscle and bone strength
      • Yoga and Pilates – build flexibility, core strength, balance
      • Tai Chi – improves balance and mental focus
      • Group exercise classes – provide social interaction and motivation
  • More Competitive or Serious Older Athletes
    • Some aged athletes still train at higher intensities
    • Must be:
      • Supervised by a qualified coach
      • Monitored for health risks (especially heart-related)
      • Following a well-structured, progressive plan
      • May compete in Masters events or senior competitions
Heart Conditions
  • Heart conditions are disorders of the cardiovascular system that are more common as people age.
  • These include:
    • Hypertension (high blood pressure)
    • Heart attack (damage to the heart muscle due to blocked arteries)
    • Bypass surgery (surgery to improve blood flow around blocked arteries)
    • Arrhythmias (irregular heartbeat)
  • How Age Affects the Cardiovascular and Respiratory System
    • As adults and older people get older:
      • The heart muscle becomes weaker → less able to pump blood efficiently
      • Blood vessels become narrowed and less elastic, → raises blood pressure
      • Lung tissue loses elasticity → breathing becomes harder
      • Oxygen delivery to working muscles decreases → exercise becomes harder
      • Fatigue happens quicker, and recovery takes longer
  • Considerations When Designing Exercise Programs
    • When planning a fitness program for someone with a heart condition, you MUST:
      • Get medical clearance from a GP
      • Include proper warm-up and cool-down
      • Keep intensity at 60–70% of Maximum Heart Rate (MHR) – moderate intensity only
      • Encourage exercising with a partner in case of emergency
      • Ensure gradual increases in intensity – no sudden changes
      • Be aware they fatigue more easily and need more time to recover
      • Ensure the program is: Individualised Low-risk Sustainable long-term
      • Avoid outdoor exercise in extreme heat, cold, or humidity – these conditions increase cardiovascular strain
      • Recommend light resistance training only – no isometric exercises or weights heavier than 10RM
  • Safe Sports & Activities for Athletes with Heart Conditions
    • Athletes with heart conditions should NOT participate in high-intensity sports. Such as: competitive running, Basketball, Rugby
    • Instead, they should do low to moderate intensity activities like:
      • Golf Low intensity, social, walking-based
      • Dancing Fun, social, improves coordination and heart health
      • Walking Gentle, can be done anywhere, promotes circulation
      • Cycling Low-impact cardio exercise
      • Social tennis Light movement improves coordination, not too intense
      • Water aerobics Gentle on joints, excellent for heart and lung fitness
  • Are low to moderate in intensity, which reduces the risk of heart attack or stroke
  • Help maintain cardiovascular fitness and slow the effects of ageing
  • Improve mental health, social connection, and independence
Fractures and Bone Density
  • Physical activity = ↑ bone mass + makes bones stronger
  • Bone density refers to the thickness and strength of bones.
  • As people age, bones become:
    • Less dense
    • More brittle and weak
  • This leads to a higher risk of fractures, especially in the hips, spine, and wrists.
  • A common condition: osteoporosis, particularly In post-menopausal women Due to reduced oestrogen levels.
  • Factors That Increase Bone Degeneration Risk
    • Low calcium intake during early life
    • Lack of physical activity, especially weight-bearing or resistance training
    • Inactivity → causes calcium to leave the bones, weakening them
    • Menopause in women → lower oestrogen → faster bone loss
  • Why Exercise Is Important
    • Exercise helps to:
      • Increase or maintain bone density
      • Strengthen muscles that support bones
      • Improve balance, coordination, and agility → reduces the risk of falls
      • Slow down natural bone deterioration with age
  • Safe Exercise Guidelines for Low Bone Density
    • Recommended: 30–45 minutes, 3–4 days per week
    • Include:
      • Weight-bearing activities (e.g., walking, tennis, golf)
      • Low-impact aerobic exercise (e.g., swimming, cycling, water aerobics)
      • Balance and coordination training (e.g., gentle aerobics, yoga, Tai Chi)
      • Low-range strengthening exercises for the back, trunk, and limbs
      • Light resistance training using resistance bands or light weights
  • Exercises and Activities to Avoid
    • Avoid:
      • High-impact exercises (e.g., running, jumping)
      • High-contact sports (e.g., rugby, soccer)
      • Activities with a high risk of falls or sudden changes in direction (e.g., basketball, skiing)
      • Some programs, like Golden Oldies Rugby, allow aged athletes to participate safely using a coloured shorts system to indicate contact level: For example: Red shorts = no contact, Blue shorts = light contact
Flexibility and Joint Mobility
  • Flexibility refers to the ability of a joint to move through its full range of motion (ROM).
  • Joint mobility refers to how freely and easily a joint can move.
  • These abilities naturally decline with age due to:
    • Reduced elasticity in muscles, tendons, and ligaments
    • Loss of muscle length and joint fluid
    • More sedentary lifestyles
  • This decline can result in:
    • Muscle tightness
    • Joint stiffness
    • Reduced ability to perform everyday activities like bending, reaching, or walking
  • Effects of Reduced Flexibility and Mobility in Older Adults
    • May lead to reduced independence
    • increases the risk of falls and fractures
    • Causes postural problems and chronic pain
    • Can prevent participation