8. Basic Sport Science-นพ.สุนิคม

Basic Sports Science

Piyabuth Kittitihamvongs M.D.

Upper Extremity and Reconstructive Microsurgery Unit, Lerdsin General Hospital

Sunikom Suppauksorn M.D.

Sports Medicine Service
Center of Excellent in Orthopaedics, Lerdsin General Hospital

Exercise

Topic

General principle of therapeutic exercise
First aid treatment

Exercise in older adult
Exercise in children

Topic

General principle of therapeutic exercise
First aid treatment

Exercise in older adult
Exercise in children

Therapeutic Exercise

Physical activities that focuses on restoring
and maintaining strength, endurance,
flexibility, stability and balance.

Physical Fitness

Definition : General state
of health and well-being.
The ability to perform
aspects of sports or works.

Type of Physical Fitness

Health-related Skill-related

Cardiorespiratory Body composition
endurance

Health-related

Muscular Flexibility
strength

Agility Power

Skilled-related

Reaction time & Speed

Balance & Coordination

Therapeutic
Exercise

Goal : improve health-related
physical fitness

• Cardiovascular endurance
• Body composition
• Muscle strength &

endurance
• Flexibility

Component of Exercise Session

A single exercise session should include…

Warm-up 5-10 min light-to-moderate intensity of aerobic or
muscular endurance activity

Conditioning 20-60 min aerobic, resistance, flexibility exercise,
and/or sports activities

Cool-down 5-10 min light-to-moderate intensity of aerobic or
muscular endurance activity

Stretching ≥ 10 min stretching exercise after warm-up or
cool-down phase

Principle of Fitness

F.I.T.T Principle

F requency How often you exercise ?

I ntensity How hard you exercise ?

T ime How long you exercise ?

T ype What kind of exercise you do ?

Intensity

Aerobic exercise
MET (Metabolic Equivalent of Task)
VO2max (Maximal Oxygen Consumption)
HRmax (Maximum Heart Rate)
RPE (Rating Perceived Exertion)

Strengthening exercise
RM (Repetition Maximum)

Intensity: Aerobic Exercise

VO2max

The maximum rate of oxygen
consumption as measured
during incremental exercise

HRmax

HRmax = 220 - Age in year

Relationship of VO2max & HRmax

VO2 is depend on cardiac output (CO)

The Fick equation :

VO2 = CO x a-vO2diff
VO2 = HR x SV x a-vO2diff

Intensity: Aerobic Exercise

RPE

Rate of Perceived Exertion

Measuring the intensity of your
exercise.
Scale from 0-10

Intensity: Aerobic Exercise

Intensity MET VO2max HRmax RPE
2-3
Light <3 25-45 % 35-60 % 4-6
7-8
Moderate 3-6 45-60 % 60-70 %

Vigorous >6 60-85 % 70-90 %

Cardiorespiratory Body composition
endurance

Health-related

Muscular Flexibility
strength

Cardiovascular
Endurance

Cardiovascular Endurance

Aerobic exercise
(Endurance exercise)

• Large muscle group to
perform continuous and
rhythmic exercise

• Improve functional
capacity

Principle of Fitness

F.I.T.T Principle

F requency How often you exercise ?

I ntensity How hard you exercise ?

T ime How long you exercise ?

T ype What kind of exercise you do ?

Aerobic Exercise

ACSM guideline

F.I.T.T Principle

F requency 3-5 days/week

I ntensity Moderate to vigorous

T ime 20-60minutes

T ype Running, swimming, walking, cycling
and stair climbing

Cardiorespiratory Body composition
endurance

Health-related

Muscular Flexibility
strength

Muscle Strength &
Endurance

Muscle Strength & Endurance

Strength : the maximum force that
a muscle can exert against some
form of resistance in a single effort.

Endurance : the ability to move
your body or an object repeatedly
without getting tired.

Strengthening Exercise

To increase the maximal force that a muscle can
generate

Strength is affected by several factors
• Type of muscle contraction (eccentric vs. concentric)
• Speed of contraction
• Cross-sectional size of the muscle
• Length-tension relationship of the muscle
• Recruitment of motor unit

Muscle Fiber Types

Type I fiber (Slow twitch, slow oxidative, SO)

Type II fiber (Fast twitch, FT)

Type IIa (Fast oxidative glycolytic, FOG)
Type IIb (Fast glycolytic, FG)

Type I Type IIa Type IIb

Colour Red Red White

Contraction Speed Slow Fast Fast

Cross-section Size Small Medium Large

Capillary Density High Intermediate Low

Activity Aerobic Long-term Short-term
Anaerobic Anaerobic
Fatigue Resistance
Resistance Easily

Force Production Low Intermediate High
Low
Glycolytic High High High
Capacity Triglyceride
Oxidative High Low
Capacity
Creatinine phosphate, glycogen
Major Storage Fuel



Type of Strengthening Exercise

Isotonic Isometric Isokinetic

Joint movement No joint movement Joint movement
Same length

Variable speed Internal force does Constant speed
not overcome
external force

Constant resistance Exertion against Variable resistance

immovable objects

What type is it?







Type of Muscle Contraction

Concentric Contraction Eccentric Contraction

Shortening contraction Lengthening contraction
High metabolic cost Low metabolic cost
Generate little force Generate high force

(More energy efficient)

More tissue destruction

Intensity

RM (Repetition Maximum)
Definition : the maximum amount of force that can be
generated in one maximal contraction

• < 6 RM : improve maximal strength

• 8-12 RM : health fitness, hypertrophy

• > 12 RM : improve muscular endurance

Strengthening Exercise

ACSM guideline

F.I.T.T Principle

F requency 2-3 days/week, rest 48 hours

I ntensity Depend on goal (8-12RM)

T ime 2-4 sets, rest 2-3 mins between set

T ype Free weight, machine, elastic band

Strength-Training Resistance Sets Rest Between Frequency
program
Sets (min) (per wk)

Health fitness 8-12 RM 3 2 2-3

Maximal strength 1-6 RM 3-6 3 2-3
2 3-6
Muscular 10-30 RM 3-6 up to 1 4-12
endurance 8-20 RM 3-8
(near fatique)
Body building

Aerobic vs. Resistance

Effects on Body Composition

Body BMI Fat Mass Lean Mass Visceral Adipose Intramuscular
weight tissue Fat

Aerobic

Resistance

Effects on Metabolic Parameters

Insulin LDL HDL TG TC BP
Sensitivity

Aerobic

Resistance - -

Effect on Physical Fitness

Musculoskeletal Fitness Cardiovascular Fitness

Aerobic ?
Resistance

Cardiorespiratory Body composition
endurance

Health-related

Muscular Flexibility
strength

Flexibility

Flexibility Exercise

• Flexibility : the ability to move body joint
through entire ROM

• Each joint has a specific ROM

Flexibility Exercise

ACSM guideline

F.I.T.T Principle

F requency 5-6 days/week then 2-3 days/week

I ntensity Stretching to the point of tightness or
slight discomfort, Hold for 10-30
second at terminal stretch

T ime Repeat each stretch 2-4 times,
accumulating 60 seconds per stretch

T ype Slow sustained stretching

Topic

General principle of therapeutic exercise
First aid treatment

Exercise in older adult
Exercise in children

Acute Injury

Terminology

Bruise : Bleeding under the skin
Sprain : Torn or Damaged ligaments
Subluxation : Incomplete dislocation
Dislocation : Total displaced at a joint
Fracture : A break in a bone



Rest, Ice, Compression, Elevation

Initial Treatment

For all acute musculoskeletal injuries

• Immediate, appropriate treatment (R.I.C.E.)
during the first 72 hours is vital for an optimal
outcome or when inflammation is present.

R.I.C.E. : Rest, Ice, Compression, Elevation

Rest

Rest from any activity that
increases pain.
Ideally lie down in a
comfortable position
To minimize bleeding,
swelling and further damage.
The use of crutches, a
protective brace or tape or the
use of a sling etc.