8. Basic Sport Science-นพ.สุนิคม

Ice

Minimize swelling and pain

Applied intermittently during the first 24 to 48 h (for 15 to
20 min, as often as possible)

Compression

Compress with a compression bandage to minimize swelling.

If an applying a compression bandage you experience pins
and needles, numbness or ANY colour change in your

extremities (e.g. foot or hand), the bandage is too tight and is

cutting off your circulation.

Elevation

Elevate the injured area above the level of your heart

Allows gravity to help drain edema fluid and

minimize swelling.



Hyperextension

• Injury to
• ACL
• PCL
• Posterior capsule
• Popliteal artery



Topic

General principle of therapeutic exercise
First aid treatment

Exercise in older adult
Exercise in children

Elderly & Exercise

Elderly

Definition
Age ≥ 65 years

Aging Profile Map

2015
10-19%

2050
30+%

Source: UNDESA Population division, World population prospects: the 2015 revision, DVD Edition, 2015.

Age-related Changes

Aging Wear & tear Impacts on ADL
in most of the body

Changes in…
Functional capacity
Muscle
Body composition

Functional capacity

Cardiovascular changes

Cardiac output : 20-30% by age 65 years
Maximum HR : 220-age
Vascular elasticity : 10-40 mmHg SBP/DBP

Functional capacity

Respiratory changes

Vital capacity : 40-50% by age 70 years
Chest wall compliance
Residual volume

Muscles

Muscle mass : age~ 40 year, lower > upper
limp

Muscle endurance & strength
No. of motors & MNJ : Decrease speed,
repetitive movement, balance

Sarcopenia

Involuntary loss of skeletal muscle mass, strength,
and function.

Part of the normal aging process.

Enhanced by morbidity, chronic malnutrition, a
sedentary lifestyle, and smoking.

Limits Functional Capacity.

Increases the risk for incapacitation, falls, fractures,
and a dependent lifestyle.

Connective Tissues

Cartilage degeneration : water and collagen
Ligaments & tendons : stiffness, ultimate tensile load

Body Compositions

Bone mineral density (BMD)

1% ⬇ bone mass/year after age 35
2.3% ⬇ bone mass/year post
menopausal for 5-10 year

% of body fat









Exercise & Aging

Aerobic Exercise

Aerobic exercise = cardiovascular exercise

Functional capacity (3 times/week)

The longer training periods (20-30wks), the larger
improvements
But not necessarily higher training intensities.

Cardiovascular Changes

Heart rate at rest and moderate exercise
Smaller mean BP

Oxygen uptake capacities of muscles

Body Composition

Total body fat.

However !!!
Aerobic exercise does not improve skeletal
muscle growth or strength.
Aerobic exercise does not increase BMD.

Aerobic Exercise

ACSM guideline

F.I.T.T Principle

F requency ≥ 5 days/week for moderate intensity
≥ 3 days/week for vigorous intensity

I ntensity Moderate (5-6 RPE) to vigorous (7-8 RPE) intensity

T ime 30-60 min for moderate intensity
T ype 20-30 min for vigorous intensity
No excessive orthopedic stress eg. walking
Aquatic exercise and stationary bicycle

Strengthening Exercise

Strengthening exercise = Resistant exercise
Muscle mass and strength
Muscle endurance
Body fat
Loss of bone density

Strengthening Exercise

ACSM guideline

F.I.T.T Principle

F requency ≥ 2 days/week

I ntensity Beginning : light intensity
Progress to moderate intensity

T ime ≥ 1 set of 10-15 repetitions

T ype Progressive weight-training program
8-10 exercises that use all major muscle groups.
(legs, hips, back, abdomen, chest, shoulders, and
arms)

Summary

Aging is associated with functional capacity,
muscle strength and body compositions.
Aging is multi-factorial process e.g.genetic,
lifestyle, disease.
Regular exercise can modify aging process.
Combination of resistive and aerobic exercise.

Topic

General principle of therapeutic exercise
First aid treatment

Exercise in older adult
Exercise in children

Children & Exercise

Phase of Growth

Infancy : first year of life
Childhood : age 1 to puberty
Puberty : development of secondary sex characteristic
Adolescence : puberty to complete growth

Female ~2 yr
Male

What we do know ?

Children are not just smaller versions of adults.
Children and adolescents don’t follow the same rates of
change (early and late biologic maturers).

What we do know ?

As children’s size increases, so do almost all of
their functional capacities:

• Strength
• Motor abilities
• Cardiovascular and Respiratory function
• Aerobic and Anaerobic capacities

Key Points of Tissue Growth &

Development

Girls mature 2 to 2.5 years earlier than boys do.

Bones : usually complete by age 20 years.

• Physical activity during growth (particular
running and jumping activities or multi-joint
exercises) can significantly increase bone
mass.

Muscle : occurs primarily at puberty due to
hypertrophy and increases in sarcomere length.

Key Points of Tissue Growth &

Development

Fat storage : ⬆ Size and number of fat cells.

• Starts at birth and is influenced by diet,
exercise, and heredity.

Balance, agility, and coordination : improve as
nervous systems develop.

Myelination of nerve fibers—which speeds the
transmission of impulses—is necessary before fast
reactions and skills are fully developed.

Aerobic Exercise in Children

Smaller heart, total blood volume = smaller stoke volume
and lower cardiac output.
Children’s performance is inferior to adults due to reduced
capacity deliver O₂ (smaller hearts, ↓ stroke volume).

Anaerobic Exercise in Children

Ability to perform anaerobic activities is lower.
Lower muscle glycogen (Energy source).
Lower glycolytic capacity.
Anaerobic mean and peak power outputs are lower.

Resistance Training in Children

Prepuberty period
Strength gains occur in the absence of changes in muscle
size.
Muscle stronger because of growth and:

• Improvements in neural mechanisms
• Learned motor skill coordination
• Increased motor unit activation

Resistance Training in Adolescents

Puberty period
Strength gains are a result of increasing muscle mass.
Boys can gain greater mass and strength than women
because of higher levels of testosterone.

Potential Hazards with
Resistance Training

Acute musculoskeletal injuries
Epiphyseal fractures: injury to growth plate at the end of
long bones
Chronic musculoskeletal injuries
Stress fractures, cartilage damage

Acute Musculoskeletal Injuries

Epiphyseal Plate Fx

Chronic Musculoskeletal Injuries

Osgood-Schlatter Stress Fx Little League
elbow

Exercise Prescription

• Safe to start moderate intensity exercise training.
• Training programs for children should be conservative

to reduce the risk of injury, overtraining, and loss of
interest in the sport.
• Avoid power lifting and body building until child has
reached physical and skeletal maturity.

Aerobic Exercise in Children

ACSM guideline

F.I.T.T Principle

F requency Everyday

I ntensity Moderate to vigorous intensity

T ime ≥ 60 min/day

T ype Enjoyable & developmental aerobic physical
activities, e.g. running, swimming, dancing, and
bicycling.

Strengthening Exercise in
Children

ACSM guideline

F.I.T.T Principle

F requency ≥ 3 days/week

I ntensity 8-12 repetitions of sub maximal weight, 1-3 sets
T ime Start with no weight, increase gradually, no
maximum lifts.

As part of their 60 min/day or more of exercise.

T ype Unstructured (e.g., playing on playground equipment,
climbing trees, tug-of-war) or structured (e.g., lifting
weights, working with resistance bands).

Thank You