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Chapter 23: Additional Health Concerns and General Medical Conditions


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Title: Chapter 23: Additional Health Concerns and General Medical Conditions

Chapter 23 Additional Health Concerns and
General Medical Conditions
Skin Infections
Viral Infections
  • Virus
  • Small organism that can live only in a cell
  • Upon entering cell it may immediately trigger a
    disease (influenza) or remain dormant (herpes)
  • Can damage host cell by blocking normal function
    and using metabolism for own reproduction
  • Virus ultimately destroys cell

  • Cause of Condition
  • Herpes simplex viral infection that tends to
    occur in the same location (mucous membranes)
  • Type I (cold sore) Type II (genitals)
  • Herpes zoster
  • Appears in specific pattern on body (innervated
    by specific nerve root)
  • Re-appearance of chicken pox virus

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  • Signs of Condition
  • Early indication tingling or hypersensitivity
    in an infected area 24 hours prior to appearance
    of lesions
  • Local swelling followed by outbreak of vesicles
  • Heal in generally 10-14 days
  • Care
  • If an athlete has an outbreak they should be
    disqualified from competition due to contagious
    nature of condition
  • Utilize universal precautions when dealing with
    herpes virus
  • Use of antiviral drugs can reduce recurrence and
    shorten course of outbreak

Verruca Virus and Warts
  • Variety of forms exist
  • verruca plana (flat wart), verruca plantaris
    (plantar wart), and condyloma acuminatum
    (venereal wart)
  • Different types of human papilloma virus have
    been identified
  • Uses epidermal layer of skin to reproduce and
  • Wart enters through lesion in skin

  • Signs of Condition
  • Small, round, elevated lesion with rough, dry
  • Painful if pressure is applied
  • May be subject to secondary bacterial infection
  • Care
  • If vulnerable, they should be protected until
    treated by a physician
  • Use of electrocautery, topical salicylic acid or
    liquid nitrogen are common means of managing this

Bacterial Infections
  • Bacteria are single celled micro-organisms
  • Disease development
  • Bacterial pathogen enters host, growth of
    bacteria and production of toxic substances
    occurs and host attempts to fight infection
  • Two types
  • Staphylococcus
  • Streptococcus

  • Furuncle (Boils)
  • Infection of hair follicle that results in
    pustule formation
  • Generally the result of a staph infection
  • Become large and painful
  • Folliculitis
  • Inflammation of hair follicle around face/neck or
    in the groin
  • Impetigo Contagiosa
  • Caused by streptococci
  • Spread through close contact

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  • Symptoms of Condition
  • Mild itching and soreness followed by eruption of
    small vesicles and pustules that rupture and
  • Exhibits signs of inflammation
  • Tenderness, warmth, redness and swelling
  • Care
  • Cleansing and topical antibacterial agents
  • Systemic antibiotics
  • Pus filled lesions should be drained
  • Minimize the chances of the infection to spread
    to others

Fungal Infections
  • Cause of Condition
  • Ringworm fungi (tinea)
  • Cause of most skin, nail and hair fungal
  • Tinea of the Groin (tinea cruris)
  • Signs and Symptoms
  • Mild to moderate itching and found bilaterally
  • Brownish or reddish lesion resembling outline of
    butterfly in groin

  • Care
  • Treat until cured
  • Will respond to many of the non-prescription
  • Medications that mask symptoms should be avoided
  • Failure to respond to normal management may
    suggest a non-fungal problem (such as bacteria)
    and should be referred to a physician
  • May require additional topical medications and
    oral prescriptions

  • Athletes Foot (tinea pedis)
  • Cause of Condition
  • Most common form of superficial fungal infection
  • Webs of toes may become infected by a combination
    of yeast and dermatophytes
  • Signs of Condition
  • Extreme itching on soles of feet, between and on
    top of toes
  • Appears as dry scaling patch or inflammatory
    scaling red papules forming larger plaques
  • May develop secondary infection from itching and
  • Care
  • Topical antifungal agents and good foot hygiene

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Respiratory Conditions
  • The Common Cold
  • Cause of Condition
  • Attributed to filterable virus that produces
    infection in upper respiratory tract in
    susceptible individual
  • Susceptible individual
  • Physical debilitation from overwork or lack of
  • Chronic inflammation from local infection
  • Inflammation of nasal mucosa from allergy or from
    breathing in foreign substance
  • Sensitivity to stress

  • Sign of Condition
  • Begins w/ scratchy, sore throat, stuffy nose,
    watery discharge and sneezing
  • Some may experience a fever
  • Various aches and pains
  • Nasal discharge becomes thick and discolored from
  • Care
  • Symptomatic treatment (may last 5-10 days)
  • Non-prescription cold medications
  • Eat a balanced diet, consume 64 oz. of water
  • Avoid emotional stress and extreme fatigue

  • Influenza (Flu)
  • Cause of condition
  • Occurs in various forms as an annual epidemic
  • Caused by a virus
  • Symptoms of Condition
  • Fever (102-103oF), chills, cough, headache,
    malaise, and inflamed respiratory mucous membrane
    w/ non-productive cough, watery eyes
  • General aches and pains, headache becomes worse
  • Weakness, sweating, fatigue may persist for many
  • Care
  • Bed rest and supportive care
  • Steam inhalation, cough medicines, and gargles
  • Flu prevention avoid contact with someone that
    has it

  • Acute Bronchitis
  • Cause of Condition
  • Infectious winter disease that follows common
    cold or viral infection
  • Fatigue, malnutrition or becoming chilled could
    be predisposing factors
  • Sign of Condition
  • Upper respiratory infection, nasal inflammation
    and profuse discharge, slight fever, sore throat
    and back muscle pains
  • Fever lasts 3-5 days while cough can last 2-3
  • Yellow mucus indicates infection
  • Pneumonia can complicate condition
  • Care
  • Avoid sleeping in cold environment, avoid
    exercise in extreme cold w/out protection
  • Rest until fever subsides, drink 3-4 quarts of
    water daily, ingest antipyretic analgesic, cough
    suppressant, and antibiotic

  • Bronchial Asthma
  • Cause of Condition
  • Caused by viral respiratory tract infection,
    emotional upset, changes in barometric pressure
    or temperature, exercise, inhalation of noxious
    odor or exposure to specific allergen
  • Sign of Condition
  • Spasm of smooth bronchial musculature, edema,
    inflammation of mucus membrane
  • Difficulty breathing, may cause hyperventilation
    resulting in dizziness, coughing, wheezing,
    shortness of breath and fatigue
  • Care
  • Prevention determine causative factors
  • Use of prescribed inhalers are effective in acute

  • Exercise-Induced Bronchial Obstruction (Asthma)
  • Cause of Condition
  • Brought on by exercise w/ exact cause unknown
  • Loss of heat and water (airway reaction), eating
    certain foods, sinusitis may also trigger
  • Sign of Condition
  • Airway narrowing due to spasm and excess mucus
  • Tight chest, breathlessness, coughing, wheezing,
    nausea, hypertension, fatigue, headache, and
    redness of skin

  • EIA (continued)
  • Care
  • Regular exercise, appropriate warm-up and cool
    down, w/ intensity graduated
  • Inhaled bronchodilators may be useful
  • Exercise in warm, humid environment
  • Coaches should be sure to remind athletes to have
    inhaler with them at all times

Other Conditions That Can Affect the Athlete
  • Infectious Mononucleosis
  • Cause of Condition
  • Virus that has incubation period of 4-6 weeks
  • Transmitted through saliva
  • Signs and Symptoms
  • First 3-5 days -severe fatigue, headache, loss of
    appetite and myalgia
  • Days 5-15 - fever, swollen lymph nodes and sore
    throat (50 will experience enlarged spleen)
  • Possible jaundice, skin rash, puffy eyelids
  • Care
  • Supportive symptomatic treatment
  • Acetaminophen for headache, fever and malaise
  • Resume training after 3 weeks after onset if
    spleen not markedly enlarged/painful, athlete is
    afebrile, liver function is normal, and
    pharyngitis is resolved

  • Iron Deficiency Anemia
  • Cause of Condition
  • Prevalent in menstruating women and males age
  • Three things occur during anemia
  • Small erythrocytes
  • Decreased hemoglobin
  • Low ferritin concentration (compound that
    contains 23 iron)
  • GI loss of iron in runners is common
  • Aspirin and NSAIDs may cause GI bleeding and
    iron loss
  • Menstruation accounts for most iron lost in women
  • Vegetarian athletes may also be deficient in
    intake relative to iron loss

  • Sign of Condition
  • First stage of deficiency, performance declines
  • Athlete may feel burning thighs and nausea from
    becoming anaerobic
  • May display some mild impairments in maximum
  • Care
  • Eat a proper diet including more red meat or dark
    poultry avoid coffee and tea (hamper iron
  • Consume vitamin C (enhance absorption)
  • Take supplements (dependent on degree of anemia)

  • Sickle-Cell Anemia
  • Cause of Condition
  • Hereditary hemolytic anemia - RBCs are sickle or
    crescent shaped (irregular hemoglobin)
  • Less ability to carry oxygen, limited ability to
    pass through vessels, causing clustering and
    clogging of vessels (thrombi)
  • Signs of Condition
  • Fever, pallor, muscle weakness, pain in limbs
  • Pain in upper right quadrant indicating possible
    splenic infarction
  • Headaches and convulsions are also possible
  • Care
  • Provide anticoagulants and analgesics for pain

Diabetes Mellitus
  • Most common forms are Type I (insulin-dependent
    diabetes mellitus) and Type II (non-insulin-depend
    ent diabetes mellitus)
  • Cause of Condition
  • Result of interaction between physical and
    environmental factors
  • Involves a complete or partial decrease in
    insulin secretion

  • Insulin Shock
  • Cause of Condition
  • Occurs when the body has too much insulin and too
    little blood sugar
  • Sign and Symptoms
  • Tingling in mouth, hands, or other parts of the
    body, physical weakness, headaches, abdominal
  • Normal or shallow respiration, rapid heart rate,
    tremors along with irritability and drowsiness
  • Care
  • Adhere to a carefully planned diet including
    snacks before exercise
  • Must determine food and insulin intake during

  • Diabetic Coma
  • Cause of Condition
  • Loss of sodium, potassium and ketone bodies
    through excessive urination (ketoacidosis)
  • Sign and Symptoms
  • Labored breathing, fruity smelling breath (due to
    acetone), nausea, vomiting, thirst, dry mucous
    membranes, flushed skin, mental confusion or
    unconsciousness followed by coma
  • Care
  • Early detection is critical as this is a
    life-threatening condition
  • Insulin injections may help to prevent coma

  • Disordered cerebral function characterized by
    periods of altered consciousness, motor activity,
    sensory phenomena or inappropriate behavior
    caused by abnormal cerebral neuron discharge
  • Not a disease
  • Symptom manifested by a large number of
    underlying disorders
  • Cause of Condition
  • For some forms of epilepsy there is genetic
  • Brain injury or altered brain metabolism

  • Sign of Condition
  • Periods of altered consciousness, motor activity,
    sensory phenomena or inappropriate behavior
  • May last 5-15 seconds (petit mal seizure) or
    longer (grand mal seizure)
  • Include unconsciousness and uncontrolled
    tonic-clonic muscle contractions
  • Care
  • Individuals that experience daily or weekly
    seizures should be prohibited from participating
    in collision sports (blow resulting in
    unconsciousness could result in serious injury)
  • Must be careful with activities involving changes
    in pressure
  • Can be managed with medication

  • Care (continued)
  • Athlete may experience undesirable side effects
    care giver must be aware
  • Be sure to have individual sit or lie down
  • Remain composed
  • Try to cushion athletes fall
  • Keep athlete away from surrounding objects that
    could cause injury
  • Loosen restrictive clothing
  • Do not force anything between the athletes teeth

  • Meningitis
  • Cause of Condition
  • Inflammation of meninges surrounding spinal cord
    and brain
  • Caused by infection brought on by meningococcus
  • Sign and Symptoms
  • High fever, stiff neck, intense headache,
    sensitivity to light and sound
  • Progress to vomiting, convulsions and coma

  • Meningitis (continued)
  • Care
  • Cerebrospinal fluid must be analyzed for bacteria
    and WBCs
  • If bacteria is found isolation is necessary for
    24 hours (very contagious), antibiotics must be
    administered immediately
  • Monitored closely in intensive care unit

Substance Abuse Among Athletes
  • Substance abuse has no place in athletics
  • Use and abuse of substances can have a profound
    effect on performance
  • Both positive and negative
  • Use of performance enhancing and street drug use
    occurs throughout athletics, on various levels

Performance Enhancing Drugs
  • Drug use designed to improve performance is known
    as doping
  • Doping
  • Administration or use of substances in any form
    alien to the body, or of physiological substances
    in abnormal amounts and with abnormal methods by
    healthy persons with the exclusive aim of
    attaining an artificial and unfair increase in
    performance in sports.

  • Stimulants
  • Used to increase alertness, reduce fatigue,
    increase competitiveness and hostility
  • Some respond with loss of judgment that may lead
    to personal injury or injury to others

  • Amphetamines
  • Extremely potent and dangerous
  • Injected, inhaled, taken as tablets
  • Most widely used for performance enhancement
  • Can produce euphoria w/ heightened mental status
    until fatigue sets in, accompanied by
    nervousness, insomnia, and anorexia
  • In high doses, will reduce mental activity and
    decrease performance
  • Athlete may become irrational
  • chronic use causing individual to become hung
    up in state of repetitious behavioral sequences

  • Can lead to amphetamine psychosis, manifesting in
    auditory and visual hallucinations and delusions
  • Physiologically, high doses can cause abnormal
    pupil dilation, increased blood pressure,
    hyperreflexia and hyperthermia

  • Anabolic Steroids
  • Synthetic chemical (structure resembles sex
    hormone, testosterone)
  • Androgenic effects
  • Growth, development and maintenance of
    reproductive tissues, masculinization
  • Anabolic effects
  • Protein synthesis - causing increased muscle mass
    and weight, general growth and bone maturation
  • Goal is to maximize this effect
  • Can have deleterious and irreversible effects
    causing major threats to health
  • Use most commonly seen in sports that involve
    strength and power

  • In prepubescent boys
  • Decrease in ultimate height, cessation of long
    bone growth, acne, deepening of the voice
    (hirsutism), and swelling of the breasts
  • Ingestion by females
  • Hirsutism
  • Increases in duration and dose increases the
    likelihood of androgen effects
  • Abuse may lead to liver and prostate cancer and
    heart disease

  • Human Growth Hormone (HGH)
  • Produced by anterior pituitary and released into
    circulatory system
  • Amount released varies with age
  • Can be produced synthetically
  • Results in increases muscle mass, skin thickness,
    connective tissue in muscle, organ weight
  • Can produce lax muscles and ligaments during
    periods of growth and alterations in bone growth

  • Can cause premature closing of growth plates,
    acromegaly which may also result in diabetes
    mellitus, cardiovascular disease, goiter,
    menstrual disorders, decreased sexual desire and
  • No proof that increased HGH and weight training
    contributes to strength and muscle hypertrophy

  • Androstenedione
  • Weak androgen produced primarily in testes and in
    lesser amounts by adrenal cortex and ovaries
  • Increases testosterone in men and particularly
  • Effects last a few hours
  • No scientific evidence to support or rebuke
    efficacy or safety of using this ergogenic aid

  • Creatine Supplementation
  • Naturally occurring in the body synthesized by
    kidneys, liver and pancreas
  • Can also be obtained from ingestion of fish and
  • Positive physiological effects
  • Increase workout intensity, prolong ability to
    perform maximal effort, improves exercise
    recovery, stimulates protein synthesis, decreases
    total cholesterol and triglycerides and increases
    fat free mass

  • Side effects
  • Weight gain
  • No apparent long term side effects
  • May enhance muscular performance during high
    intensity resistance training

  • Blood Reinjection (Blood Doping, Packing or
  • Endurance, acclimatization and altitude make
    increased metabolic demands for the body,
    requiring increased blood volume and RBCs
  • Can replicate physiological responses by removing
    900 ml of blood and reinfusing is after 6 weeks
    (allows time to replenish supply)
  • Can significantly improve performance
  • While unethical, it can also prove to be
  • Risks involve allergic reactions, kidney damage,
    fever, jaundice, infectious disease, blood
    overload (circulatory or metabolic shock)

Recreational Substance Abuse Among Athletes
  • It occurs among athletes
  • Desire to experiment, temporarily escape, be part
    of the group
  • Can be abused and habit forming
  • Drug used for non-medical reasons with the intent
    of getting high, or altering mood or behavior

  • Psychological vs. Physical Dependence
  • Psychological dependence is the drive to repeat
    the ingestion to produce pleasure or avoid
  • Physical dependence is the state of drug
    adaptation that manifests self in form of
  • When cease consumption abruptly unpleasant
    withdrawal occurs
  • Tobacco Use
  • Cigarettes, cigars pipes are increasingly rare
    in athletics
  • Smokeless tobacco and passive exposure to others
    continues to be an ongoing problem

Smokeless Tobacco
  • Loose leaf, moist, dry powder, and compressed
  • Posses serious health risk
  • Bad breath
  • Stained teeth
  • Tooth sensitivity to heat and cold
  • Cavities and gum recession
  • Tooth bone loss
  • Leukoplakia
  • Oral and throat cancer
  • Major substance ingested is nitrosonornicotine
  • Absorbed through mucous membranes
  • More addictive habit w/out exposure to tar and
    carbon monoxide
  • Will increase heart rate but does not impact
    reaction time
  • Coaches, athletic trainers and professional
    athletes should avoid use in order to present a
    positive role model

  • Most widely used and abused substance with
  • Depresses CNS
  • Absorbed from digestive tract into bloodstream
  • Does not improve mental or physical abilities and
    should be avoided by athletes
  • Consumption on a large scale can result in
    development of a moderate degree of tolerance
  • No place in sports participation

  • Formerly most abused drug in Western society
  • Similar components and cellular changes as
  • Can lead to respiratory disease, asthma,
    bronchitis, lowered sperm count and testosterone
    levels, limited immune functioning and cell
  • Causes increased pulse rate and can cause
    decrease in strength
  • Psychologically causes diminution of
    self-awareness and judgment, slower thinking and
    short attention span

  • Has also been found to alter the anatomical
    structures suggesting irreversible brain damage
  • Contains cannabinoids (can store like fat cells)
  • May remain in the body and brain for weeks and
    months resulting in cumulative deleterious effects

Drug Testing in Athletics
  • NCAA and USOC have established banned substances
    lists and testing programs
  • Banned substances list have not been set at the
    high school level
  • Choice is left up to the individual schools
  • Testing at the high school level is on the rise
  • Program screens for some and leaves out several
    commonly used substances (alcohol, tobacco and

The Female Athlete Triad
  • Cause of Condition
  • Relationship between disordered eating,
    amenorrhea and osteoporosis
  • Driven to meet standards of sport or to meet a
    specific athletic image to attain goals
  • Sign and Symptoms
  • Disordered eating - bulimia and anorexia
  • Osteoporosis - premature bone loss in young
    women, inadequate bone development
  • Care
  • Prevention is key identify and educate