1 / 59

By: Lai Chi Kit Jerry, Lam Kit Yan Wendy, Tang Wing Yan Tracy, Yiu On Yee Annie

Sports Presentation On Trailwalker. By: Lai Chi Kit Jerry, Lam Kit Yan Wendy, Tang Wing Yan Tracy, Yiu On Yee Annie. Outline. Overview of Trailwalker Physiologic demand and common injuries 2 Case scenarios assessment, treatment and advice Training guidelines Nutrition in Sports

yasir-alford
Télécharger la présentation

By: Lai Chi Kit Jerry, Lam Kit Yan Wendy, Tang Wing Yan Tracy, Yiu On Yee Annie

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Sports Presentation On Trailwalker By: Lai Chi Kit Jerry, Lam Kit Yan Wendy, Tang Wing Yan Tracy, Yiu On Yee Annie

  2. Outline • Overview of Trailwalker • Physiologic demand and common injuries • 2 Case scenarios • assessment, treatment and advice • Training guidelines • Nutrition in Sports • General advice • Q & A

  3. Overview of Trailwalker • An annual fundraising walkathon organised by Oxfam Hong Kong since 1981. • The 100-km MacLehose Trail • To develop their potential and abilities of disadvantaged people in Hong Kong and poor people in Asia and Africa. • From 1981, $80,000 raised increase to over $16 million in 2000.

  4. Interest Arouse

  5. Exercise Physiology of Endurance Sports • High oxygen transport capacity • VO2max • High fatigue resistance in working muscles • lactate threshold (Tanaka, 1995) • Muscle fibre composition • type I > type II • Energy utilization • carbohydrate + fat

  6. Common Injuries Medical (59%) Dermatologic (21%) Musculoskeletal (17%) • Exercise-associated collapse (EAC) • Hyponatremia • Blisters • Abrasions • Sprains • Strains • Fracture Dehydration, exhaustion, syncope, hyperthermia & hypothermia (Roberts W.O., 2000)

  7. Musculoskeletal Injuries • Knee > Ankle (31.3% vs 28.1%) • Injuries (in descending order) • PFJ pain • Tendinitis of tendons passing under extensor rectinaculum • Muscle cramp • Achilles tendinitis • Ankle sprain (Fallon K.E.,1996)

  8. Case scenario • Team A • 4 long-distance runners who have no experience in Trailwalker before. Fitness level for the 4 members is good. However, one suffers from chronic TA tendinitis and one claims that has sore heel after 8-hour hiking practice. He wonders if it is to do with shoe-wear.

  9. Case scenario • Team B • Mixed team – 2 females & 2 males of average fitness. One female team member suffers from symptoms of nausea and vomiting in her last 3 Trailwalker events, possibly suffering from hyponatremia. One male team member suffers from patellofermoral pain after going up & down hills for 4 hours. He is slightly overweight.

  10. General Assessment of Physical Fitness (ACSM)

  11. Chronic Achilles Tendinitis • Signs & symptoms: • Persistent pain over TA • Pain occurs especially in the morning, after exercise & hill walking • Nodules around TA on palpation

  12. Intrinsic factors stiff MTP joints tightness of calf and hamstring muscle flat foot / over-pronation Extrinsic factors sudden increases in training excessive downhill running improper footwear Chronic Achilles Tendinitis

  13. Sore Heel Structures underlying symptomatic area: • bone: calcaneus • plantar aponeurosis • plantar fat pad • nerve: post tib n, med calcaneal n, med and plantar n, which pass thro tarsal tunnels • mm tendon: peroneal and tib mm • bursa: retrocalcaneal bursa

  14. Differential Dx of Heel Pain Detailed assessment is essential !

  15. Plantar Fasciitis • an overuse condition • Repetitive stress on the plantar fascia results in inflammation at its attachment to the calcaneus

  16. Plantar Fasciitis • Signs & symptoms: • Heel pain • Pain is worse usually at 1st few steps in morning • Pain is common at start of exercise & resuming activity after rest • Pain aggravated by standing, walking, running, with running most painful

  17. Plantar Fasciitis • Predisposing factors • Flat foot/high arch • Excessive pronation • Obesity • Tight TA • Training error • Improper footwear • Occupation with prolonged standing

  18. Assessment • Training habit • Alignment of whole LL, esp TA • Observe foot arch • Muscle length esp calf • Test plantar fascia in a stretched position (toes ext with ankle PF) + WB position

  19. Assessment - Shoes

  20. Management • Acute • PRICE, US, tapping, NSAID • Chronic • stretching / transverse friction • tapping • removal of triggering factors • proper footwear • addition of heel pad or other orthotics • eccentric loading • foot intrinsic muscle strengthening

  21. Exercise-induced Hyponatremia Na+ • Plasma Na level < 135 mmol/L • BW loss is less than that of normal athletes • % Median weight change (Speedy et al. 2000) • Normal: - 3.9% • Hyponatremia: - 0.5% • Common in ultra-endurance exercise • marathon • S/S • Ranges from asymptomatic to life threatening conditions eg seizures, coma, even death • Common: headache, nausea, vomiting, muscle cramps, disorientation, confusion

  22. Exercise-induced Hyponatremia • Idiopathic • 2 common hypotheses • Loss of large amount of salts through sweating without replacement • Excessive pure water consumption (10L / 4hr)

  23. Exercise-induced Hyponatremia • Management • Na containing sport drink • Salty foods • Seek professionals if necessary

  24. Prevention methods Before event During event After event  salt intake by 10-25 g  Avoid use of NSAIDs  Na containing sport drinks    Salty foods   Weighing   Exercise-induced Hyponatremia

  25. Patellofemoral Pain • Etiology: • biomechanical problem (patella tracking), malalignment, overuse & muscular dysfunction of PFJ • Training errors

  26. Patellofemoral Pain • S/S: - pain ↑by prolonged sitting, ↑duration of activity (esp. squatting &↓ stairs) - swelling - crepitus

  27. Assessment of PFJ pain • S/E: activity pattern, training techniques, footwear, details of onset, SAND etc. • O/E: observation of whole LL alignment (? Ant/post pelvic tilt, ↑Q-angle, genu valgum/varum, patellar position, flat foot, pes cavus, leg length discrepancy)

  28. Assessment of PFJ pain • Palpation: bursa, tendon, ligament, jt line, patellar facets & retinaculum • ROM, MMT (∵ weak VMO poor tracking of patella), patellar gliding movt, ligament stress test, McMurray test • Test for mm tightness e.g. hamstring, quads, hip flexors, ITB

  29. Management of PFJ pain • Acute phase - PRICE - Symptomatic relief e.g. use of EPT - NSAID - Avoid stair walking, inclined slope & squatting • Chronic phase - Stretch tight mm - Strengthening ex esp VMO - Taping - ↑proprioception training - Balance training e.g. bouncer, wobble board

  30. Hiking poles •  joint loading, especially knee •  knee flexion moment •  quads eccentric loading •  shearing force on TFJ •  stress on ligaments (Muller et al, 1999) Prevention of PFJ / TFJ problems & traumatic injuries on uneven terrain

  31. Overweight • Assessment: BMI • Implication • limits endurance & speed •  loading on knees • Predispose to PFJ pain • Management • Weight control • Endurance exercise + diet

  32. Overweight • Weight reduction guidelines (Axe 1995, ACSM 2001) • Reduce dietary fat intake to < 30% of total energy intake per day • Lose 1-2 lb/week is safe • Min of 2.5hr of moderate intensity ex per week

  33. Training

  34. Training Guidelines • Overload • 10% rule (Patti F) • Hard/Easy system • Specificity Minimize injury

  35. Training Guidelines • Mainly focus on aerobic training • Beginning: slow pace  progress to competition pace • Longest distance to train should not exceed total distance • Combination of distance & difficulty of different sections

  36. Training Guidelines • Incorporate appropriate amount of weight training (back, UL & LL) & stretching • general fitness • avoid injury • Weight training: min 1 set of 8-12 reps; 2-3 sessions/wk • A period of rest at last couples of weeks • called taper • for carbohydrate loading

  37. Training Suggestion Initial 4 wks…(conditioning through track running) • Team A 70-80% HRmax; 3-5 sessions/wk; 35-40 mins • Team B 60-70% HRmax; 3-4 sessions/wk; 30-35 mins

  38. Training suggestions • Next 4 wks, • Walk practice + running x 15-20 mins alt day • Walk at least one day per week minimum of 4-6 hrs (about 15-25km)

  39. Checkpoint Distance

  40. Training Suggestion Last 4 wks…(at least once per wk) • Sections 1 & 2 or 9 & 10 Sections 6, 7 & 8 Sections 3 & 4 or 4 & 5 (night training) with backpack on

  41. NUTRITION IN SPORTS

  42. Nutrition needs

  43. Diet before competition

  44. Diet before competition--Glycogen Loading • 7 days before…. • Take in 6-10 g/kg of complex CHO, and progressive  in training intensity daily • 1-6 hrs before…. • Low fat, low fiber, high CHO food e.g. bread, congee •  time for food to day in stomach and so the chance of getting stomache • keep blood glucose level stable • choose the food that the athletes like • Within 1 hr before…. • Don’t eat ‘.’ diverts blood from mm to stomach

  45. Diet during competition

  46. Energy and Fluid Replacement • 30-60g/kg CHO every hr • 150-350 ml water every 15-20 min • little glucose concentration(otherwise easy dehydration ‘.’ high osmolarity) • ~ 6 % glucose concentration •  : Maltodextrin, surcose, glucose • Sodium • 0.5-0.7 g/L • prevent hyponatremia • don’t drink water until feel thirsty

  47. After Exercise…..

  48. Replacement • CHO (~ 600 g) replacement when • 30 min after exercise and • every 2 hrs after exercise • Sodium replacement helps water replacement • e.g. soup, cheese, meat……. • Every pound weight loss needs at least 16 oz water replacement

  49. General Advice

More Related