Lecture # 22

Other

Male Genital Injuries

Direct trauma to the groin can cause severe pain and dysfunction to the testes and penis

swelling and hemorrage inside the scrotal sac may occur

assessment and follow-up self assessments for pain and swelling should be periodically performed and if necessary referral to physician

blunt trauma can cause contusion , hematoma , torsion , dislocation or rupture of the testicle.

commonly caused by a knee , foot or elbow to the groin

leads to a nauseating , painful condition - immediate internal hemorrhage, effusion and or muscle spasm

Scrotal injuries

testicular spasm can be relieved by placing individual on his back and flex knees to chest

Rx- after pain subsides the area should be iced - cold compress

Tinea cruris ( jock itch)

common fungal infection involving the genitalia , seen more commonly in men than women.

perspiration accumulates - this is augmented by wearing tight clothing such as a athletic supporter , tight shorts and or spandex - all encourage fungal growth

s/s - small patched of scaling or diffuse thick and dark lesions, weeping vesicles or pustules on the margin of inflammation , severe itching.

Rx- with topical anti-fungal medications groin area should be kept clean and dry

with loose absorbent clothing worn

Bloodborne Viral Diseases

Hepatitis B most common hepatitis transmitted via blood or blood products,

seaman , vaginal secretions and saliva incubation period 45 - 160 days usually attacks the liver, severely

impairing the function early signs include flu like symptoms,

fatigue , loss of appetite

progressive signs include severe fatigue, anorexia, nausea, vomiting , diarrhea, general muscle and joint pain , fever , abdominal pain and dark urine

most notable yellowing of the whites of the eyes and a yellowish or jaundiced skin appearance

Rx- currently no cure for hepatitis B bed rest and adequate fluid intake immunization is available for individuals

possibly exposed to Hepatitis B

AIDS

results from a viral infection human immun deficiency virus(HIV)

HIV transmitted in blood , semen and vaginal secretions

in sports the risk of AIDS is rare, although AIDS was recently reported in a body builder who injected steroids with a contaminated needle

in boxing , football, wrestling where participants may have a bloody nose , or lacerations close contact may pose a health risk

individual's uniforms that become saturated with blood must be change before returning to competition

S/S vary depending on the degree to which the immune system is impaired

persistent fever or night sweats, unexplained weight loss and loss of appetite, extreme fatigue , white spots or blemishes in the mouth , persistent dry cough , persistent diarrhea , easy bruising or atypical bleeding from any body opening, blotches or bumps under the skin ,persistent severe headaches.

there is no effective cure or vaccine for AIDS

Preventing the Spread of Infectious Diseases in Athletic Therapy Room.

Hygiene hands should be washed with soap and

warm water before & after treating each athlete

hands should be washed after the removal of latex gloves

if bleeding occurs the individual's participation stopped and the wound cleaned and dressed before return to play

skin exposed to blood or other body fluids should be cleaned with soap and water

after participation athletes should shower before treatment

Protective Equipment latex gloves should be readily available

and worn for all staff when handling blood or other body fluid

in handling heavy bleeding - double gloving is recommended

use of mask or eye guards when blood could be splashed or spurted

CPR microshields and resuscitation bags should be used when ever possible

Cleaning and Caring for Equipment disinfect all surfaces in athletic therapy room

with antiseptic ( javex 1:10 solution) following any exposure to blood etc

all tables and work space cleaned on regular daily basis

use sharps container - plastic , leak proof and puncture resistant clearly marked

all solid products should be handled only with gloves on and places in leak proof bags

soiled linens and towels should be handled with gloves and placed in leak proof bag and washed separately from regular laundry in hot water for 25 minutes

Other Health Concerns

Asthma caused by constriction of the bronchial

smooth muscles , causing narrowing of the airway.

wheezing is a common sign and results from air squeezing past the narrow airways

increased workload leads to fatigue acute attacks may occur spontaneously

but are often provoked by a viral infection

a large amount of mucus is produce and breathing becomes difficult

anxiety, panic wheezing , sweating , rapid heart rate and labouring to breath

individuals with asthma usually carry medication once attack subsides the lungs return to normal

Exercise induced Asthma

affects up to 90% of asthmatics develops 6-8 minutes after strenuous

activity and between 65-85% of maximum workload

-factors that contribute are air conditions (cold air , low humidity and polluants)

duration and type of exercise , physical condition and respiratory infections

S/S include chest pain , chest tightness , burning sensations , wheezing , a dry cough , lack of energy and shortness of breath

medications are used to treat this

Asthmatics who are physically fit and free of significant airway obstructions respond well to exercise.

exercise should be preceded with a warm-up and warm down

Diarrhea

common troublesome disorder characterized by abnormally loose ,

watery stools this is due to food residue rushing through

the large intestine before it has sufficient time to absorb the remaining water

prolonged diarrhea can lead to dehydration and depletion of electrolytes

diarrhea may respond to drugs like -Imodium etc

eliminating food that trigger bowel irritation , lactose intolerance

hydration before and during exercise eating low fibre diet 24 hours before

competition

Constipation

infrequent or incomplete bowel movements

may indicate more serious underlying conditions

Causes- lack of fibre in diet, improper bowel habits, emotional stress, diabetes, laxative abuse

increase exercise - hydration and fibre in diet

Diabetes mellitus

chronic systemic disorder characterized by near or absolute lack of the hormone insulin, insulin resistance or both

Insulin is secreted by the pancreas , and is needed to transfer glucose from the blood to skeletal and cardiac muscles

insulin promotes glucose storage in muscles and liver in form of glycogen

Two classes Type I or insulin dependent Type II or non-insulin dependent

Type I onset prior to age of 30 in people who are

not typically obese and is associated with an absolute deficiency of insulin

effects of exercise on metabolic state are more pronounce and management of exercise related problems are more difficult

Type II onset after age of 30 nearly 70-80% of affected people obese associated with significant resistance to

insulin's actions diet usually sufficient to control factors affecting severity and frequency of

diabetes: heredity, female,stress, and diet high in

carbos and fat

Control of diabetes rest on a balance of glucose levels, insulin production, diet and exercise

Alterations in this equilibrium can lead to two separate conditions

Diabetic Coma and Insulin Shock

Hyperglycemia abnormally high levels of glucose in the

blood , can lead to diabetic coma glucose not able to enter cells leads to cell dehydration because of the

increase osmotic pressure excess glucose is passed into kidneys and

secreted in the urine, drawing large amounts of water and electrolytes

leads to weakness , fatigue, increased thirst

body shifts from carbohydrate metabolism to fat for energy

this produces an excess of ketoacids (resulting from acidosis)

Acetone - produced in fat metabolism is blown off in expiration

fruity or sweet smelling breath if condition not rectified with insulin

injection - further dehydration and ketoacidosis can depress brain function

individual becomes confused , drowsy and may lapse into diabetic coma

coma is a serious condition and needs immediate medical attention

Insulin Shock exercise lowers blood sugar level hence it must be counterbalanced with

increase food intake or decreased amounts of insulin

if blood levels fall below normal -hypoglycemia or insulin shock results

S/S are rapid in onset and include , dizziness , aggressive behaviour, intense hunger fainting , pale , cold and clammy skin and profuse perspiration , salivation and drooling

since glucose levels are low treatment includes getting sugar into the system

honey , table sugar,orange juice or soda place sugar under the tongue in an

unconscious person , it will be absorbed into the system

recovery is usually rapid , however physical performance and judgement may be impaired even after glucose level is returned to normal

If in doubt as to the condition you can give sugar to both - if recovery is not rapid then hyperglycermia is the problem and get to hospital ASAP

Exercise and Diabetes prior to any exercise program a physician

should be consulted normal blood glucose levels measured

and documented strenuous exercise is contraindicated for

some diabetics blood glucose self monitoring makes

determining levels much easier

Diabetic should eat well balanced diet 55-65% carbo , 20% fat and less than 15% protein, with adequate hydration

carbos in forms of snacks should be eaten every 30 minutes during exercise and should follow exercise

emphasis placed on aerobic low resistance activities - walking jogging and swimming