Nutrition in Combat Sports

166 M. Zetaruk
excessive bruising, epistaxis, and hemorrhage after tooth extraction. [49] In severe
VWF deficiencies, joint and spontaneous central nervous system hemorrhages may
occur. [49] In milder forms of the disease, increased bruising and prolonged bleeding
with mouth lacerations or prolonged epistaxis may be encountered in contact
combat sports. Recurrent thigh hematomas have also been described following
minor trauma in mild Von Willebrand Disease. [51] Even in noncontact styles,
bruising of the forearms occurs in children without bleeding disorders (Fig. 10.6 );
therefore, increased bruising could be expected in children with VWD. In more
severe instances, the risk of serious central nervous system bleeding associated with
throws or strikes to the head could be similar to that of factor VIII deficiency.
Children with VWD should not participate in the contact aspects of combat
sports. Noncontact training such as kata practice is appropriate. Nonsteroidal
anti-inflammatories prolong bleeding; therefore, other treatment options should
be considered when treating an injured martial artist with VWD.
10.6.3 Seizure Disorders
Children with well-controlled seizure disorders are not restricted from participation
in combat sports. [43] Although a theoretical risk exists that recurrent minor head
trauma could exacerbate the condition, there is little evidence to support this in the
literature. [52] The main concern in combat sports is the risk associated with poorly
controlled seizure disorders. Unanticipated falls, particularly on a hard training or
competition surface, and unprotected blows pose the greatest risks in combat
sports. [52] Atonic seizures, generalized tonic-clonic seizures, and partial seizures
that become secondarily generalized may result in unprotected falls, placing the
child at risk of injury from striking the playing surface. [52] Absence and complex
partial seizures are both characterized by impaired consciousness, and may predispose
children involved in martial arts to injury because of the inability to protect
themselves from blows [52] (see Table 10.4 ). The American Academy of Pediatrics
recommends that children with poorly controlled seizure disorders be restricted
from participation in contact sports. [43]
10.6.4 Single Paired Organ
Children who have only one functioning kidney, a single testicle or one undescended
testicle, or vision in only one eye have to take special precautions in
martial arts. In individuals with two functioning paired organs, the risk of disability
resulting from injury to one organ is lower. On the other hand, in the
child with only one functioning kidney, injury to that one organ could precipitate
the need for dialysis or renal transplant, and injury to the one eye with
functional vision could leave a child blind. Single paired organ is not, by itself,