Sports Medicine Handbook - NCAA

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isk. Inadequate energy intakes increase fatigue, deplete muscle glycogen stores, increase the risk of dehydration, decrease immune function, increase the risk of injury and result in unwanted loss of muscle mass. A low caloric intake in female student-athletes can lead to menstrual dysfunction and decreased bone mineral density. The maintenance or attainment of an ideal body weight is sportspecific and represents an important part of a nutritional program. However, student-athletes in certain sports face a difficult paradox in their training/nutrition regimen, particularly those competing in “weight class” sports (e.g., wrestling, rowing), sports that favor those with lower body weight (e.g., distance running, gymnastics), sports requiring student-athletes to wear body contour-revealing clothing (track, diving, swimming, volleyball) and sports with subjective judging related to “aesthetics” (gymnastics, diving). These student-athletes are encouraged to eat to provide the necessary fuel for performance, yet they often face self- or teamimposed weight restrictions. Emphasis on low body weight or low body fat may benefit performance only if the guidelines are realistic, the calorie intake is reasonable and the diet is nutritionally well-balanced. The use of extreme weight-control measures can jeopardize the health of the student-athlete and possibly trigger behaviors associated with eating disorders. NCAA studies have shown that at least 40 percent of member institutions reported at least one case of anorexia nervosa or bulimia nervosa in their athletics programs. Once identified, these individuals should be referred for medical evaluation and psychological and nutritional therapy. A more prevalent issue is the large number of sub-clinical or chronically dieting athletes. Department-wide efforts to educate staff and student-athletes should include addressing the negative impacts of under-fueling and weight/food preoccupation on the athletes’ performance and overall well-being. Although dysfunctional eating is much more prevalent in women (approximately 90 percent of the reports in the NCAA studies were in women’s sports), dysfunctional eating also occurs in men. Female athletes who miss three or more menstrual cycles in a year, are preoccupied with weight, experience rapid changes in body weight, avoid eating with others, or are over-focused on shape and food are exhibiting warning signs worth addressing, if prevention of eating disorders is desired. The medical examination and updated history (Bylaw 17.1.5) is an opportunity to assess athletes for these risk factors and refer them to appropriate professionals for further evaluation and diagnosis. Eating disorders are often an expression of underlying emotional distress that may have developed long before the individual was involved in athletics. Eating disorders can be triggered in psychologically vulnerable individuals by a single event or comments (such as offhand remarks about appearance, or constant badgering about a student-athlete’s body weight, body composition or body type) from a person important to the individual. Coaches, athletic trainers, sport dietitians and supervising physicians must be watchful for student-athletes at higher risk for eating disorders. Disordered eating can lead to Nutrition and Athletic Performance Eating disorders are often an expression of underlying emotional distress that may have developed long before the individual was involved in athletics. Eating disorders can be triggered in psychologically vulnerable individuals by a single event or comments (such as offhand remarks about appearance, or constant badgering about a studentathlete’s body weight, body composition or body type) from a person important to the individual. 45
46 Nutrition and Athletic Performance dehydration, resulting in loss of muscular strength and endurance, decreased aerobic and anaerobic power, loss of coordination, impaired judgment, and other complications that decrease performance and impair health. These symptoms may be readily apparent or may not be evident for an extended period of time. Many student-athletes have performed successfully while experiencing an eating disorder. Therefore, diagnosis of this problem should not be based entirely on a decrease in athletic performance. Body composition and body weight can affect exercise performance but References 1. Nutrition and Athletic Performance. American College of Sports Medicine, American Dietetic Association, and Dietitians of Canada, Joint Position Stand, Medicine and Science in Sports and Exercise. 109:3:509-527, March 2009 2. The Female Athlete Triad. American College of Sports Medicine (ACSM) Position Stand, Medicine and Science in Sports and Exercise, 39:10: 1-10 2007. 3. Exercise and Fluid Requirements. American College of Sports Medicine (ACSM) Position Stand. 2007 4. Brownell KD, Rodin J, Wilmore JH: Eating, Body Weight, and Performance in Athletes: Disorders of Modern Society Malvern, PA: Lea and Febiger, 1992. should not be used as the main criteria for participation in sports. Decisions regarding weight loss should be based on the following recommendations to reduce the risk of disordered eating. 1. Frequent weigh-ins (either as a team or individually) are discouraged unless part of strategies outlined in Guideline 2c. 2. Weight loss (fat loss) should be addressed during base or transition phases. 3. Weight-loss goals should be determined by the student-athlete and medical and nutritional 5. Dale, KS, Landers DM. Weight control in wrestling: eating disorders or disordered eating? Medicine and Science in Sports and Exercise 31:1382- 1389, 1999. 6. Dick RW: Eating disorders in NCAA athletics programs. Athletic Training 26:136-140, 1991. 7. Sandborn CF, Horea M, Siemers BJ, Dieringer KI. Disordered eating and the female athlete triad. Clinics in Sports Medicine:19:199-213, 2000. personnel, with consultation from the coach. 4. Weight-loss plans should be individualized and realistic. For each student-athlete, there may be a unique optimal body composition for performance, for health and for self-esteem. However, in most cases, these three values are NOT identical. Mental and physical health should not be sacrificed for performance. An erratic or lost menstrual cycle, sluggishness or an obsession with achieving a number on a scale may be signs that a student-athlete's health is being challenged.
Page 1 and 2: 2011-12 NCAA® Sports Medicine Hand
Page 3 and 4: 2 PREFACE The health and safety pri
Page 5 and 6: 4 FOREWORD Shared Responsibility fo
Page 7 and 8: 6 Sports Medicine Administration Oc
Page 9 and 10: 8 Medical Evaluations, Immunization
Page 11 and 12: 10 Medical Evaluations, Immunizatio
Page 13 and 14: 12 Emergency Care and Coverage Guid
Page 15 and 16: 14 Lightning Safety Dangerous Locat
Page 17 and 18: 16 Catastrophic Incident in Athleti
Page 19 and 20: 18 Dispensing Prescription Medicati
Page 21 and 22: 20 Nontherapeutic Drugs July 1981
Page 23 and 24: 22 NCAA Alcohol, Tobacco and Other
Page 25 and 26: 24 Preseason Preparation directly d
Page 27 and 28: 26 Preseason Preparation NCAA Footb
Page 29 and 30: 28 Medical Disqualification of the
Page 31 and 32: 30 Cold Stress and Cold Exposure to
Page 33 and 34: 32 Cold Stress and Cold Exposure Re
Page 35 and 36: 34 Prevention of Heat Illness The A
Page 37 and 38: 36 Prevention of Heat Illness Refer
Page 39 and 40: 38 Assessment of Body Composition J
Page 41 and 42: 40 Assessment of Body Composition i
Page 43 and 44: 42 Assessment of Body Composition p
Page 45: 44 Nutrition and Athletic Performan
Page 49 and 50: 48 Dietary Supplements or muscle ma
Page 51 and 52: 50 “Burners” (Brachial Plexus I
Page 53 and 54: 52 “Burners” (Brachial Plexus I
Page 55 and 56: 54 Concussion or Mild Traumatic Bra
Page 61 and 62: 60 Skin Infections in Athletics In
Page 63 and 64: 62 Skin Infections in Athletics Ski
Page 65 and 66: 64 Skin Infections in Athletics Ref
Page 67 and 68: 66 Menstrual-Cycle Dysfunction Janu
Page 69 and 70: 68 Blood-Borne Pathogens and Interc
Page 75 and 76: 74 The use of local injectable anes
Page 77 and 78: 76 The Use of Injectable Corticoste
Page 79 and 80: 78 Depression: Intervention for Int
Page 81 and 82: 80 Depression: Intervention for Int
Page 83 and 84: 82 Participation by the Student-Ath
Page 85 and 86: 84 Pregnancy in the Student-Athlete
Page 87 and 88: 86 The Student-Athlete with Sickle
Page 89 and 90: 88 should provide an environment in
Page 91 and 92: 90 Protective Equipment June 1983
Page 93 and 94: 92 Protective Equipment Sport 5. Fo
Page 95 and 96: 94 Protective Equipment Mandatory P
Page 97 and 98:
96 Eye Safety in Sports January 197
Page 99 and 100:
98 Mouthguards January 1986 • Rev
Page 101 and 102:
100 Head and neck injuries causing
Page 103 and 104:
102 Guidelines for Helmet Fitting a
Page 105 and 106:
104 Use of Trampoline and Minitramp
Page 108 and 109:
Appendixes Also found on the NCAA w
Page 110 and 111:
NCAA Legislation Involving Health a
Page 112 and 113:
Tobacco Use Medical Expenses Medica
Page 114 and 115:
Student-Athlete Welfare and Safety
Page 116 and 117:
NCAA Injury Surveillance Program Su
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Figure 1 Competition and Practice I
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Acknowledgements John R. Adams West
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The NCAA salutes the more than 400,
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