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"Health Issues of Athletics" concerns the health and wellbeing of athletes participating in an organized sport. Given that these athletes are physically and mentally underdeveloped, they are particularly susceptible to mental or physical issues. Some athletes who intend on improving their performance in sports can actually do harm to their bodies either through disorder eating, overtraining, use of steroids/supplements, and injury.

Eating Disorders

The term eating disorder refers to abnormal eating habits that involve either insufficient or excessive food intake to the detriment of an individual’s physical and mental health. Over-dieting can be extremely harmful to athletes when combined with the increased physical activity. Doctors have recently started to use the term "Female Athlete Triad" for female athletes who have inadequate nutrition, amenorrhea, and low bone mass. Athletes have employed a variety of methods to lose weight, including dehydration, fasting, diet pills, laxatives, vomiting (bulimia), overtraining, even the use of rubber exercise suits. These practices result in “decreased plasma and blood volume, reduced cardiac outputs, impaired thermoregulatory responses, decreased renal blood flow, and an increase in the amount of electrolytes lost from the body.” A female athlete who feels pressured to maintain a certain body weight or appearance may exercise excessively and/or restrict calorie intake. Other effects include changes in mood: feelings of tension, depression, anger, fatigue, and confusion. A lack of estrogen and nutrients such as calcium can actually cause a loss in bone density or formation, which increases the risk for injury. Poor nutrition can also lead to hormonal changes that stop menstrual periods. These pressures may also be rooted in the relations between men and women. Female athletes participate sport culture that is innately masculine but struggle with their body image in a society where femininity is praised. Some athletes develop a poor body image, perceive themselves as too masculine, and were worry they were unattractive to men. Some female athletes struggle with their physicality in a society where femininity is praised. The pressure to please is intense, and correspondingly, 42% of female aesthetic athletes have been diagnosed with eating disorders. Furthermore, although the Female Athlete Triad is specifically termed for diagnosis among female athletes, girls and women participating in a wide range of physical activities are at risk. There is a very distorted meaning of both femininity and masculinity in today's society that often emphasizes appearance and body size. This is an issue that is not limited in significance to just female athletes, but one that can be extended to the general female population because most females face societal pressure to be thin at some point in their lives. Societal perpetuation of the ideal body continues to intensify young women athletes desire to be thiner in order to enhance perform. While aiming to restore the affected individuals' physical and mental health, these efforts extend beyond the realm of the athletic field to address the deeper social influences being placed on the individual. Family, peers, and coaches all play key roles in contributing to the risk factors associated with eating disorders, however influential they may be. While the issue presents itself for many male and female athletes, the pressures are rooted in the greater societal pressures to be thin, which continue to effect males and females at large. Thus, the cultural obsession with being thin as a physical, psychological, and moral issue must be addressed.

While any sport can create an environment in which an eating disorder may arise, certain sports place a heavier emphasis upon weight and body image as ingredients for success in competition. Certain sports are more likely to breed eating disorders if the appearance of the athlete a performance factor or is implied through the culture of the activity. Athletes in sports such as wrestling, boxing, gymnastics and skating often feel the pressure to lose large amounts of weight in order to compete at their peak performance levels.

Wrestling

Though there is no concrete data on the prevalence of eating disorders in wrestling, the sport's emphasis on eating and exercise plans can facilitate behaviors that may be harmful to their health. From the youth to the collegiate level, wrestlers compete is various weight classes to ensure the athletes are fairly matched. As a result, many wrestlers participate— whether it is self-motivated and encouraged by their coach—in fasting, purging, or over-exercising. In order to compete, 81% of wrestlers will deliberately lose weight. This involves shedding 3% to 20% of their body weight—most of which being dropped within a short period of time. The issue gained a lot of attention in when three collegiate wrestlers died within a 32-day period in order to 'make weight' according to an article in 1998 on "The Effects of Dehydration on Wrestling Performance and Health." It has been postulated that wrestlers may suffer impaired growth and development due to their fluctuating body weight. However, a study examining high school wrestler growth patterns concluded that participation does not stunt growth.

Gymnastics

For rhythmic gymnasts, “success is strongly influenced by visual appeal and body aesthetics. Rhythmic gymnasts are often required to meet certain weight targets to attain and maintain a thin shape.” Various studies have estimated that as many as 60% of female gymnasts in the United States have felt pressure at some point in their competitive career to engage in eating disorder practices. As a result of disordered eating, Young female gymnasts may suffer from delayed menarche, menstrual irregularities, low body fat, and delayed maturity. Of these athletes, 11% are at risk for a mental disorder, while 40% risk delayed physical maturation. According to an article on "Athletes and Eating Disorders: The National Collegiate Athletic Association Study," the there has been a trend in gymnastics to reward thinness and the average weights continue to decline significantly. In 1972, the winning female gymnastics team had an an average height 5 ft 3 inches and weight of 106 lb and in 1992 the average height was an average height 4 ft 9 inches and weight of 83 lb.

Treatment

Because eating disorders can be both physically and emotionally harmful, the most effective and long-lasting treatment for an eating disorder is some form of psychotherapy or some form of professional help. Treatment must address the eating disorder symtoms— psychological, biological, interpersonal, and cultural influences that contribute to the athlete's disordered eating. Early diagnosis and intervention enhances the effectiveness in the recovery period. Because the physiological and psychological complexities behind disordered eating, treatment for female athletic triad may require medical professionals including a doctor, gynecologist, physician, trainer, nutritionist, and/or counselor. Recovery depends on the wiliness of the athlete and hard work from professional help. Effective treatments can take many months or even years depending on the severity and may vary depending on the type of disorder. In more severe cases, inpatient care or hospitalization is available when the patient's eating disorder is life-threatening or has reached a level of serious behavioral problems. For females who are suffering from the female athlete triad, the athlete should be treated using a multidisciplinary approach. The main goal in treatment is a natural return of menses as well as enhancement of bone mineral density. So far, no specific drug intervention has been shown to consistently improve bone mineral density for females suffering from eating disorders; it is, however, recommend to maximize energy availability by optimizing vitamin D and calcium intake. In severe cases, the potential damage of osteoporosis may be irreversible. Education and treatment efforts about the Triad and its possible devastating consequences is encouraged for both females and female athletes themselves as well as their parents, coaches, and peers.

Overtraining

A female athlete who feels pressured to maintain a certain physique or body weight may exercise excessively and develop eating disorders to restrict calorie intake. Overtraining includes one condition of the female athlete triad. As her body's need for rest increases and her overall energy declines as a result of over-exercising, her total body fat decreases and her estrogen is reduced--a condition known as amernorrhea. Both male and female athletes may feel the pressure to overtrain excessively in order to achieve a certain body image. The human body has a tremendous capacity to adapt to physical stress. Stress not only refers to physical stress but can also refer to physical stress, which is simply exercise and activity, is beneficial for our bones, muscles, tendons, and ligaments, making them stronger and more functional. This is also known as "remodeling" which involves both the breakdown and buildup of tissue. However, if the breakdown occurs more rapidly than buildup, an overuse injury occurs. Nearly half of all injuries in pediatric sports medicine are due to overuse. An overuse injury is a micro traumatic damage to a bone, muscle, or tendon that is subjected to repetitive stress without time to heal naturally as a result of long and/or high intensity workouts. Many youth athletes are participating in sports year-round or on multiple teams at once. Another factor could include parental pressure to compete and succeed. Other risk factors include sleep deprivation, general physical and cognitive immaturity, dietary imbalance and inadequate physical fitness. Among young athletes, common overuse injuries are stress fractures, which include injury of the:

• femoral neck/pubic ramus
• femoral shaft
• tibia
• fibula
• metatarsals
• calcaneus
• cuboid

'Overtraining Syndrome' is a term that has been used to describe athletes who are training for competition and train beyond the body's ability to recover naturally. Common warning signs include tiredness, soreness, drop in performance, headaches, loss of enthusiasm. Without adequate rest and recovery, training regimens can backfire, eventually decreasing an athlete's performance. Overtraining can also be associated with eating disorders: athletes may turn to excessive exercise in order to loss weight. In cases where athletes are overtraining, the most effective treatment is rest and proper nutrition.

Supplements/Steroids

Anabolic steroids are artificially produced hormones called androgens, which are essentially male-type sex hormones in the body. The most powerful of the androgen is testosterone. Another group of steroids include steroidal supplements, a weaker form of androgen. Steroids and supplements are controversial in their use for sports because of the health risks associated with them. Some serious and long-term effects on the body include hair loss, dizziness, mood swings, delusion, paranoia, high blood pressure, increased risk of heart disease, stroke, and even cancer. Newer studies also suggest that steroid users had an increase risk of depression and alcohol use later in life: doctors are calling this the 'snowball effect' of steroid-related health problems. Injury patterns of steriods suggest that joint ligaments aren't able to adapt to steroid-induced muscles and are leading to injury.

Illness

Heat illness and dehydration are typically brought on by conditions of high temperatures and high humidity. These conditions carry increased risk for young athletes, particularly if at the beginning of a season when they are less fit. Other factors, which increase vulnerability include: heat-retaining clothing, recent illness, previous experience with heat illness, chronic conditions, or sleep deprivation. Additional precaution is to be taken if the child is taking supplements or using cold medication.

Heat illnesses are among the primary causes of sports-related death or disability, and as such they require immediate medical attention. Symptoms to watch for are as follows:

• dry or sticky mouth
• headache
• dizziness
• cramps
• unusual fatigue
• confusion
• loss of consciousness

Injury

Sports injury is often the result of overuse or trauma to a part of the body due when participating in a certain sports-related activity. An issue unique to youth athletics is that the participants’ bones are still growing, placing them at highest risk for injury. Around 8,000 children are rushed to the emergency room daily because of sports injuries. High school athletes suffer approximately 715,000 injuries annually. Regarding American football, there are five times more catastrophic injuries in high school than compared to college-level competition. Some injuries include heat illness and dehydration, concussions, and trauma-related deaths. Heat illnesses are a recent concern in youth athletics. They include heat syncope, muscle cramps, heat exhaustion, heat stroke and exertional hyponatremia. Per year, high school athletes sustain 300,000 head injuries, 90% of which being concussions. Though by the beginning of high school, 53% of athletes will have already suffered a concussion. Less than 50% of them say something about it in order to stay in the game. Ice hockey, soccer, wrestling and basketball carry a high risk for concussion, with football at the top. A history of concussion in football players can contribute to sports-related sudden death.

Prevention

To prevent sport-related injury, a proper warm-up is extremely important because it allows the athlete to increase their heartrate along with dynamic stretching--warm-ups should be sports-specific. A proper warm up allows for an increased muscle temperature. Warm muscles are less susceptible to injuries because they can contract more forcefully and relax more quickly. This way, both speed and strength can be enhanced. Also, the probability of over-stretching a muscle and causing injury is far less. Other forms of prevention include strengthening muscles, increasing flexibility, proper technique, taking breaks, weight training, and playing safe. Warm ups also increase body and blood temperature which allows more oxygen to reach the muscles, improves muscle elasticity, and reduces the risk of strains and pulls. Mental preparation is also an important before practice or games. Clearing the mind and visualizing skills and strategy can relax the athlete's muscles and build concentration.

Sports-related death

Sometimes sports injuries can be so severe as to result in actual death. Over the past year, 48 youths died from sports injuries. The leading causes of death in youth sports are sudden cardiac arrest, concussion, heat illness and external sickling. Cardiac-related deaths are usually due to an undiagnosed cardiovascular disorder. Trauma to the head, neck and spine can also be lethal. Among young American athletes, more than half of trauma-related deaths are to football players, with track and field, baseball, boxing and soccer also having relatively high fatality rates.