Olympic Textbook Of Medicine In Sport


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OLYMPIC TEXTBOOK OF MEDICINE IN SPORT

OLYMPIC TEXTBOOK OF MEDICINE IN SPORT
VOLUME XIV OF THE ENCYCLOPAEDIA OF SPORTS MEDICINE AN IOC MEDICAL COMMISSION PUBLICATION EDITED BY PROFESSOR MARTIN P. SCHWELLNUS, MBBCh, MSc, MD
A John Wiley & Sons, Ltd., Publication

This edition first published 2008, © 2008 International Olympic Committee Published by Blackwell Publishing Ltd

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Library of Congress Cataloging-in-Publication Data

The Olympic textbook of medicine in sport / edited by Martin Schwellnus. p. ; cm. – (Encyclopaedia of sports medicine ; v. 14)
“An IOC Medical Commission publication in collaboration with the International Federation of Sports Medicine.”
Includes bibliographical references. ISBN 978-1-4051-5637-0 (alk. paper) 1. Sports medicine. I. Schwellnus, Martin. II. IOC Medical Commission. III. International Federation of Sports Medicine. IV. Series. [DNLM: 1. Sports Medicine. 2. Athletic Injuries. 3. Athletic Performance. QT 13 E257 1988 v.14]

RC1210.O46 2008 617.1’027– dc22
ISBNs: 978-1-4051-5637-0; 978-1-4051-9077-0 (leather bound)

2008005042

A catalogue record for this book is available from the British Library.

Set in 9/12 pt Palatino by Graphicraft Limited, Hong Kong Printed and bound in Malaysia by Vivar Printing Sdn Bhd

1 2008

Contents

List of Contributors, vii
Foreword, x
Preface, xi
1 General Principles of Training, 1 michael i. lambert, wayne viljoen, andrew bosch, alan j. pearce and mark sayers
2 Adaptations to Training, 49 Introduction, 49 iñigo mujika Models of fatigue, 49 shona halson and iñigo mujika Neuromuscular adaptations to training, 67 nicholas a. ratamess and mikel izquierdo Metabolic adaptations to training, 78 john a. hawley and gustavo a. nader Endocrine adaptations to training, 87 michael kjÆr, simon doessing and katja peltola mjØsund
Cardiorespiratory adaptations to training, 93 darren e.r. warburton, a. william
sheel and donald c. mckenzie
Adaptations of bone and connective tissue to training, 111
pekka kannus, riku nikander, harri sievänen and iñigo mujika

3 The Overtraining Syndrome: Diagnosis and Management, 138 romain meeusen
4 Clinical Exercise Testing and Assessment of Athletes, 160 robert u. newton, paul b. laursen and warren young
5 Clinical Myology in Sports Medicine, 200 wayne e. derman, martin p. schwellnus, dale e. rae, yumna albertus-kajee and michael i. lambert
6 Sports Cardiology, 232 christos kasapis and paul d. thompson
7 Sports Pulmonology, 268 joseph cummiskey, kai-håkon carlsen, keun-youl kim, conleth feighery, andrew green, fabio pigozzi, walter canonica, vito brusasco, stefano del giacco, sergio bonini and matteo bonini
8 Endocrinology, 302 jeffrey m. anderson, thomas h. trojian and william j. kraemer
9 Dermatology, 326 brian b. adams
10 Exercise and Infections, 344 martin p. schwellnus, austin jeans, sello motaung and jeroen swart

v

vi contents
11 Gastrointestinal System and Exercise: A Clinical Approach to Gastrointestinal Problems Encountered in Athletes, 365 martin p. schwellnus and john wright
12 Exercise and the Kidney, 375 brian rayner and martin p. schwellnus
13 Obstetrics and Gynecology, 390 raul artal and susan hoffstetter
14 Neurologic Problems in Sport, 412 paul mccrory
15 Medical Care of the Disabled Athlete, 429 douglas b. mckeag and chris klenck

16 Environmental Sports Medicine, 444 timothy d. noakes, tamara hew-butler and ross tucker
17 Drugs in Sport, 482 don h. catlin, gary green and caroline k. hatton
18 Emergency Sports Medicine, 504 lucy-may holtzhausen and chris hanna
19 Genetics and Sports Participation, 548 kyriacos i. eleftheriou and hugh e. montgomery
20 Sports Nutrition: Practical Guidelines for the Sports Physician, 580 louise m. burke
Index, 601

List of Contributors

B R I A N B . A D A M S MD, MPH, Department of
Dermatology, University of Cincinnati, Cincinnati, OH, USA, and Veterans Administration Medical Center, Cincinnati, OH, USA
Y U M N A A L B E R T U S - K A J E E Bsc(Med),
UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa
J E F F R E Y M . A N D E R S O N MD, Division
of Athletics, University of Connecticut, Storrs, CT, USA
R A U L A R T A L MD, Department of Obstetrics,
Gynecology and Women’s Health, St. Louis University, School of Medicine, St. Louis, MO, USA
M A T T E O B O N I N I MD, IRCCS San Raffaelo,
Rome, Italy
S E R G I O B O N I N I MD, IRCCS San Raffaello,
Rome, Italy
A N D R E W B O S C H PhD, UCT/MRC Research
Unit for Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, South Africa
V I T O B R U S A S C O MD, Department of Internal
Medicine, Genoa University, Genoa, Italy
L O U I S E M . B U R K E PhD, APD, Department of
Sports Nutrition, Australian Institute of Sport, Bruce, ACT, Australia, and Deakin University, Melbourne, Victoria 3125, Australia

W A L T E R C A N O N I C A MD, Department of
Allergy and Respiratory Disease Clinic, Department of Internal Medicine, Genoa University, Genoa, Italy
K A I - H Å K O N C A R L S E N MD, PhD, University
of Oslo, Norwegian University of Sport and Physical Education, Oslo, Norway
D O N H . C A T L I N MD, Department of Molecular
and Medical Pharmacology, University of California, Los Angeles, Anti-Doping Research, Inc., Los Angeles, CA, USA
J O S E P H C U M M I S K E Y MD, The Blackrock
Clinic, Blackrock, Dublin, Ireland
S T E F A N O D E L G I A C C O MD, Policlinico
Universitario, University of Cagliari, Monserrato, Italy
W A Y N E E . D E R M A N MBChB, PhD,
UTC/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa
S I M O N D O E S S I N G MD, Institute of Sports
Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen, Denmark
K Y R I A C O S I . E L E F T H E R I O U MBBS,
MRCS(Ed), UCL Centre for Health and Human Performance, Royal Free and University College Medical School, London, UK
C O N L E T H F E I G H E R Y MD, Department of
Immunology, St. James’ Hospital and Trinity College Dublin, Dublin, Ireland

viii list of contributors

A N D R E W G R E E N PhD, National Centre for
Medical Genetics, University College Dublin, Ireland
G A R Y G R E E N MD, Division of Sports Medicine,
University of California, Los Angeles, and Pacific Palisades Medical Group, Pacific Palisades, CA, USA
S H O N A H A L S O N PhD, Department of Physiology,
Australian Institute of Sport, Belconnen, ACT, Australia
C H R I S H A N N A MBChB, Adidas Sport Medicine
Center, St. Johns, Auckland, New Zealand
C A R O L I N E K . H A T T O N PhD, Anti-Doping
Research, Inc., Los Angeles, CA, USA
J O H N A . H A W L E Y PhD, Exercise Metabolism
Group, School of Medical Sciences, RMIT University, Bundoora, Victoria, Australia
T A M A R A H E W - B U T L E R PhD, UCT/MRC
Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Sports Science Institute of South Africa, South Africa
S U S A N H O F F S T E T T E R PhD, Department of
Obstetrics, Gynecology and Women’s Health, St. Louis University, School of Medicine, St. Louis, MO, USA
L U C Y - M A Y H O L T Z H A U S E N MBBCh, BSc,
Auckland Family Medical Center, Remuera, Auckland, New Zealand
M I K E L I Z Q U I E R D O PhD, Studies, Research
and Sport Medicine Center, Government of Navarra, Pamplona, Spain
A U S T I N J E A N S MBBCh, BSc, Centre for Sport and
Exercise Medicine, Harare, Zimbabwe
P E K K A K A N N U S MD, PhD, Accident and Trauma
Research Center, UKK Institute, Tampere, Finland
C H R I S T O S K A S A P I S MD, Department of
Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA
K E U N - Y O U L K I M MD, MPH, PhD, Medical
College of Seoul National University, Seoul, Korea

M I C H A E L K J Æ R MD, PhD, Institute of Sports
Medicine, Copenhagen University Hospital at Bispebjerg, Copenhagen, Denmark
C H R I S K L E N C K MD, University of Tennessee,
Knoxville, TN, USA
W I L L I A M J . K R A E M E R PhD, Human
Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
M I C H A E L I . L A M B E R T PhD, UCT/MRC
Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa
P A U L B . L A U R S E N PhD, School of Exercise,
Biomedical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
P A U L M C C R O R Y MBBS, PhD, Centre for Health,
Exercise and Sports Medicine, University of Melbourne, Parkville, Victoria, Australia
D O U G L A S B . M C K E A G MD, MS, IU Center
for Sports Medicine, Department of Family Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA
D O N A L D C . M C K E N Z I E MD, PhD, Division
of Sports Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
R O M A I N M E E U S E N PhD, Vrije Universiteit
Brussel, Faculteit LK – Department of Human Physiology & Sports Medicine, Brussels, Belgium
K A T J A P E L T O L A M J Ø S U N D MD,
Biomedicum – Helsinki, Helsinki University, Finland
H U G H E . M O N T G O M E R Y MBBS, MRCP,
MD, UCL Centre for Health and Human Performance, Royal Free and University College Medical School, London, UK
S E L L O M O T A U N G BSc, MBBCh, Centre
for Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

list of contributors ix

I Ñ I G O M U J I K A PhD, Department of Research and
Development, Athletic Club Bilbao, Spain
G U S T A V O A . N A D E R PhD, Department of
Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
R O B E R T U . N E W T O N PhD, School of Exercise,
Biomedical and Health Sciences Edith Cowan University, Joondalup, Western Australia, Australia
R I K U N I K A N D E R MD, PhD, Accident and Trauma
Research Center, UKK Institute, Tampere, Finland
T I M O T H Y D . N O A K E S MBChB, MD, DSc,
UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Sports Science Institute of South Africa, South Africa
A L A N J . P E A R C E PhD, Centre for Aging,
Rehabilitation, Exercise and Sport (CARES), School of Human Movement, Recreation and Performance, Victoria University, Melbourne, Victoria, Australia
F A B I O P I G O Z Z I MD, Internal Medicine Unit,
Department of Health Services, University of Rome (IUSM), Rome, Italy
D A L E E . R A E PhD, UCT/MRC Research Unit for
Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa
N I C H O L A S A . R A T A M E S S PhD, Department
of Health and Exercise Science, The College of New Jersey, Ewing, NJ, USA
B R I A N R A Y N E R MBChB, MMed, Department of
Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
M A R K S A Y E R S PhD, Centre for Healthy Activities,
Sport and Exercise (CHASE), Faculty of Science, Health and Education, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia

M A R T I N P . S C H W E L L N U S MBBCh,
MSc, MD, UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, South Africa
A . W I L L I A M S H E E L PhD, School of Human
Kinetics, University of British Columbia, Osborne Centre, Vancouver, BC, Canada
H A R R I S I E V Ä N E N MD, PhD, Accident and
Trauma Research Center, UKK Institute, Tampere, Finland
J E R O E N S W A R T MBChB, UCT/MRC Research
Unit for Exercise Science and Sports Medicine, Department of Human Biology, Sports Science Institute of South Africa, South Africa
P A U L D . T H O M P S O N MD, Preventive
Cardiology & The Athletes’ Heart Program, Division of Cardiology, Hartford Hospital, Hartford, CT, USA
T H O M A S H . T R O J I A N MD, Division of
Athletics, University of Connecticut, Storrs, CT, USA
R O S S T U C K E R PhD, UCT/MRC Research Unit for
Exercise Science and Sports Medicine, Department of Human Biology, Sports Science Institute of South Africa, South Africa
W A Y N E V I L J O E N PhD, Sport Science Institute
of South Africa, Newlands, Cape Town, South Africa
D A R R E N E . R . W A R B U R T O N PhD, School
of Human Kinetics, University of British Columbia, Vancouver, BC, Canada
J O H N W R I G H T MBChB, PhD, Fairfield Suites,
Kingsbury Hospital, Claremont, South Africa
W A R R E N Y O U N G PhD, School of Human
Movement and Sport Sciences, University of Ballarat, Ballarat, Victoria, Australia

Foreword
This Volume represents the XIVth volume of The Encyclopaedia of Sports Medicine series, scientific publications by the IOC Medical Commission which began in 1988 with Volume I, The Olympic Book of Sports Medicine. To produce each volume, the most respected clinicians and scientific investigators have collaborated to produce reference texts that are both comprehensive for the topic and representative of the leading edge of knowledge.
The positive impact of the Encyclopaedia on a central theme, the health and welfare of all persons participating in sport, has exceeded all expectations.
Volume XIV, The Olympic Textbook of Medicine in Sport, addresses the clinical issues that were included in the original Volume I and synthesizes the new research information that has been published during the intervening 20 years. I wish to congratulate Professor Martin Schwellnus and all of the Contributing Authors on the excellent quality of this publication.
Dr Jacques Rogge President of the International Olympic Committee

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Olympic Textbook Of Medicine In Sport