MEDICAL CONTROL in physical culture and sports- the system of medical supervision in the USSR for persons involved in physical culture and sports, aimed at the effective use of means and methods of physical. education, health promotion, improvement of physical. development and physical preparedness of the population. V. to. is one of sections of sports medicine (see). The founder of the ideas of scientific substantiation of physical. education is P. F. Lesgaft; his student V. V. Gorinevsky deserves the merit of developing the foundations of V. to. as a system of honey. services for athletes and athletes.
The resolution of the party and government on the development of physical culture and sports, in particular the resolution of the Council of People's Commissars of the RSFSR of 1928, the resolution of the Central Executive Committee of the USSR of 1930 and the Central Committee of the All-Union Communist Party of Bolsheviks of 1932, ) of 1948, the resolution of the Central Committee of the CPSU and the Council of Ministers of the USSR of 1966 on measures for the further development of physical culture and of 1972 on the introduction of a new All-Union sports complex"Ready for Labor and Defense of the USSR" (TRP). Creation in 1950 of a network of specialized to lay down. - prof, establishments - medical and sports dispensaries (see Dispensary, medical and sports) - promoted V.'s organization to. and development of its methods. V. to. as a system of honey. provision of those involved in physical education and sports is carried out by medical and physical education dispensaries (republican, regional, city, district), as well as medical control rooms in clinics, universities, voluntary sports societies, children's and youth sports schools. The current regulation on V. to. provides for the participation of general doctors to lay down. - prof., networks in monitoring people involved in physical education and sports. The general management of the medical and physical education service is carried out by a medical professional, a department of the USSR Ministry of Health. The Committee for Physical Culture and Sports under the Council of Ministers of the USSR has a special medical and biological department, which, together with the health authorities, organizes V. to. over groups of the country's leading athletes.
V. to. in physical education and sports consists of a number of sections: 1) medical examinations of persons involved in physical education and sports; 2) medical and pedagogical observations directly in the course of classes; 3) medical and sports consultation; 4) san.-gig. supervision of places of employment and competitions; 5) dignity.-clearance, work; 6) health care sports competitions and mass sports and health events.
During the medical examination, methods of clinical examination and functional diagnostics are used, as well as special techniques developed in sports medicine. The frequency, volume and content of the medical examination are determined by the contingent of those involved - their age, gender, nature of activities, sports qualifications, respectively, with which the examination is carried out according to a short or in-depth methodology.
An examination according to a brief methodology (in form 227) to resolve issues of admission to classes, check their impact on health and physical development is subject to persons of the following categories: those involved in the compulsory physical program. education in educational institutions; preparing to pass the TRP standards; engaged in groups of general physical. training, in sports teams of industrial enterprises, institutions, collective farms, state farms, etc. According to a brief method of medical examination, a physical examination is carried out, basic anthropometric measurements (determination of weight, height, muscle strength etc.), clinical analyzes of urine and blood. If necessary, the general practitioner conducting the examination involves other specialists. These examinations are carried out by doctors of district clinics, first-aid posts of stadiums, swimming pools and other sports facilities, doctors of health posts of industrial enterprises, as well as doctors of secondary and higher educational institutions. This work is carried out under the general organizational and methodological guidance of medical and physical education dispensaries. Examination of students in secondary schools, vocational schools, technical schools and universities is timed to coincide with the beginning of school year. Based on the state of health, development and physical preparedness, students are divided into three honey. groups for physical education (basic, preparatory and special).
In the main honey. the group enrolls persons who do not have deviations in the state of health or have minor changes with sufficient physical. readiness. They are shown classes in the curriculum in full, passing the control standards of the TRP, playing sports, participating in competitions.
In preparatory honey. the group includes persons who have minor deviations in the state of health, but are not physically fit enough, and therefore a nek-swarm restriction and gradual increase in loads, exclusion (sometimes temporary) of competitions are required. In a special honey. the group is enrolled by persons with diseases, with which group classes can be held only according to special programs; according to indications exercise therapy classes in a polyclinic or in a medical and physical education dispensary. This takes into account the nature of the disease, the level of physical. readiness, etc. Medical examination of contingents of middle and old age, in particular, before enrolling in groups of general physical. preparation, in preparation for passing the standards of the 5th stage of the TRP complex "Venerosity and Health", additionally include an electrocardiographic study. In addition, to determine the degree of age-related changes cordially- vascular system or identifying signs of a latent pathology, a modified Master's test is used - climbing and descending a two-step ladder with a total height of 40 cm (step height 20 cm). The duration of the test is 2 - 3 minutes. (depending on the physical fitness of the subject) at a constant pace - 20 transitions per 1 minute; You can use other options for ladder test. Before and after the test, the pulse is counted, blood pressure is measured, and an electrocardiogram is recorded.
When deciding on admission to physical education and passing the TRP standards, the doctor also takes into account the data on the appeal for medical care on the basis of an extract from the outpatient card of the polyclinic submitted by the subject.
An examination according to an in-depth methodology is carried out in the course of dispensary observation of highly qualified athletes (according to form 227a). Clinical examination is based on the principles of a comprehensive study of the main fiziol, body systems, the functional orientation of research methods, a differentiated approach depending on the sports specialization of the subject; individual assessment of the results of the examination, the dynamic nature of medical observations. Highly qualified athletes are subjected to in-depth medical examination.
Medical examination of athletes according to an in-depth methodology is carried out by medical and physical education dispensaries and doctors of voluntary sports societies. The study is carried out by a therapist-specialist in V. to., In necessary cases, a neuropathologist, oculist, surgeon, dentist, gynecologist, etc. are involved. A detailed general and sports history is collected, a physical examination, clinical urine and blood tests are performed, and the necessary instrumental methods are used including obligatory X-ray and electrocardiographic examinations), special functional tests are carried out.
Particular importance is attached to V. to. over athletes high ranks, participants of city, republican, all-Union and international competitions, incl. Olympic Games.
The in-depth medical examination program includes examinations at the main stages of the annual training cycle, timed to coincide with the preparatory and competitive periods of training (2-3 times a year), and additional examinations according to indications. The main objectives of an in-depth medical examination are: a) evaluation of the effectiveness of the applied modes and training methods; checking the impact of systematic training on health, physical development and sports performance; b) determination of readiness for the upcoming competitions (assessment of "sports form") in order to recommend selection for national teams; c) appointment effective methods and means of restoring and maintaining high performance (vitamins, restorative agents, etc.), preventing the state of overtraining (reducing the volume and intensity of the load, its nature, if necessary, the appointment of therapeutic measures).
Determination of the impact of systematic training on physical. development is established by external examination and anthropometric measurements of height, weight, circumference chest, vital capacity of the lungs, backbone strength, hand strength, diameters and perimeters of various parts of the body, etc. Assessment of physical. development is carried out on a five-point system (low, below average, average, above average, high) based on local physical standards. development or special correlation tables (see Physical development).
When examining adolescents, the degree of puberty is also determined; at the same time, the development of secondary sexual characteristics (according to the method of Aron and Stavitskaya) is taken into account - the degree of hair growth of the pubis, armpits, the development of the mammary glands, the time of the onset of menstruation, etc. The proportions of the body are determined to characterize the type of physique (one of the criteria for sports selection, see the section below medical sports consultation). The study of physical development allows you to correctly assess the individual data of the athlete, to trace the dynamics of physical. development in progress regular classes sports, the impact of a particular sport on physical improvement.
An in-depth technique of V. to. makes it possible to identify certain morphological and functional changes in the body that occur during regular training, as well as disorders associated with overtraining and overstrain. For this purpose, research indicators are very important. of cardio-vascular system. Thus, a typical result of repeated training with heavy loads, especially in sports that develop endurance, is a physiological increase in the heart in athletes due to tonogenic dilatation of its cavities and myocardial hypertrophy.
Moderate expansion of the cavities of the heart is physiologically reduced to an increase in the residual (reserve) intraventricular blood volume during rest, due to which cardiac output can increase significantly during intense muscular work.
Changes in the main functions of the heart (automatism, excitability and conduction), to-rye may occur in connection with systematic training, are reflected in the electrocardiogram. Trained athletes at rest often have severe sinus bradycardia (40-60 beats per minute) with moderate sinus arrhythmia and signs of myocardial hypertrophy (see Bradycardia, Heart, heart and sports).
An expression of the economical form of heart activity at rest, which develops with increasing training, is, in addition to slowing down the rhythm, also a decrease in the initial rate of increase in intraventricular pressure, stroke and minute blood volumes.
In the presence of foci of hron, infection, as well as with significant overvoltage due to excessive loads, changes in the ECG may appear, reflecting changes in myocardial metabolism: impaired intraventricular conduction, lengthening of atrioventricular conduction, electrical systole of the heart; rhythm disturbances, biphasic or inversion of the T waves, displacement of the RS-T segment downward from the isoline, an increase in the QRS-T angle over 60 ° or more.
To assess the performance of the heart, if necessary, use the methods of polycardiography (see), determine the stroke and minute blood volumes - gas analytical, dilution of the dye (Stuart-Hamilton method), etc. With intense muscular work, the minute blood volume in athletes reaches 30 l / min and more. A number of athletes observed so-called. syndrome of controlled hypodynamia of the myocardium (V. L. Kariman, 1959). In these cases, the structure of the cycle changes heart contraction. So, on the polycardiogram with an increase in the duration of the cardiac cycle, the phase of asynchronous and isometric contractions, there is a decrease in the relative duration of the ejection phase and the duration of the mechanical systole. These changes cause an increase in the potential of the trained heart. Strengthened muscular work causes the transition of the state of regulated hypodynamia of the myocardium into a state of hyperdynamia. This shortens the phase. isometric contraction and expulsion, the intrasystolic index increases, i.e. most of the energy of cardiac contraction is spent on the expulsion of blood. These changes cause an increase in the potential of the trained heart.
To check the system blood pressure(maximum, minimum and average), the speed of propagation of the pulse wave, the degree of correspondence of peripheral resistance to minute volume of blood and other indicators of hemodynamics use the methods of sphygmography (see) and tachooscillography (see Oscillography). The use of venous occlusive plethysmography (see) makes it possible to quantify the state of muscle blood flow and its changes due to increased fitness. With the growth of fitness, a tendency to a nek-rum decrease in blood pressure is determined in a state of muscle rest.
When researching respiratory system use clinical and instrumental methods of research, incl. h. determination of respiratory volumes (frequency, depth and rhythm of breathing, minute volume of breathing, vital capacity of the lungs, maximum arbitrary pulmonary ventilation, strength of the respiratory muscles, etc.). Assessment of respiratory volumes and their changes under the influence of physical. load and in the process of increasing fitness is carried out by comparing the actual values with the "proper" according to special formulas and tables (A. G. Dembo et al., 1939). With an increase in training in a state of muscle rest, a more economical type of breathing is observed: its frequency slows down, and its depth increases. The highest values of lung capacity (up to 6-7 l) and maximum voluntary ventilation of the lungs (up to 100-200 l) are determined in athletes involved in sports that develop endurance - in rowers, swimmers, skiers, etc.
Research nervous system include definition of function of cranial nerves, motive and sensitive spheres, studying of vegetative reflexes (see). Orthostatic, clinoorthostatic tests are used (see. Orthostatic tests), the oculo-cardiac reflex (see) and dermographism (see) are examined. Special tests are carried out to determine the latent period of a motor reaction, coordination of movements, etc. According to indications (consequences of traumatic brain injuries, repeated knockouts, residual effects of neuroinfection, etc.), electroencephalography (see), electromyography (see) and other special methods are used . Based on the examination data, the neuropsychic status of the athlete is determined; possible deviations are recorded.
To obtain data on the functional state of the cardiovascular and other basic fiziol, systems of the athlete's body, to identify early signs of a violation of sports performance in the process of in-depth medical examination, functional tests with dosed physical are used. loads. So called. dynamic functional tests allow you to monitor the fitness of an athlete and the adaptation of the body to increased loads.
The most widely used are tests with dynamic muscle load, in particular, a combined three-moment functional test for speed and endurance (20 squats for 30 seconds, 15-second fast running in place and 3-minute running in place at an average pace - 180 steps per 1 min using metronome). During the study after each load for 3 - 4 minutes. pulse rate and blood pressure are recorded. The evaluation of the results of the test is carried out by changing these indicators in absolute terms and as a percentage of the initial data, which determines the nature of the reaction to the load and the recovery time of the studied functions after it. Five types of reactions were identified. I. Normotonic reaction, characterized by a moderate increase in heart rate (60-100% of the original) and an increase in blood pressure (the maximum should not increase by more than 20-40%, and the minimum should decrease by more than 10-35%), as well as a short ( 1-3 min.) recovery period (return to the original data). Usually this reaction is determined in athletes in a state of good fitness. II. Asthenic (hypotonic), with a significant increase in heart rate (120 -150% of the original) with a slight increase in maximum pressure and lengthening of the recovery period. It is observed in undertrained athletes or in a state of fatigue. III. Hypertonic, with a large increase in maximum pressure (up to 200 - 220 mm Hg) and a significant increase in heart rate, as well as a certain increase in minimum pressure. It is found more often in individuals with hypertension or the initial stages of hypertension. IV. With a "stepped" rise in maximum blood pressure, when immediately after the load its level is lower than at the 2nd, and sometimes even at the 3rd minute of the recovery period. It is observed with poor adaptability of the body to physical. load, in particular during overwork, including after previous significant physical. loads. V. Dystonic, at which the minimum pressure is not determined due to the sound of an “endless tone” (see Blood pressure), and the maximum pressure rises significantly (sometimes over 200 mm Hg). If the "endless tone" lasts no more than 1-2 minutes after a normal functional test, it can be considered physiological. A longer preservation of the "endless tone" requires a medical examination to identify the causes of its occurrence. There is a pronounced increase in heart rate, the recovery period is slow. The dystonic reaction is due to an increase in the true pulse amplitude, kinetic energy blood during systole and a change in the elastic properties of the vessels, which is confirmed by an increase in the volumetric rate of cardiac output, the speed of propagation of the pulse wave and other indicators of vascular tone. The dystonic reaction is most often determined in young people (15-24 years old) and is not regarded as a pathological reaction. However, it can also occur in a state of fatigue after previous significant physical. stress or as one of the signs of vascular-vegetative dystonia (along with other manifestations of this disease).
Normotonic reaction is the most favorable type of adaptation of the circulatory apparatus to the loads of a functional test.
In order to determine the physical performance of sportsmen-dischargers, a functional test is used - the PWC170 test (the test is recommended by WHO); PWC - the first letters of the words Physical Working Capacity - physical performance. The use of the test is based on the premise that the heart rate is 170 beats. in 1 min. corresponds optimal conditions functioning of the cardiovascular system in conditions of large sports loads and that the linear relationship between heart rate and work power is maintained up to 160 bpm. in 1 min. The test consists in the fact that the athlete performs two loads on a bicycle ergometer, each of which lasts 5 minutes, with a rest of 3 minutes between them, the cadence is 60-80 in 1 minute. By determining the pulse rate during the last 30 seconds. the first (f1) and second (f2) loads according to the formula developed by V. L. Karpman et al., physical performance is calculated for this athlete:
PWC 170 \u003d N 1 + (N 2 -N 1) (170-f 1) / (f 2 -f 1),
where N1 and N2 are the power of work (in watts), f1 and f2 are the pulse rate, respectively, at the end of the first and second loads. The PWC170 value depends on age, sex, physical fitness, the kind of sport, to which the subject is engaged. According to a special formula, the calculated value of the maximum oxygen consumption is determined.
The physical readiness of high-level athletes, participants in important competitions (including the Olympic Games, etc.), especially in sports that develop endurance, is checked using different load models (on a bicycle ergometer, treadmill) with a stepwise increasing power of work "to failure ". The duration of the load at each stage is from 3 to 6 minutes, the increase in power every 1 - 2 minutes is 200 - 250 kw. The test is terminated when there are pronounced external signs of fatigue, the inability to maintain a given pace of pedaling, an increase in heart rate exceeding 200-210 beats. in 1 min. with a simultaneous decrease in blood pressure, stabilization or decrease in the oxygen utilization rate, and an increase in the respiratory coefficient. In addition, to determine the functional state of the body of athletes, you can use the Harvard step test, which consists in climbing onto a bench (50.8 cm high for adults, 40-45 cm high for adolescents and young men) for 5 minutes. According to the duration of the performed load and the number of pulse beats, the index of the test results is calculated using a special formula. Average performance is estimated at an index value of 50-80, high - more than 80, low - less than 50.
During the performance of functional tests and in the recovery period, gas exchange indicators (oxygen consumption, carbon dioxide release) are determined using the Haldane apparatus or other gas analyzers (see). According to indications, other research methods are also used. The use of spiroergometry allows you to determine important indicators state of fitness: the limit of a possible increase in oxygen consumption with increasing power of muscle work, which characterizes the aerobic performance of the body, i.e. the ability to maximize oxygen consumption by the body during intense muscular work (for outstanding athletes, the maximum oxygen consumption reaches 80 - 85 ml / min and more per 1 kg of body weight), the efficiency of work in terms of oxygen consumption per unit of work performed. With age, the maximum oxygen consumption decreases, in women it is 20-25% lower than in men.
In special examinations of certain groups of athletes, to determine the anaerobic performance of the body, i.e., the ability to perform work in conditions of oxygen deficiency (motor hypoxemia), when biochemical transformations take place with a predominance of glycolytic processes, in the laboratory they use a bicycle ergometric load model in the form of repeated " races" with an intensity of 90% of top speed pedaling, determined by the subject for 20 seconds. before experience; the duration of each repetition is 30 seconds. with a rest interval of 10 sec. The load is repeated several times until the set cadence is maintained. During work and 10-second intervals for rest, as well as within 30 minutes. recovery after the entire load, the number of revolutions of the pedals, the absorption of oxygen, the release of carbon dioxide, the rhythm of heart contractions (by ECG) are recorded. The total oxygen demand is calculated, oxygen debt as a percentage of the total demand.
Aerobic productivity and resistance to oxygen deficiency are determined by the value oxygen debt and an increase in the content of lactic acid in the blood. Before exercise on a bicycle ergometer, immediately after it and at the 30th minute of the recovery period, biochemical parameters are examined: a) the stability of carbohydrate-energy metabolism (lactic and pyruvic acids, inorganic phosphorus, "true" glucose, total activity of lactate dehydrogenase in the blood and creatinine in urine); b) blood reactivity: the number of leukocytes (leukocytosis phase), hemoglobin content and the number of erythrocytes (calculation of a color index, average hemoglobinization of erythrocytes, calculation of total hemoglobin content using formulas).
With V. to. for certain groups of athletes - weightlifters, gymnasts, throwers, participants in competitions in figure skating, auto and motorcycle racers, etc. - to study the functional state of the neuromuscular apparatus, which has a significant impact on special performance in speed-strength and complex technical sports, different types of electromyography are used.
On the basis of an in-depth medical examination, a general conclusion is given, in which it is provided: assessment of the state of health, physical. development, functional state; training regime recommendation (according to general plan or individual) if necessary, it is recommended to lay down. - professional, measures and rehabilitation therapy; the appointment of additional functional diagnostic examinations and the timing of repeated medical examinations.
Contraindications to sports
If there are deviations in the state of health, the necessary restrictions on sports are established. A number of diseases are a contraindication to sports.
As to occupations by physical culture and to lay down. gymnastics, then the issue is resolved in each case individually, taking into account the nature and clinical course of the disease, physical. readiness of the subject, his age, gender, etc. (see "Ready for work and defense", Therapeutic physical education).
Persons suffering from the consequences of injuries of the brain and spinal cord, accompanied by disorders in the motor and sensitive areas, are not allowed to go in for sports; organic diseases c. n. With.; mental illness, persistent illness vestibular apparatus; diseases of peripheral nerves in the presence of movement disorders or persistent pain syndrome.
Active tuberculosis is a contraindication to sports; with inactive tuberculosis and nonspecific lung diseases, the presence of respiratory or pulmonary heart failure is an absolute contraindication.
Sports activities are excluded for acquired and congenital heart valve defects. Contraindication is hypertonic disease II and III stages; in the IA (transient) stage, in the absence of a tendency to hypertensive crises, under medical supervision, training can be allowed (boxing, weightlifting, wrestling, fencing, acrobatics, football, hockey, diving, slalom, ski jumping, technical sports are excluded). Sports are also contraindicated in symptomatic forms of arterial hypertension. Neuro-circulatory dystonia of the hypertonic type and the so-called. juvenile hypertension is not a contraindication to training, but it requires particularly strict medical supervision. In the presence of cardiosclerosis of various etiologies or myocardial dystrophy of atherosclerotic and infectious-allergic origin, sports withdrawals are prohibited. Obliterating diseases of the arterial vessels make it necessary to stop playing sports due to functional disorders caused by a deterioration in the blood supply to the extremities. Chron. diseases of kidneys and urinary tracts, and also hron. diseases of the digestive system are a contraindication to sports. In the phase of stable long-term remission, training is possible under close medical supervision (excluding vaults, cycling, water sports, equestrian sports, cross-country skiing and other sports associated with possible hypothermia and severe shaking). Joint diseases of metabolic, allergic, infectious and endocrine origin are incompatible with systematic recreational sports. The same applies to diseases of the spine with limited function and pain. In the presence of osteochondrosis, the issue of admission to sports is decided individually. Endocrine diseases (diabetes mellitus, gout with a tendency to attacks, impaired fat metabolism II-III degree, thyrotoxicosis) prevent sports. With obesity of the 1st degree and struma of the 1st degree without symptoms of thyrotoxicosis, training can be allowed.
Contraindications to sports are also diseases of the blood system, hron, diseases of the ENT organs and upper respiratory tract in the presence of frequent exacerbations and functional disorders. With otosclerosis and various forms of progressive hearing loss, it is not advisable to engage in cycling and motor sports, shooting, playing sports. Persons suffering from deaf-mutism are engaged in special programs in groups organized for them.
The women suffering hron, inflammatory diseases of generative organs with frequent exacerbations cannot go in for sports. In the period of long-term remission, the resumption of training is possible. The prolapse of the female genital organs II and III degree with the phenomena of dysuria interferes with sports, with I degree classes are allowed, but jumping and gymnastics are excluded.
Anomalies in the development of the musculoskeletal system in children and adolescents, accompanied by a lag in physical. development, violation of posture, deformity of the feet, causing functional disorders, are a contraindication to playing sports. In these cases, it is recommended physiotherapy.
With a small degree of myopia, sports can be allowed without correction; with an average degree (from -3.0 to -5.0 diopters) or farsightedness (from +3.0 to +5.0 diopters), wearing glasses is allowed during training and competition. A more pronounced degree of myopia, if it progresses or is poorly corrected with glasses, or is accompanied by changes in the optic nerve head, is a contraindication to most sports.
If systematically training athletes have diseases that are not recognized during admission to classes, there are temporary contraindications to both sports and physical education.
In acute infectious diseases and injuries, there are temporary contraindications to physical exercises. culture and sports. After recovery, admission to classes is possible only with the permission of a doctor. The timing of the resumption of classes is set individually depending on the nature and severity of the disease or injury, the presence of complications, the functional state of the subject.
The terms of admission to competitions, as well as to the delivery of standards (training, TRP) are determined, in addition to the above factors, also by the duration of the break in regular classes.
If there are contraindications to sports or restrictions to them, it is necessary to take into account: a) the features of the clinical course of the disease in each specific case; b) the nature of the classes (according to compulsory programs, general physical training, sports training and competitions), as well as specific sports specialization; c) physical preparedness, fitness: d) gender, age, profession of the subjects.
Overtraining and various manifestations of overstrain require rehabilitation treatment, followed by a gradual inclusion in the training process according to individual plan under medical supervision.*
The contraindications listed above are only the main ones, but in the practice of V. to. Other deviations can be identified that must be taken into account for the decision on admission to physical education and sports.
An important section of V. to. are medical and pedagogical observations carried out directly in the process training sessions and competitions. These observations help to the greatest extent to study the adaptation of the athlete's body to the specific conditions of training, to determine fitness, and to study the level of requirements imposed on the body by the corresponding program of physical culture and sports. In the course of medical and pedagogical observations, direct acquaintance with the content, organization and methods of conducting classes is carried out. Timing allows you to determine the density of classes, i.e. the time actually spent directly on the exercise. The duration of each of the exercises and the duration of the pauses between them are fixed; timing data is recorded in the protocol. To characterize the intensity of physical. loads, the “physiological curve” is studied by the pulse (its frequency is determined immediately before the start and immediately after the main stages or series of basic exercises throughout the session).
Medical and pedagogical supervision are carried out by means of a complex technique, the program a cut is defined by a task in view, character of occupations and a contingent of inspected. At the same time, it is necessary to determine the degree of fatigue caused by the lesson by external signs (sweating, discoloration of the skin of the face, deterioration in coordination of movements, etc.) and by the reaction of the cardiovascular and respiratory systems (study of pulse rate, respiration, blood pressure, lung capacity) at certain moments of training.
When assessing the impact of training loads that are significant in terms of volume and intensity, used in the methodology for training high-level athletes, instrumental studies (teleelectrocardiography, electromyography, and a number of others), as well as a set of biochemical tests, are additionally used. Important additional data for assessing the reaction of the organism of the subject to the load of a training session or competition is given by the method of "additional" load directly during training, as a cut, running in place at a maximum pace for 15 seconds is used. or a three-minute run at a pace of 180 steps per 1 minute, a load on a bicycle ergometer (metered or until the pulse reaches 170 beats per 1 minute). More complete data can be obtained when using a specific load (for example, for swimmers - swimming a 50-meter distance at a pace of 90% of the maximum, for runners - running a distance of 60-100 meters, etc.). The athlete is invited to perform this load before class (first load), after 10-15 minutes. after the end of the lesson (second load), as well as in the recovery period - in the morning the next day. A change in the response to the second (and third) additional load is detected by comparing the data of the pulse, blood pressure, respiratory rate with the results of the study after the first additional load. At the same time, changes in physical indicators are taken into account. working capacity and sports and technical results. The revealed shifts reflect the degree of fatigue after the main session.
The most important task of medical and pedagogical observations is to determine the state of special fitness (for each sport).
Under normal conditions sports training medical and pedagogical observations are carried out using two types of tests. The test of the first type - with continuous work, maximum for a given distance, or with a given intensity, while determining the possible duration of maintaining work. After performance of exercises the fiziol caused by them, shifts according to pulse, breath, arterial pressure, and also electrocardiography and other instrumental techniques are defined. The first test helps to establish the level of development of the qualities of speed, general or special (depending on the sport) endurance in specific sports with a cyclic structure of movements. Tests of the second type are built on the principle of repeated loads (separated by short intervals), each of which is carried out at a competitive speed or close to it. When determining fitness in sports with an acyclic movement structure, an athlete performs specially selected exercises (for example, repeated bench presses, lifting a barbell for weightlifters, etc.). In the intervals between loads, functional shifts are determined, which are compared with performance indicators (performance of loads).
The results of medical and pedagogical observations serve as the basis for managing the training process in accordance with the state of health and functional readiness of the athlete's body, as well as for taking measures to restore working capacity or improve it.
Medical and sports consultation on issues related to physical education. exercises and sports, is given by a specialist in V. to a teacher, coach, athlete and persons who wish to start regular training (group or individual, in preparation for passing TRP standards, etc.). The consultation is carried out on the basis of medical examination data and medical and pedagogical observations.
For beginners, medical and sports consultation helps to make a rational choice of physical. exercises or sports that are most appropriate for the state of health, physical. development and level of physical. readiness. Medical and sports consultations are given to coaches and athletes on the issues of the regimen, volume and nature of training loads, sports selection and orientation.
Sports selection and orientation of gifted youth are carried out on the basis of a number of criteria. The following indicators are taken into account: 1) the state of health - the absence of deviations and a tendency to diseases that limit the use of modern training methods; 2) features fiziol, the impact exerted by the chosen sport on the body; 3) physiological and psychological characteristics that favor the achievement of high results in a particular sport (constitutional features, rates of biol, maturation, personal qualities, etc.); 4) the level and pace of development of adaptive changes fiziol, systems that provide energy muscle activity(aerobic and anaerobic performance); 5) the intensity of the process of adaptation to significant training loads (according to medical and pedagogical observations); 6) the degree of resistance to increased psycho-emotional influences.
Sanitary and hygienic supervision of the places and conditions of physical culture and sports includes preventive supervision in the design and construction of sports facilities (see) or the allocation of premises for physical education and sports (a representative of the SES of the district together with a doctor of a medical and sports dispensary, a health center of an enterprise and etc.), as well as current supervision of the implementation of the established dignity. rules for the maintenance of places of employment (conducted by a doctor of the relevant sports organization stations). The following are subject to verification: compliance with the established requirements of the state of cleaning and ventilation of enclosed spaces, their lighting and heating, the maintenance of equipment and inventory; timeliness of carrying out cleaning and disinfection of water in pools, etc. It is also necessary to take into account epidemiol, the situation and, if necessary, take appropriate preventive measures.
Sanitary and educational work is aimed at promoting among the population the health-improving value of physical culture and sports (exercises, industrial gymnastics, classes in health groups, mastering the standards of the TRP, etc.); explanation of the role of the correct mode of work and rest, the use of natural factors of nature for hardening, the importance of medical supervision and self-control of an athlete (see) for successful sports training. The direct participation of the doctor in conducting classes to prepare different age groups of the population for the delivery of the "requirements" section of the TRP for mastering the skills of personal and public hygiene is envisaged.
With the medical and sanitary provision of sports competitions and mass forms of recreational and physical education (spartakiads, passing TRP standards, etc.), it is provided: 1) checking honey. documentation on admission to participation in competitions; 2) organizing the provision of first aid; 3) holding honey. commissions for the examination of athletes (individual conclusion on admission to training and participation in sports competitions, etc.); 4) checking gig. the condition of the competition venues, compliance with meteorological and other standards stipulated by the rules of the competition.
In medical - a dignity. ensuring all-Union and international competitions, including the Olympic Games, in addition, special sections of the V. to. are provided - anti-doping control and control of gender for women. The need to organize anti-doping control is due to the fact that the use of pharmacological preparations immediately before competitions or during competitions that artificially increase sports results by stimulating certain physiological processes (see Doping), entails the danger of damaging the athlete’s health and creates unequal conditions wrestling. At international competitions, anti-doping control is carried out by international honey. commissions of international sports federations with the help of doctors-specialists in anti-doping control of the host country. At the Olympic Games (see Olympic Games), anti-doping control is carried out by the medical commission of the International Olympic Committee (IOC). In the USSR, anti-doping control at sports competitions is provided for by the regulation of the Committee on Physical Culture and Sports under the Council of Ministers of the USSR of 1971. Anti-doping control is based on the use of methods of qualitative and quantitative analysis in biol, liquids (ch. arr. in urine) of the content of doping drugs, belonging to different classes of chem. compounds (drugs, sympathomimetic amines, antidepressants, stimulants, central nervous system, analeptics, anabolic steroid hormones, etc.). The analysis of biol, liquids is carried out under an encrypted number without indicating the name of the athlete and the name of the country. The conclusion on the analysis is approved at a meeting of the commission and reported panel of judges, and in case of detection of doping - to the representative of the team to which the athlete belongs.
Sanctions in relation to athletes, to-rye used doping, are accepted. leaders of an all-Union or international sports organization (depending on the scale of the competition).
By special resolution of the IOC it is established mandatory floor control in front of all the majors international competitions. A single passage of such control remains valid for life (if appropriate documentation is available).
The purpose of the gender control is to check that athletes match the genetic sex of the passport. At nek-ry forms of anomaly of the reproductive apparatus in women, most often a variant of false male hermaphroditism (see Hermaphroditism), the system of sex chromosomes does not correspond to the external signs of sex. The psychophysiological features of the body of an athlete with false hermaphroditism provide her with advantages in sports compared to women with normal development of the genital apparatus. It breaks important principle sports competitions - equality of participants on their fiziol. features. When controlling for gender, a number of express methods for determining sex chromatin are used (according to the Sanderson-Stuart and Casperson methods). The cells of the epithelium of the mucous membrane of the vagina, the mucous membrane of the cheek (during mass examinations) or the hair follicle are subjected to research. When evaluating the content of sex chromatin, the days of the menstrual cycle are taken into account (3-7 days after menstruation, its level decreases), the age of the subjects (the lowest content is 13-14 years). Research should be carried out before physical. loads. In accordance with the results of express methods, in each obvious and suspicious case, a complete chromosomal analysis of the culture of peripheral blood leukocytes using differential staining of chromosomes is performed for an anomaly. The discrepancy between the genetic sex and the passport excludes the possibility of participating in competitions among women.
The doctor organizing medical - a dignity. maintenance of sports competitions, is a member of the panel of judges and is the deputy chief judge for all matters of medicine and dignity. providing competition. All medical opinions are binding on representatives of the participating teams, referees at competitions, the administration of the stadium and other sports facilities.
Bibliography: Graevskaya N. D. Influence of sport on the cardiovascular system, M., 1975, bibliogr.; Dembo A. G. and Levin M. Ya. Hypotonic states in athletes, L., 1969, bibliogr.; Ivanov S. M. Medical control and exercise therapy, M., 1970, bibliogr.; Karpman VL, Belotserkovsky 3. B. and Gudkov IA Research of physical working capacity at sportsmen, M., 1974, bibliogr.; Kukolevsky G. M. Medical observations of athletes, M., 1975; Letunov S.P., Motylyanskaya R.E. and Graevskaya N.D. Methods of medical and pedagogical observations of athletes, M., 1962; Nalbandyan M. A. and Zotov V. V. Cytogenetic studies in sports medicine, Teor. and pract. physical cult., No. 6, p. 26, 1974; Problems of sports medicine, ed. S. P. Letunova et al., vol. 1, M., 1974; Heart and sport, ed. V. L. Karpman and G. M. Kukolevsky, M., 1968, bibliogr.; Sports medicine, ed. A. G. Dembo, M., 1975.
S. Letunov, R. E. Motylyanskaya.
ATHLETICS- one of the main and most popular sports, uniting various exercises on the run race walking, jumping and throwing. In the sports classification, there are St. 60 varieties of athletics exercises. The program of the Olympic Games includes 24 types of track and field exercises for men and 16 for women.
Run- the main exercise in L. a., which has the most versatile effect on the body, since almost all the muscles of the body are involved in the work and the activity of the fiziol is activated. systems. The intensity and duration of the impact of running exercises on the body is determined by the length of the distance. The shorter it is, the more intense the work. Running on short distances(from 60 to 400 w) and hurdling is performed at maximum intensity, this is a typical speed exercise. Middle distance running (800-1500 m) is a work of submaximal intensity. Long running (3-10 thousand meters) and over long distances(up to 42 km 195 m) and steeplechase is performed with high and moderate intensity and, by the nature of the impact on the body, is an endurance exercise. The longer the running distance, the more physiological, changes in the body (increased heart rate and respiration, increased systolic and minute blood volume, increased blood pressure, etc.) are more pronounced and the recovery period is longer (see. Run).
Race walking- an exercise in which movements are cyclical; differs from running in the absence of the so-called. flight phases, and from normal walking- more energetic movements with greater amplitude. The main distances in the competitions for men are 20 and 50 km, for boys - 3-10 km. Walking exercises develop endurance. During strenuous training and competition, large functional changes in the body are noted: oxygen consumption reaches 1.5-2.5 l / min, pulmonary ventilation - 15-25 l / min, heart rate - 180-200 beats per 1 min., systolic blood pressure - up to 180-200 mm Hg. Art. and more, weight loss - up to 3-4 kg. The recovery period after training and competition - sometimes up to 1 - 2 days. and more; its duration depends on the degree of fitness of the athlete.
jumping(in length, height, triple and with a pole) - exercises of a speed-strength nature with acyclic movements, combining elements of sprinting (running) and including a complex coordination act associated with repulsion, flight and landing. Make great demands on the nervous and muscular systems e, vestibular, visual, tactile analyzers. Shifts in blood circulation and respiration are relatively small due to the short duration of the load: the heart rate usually does not exceed 140-160 beats per 1 minute, systolic blood pressure - 150-160 mm Hg. Art., systolic blood volume 80-100 ml, weight loss - 0.2-0.5 kg. The recovery period is within 20-30 minutes, but since the exercises are repeated many times in training and competitions, the shifts can reach much larger values and the recovery period sometimes drags on up to several hours.
Throwing- exercises in throwing various projectiles at a distance. They are divided into several types: throwing a discus, hammer, spear, grenade, ball, shot put, etc. Throwing is an acyclic type of speed-strength movement that requires a high level of development of muscle strength, speed and coordination of movements. The greatest fiziol, shifts at throwings are observed from a muscular, nervous system and a vestibular analyzer. Changes in the functions of blood circulation and respiration are relatively small. But since the competition (as in jumping) lasts a long time (up to several hours), in general, the energy consumption is high and the recovery period can be extended up to 2-3 hours.
all-around- complex view of L. a. - combination various kinds running, jumping and throwing. The classic types of all-around events for adults are the decathlon for men (100, 400, 1500 m and 110 m hurdles, long jump, high jump and pole vault, javelin and discus throw, shot put) and the pentathlon for women (200 m run). and 80m hurdles, long jump, high jump, shot put). All-around classes make the greatest demands on the body and contribute to a versatile physical. development, since the conditions of training and competition require a change in various physical. exercises. Fiziol, shifts after each exercise are due to its nature, the total energy consumption and shifts in the activity of various systems reach significant values. Competitions are held for two days. The recovery period is delayed up to 24 hours. and more.
The effect of athletics on the body
Regular, systematic classes L. a. promote harmonious physical. development, health promotion, the formation of a variety of vital motor skills, the development of speed, strength, dexterity, endurance, the expansion of funkts, capabilities of the body, increasing its resistance and resistance to adverse meteorol, influences. The degree of impact of certain types of athletics exercises on the body is determined by their nature, intensity and duration. Increases in track and field athletes muscle mass, the ability to maximize tension and relaxation, muscle strength increases (especially in sprinters, throwers and jumpers), coordination of movements improves, speed and accuracy of motor reactions increase. The fastest reactions are sprinters, jumpers and throwers. The function of the analyzers (especially visual and vestibular) is improved to the greatest extent in jumpers and throwers. Regularly trained athletes improve the functions of the respiratory system, increase the vital capacity of the lungs (up to 5-6 thousand ml and more) and the maximum pulmonary ventilation (up to 150-200 l / min), as well as increase the diffusion capacity of the lungs and tissue respiration. Increased resistance to hypoxia. The functions and possibilities of the cardiovascular system are significantly expanded. The volume of the heart increases to 800-1000 cm3 or more, moderate myocardial hypertrophy develops, the work of the cardiovascular system becomes more economical: the pulse slows down to 40-64 beats per 1 minute, systolic blood pressure decreases to 100-115 mm Hg. Art., systolic volume increases, blood flow slows down somewhat, diastole lengthens, myocardial contractility increases, peripheral blood resistance decreases. Increase funkts, opportunities of respiratory and cardiovascular system in the course of regular occupations L. and. the greater, the higher the proportion of exercises in it that contribute to the development of endurance, i.e., when doing running, walking, all-around. Changes in the nervous, muscular systems and analyzers are most pronounced in athletes involved in hurdling, throwing and all-around.
Athletes have, as a rule, a proportional physique. Athletes who specialize in different types L. a., have some characteristic morphofunctional features that contribute to the achievement of high sports results. So, long-distance runners are more often of average height with relatively low body weight, large respiratory volume of the lungs. Athletes specializing in hurdling and jumpers, as a rule, are tall, relatively light in body weight, long legs with well-developed muscles; throwers - high growth, large body weight, broad shoulders, powerful muscles, large physical. by force.
Medical control
In the course of selection of sportsmen for employment L. and. and in the process of training, qualified medical supervision is very important. Its task is to promote the maximum healing effect of classes, the prevention of diseases and injuries, etc. Contraindications for L. a. coincide with the general contraindications for sports (see. Medical control). Sports training in sprinting, in long and high jumps can be started in children from 10-12 years old, in hurdling and throwing - from 13-14 years old, in pole vaulting - from 15-16 years old. Athletes are allowed to compete after 1 - 1.5 years systematic studies. Competitions and trainings are held for the following age groups: teenage (11-12 years old), junior youth (13-16 years old), senior youth (16-17 years old), youth (18-19 years old), youth (20 years old - 21 years old) ). The length of the distance, the weight of the projectiles, the height of the barriers are determined taking into account the age and gender characteristics of the athletes. So, for children and women, competitions in running for long and extra long distances and in race walking, in hammer throwing, pole vaulting, triple jump (for women), and decathlon are excluded.
Of the most common injuries in athletes, it should be noted myositis and damage to the muscle fibers of the two -, quadriceps femoris muscles, sprains ankle joints in sprinters and jumpers (in the latter, in addition, bruises in the heel area and damage to the calcaneus); inflammation and damage to the calcaneal (Achilles) tendon, periostitis tibia, damage to the bag-ligament formations of the ankle joints in runners for medium and long distances; damage to the bag-ligament formations of the shoulder, elbow joints and hand, as well as muscles shoulder girdle at the throwers. With irrational training and physical. overvoltage, dystrophic changes in the myocardium can be observed (mainly in athletes involved in the types of L. a., developing endurance), osteochondrosis of the spine and radiculitis (ch. arr. in throwers).
Bibliography: Medical observations of athletes during training, ed. Edited by N. D. Graevskaya and S. P. Letunov. Moscow, 1966. GraevskayaN. D. The influence of sports on the cardiovascular system, M., 1 975, bibliogr.; Athletics, ed. Edited by N. G. Ozolina and D. P. Markov. Moscow, 1972. Lightweight Basics athletics, comp. A. F. Boyko, M., 1976; Human Physiology, ed. N. V. Zimkina, Moscow, 1975.
N. D. Graevskaya, N. G. Ozolin.
Chapter 3 physical training
Features of the methodology for conducting training sessions in various sections of physical training
FP classes are organized and conducted in the following sections: applied gymnastics, athletics, accelerated movement (march), overcoming obstacles, fighting techniques, ski training and swimming and swimming.
The main content of the section "Applied gymnastics": pulling up and lifting with a coup on the crossbar, raising the legs to the crossbar, bending and unbending the arms in emphasis on the uneven bars, etc. A feature is the organization of strength training on projectiles, simulators and the use of exercises for surprise, speed of action in each lesson, requiring the manifestation of speed-strength abilities .
Athletics. Content: running for short (100.200.400 m), medium (800.1000.1500 m) and long (3000.5000.10000 m) distances.
Teaching the technique of performing these exercises is carried out mainly by the method of “learning as a whole”. Before working out the technique of running for short, medium and long distances, throwing a grenade, shot put and jumping, an additional warm-up is carried out.
Fast travel(march) for 6, 10 km. Feature: carried out on rough terrain (if possible in uniform with weapons and equipment). When preparing for a forced march, it is necessary to increase the load from one lesson to another by gradually increasing the distance and its segments covered by running, by complicating the route of movements, etc.;
Overcoming obstacles. Feature: classes are held on specially equipped obstacle courses and on terrain with natural obstacles and barriers. Learning to overcome obstacles is carried out at the beginning without a weapon, then with a weapon, and training - with a gradual increase in the weight of the calculation, the complication of the conditions for overcoming obstacles.
Fighting fighting techniques. Classes are held both in a hall with a special coating, equipped with boxing and wrestling equipment, and in a specially prepared pit with sand and sawdust, on the ground, as well as in conditions that simulate a certain operational situation. In order to avoid injuries during classes, special attention is paid to preparing the places of classes, the body of the trainees to perform techniques, and the discipline of those involved. Painful techniques during training are performed smoothly, without jerks, and at the signal of the partner (claps on the body or voice - “Yes”) immediately stop. Throws are carried out from the middle to the edges of the carpet. Learning the techniques of self-insurance and insurance is carried out in the first lessons, and in the future they are constantly being improved. Training in techniques is carried out in pairs, approximately equal in height and weight. Techniques and actions related to the performance of strikes, throws and painful techniques are studied and improved in both directions, with the right and left limbs, first at a slow and then at a fast pace. When teaching disarmament techniques in the classroom, models of knives, pistols, machine guns and other items are used.
Ski training. Features: at the first lesson, the leader checks the ability of the personnel to ski. For non-skiers, the first 2-3 lessons are held separately. To learn skiing, a flat area protected from the wind (approximately 50 x 80 m in size) is selected, on which two closed ski tracks are laid 5-10 m from one another. The movement on the ski tracks is carried out in one direction.
Swimming and swimming. Classes are held at specially equipped reservoirs, water stations, indoor and outdoor pools at t° of water not lower than +17°С. In the first swimming lessons, as well as during the ski training the ability to swim is checked and the personnel are divided into three groups:
· the first group - not able to swim, not swimming 25 m;
· the second group - able to swim, swimming 25 m, but not owning one of the most beneficial ways of swimming in terms of service and application (on the side, breaststroke);
The third group - the most trained swimmers who own one of the indicated methods and swim at least 200 m.
Physical exercises affecting the human body, bring it out of the state of homeostasis (constancy and stability of the internal environment). Due to various reactions of organs and systems, the body returns to a homeostatic state after the cessation of exercise. Therefore, for the correct organization and conduct of PT classes, knowledge of the physiological patterns of the body's activity during classes exercise and basic methods of assessing his reaction is absolutely necessary. This applies not only to specialists in the field of FP, but also to everyone who has anything to do with it (who is engaged in it independently, who organizes, who manages the process of FP).
Cadets, in the future officers of the Ministry of Emergency Situations, have the most direct relationship. Therefore, they must have the necessary minimum knowledge in the field of regulation of physical activity and determination of the body's response in the process of practicing PT.
Medical and pedagogical control (VPK) is an important integral part medical monitoring of the health of people involved in physical culture or its applied form - physical preparation. It drives process improvement. physical education and sports training in order to optimize health-improving orientation and enhancing the training impact of physical exercise.
VPK is a set of measures that allow assessing the effectiveness of PT classes on the body of those involved and is carried out by PT specialists together with representatives of the medical service. Separate measures for the military-industrial complex can be carried out by commanders (chiefs) of all levels and by the students themselves.
The goal of the military-industrial complex is to improve physical condition involved, which combines physical development, functional state and physical fitness of a person.
To achieve this goal, it is necessary to solve the tasks of medical support for AF in the process of military-industrial complex, which are specified in the following aspects:
· determination of the adequacy of physical load on various forms of physical fitness to the level of physical development, functional state and physical fitness of cadets;
assessment of the dynamics of various indicators of the physical condition of those involved during the semester, academic year;
injury prevention.
We will talk about the first two directions in the subsequent educational questions of the lecture, and now we will note the main components of injury prevention:
monitor the serviceability of sports equipment, facilities, exercise equipment, sports shoes and clothing;
· observe the right technique and rational organization of classes;
Maintain discipline in the classroom and comply with the requirements for the implementation of physical exercises and the rules of sports competitions;
provide competent insurance and assistance in performing complex exercises;
to monitor the condition of those involved;
- carry out explanatory and propaganda work on the need and importance of preventive work to prevent injuries in PT classes.
Medical supervision of young athletes. The stressful effect of physical activity on a young athlete, if specialization begins at a young age without sufficient versatile training, leads to a decrease in immunity, stunted growth and development, and frequent diseases and injuries. The early specialization of girls, especially in gymnastics, diving, acrobatics and other sports, affects sexual function. They, as a rule, begin menstruation later, sometimes it is associated with disorders (amenorrhea, etc.). Taking pharmacological drugs in such cases adversely affects health and reproductive function.
Medical supervision during physical education and sports includes:
Dispensary examination - 2-4 times a year;
Additional medical examinations including physical performance testing before participation in competitions and after an illness or injury;
Medical and pedagogical observations with the use of additional repeated loads after training;
Sanitary and hygienic control over the places of training, competitions, equipment, clothing, footwear, etc.;
Control over the means of recovery (if possible, exclude pharmacological preparations, a bath and other potent means);
Physical (sports) training children and adolescents has the following tasks: health-improving, educational and physical improvement. Means and methods of their solution must comply age characteristics athlete's body.
Sports specialization- this is a systematic versatile physical training of children and adolescents to achieve high sports results in their chosen sport at the most favorable age for this.
The coach (physical education teacher) should remember that the age that allows a student to take on higher training loads depends on the sport.
Underestimation of the age and individual morphological and functional characteristics of young athletes by a coach is often the reason for the cessation of the growth of sports results, the occurrence of prepathological and pathological conditions, and sometimes leads to disability.
Absolutely healthy children should be allowed to train! If they have any deviations, then they are transferred to a preparatory or special medical group.
Medical control over physical education includes:
l study of physical development and health status;
l determination of the effect of physical activity (physical education) on the body using tests;
- assessment of the sanitary and hygienic condition of places of employment, inventory, clothing, footwear, premises, etc.;
l medical and pedagogical control during classes (before classes, in the middle of the lesson and after it ends);
l prevention of injuries in physical education classes, depending on the quality of insurance, warm-up, adjustment of equipment, clothing, shoes, etc.;
- promotion of the health-improving effect of physical education, hardening and sports on the student's health using posters, lectures, conversations, etc.
Medical control is carried out according to the general scheme, including testing, examination, anthropometric studies and, if necessary, examination by a specialist doctor (urologist, gynecologist, therapist, traumatologist, etc.). Classes should be conducted taking into account the anatomical and physiological features. Morphological, functional and biochemical characteristics of the body during the aging period affect its most important property - the ability to respond to environmental influences, physical exertion, etc. Reactivity is determined by the state of receptors, the nervous system, visceral organs, etc.
Practice shows that moderate physical training delays the development of many symptoms of aging, slows down the progression of age-related and atherosclerotic changes, improves the functional state of the body's main systems. And if we take into account that for people of middle, and especially the elderly, physical inactivity and overnutrition are characteristic, then the need for regular classes becomes obvious. A medical examination of student-athletes with category I or higher is carried out directly by a medical and physical education dispensary, where a dispensary observation card is issued for the specified athlete.
Doctors of the medical and physical education dispensary conduct an in-depth examination of the state of fitness of an athlete. And on the basis of this examination, a medical conclusion is made, recommendations are given to the coach on planning and conducting the training process.
Under the term t renovation This refers to a complex concept that includes the health, functional state, level of physical, technical, and tactical, and volitional fitness of athletes. Training determines the level of performance of an athlete, his readiness to achieve maximum results in a particular sport.
During repeated medical examinations, the medical report indicates what changes have occurred in health and the state of fitness since the previous examination, what changes need to be made in the regimen and methods of training, what therapeutic and preventive measures to take.
Physical education teachers and coaches must build their work taking into account the medical opinion, which is also mandatory for referees of sports competitions.
Physical exercises are beneficial only with a rational system of training sessions. Violation in the dosage of physical activity and methodology can adversely affect physical development, physical fitness and health of those involved. Due to prolonged and intense muscle activity, a state of the body called fatigue occurs. It manifests itself in a decrease in working capacity, a decrease in muscle strength, a deterioration in accuracy and coordination of movement, etc. Fatigue is a kind of protective reaction of the body, which does not allow it to go beyond the limit, beyond which there are functional and biochemical changes that are incompatible with life. The essence of this reaction is to change the coordination of functions, which leads to limited performance and difficulty in further continuation of work. The rate of onset of fatigue depends on the intensity of work: the higher the intensity, the faster fatigue appears. The degree of fatigue depends on how. on the intensity and duration of the work.
Recovery after fatigue, as a rule, is the slower, the greater the degree of fatigue. Ceteris paribus, rapidly developing fatigue is eliminated faster than slowly developing, but reaching high degrees.
Performing physical work against the background of a high degree of fatigue, without sufficient recovery, can lead to overwork, which will require much more time to bring the body to a working state, and sometimes is the cause of negative physiological changes in human organs and systems.
An effective means of reducing work fatigue is the correct alternation of work and rest of nerve cells, the shift of work of functional units. When playing sports, the onset of fatigue is delayed by a variety of means, methods and forms of exercise, as well as a change in the environment in which they are carried out. But the elimination of fatigue occurs during the rest period, the duration of which between sessions should be individualized depending on the nature and magnitude of the load and the degree of fitness of the athlete.
Some nutritional factors, in particular vitamins, help in the fight against fatigue and speed up the recovery of working capacity. However, it should be remembered that fatigue is a protective reaction of the body, so fighting it with the help of pharmacological stimulants is not always beneficial for the body.
With a sharp discrepancy between physical activity and the athlete’s preparedness for it, i.e. when the work performed during training or competition exceeds the functional capabilities of the athlete's body, overstrain occurs. Overexertion is more often the result of a single exposure to an overly strenuous workout or competition. It can also occur as a result of forced training. The appearance of overvoltage is often facilitated by training with a heavy load or participation in competitions, shortly after suffering an infectious disease (flu, tonsillitis, etc.). With overvoltage, a number of disorders appear in the body of an athlete, which are on the verge of being painful, sometimes the state of health deteriorates sharply. Characteristic features surge; great weakness, pallor of the skin, a sharp decrease in blood pressure, sometimes dizziness, vomiting, the appearance of protein and formed elements in the blood, urine, etc. With a more severe overstrain, right ventricular failure develops, cyanosis of the face, shortness of breath, pain in the right hypochondrium, palpitations appear, the size of the heart and liver increase.
A frequent consequence of overexertion is an increase in blood pressure (hypertension). With signs of overvoltage, it is necessary to take timely measures to establish the correct mode of training and rest, and, if necessary, to carry out the necessary treatment.
As a result of shortcomings in the mode and methodology of training, the state of sports performance, neuropsychic and physical condition of the athlete may worsen. This condition is called overtraining. It, as a rule, develops already when the athlete reaches sufficient fitness or even sports form. This distinguishes overtraining from overtraining, which occurs more often in people who are undertrained. The state of overtraining, first of all, is expressed in changes in the nervous system, at the same time or somewhat later, changes or disturbances in the state and other systems of the body appear. Often, during overtraining, deviations from the cardiovascular system and metabolic processes are observed.
In the development of the state of overtraining, three stages can be noted. For the first characteristic: some decrease in sports results or cessation of their growth; inconsistent or always distinct complaints of an athlete about a deterioration in physical condition; deterioration in the body's adaptability to high-speed loads that is objectively detected during a medical examination. At this stage, overtraining can be eliminated with a training regimen for 15-30 days.
In the second stage overtraining are noted: an expression of a decrease in sports results, complaints of a deterioration in well-being, a decrease in working capacity, a deterioration in the body's adaptability to physical activity for speed and endurance. At the second stage of overtraining, the use of a special recovery regimen and some means of treatment is required, it is possible to fully restore the health and performance of an athlete within 1-2 months.
In the third stage overtraining, along with changes in the state of the body, there is already a persistent deterioration in sports performance, despite persistently prolonged training. At this stage, it is not always possible to achieve a significant improvement in sports performance even over a much longer period of time. That's why timely diagnosis overtraining is a very important condition for the successful restoration of health and sports performance of an athlete.
In the initial period of intensive physical work, the so-called "dead spot" appears - a state of acute fatigue of the athlete's body. It is observed while running for medium and long distances: in swimming, rowing, cross-country skiing, cycling, skating. With a "dead point" there is a decrease in working capacity, an increase in energy expenditure per unit of work, impaired coordination of movements, deterioration of attention, memory, etc., negative manifestations of higher nervous activity, the pulse quickens to 180-200 beats per minute, blood pressure rises sharply. The athlete has a painful feeling in the "chest", a lack of air and a desire to stop working. However, if by an effort of will he overcomes this desire and continues to move, then the "dead point" is replaced by a state of relief, known as "second wind".
The total indicator of the magnitude of the load (volume plus intensity) is the value of heart rate, exhausted 10 and 60 minutes after the end of the session. After 10 minutes, the pulse should not exceed 96 beats / min, or 16 beats per 10 s, and after 1 hour it should be 10-12 beats / min (no more) higher to the working value. For example, if before the start of the run, the pulse was 60 beats / min, then if the load was adequate, 1 hour after the finish, it should be no more than 72 beats / min. If, within a few hours after training, the heart rate values are significantly higher than the initial ones, this indicates an excessive load, which means that it must be reduced. A prolonged increase in heart rate (within several days) is usually observed after overcoming a marathon distance.
Objective data reflecting the total value of the training effect on the body (for a weekly and monthly training cycle) and the degree of recovery can be obtained by daily counting the pulse in the morning after sleep, in the supine position. If its fluctuations do not exceed 2-4 beats / min, this indicates a good tolerance to stress and a complete recovery of the body. If the difference in pulse beats is greater than this value, this is a signal of incipient overwork; in this case, the load should be reduced immediately.
Orthostatic test is even more informative. Count your pulse while lying in bed; then slowly stand up and after 1 minute count the pulse again in a vertical position for 10 seconds, followed by recalculation for 1 minute (to do this, the resulting value must be multiplied by 6). If the difference between the pulse in the vertical and horizontal position does not exceed 10-12 beats / min, then the load is quite adequate and the body recovers well after training. If the increase in heart rate is 18-22 beats / min, then the condition is satisfactory. If this figure is more than the indicated values, this is a clear sign of overwork, which, in addition to excessive training volume, can be caused by other reasons (large production and household loads, constant lack of sleep, past illness, etc.). Unsatisfactory results of the orthostatic test are usually observed in people suffering from physical inactivity and completely untrained, as well as in beginner athletes. With increasing fitness, the response of the cardiovascular system to this test gradually decreases - just like heart rate at rest. So, for example, according to the author's observations, for novice amateurs health jogging transition to a vertical position (after sleep) causes an increase in heart rate by 20--30 beats / min, and in well-trained runners with many years of training experience - only 8--16 beats / min.
For operational control over the intensity of the load, in addition to heart rate data, it is also advisable to use breathing indicators, which can be determined directly during the run. These include a nasal breathing test. If breathing is easily carried out through the nose during running, this indicates aerobic mode workout. If there is not enough air and you have to switch to a mixed nasal-oral type of breathing, then the running intensity corresponds to a mixed aerobic-anaerobic energy supply zone and the speed should be somewhat reduced. The speaking test can also be used successfully. If you can easily carry on a casual conversation with a partner while running, then the pace is optimal. If you begin to choke and answer questions in monosyllabic words, this is a signal of a transition to a mixed zone. These tests confirm the motto of the founder of recreational running, the famous New Zealand trainer Arthur Lydiard - "Run easy"
No less important for self-control are subjective indicators of the state of the body (sleep, well-being, mood, desire to train). Sound sleep, good health and high performance during the day, the desire to train testify to the adequacy of training loads. Poor sleep, lethargy and drowsiness during the day, unwillingness to exercise are sure signs of overload. If appropriate measures are not taken and the load is not reduced, more serious symptoms of overtraining may appear later - pain in the heart area, rhythm disturbances (extrasystole), increased blood pressure, etc. In this case, you should stop exercising for several weeks and consult a doctor. After the disappearance of these symptoms and the resumption of classes, it is necessary to start with minimal loads, use a rehabilitation training regimen. In order to avoid such troubles, you need to correctly assess your capabilities and increase training loads gradually.
Medical control at competitions
Regular keeping of a self-control diary can be of great help to trainees, which will make it possible to identify early signs of overwork and make appropriate adjustments to the training process in time. Current self-control and periodic medical control increase the efficiency and ensure the safety of health-improving physical culture.
Competitions place extreme demands on the athlete's body. Therefore, medical support for competitions, which aims to preserve the health of athletes, prevent injuries and diseases, create the most favorable conditions for achieving sports results, is of great importance and is mandatory in our country.
The coach, along with the doctor, is directly responsible for maintaining the health of athletes in competition conditions. Therefore, he should be well aware of the organization and content of the medical support of the competition, actively help the medical staff, immediately take action in cases of violations of the rules and conditions of the competition that threaten the health of athletes, in case of illness or injury, immediately refer the victim to a doctor, resolve the issue together with him about the possibility of continuing the competition, to be able to provide the victim with first aid.
