Medical supervision refers to the comprehensive inspection and observation of people engaged in sports (including athletes) by using medical and physiological methods, evaluating their development level, training level and health status, providing scientific training basis for physical education teachers and coaches, and ensuring the smooth progress of sports training and achieving better results. In short, under the medical observation, reasonable and scientific exercise can ensure health, prevent injury and improve sports skills.
Sports medicine supervision is an important part of sports medicine. The word "medical supervision" itself cannot clearly express its substantive content, such as studying the influence of exercise on the body, establishing functional diagnosis methods, diagnosing and treating sports diseases, etc. The contents directly related to medical supervision are only self-supervision, on-site health supervision and medical supervision of teaching and training.
According to the current understanding, sports medicine studies the influence of sports on the body, the health status and sports ability of sports participants. Its work should include the following contents: studying the physiological and pathological problems in sports practice; Evaluation of athletes' functional state; Prevention and treatment of sports diseases; Training arrangement after illness; Sports hygiene; Selection of athletes; Research on methods to eliminate fatigue and so on.
(A) Physical and pathological problems in sports practice
This is an important part of the daily work of sports medicine supervision, including the scientific research on the physiological laws of human body adapting to sports and its practical application in athlete training. The development of modern competitive sports requires athletes to carry out large-scale training in order to get the greatest adaptation and create excellent sports results. The adaptive changes of athletes in the process of heavy-load training are sometimes confused with some diseases, so it is often misdiagnosed when evaluating the morphological and functional changes of some organs of athletes by ordinary people's standards. For example, athletes in some sports will have bigger hearts after long-term systematic training. At this time, the enlargement of cardiac cavity with mild myocardial hypertrophy is the adaptation result of exercise training, not the sign of organic heart disease; For another example, athletes who focus on endurance training will have a very slow heartbeat when they are quiet, with a heartbeat of 30-40 times per minute. Literature reports that the slowest heartbeat of athletes is 265,438+0 beats per minute, which is also an adaptive phenomenon to training, but sometimes it needs to be differentiated from sick sinus syndrome seen in clinical medicine. Transient proteinuria in healthy people after exercise may have no clinical significance, but sometimes it needs to be distinguished from pathological proteinuria. Some athletes' anemia after exercise is related to high training intensity, and some may be caused by other reasons, so we should also pay attention to differential diagnosis. In the process of heavy exercise training, it is possible that the load exceeds the limit that the body can bear, resulting in the pathological state of overtraining. It is one of the important tasks of sports medical workers to study the diagnostic method of this physiological and pathological boundary and understand the early pathological signs of overtraining.
(B) Evaluation of athletes' physical function
Through medical examination, the general adaptability and special adaptability, training state and functional potential of athletes are comprehensively evaluated, which provides scientific basis for training arrangements. On the basis of objective indicators such as morphological characteristics, functional status and psychological status, it can be divided into preliminary examination and in-depth examination. The preliminary examination is suitable for beginners, using simple methods and indicators, such as height, weight, pulse, blood pressure, step test or PWC 170, determination of hemoglobin and urine protein, body fat, electrocardiogram, muscle strength (back strength and grip strength), nerve reaction, muscle tension, etc. In-depth examination is suitable for high-level athletes, using complex methods and special instruments and equipment, such as EEG, to evaluate the function of nervous system; Cardiopulmonary function was judged by echocardiography, systolic interval, cardiac output measurement, maximal oxygen uptake and anaerobic threshold. Understand the muscle condition with electromyography. Exercise load test mostly adopts bicycle dynamometer or movable tablet.
It is worth noting that biochemical methods, such as lactic acid, lactate dehydrogenase, phosphocreatine kinase, catecholamine, urea nitrogen, plasma testosterone (T), plasma cortisol (C), plasma testosterone/plasma cortisol (T/C), catecholamine and so on, have been paid more and more attention in functional evaluation. (3) Pulse supervision found in exercise practice that, within a certain range, pulse has a linear relationship with oxygen uptake and the body's ability to do work. Therefore, the speed of pulse during exercise can reflect the intensity of exercise; In a quiet state, the pulse reflex reflects the recovery degree of the body. In sports practice, people often regard pulse as a window to reflect the state of motor function, which is widely used.
1. Endurance athletes who train in pulse system at rest often have sinus bradycardia, that is, their pulse is less than 60 times per minute at rest, which is a good performance in most cases and an adaptation to long-term systematic training. The phenomenon of sinus bradycardia in athletes is widespread, and there are many reports. When the athlete is quiet, the slowest heart rate can reach 18-25 beats per minute. Athletes' slow heartbeat in quiet time should pay attention to the difference from sick sinus syndrome.
2. The morning pulse is the basic pulse, which is the number of pulses in the lying position before getting up in the morning and waking up. It is characterized by relative stability, and it slows down appropriately with the extension of training years and the improvement of training level. If the basic pulse suddenly speeds up or slows down, it often indicates that the body is overtired or has a disease. In addition, special attention should be paid to whether there is intermittence and symmetry. If there is intermittence, find out the reason in time.
3. Monitoring the heart rate during exercise is mainly used to judge the fatigue degree of the body and control the intensity of exercise.
(1) Judge the degree of physical fatigue. The athlete's heart rate is obviously higher than usual when the quantitative load and a set of movements are completed, indicating that the athlete's functional level is declining or physical fatigue.
(2) control the intensity of exercise. Using heart rate to control exercise intensity varies from person to person and from training purpose, such as development speed or endurance, anaerobic endurance or aerobic endurance. Let's talk about the specific application methods first:
① In repeated training, adjust the intensity according to the change of pulse. In repeated training, athletes are often required to complete the same distance within the specified time. Keep the intensity of exercise within a certain range, and the pulse value of athletes should be relatively stable when they complete a certain distance in a certain period of time. If the decrease of pulse value indicates the improvement of motor function level, the intensity can be increased to promote the continuous improvement of motor level. On the other hand, the increase of pulse value indicates that the functional level is declining or the intensity is too high, and the exercise intensity should be constantly adjusted according to the specific reaction of athletes.
② Adjust or control exercise intensity in endurance training. The research of sports medicine and sports physiology scholars all over the world confirms that in order to improve the level of cardiopulmonary function and the maximum oxygen uptake of athletes, the training intensity must reach a threshold, such as a certain lactate threshold and a certain heart rate threshold. In other words, this threshold can be reflected in the heart rate. For example, an expert in sports physiology in China used telemetry to measure the heart rate of national elite middle and long distance runners during cross-country training, and found that the heart rate of men was 26-26.6 beats/10s; Female after 27-28 times/10; Many scholars have reported that training with heart rate lower than 150 beats/min will not improve the level of VO2max; Astland, a Swedish physiologist, thinks that when the exercise intensity is close to the anaerobic threshold, that is, when the oxygen intake is close to the maximum without causing too much lactic acid in the body, the effect of improving aerobic capacity is the best, and its heart rate is equivalent to 160- 170 beats/min.
4. Heart rate after exercise. Measuring the recovery speed of athletes' heart rate within a specified time after quantitative load can also reflect the fatigue degree of athletes. When the physical function is good, the athlete's heart rate recovers faster, but when he is tired or overtired, the recovery speed is slower.