PDHPE Notes

PDHPE NOTES
Core One
Health Priorities in Australia
HOW ARE PRIORITY AREAS FOR AUSTRALIAS HEALTH
IDENTIFIED?
Measuring Health Status
Role Of Epidemiology
Epidemiology is the study of disease among particular populations or groups in
society. It Provides information to assist planning and decision making about
health expenditure, health priority areas and health promotion initiatives from
local, state and national perspectives. This enables conclusions to be drawn about
the health status of different populations.
Prevalence: Number of cases of disease that exists in a defined population at one

point in time.
Incidence: Number of new cases of disease occurring in a defined population over
a period of time.
Measures of Epidemiology
Mortality Death Rates. Indicates how many people die in a particular
population, how they died and over what period. Expressed per
100,000.
Infant Mortality Indicates the number of infant deaths in the first year of life per
1000 live births.
Morbidity (Disease and sickness rates) Examines the prevalence and
incidence of disease and sickness in a specific population.
Life Expectancy Indicates the number of years a person is expected to live.
Critique the use of Epidemiology to describe health status by considering

such questions as:
What can Epidemiology tell us?
The statistics and findings of Epidemiology can help researchers and health
authorities to:
Describe and compare patterns of health of groups, communities and
populations
Identify needs and allocate resources
Evaluate strategies and behaviours for prevention and control of disease
Promote behaviours to improve health status of the overall population
Who uses these measures?

Researchers, Health Practioners, Government Health Officials. All levels of
government, health service providers, Individual consumers.
Do they measure everything about health status?

No. They do not
Always show the variations of health status among populations subgroups
(eg: aboriginal and non-aboriginal Australians.)
Accurately indicate quality of life statistics tell little of degree and impact of
illness
Provide a whole picture, data in some areas is limited/non existent, i.e. mental
health
Provide reasons as to Why these problems exist
Account for social, economic and cultural factors that shape health.
The Health Status of Australians
Current Trends
Life Expectancy Improved 40%

since 1901-1910
Male Female
75 81
Major Causes of Illness and Death
MALES FEMALES
Coronary Heart Disease Coronary Heart Disease
Lung Cancer Cerebo Vascular Disease
Cerebo Vascular Disease Other Heart Disease
Other Heart Disease Dementia and Related

Conditions
Prostate Cancer Breast Cancer
Lung Cancer
Groups Experiencing Health Inequalities
Aboriginal and Torres Strait Islanders

Rates of Diabetes, infant mortality, high blood pressure are higher
Death rates are higher for almost every specific major cause of death
Life expectancy 20 years less than other Australians
Infant mortality rates are more than three times higher
Socio-Cultural Factors
Poor Public Health: inadequate housing, water and waste disposal
Access to Health Services: Geographical isolation
Historical Dispossession: contributed to economic disadvantages and poor
health status
Socio-Economically Disadvantaged
Determined by income, occupation and education
Leads to financial limitations
More likely to die from CVD
Higher rates of: youth unemployment, infant mortality, high blood
pressure, smoking, children levels of chronic asthma
Result
Lack of income and education can reduce opportunities of employment
Housing
Inadequate knowledge and practice of nutrition
Affects ability to raise the standard of living
Higher suicide rates, higher probability of risk-taking behaviours
Overseas Born Australians
Immigrants on arrival in Australia have better health than Australian born.
However this decreases with length of residence. Why? Governments
highly selective health criteria
Less likely to: be in a healthy weight range, to immunise, exercise, report
mental health problems.
People Living in Rural and Isolated Areas

Poorer Health Status
Higher: death from injury, death rates, infant mortality
Why? Result
Lack of Access to Health care
Lower economic status effects occupational hazards
Poorer overall living standards (living environment)
People with Disabilities

Limitation of normal functioning abilities (mainly physical)
Prejudice may affect their mental/emotional health
Lower life expectancy and higher morbidity rates
Financial constraints, lack of access to employment, needs for ongoing
health care
Gender
Male Female
Smoke more lung Live Longer (genetic
cancer/heart disease advantage, behavioural
Work more risky jobs patterns, work less strenuous
High contact sports or risky)
High risk of motor vehicle More prone to Eating
accidents Disorders
Make better use of medical
assistance
Gap is closing between genders.
Elderly People
Ageing population
Life expectancy increasing
Greatest cause of mortality: cancer, coronary heart disease, stroke
CVD has decreased due to: awareness of risk factors, medical advances
Common conditions: Arthritis, Visual and Hearing problems, Hypertension
Dementia and Hip Fractures
Identifying Priority Areas
Social Justice Principles

Social Justice refers to the notion of eliminating inequity in health and promoting
inclusiveness of diversity and establishing supportive environments for all
Australians.
Rights: Equal opportunity to achieve optimal health
Access: Ability to use a range of health services
Participation: In planning and making decisions about local and community

health
Equity: Fair allocation of resources and entitlements without discrimination
Priority Population Groups

- Groups within society, which has been identified as at risk of developing a
particular disease.
- The identification of these priority population subgroups with inequitable health
status is important for determining health priority areas.
- An example is ATSI who suffer higher death rates from heart disease.
Prevalence of condition
- Epidemiological data provides a path for determining the priority areas, by
revealing the prevalence of disease and illness.
- High prevalence rates of a disease indicate the health and economic burden that
the disease or condition places on the community.
- Eg: CVD is the leading cause of preventable death and will therefore take priority.
Costs to Individuals
- Disease/illness can place a large financial burden on an individual, measured in
terms of:
- Financial loss,
- Loss of productivity,
- Diminished quality of life
- Emotional stress.
Costs to the community

- Illness, disease and premature death all place en economic burden on the
community.
- Direct costs: money spent on diagnosing, treating and caring for the sick, plus the
money spent on prevention.
- Indirect costs: Value of output lost when people become too ill to work, or die
prematurely (loss of productivity)
Potential for Change

- Majority of priority areas in Australia result from preventable lifestyle behaviours.
- However not as easy as changing the individual: socio-cultural, environmental
factors need to be addressed
- For change to occur, individual and environmental factors must be addressed
How do we identify priority areas for Australias health?
In terms of:
- Social Justice Principles
- Prevalence of condition
- Priority population groups
- Costs to individual
- Costs to community
- Potential for change
How do socio-cultural, physical or economic environmental factors affect the

health status of populations?
Health inequities exist not solely because of poor health choices made by individuals,
but because of the environmental factors that shape how individuals and communities
live. Environmental factors include socio-cultural, which is to do with the attitudes,
beliefs and influences that exist in different groups within society; physical which
relates to air and water quality, pollution, proximity to health services and areas
conducive to good health, economic which has direct links with health (the wealthier
a community is, the better informed it is to make healthy decisions, the better off it is
to be able to afford to make its environment healthy and the more likely it is to avoid
unhealthy behaviours.
How is health status linked to gender?

The inequity in the health status of males and females may be attributed to:
Biological factors: increased female morbidity is due to childbirth, menstruation and
menopause
Gender based variations in reporting illness eg: men tend not to perceive symptoms
and seek medical help as readily as females
Social factors: eg: risk taking behaviours are considered more acceptable for men.
However, these differences have decreased in recent years, reflecting a change in
gender roles and relationships.
What role does the principle of social justice play?

Considerations of the social justice principles help identify the need to address the
health inequities that exist in Australia. There are groups in Australia that do not enjoy
the same level as health as the rest of the population (ATSI, socio-economically
disadvantaged, etc.) The reasons for the differences are largely socially related. The
social justice principles of equity, access, participation and rights help direct health
promotion to address these differences.
Why is it important to prioritise?

In order to provide some common direction in national health. Prioritising helps focus
funding and attention towards the areas of greatest need.
WHAT ARE THE PRIORITY AREAS FOR IMPROVING AUSTRALIAS
HEALTH?
Priority Areas for Action
Cardiovascular Disease (CVD)

- Major health and economic burden on Australia
- 36% of deaths in 2004
- General term to cover all diseases of the heart and circulatory system
- Can be coronary heart disease (poor supply of blood) stroke (interruption of
supply of blood to brain) or peripheral vascular disease (disease of arteries etc
that affects limbs)
- 36% of deaths in 2004
- Significant differences in population subgroups
- New technologies have led to improved prevention and treatment (trends have
decreased)
- ATSI Death rates from CVD twice as high as other Australians
- Over 65 2/3rds of those with Coronary Heart Disease are over 65
- Low Socio-Economic: Lower education which leads to higher incidence of risk
factors
Prevalence of the Condition
- 36% of all deaths in 2004
- Prevalence increases as an individual ages
- Considerable decline in death rates over the last 30 years (technology and
reduction in risk factors)
Cost to Individuals/Communities
- In 2002, was the most costly disease for Aus Health System - $55B and likely to
increase with ageing population
- New technologies have lead to higher costs to communities with direct
(hospitals/nursing homes/drugs) and direct (sick leave of loss earnings, burden on
families, loss of quality and quantity of life)
- Most risk factors are preventable inactivity, smoking, obesity, diet, alcohol
abuse, blood pressure, cholesterol
- The use of health promotion has seen good results in the past
Cancer
- Rapid growth and spread of abnormal cells caused by cells receiving the wrong
message. Creates a lump or tumour, usually.
- Cancer is the second leading cause of death
- In 2001 almost 1/3 of people who died had malignant cancer
- Its risk increases with age
- Currently accounts for 30% of male deaths, 25% female deaths
Prevalence of Condition
- In 2000, approx 459,000 new cancer cases reported
- Second biggest killer in Australia, 30% of male deaths, 25% of female deaths
- Highest to lowest incidence: colorectal, breast, prostate, melanoma, skin, and
lung.
Costs to individuals/Communities
- 2.8 Billion to Australia
- Indirect costs include loss of earnings, sick leave and decreased productivity
- Many preventable, many hereditary
- Educating people on risks of smoking, sun exposure, benefits of
prevention/screening
Injury
- A trauma, poisoning or other condition of rapid onset to which factors and
circumstances external to the person contributed significantly
- 4th leading cause of death in Aus
- 0-14 year old group most likely to sustain injury, 25%
- Car accident injuries prevalent in 25-34 age group (34%)
- Death rates from injuries increase with remoteness
Prevalence of the condition
- 2000/05 18% of population had sustained a recent injury (4 weeks)
Costs to individual/communities
- 2000/2001 it was 8% of Health expenditure
- 223 million was spent on intentional harm including suicide and homicide
- Many has already been done, OH&S in workplace and safety features in cars
- Decreased, peaking in 1970
- Putting chemical out of reach of children
Mental Health
- Disease or condition that affects a persons ability to cope with daily tasks and the
emotional or cognitive capacity to function
- 2003, mental illness was among 10 leading causes of disease burden in Aus
- 13% burden of disease
- Low socio-economic status have higher prevalence 16%
- Disability, homeless
- Divorced/separated 18-20% experience mental/behavioural problems
Prevalence of condition
- 11% reported currently have long term mental/behavioural problem (04/05)
Costs to individuals/communities
- Mental health represents 4.5% of all hospital separations in 03/04
- 12% of total days spent by patients in hospitals
- $3b 6% of total health expenditure
- Alcohol use
- Inactivity 75% had low levels of exercise
Diabetes
- Body is unable to maintain normal blood glucose levels
- Juvenile onset
- Late onset
- Gestational diabetes
-2004 was major cause of death
- Elderly for both types
- Indigenous Australians reported diabetes 3x at the level of other Australians
- 29% of diabetics live in low socio economic status 14% in higher socio-
economic
- Overweight/obese 10x more likely to suffer from Late onset
Prevalence of Condition
- 2004/05 3.6% of Australians suffered from diabetes
- 2000/2001 1.7% Of national expenditure, $3000 per sufferer
- Very possible, many risks preventable
- Increase physical activity/decrease obesity, better diets
Asthma
- Chronic respiratory disease in which narrowing of a persons airways causes
difficulty in breathing and maintaining a sufficient airflow in and out of lungs
- 2004, 313 deaths from Asthma 2/3 were female
- Indigenous Australians 15% affected in 2006
- 19% in over 45s against 9% overall
- Australia has higher prevalence, 11% - UK 9%
Prevalence of the condition
- 10% of Australians reported in 04/05 2 mil Australians approx
- 693$ million 1.9% of all health expenditure
- Decrease smoking
- Increase awareness for treatment ventilators
The Four-Priority Areas Selected
1) CVD
2) Cancer
3) Diabetes
4) Injuries
The nature of the problem
Extent of the problem (trends only)
Risk Factors
Social Determinants
Groups at risk
1) CVD
Nature of Problem - All diseases involving the heart and blood vessels
- Relates to the health of organs that depend on strong blood
supply.
- Major CVDs are:
o Coronary Heart Disease
o Stroke
o Heart Failure
o Peripheral Vascular Disease
- Mainly caused by atherosclerosis- abnormal fat build ups,
cholesterol etc
Extent of problem - Major economic and health problem in Australia

accounting for 40% of deaths
- Mortality declining in males and females
- CVD is largely preventable
- Males are more likely
- Decline in mortality due to improved medical care (drugs
for BP) and reduction in risk behaviours
Risk factors Lifestyle factors:
- High B.P.
- High blood fats
- Overweight/obesity
- Lack of physical activity
- Smoking (5x more likely)
- Diabetes, alcohol, the pill
Non modifiable:
- Age: Risk increases
- Gender: males, increased risk
- Heredity: Family history = more prone
Groups at risk and - Older people
Social Determinants - Indigenous people
- Socio-economically disadvantaged people
- Rural and remote Australians
2) Cancer
Nature of Problem - Occurs when normal cell division in the body becomes
uncontrolled, and the abnormal cells spread throughout the
body, causing further damage
- Malignant Cancerous tumour Benign Non-cancerous
tumours
- Mainly; lung, melanoma (+ other skin), colorectal,
prostate, cervical and breast cancer
Extent of problem - Incidence increases with age
- Cancer is larger contributor of disease and burden
- Male cancers are higher after 55 years
- Tends to vary between types
Risk factors - Smoking
- Environmental hazards (asbestos, radiation, etc)
- Overexposure to UV rays
- Heredity factors
- Alcohol and Diet
Groups at risk and - Increases with age
Social Determinants - Men have higher risk of being diagnosed with cancer and
higher risk of dying of it than women
- Men generally eat worse, smoke and drink more than
woman and work in more at risk environments
3) Diabetes
Nature of Problem - Metabolic disease in which high blood glucose levels
result from defective insulin secretion or insulin production
- Type 1 Insulin dependent and need injections and careful
diet. Without treatment is fatal.
- Type 2 Adult onset diabetes Non insulin dependent,
can go undiagnosed for years. Reduced levels of insulin
Extent of problem - Incidence of diabetes is higher in Australia
- Up to 1.7 million Australians have diabetes, half of which
are undiagnosed
- Up to 60% of cases of type 2 can be prevented
- 6th leading cause of death in Aus
Risk factors - Overweight (type 2)
- High blood pressure (Type 2)
- Heredity (Type 1)
- Physically inactive
- Unhealthy eating
Groups at risk and Disproportionately prevalent in:
Social Determinants - Older Australians
- ATSI
- Family history
- Overseas born aus
- Areas of low SES (poor nutrition low PA)
4) Injury
Nature of Problem - Road injury
- Suicides
- Spinal cord injuries
- Firearms injuries
- Injuries to children
- Other injuries from fires, falls, machinery, drowning,
poisoning and homicide
Extent of problem - Main cause of death for children + young adults
- Major cause of hospitalisation
- Mortality from injury is declining
- Greater attention to prevention (Workplace oh&s)
Risk factors - Smoking
- Environmental hazards (asbestos, radiation, etc)
- Overexposure to UV rays
- Heredity factors
- Alcohol and Diet
Groups at risk and - Young adult males higher rate of mortality from injuries
Social Determinants - People in rural areas
- Children
- Indigenous Australians
WHAT ROLE DOES HEALTH PROMOTION PLAY IN ACHIEVING
BETTER HEALTH FOR ALL AUSTRALIANS?
Approaches to Health Promotion
What is Health Promotion?
It is the process of preventing ill health. It aids to advance the health of individuals
and communities through intervention. It also helps empower individuals and
communities by providing support to increase control over and improve health.
This means that
- Political
- Social
- Environmental
- Economic
- Behavioural
Aspects all need to interact to establish a climate that is fully supportive of individual
and community well being.
Health promotion can be targeted at 3 levels of prevention:

1) Primary - all activities carried out to prevent onset of disease/injury. Includes: use
of sunscreen/100% UV clothing, children immunization programs, and pool-fencing
legislation
2) Secondary intervention at early stages of a health problem, early diagnosis and
prompt treatment, often relies on education community to recognise the early signs of
disease. Includes: weight loss programs and screening techniques.
3) Tertiary strategies adopted once a person has developed a disease, minimizes the
effect of disease, promotes effective rehab, and prevents recurrence. Includes: rehab
for people recovering from operations.
Health Promotion:
Involves activities that are aimed at enabling people to control their health, to improve
their level of health and prevent illness.
Public Health:
A combination of science, medicine, practical skills and beliefs aimed at maintaining
and improving the health of all people.
New Public Health:

Is a model that recognises the dual role of lifestyle and living conditions as
determinants of health status? It involves establishing programs, policies and services
that create environments that support health.
The Shift from an Individual Lifestyle approach to Health Promotion to the

New Public Health Approach
- Individual Lifestyle approach relies too heavily on the individual, with no

accounting for different contexts, assumes all individuals will benefit from it,
assumes all people can change, does not account for inequity in access and does
not give persons and communities a role in the determination of health premises.
- The New Public Health Approach 1886 Ottawa Charter Acknowledges

the roles played by living conditions (water, air, food, etc.) and social, economic
and environmental factors that determine health state.
- Places emphasis on establishing programs that promote health enhancing
behaviours
- Based on:
o Reducing Health Inequalities
o Have equal access to health resources
o Creating environments that promote health
o Community participation in decision making of health care
o Implementing a broad range of strategies to address health issues rather
than narrow focuses
- The new public health approach advocates the co-operation of government,
community, and health professionals in the promotion of better health for the
whole population.
Characteristics of the new public health approach

Empowerment of individuals
Individual empowerment refers to an individuals ability to make decisions about, or
have personal control over their life. We need to be encouraged to participate in
improving our level of health. This can be best achieved when:
o Provided with accurate and relevant health information
o Given the opportunity to be involved in decision making about
our own and our communitys health
o Encouraged to work with a wider range of health professionals,
knowing individual opinions will be taken into account
o Given the opportunity to develop personal skills that will aid us in
adopting positive health behaviours
o Provided with social and economic supports.
Improved decision making skills allow for a greater control over lives.
Community Participation
Dependent on community empowerment, strengthening community action as,
recommended by Ottawa Charter.
Such empowerment results in a community in which individuals and organizations
work together to meet their respective needs.
Strategies for health care are more effective when developed by communities.
Characteristics include:
o Focus on health of people in a defined community of interest
o Involvement of members in defining issues on which health
promotion effort will focus
o Development of comprehensive knowledge of local people, their
environment and needs
o Use of knowledge to identify and analyse local health issues, and
to develop and implement health promotion initiatives
o Community partnerships with health professionals
o Support for a public voice for the health of the local community
Recognition of the social determinants of health

Health is inextricably linked to the social and economic environments in which people
live.
This lay in the acknowledgement that to be successful the social determinants of
health need to be addressed. The following social determinants of health influence to
a large extent the ability of individuals to achieve good health:
o The distribution of income, poverty, health
o Access to and conditions of work
o Gender influences
o Living conditions and environments
o Access to health services and information
o Age
o Education
o Cultural background
o Housing
o Social support
Example of a Modern Health Promotion Campaign - Jamie

Olivers Ministry of Food
o Advantages teaches people to eat good food, which in turn leads

to healthier lifestyles, reduces risks of cardiovascular disease,
diabetes, obesity and other lifestyle diseases (high blood pressure,
cholesterol etc.) It works, slowly, but there is still progress to be
made. It educates and empowers.
o Disadvantages Not enough being done to resolve social
determinants, the socio-economic statuses of the population is low
and health promotion is therefore more difficult.
Major Health Promotion Initiatives

Government responses (Major Reports)
Ottawa Charter for Health Promotion (1986)
1) Developing personal skills By providing information and enhancing life skills,

leading to greater control over ones health.
2) Creating supportive environments Encouraging of reciprocal maintenance, that is

take care of one another and the environment.
3) Strengthening Community action such as encouraging self-help, social support

and participation in health related matters.
4) Reorienting health services The health sector must look beyond providing clinical
and curative services and look to health promotion that addresses the needs of the
individual as a whole person.
5) Building Healthy Public Policy eg: legislation for better health, healthier goods
and services, more enjoyable environments.
Jakarta Declaration 1997
Reaffirms the principles of the Ottawa Charter and recognised that health promotion
was essential to development.
1) Promote social responsibility for health
2) Increase investments for health development in all sectors
3) Consolidate and expand partnerships for health
4) Increase community capacity and empower the individual HP is carried out by
and with people, not on or to.
5) Secure an infrastructure for health promotion governments, groups, educational
institutes, private sector
Jakarta Cancer CVD
Promote social - No smoking in the - Labelling on food
responsibility for health workplace products
- Legislation to restrict - Reduced taxation on
advertising of low alcohol beer
cigarettes
Increase investments for - Governments need to - Governments need to
health development allocate more money allocate more money
into preventative into preventative
strategies for cancer strategies for CVD
Consolidate and expand - Governments working - Government working

partnerships in health with Cancer Council with the National Heart
eg: funding campaigns Foundation
sharing resources and
expertise
Increase community and - Quit line - Healthy Canteens

capacity to empower - No hat, no play - Support groups
individuals - Distribution of sun - Fun runs
screen at beaches
Secure an infrastructure - Intersectoral action, eg: - Doctors working with
for health promotion pharmacists working with community to promote
community centres to better health practices
engage in more
preventative strategies
Australias Health (AIHW Publication) 1998 - present
Australias health report of the Australian Institute of Health and Welfare (published
every 2 years.)
A biennial report on Australias health, including information on:

- Patterns of health and illness with particular reference to national priority areas
(seven areas by 2006)
- Determinants of health
- Supply and use of health services
- Cost and performance of health services
WHAT ROLE DO HEALTH CARE FACILITIES AND SERVICES PLAY IN
ACHIEVING BETTER HEALTH FOR ALL AUSTRALIANS?
Nature of Health Care in Australia

Role of Health Care
The role of health care in Australia once was a curative process, including Doctor-
Patient relationship. Little thought was given to the health of communities.
Now there is a much stronger relationship between public health initiatives and
medical care. There is an understanding among traditional health care providers of the
importance of prevention, health promotion and the involvement of individuals,
communities, businesses and governments.
Range and Types of Health Facilities and Services
Institutional
o Public Hospitals
Highly specialised and complex services
Heart and lung transplants, same-day surgery, take most of the non-admitted
patients (out-patients)
o Private Hospitals
Owned and operated by individuals and community groups.
Same day surgery, offer more short stay, elective procedures, less complex
procedures featuring less expensive equipment, such as operations on the nose,
eyes, etc.
Differences
Patients Public or Private
Public Public ward, hospital, allocated doctor and bed free of charge.
Private Choose doctor, pay for accommodation, Medicare & Private Health
Insurance refund certain amounts of this.
o Psychiatric Hospitals
Treatment of people with severe mental illness.
Has moved away from institutional care to services and continuing care in
community services.
Number of public psychiatric hospitals has fallen.
o Nursing Homes
Provide long-term care and nursing attention for those who are unable to look
after themselves aged, chronically ill, dementia, people with disabilities.
o Ambulance Services
Offer transportation for those who are in need of medical services.
Non-Institutional
o Medical Services, eg: G.P.
Diagnose and treat minor services.
Work in medical services, hospitals and many preventative strategies.
Refer patients to specialists.
o Pharmaceuticals
Pharmaceutical drugs are supplied through hospitals, doctors by private
prescription and over-counter in shops.
o Dental Services
Dentists and orthodontists alike take care of patients teeth. Private health care
(HCF) can supply subsidies etc.
o Admin and Research
Carry out statistical information provided to governments, doctors, and
communities.
Access to health facilities and services
- Cornerstone of Aus Health Care System is MEDICARE.
- Medicare is designed to allow simple and equitable access to all Australian
citizens.
- Funded by the Federal Government
- Supported by Medicare Safety Net and Pharmaceutical Benefits Scheme
- Does not cover and give access to all medical services:
o Specialist services: dental, speech therapy, physio etc, are not covered
and therefore may not be accessible to people of low SES.
- Overcrowding of hospitals/lack of beds/doctors/nurses
- Access in rural/remote areas
- Non-English speaking individuals or different cultures not taking full advantages
of services
Responsibility for Health Care

1) Commonwealth Government
- Concerned mainly with the formation of national policies and control of health
system financing through the collection of taxes
- Provides funds to state/territory governments for health care and influences their
health policy making/delivery
- Direct responsibility for special community services, i.e.: health programs for war
veterans and the Aboriginal community
2) State and Territory Governments

Principal functions include:
- Hospital services
- Mental health programs
- Dental Health services
- Home and community care
- Child, adolescent and family health services
- Womens health programs
- Health promotion
- Rehab systems
- Regulation, inspection, licensing and monitoring of premises, institutions and
personnel
- Have the prime responsibility for providing health and community services
3) Private Sector
- Provides wide range of services: private hospitals, dentists and alternative health
services (e.g.: chiropractors)
- Privately owned and operated, they are approved by Commonwealth Department of
Health and Ageing
- Religious organizations, charity groups and private practioners run these
- Some organizations, (National Heart Foundation and Cancer Council) receive
funding from both state governments and Commonwealth government
4) Local Government
- Vary from state to state, mainly concern environmental control and a range of
personal preventative and home care services.
- Include monitoring of sanitation, hygiene standards in food outlets, waste disposals,
monitoring of building standards, immunisation.
- State controls some of these (immunisation) while local councils are responsible for
their implementation.
5) Community Groups
Many community groups also promote health i.e.: Asthma Foundation, Diabetes
Australia.
The Health care system in Australia involves the interrelationship of many

government and non-government bodies.
Commonwealth Government
(Policies, finance, health programs, etc.)
State Government
Health Insurance
Private Public
- MBF - Medicare
- HCF
- NIB
- FAI Local Government
- Medibank Private
- HBA
- Australian
Unity
Health Fund
Health Care Providers
Institutional Care Non-Institutional Care

- Hospitals - Community health services
Reparation - Medical Services
Public - Health Promotion Agencies
Private - Pharmaceutical services
Psychiatric
- Nursing Homes
Funding of Health Care in Australia
Health Insurance (Public and Private)
Health Insurance
Accidents and illness can cost individuals a considerable amount of money. The
commonwealth Gov is committed to providing equitable health services to all, which
it attempts to achieve through its basic health insurance scheme, Medicare.
Public Health Insurance Medicare

Medicare is Australias universal health care system, established to provide affordable
and accessible health care. The funds to operate the Medicare system are obtained
through income taxes and the Medicare Levy, paid according to income level.
Medicare provides access to:
- Free treatment as a public patient in a public hospital
- Free or subsidised treatment by medical practioners, including GPs, specialists
and some specified services of optometrists and dentists.
Regardless of the charge, every Australian is covered for 85% of an amount that is set
down by the government as a common (Scheduled) fee. Some doctors charge more.
Many doctors bulk bill patients, where the patient pays nothing and the doctor
receives up to 100% (85% = specialists) of the scheduled fee from Medicare.
Private Health Insurance

Private Health Insurance allows people to cover private hospital and ancillary
expenses (i.e.: dental, physiotherapy, chiropractic services) and aids/appliances
(glasses.)
They may choose private health insurance for:
o Shorter waiting times
o Being able to stay in a hospital of choice
o Choose their own doctor
o Ancillary benefits, such as dental cover
o Security, protection, piece of mind
o Private rooms in hospitals
o Insurance cover whilst overseas
- Lower levels of private health are present in the young, the elderly and other low
SES groups
- After Medicare in 1984, figures have fallen in private health insurance
- Strains on public health urged the government in 1998, introduce a 30% rebate for
people who have private health insurance
- Also introduced 1% levy (on top of 1.5% Medicare Levy for single people) on
people who earn $50,000 or more a year and who do not have hospital insurance
Medicare Private Health Insurance

Who pays? - Commonwealth - Commonwealth
Government Government
- Taxpayers - Private contributors
How paid for? - Levy or tax linked to salary - Monthly premiums for various
forms of cover
What benefits? - Basic medical services - Hospital cover: hospital
- Choice of GP services, doctor choice,
- Basic hospital services in hospital choice, private or
public hospitals public hospital
- Specialist health care - Ancillary services dental,
- Cover for 85% of the optical, chiro
scheduled fee for Medical - Some special benefits
services - Cover while overseas
Costs of Health Care to Consumers
- The extent of preventable illness/premature death in Australia indicates great
potential for improving health through preventative activities. The high cost of
health services and continuing financial burden on governments (and taxpayers)
programs aimed at prevention have gained wide acceptance.
- Governments, individuals and communities are being made more accountable for
their expenditures. Insurance companies charge higher premiums for smokers who
wish to be covered for life insurance.
- Lifestyle factors could cause up to an estimated 70% of all premature deaths.
However 90% of Australias health expenditure is allocated to treating and curing
illnesses.
- Consumers pay for health care in a number of ways. These include taxes, health
insurance, medical services not covered by insurance and Medicare.
- The cost of health insurance is determined by the type of policy being taken out,
the age of the person, the number of people being included in the policy and the
persons own health behaviour and associated risks, for example smoking.
- A younger person may be less likely to take out health insurance, as they believe
they will not need it.
Health care expenditure versus health promotion expenditure

Health care expenditure in Australia far exceeds expenditure on illness prevention and
health promotion. An emphasis on medical treatment to cure illness dominates the
allocation of public health resources and spending. The new public health model
focuses on the social factors that lead to ill health. The model places the emphasis on
health promotion as the most cost effective way in which to address the social issues
of health. The health preventative system is more long term.
Alternative Health Care Approaches
Reasons for growth of alternative medicines and health care approaches
- Recognition of traditional medicines by the majority of the worlds population
- Effective for some people for whom western medicines have been ineffective
- Greater desire for people to use natural, herbal medicines
- Traditional beliefs of many cultures
- Increasing acceptance in Australia of the value of multicultural influences
Range of Services Available
Approach Description
Acupuncture - Traditional medicine of Eastern countries
- Involves inserting fine needles into the skin,
left in either briefly or up to 20-30 minutes.
- Claimed to be effective for many conditions,
stimulating the mind and bodys own healing
purpose
Aromatherapy - Use of pure essential oils to seek to influence
or modify the mind, body or spirit
- Accordance with holistic principles, by
strengthening ones vital energies and self-
healing capabilities, thus directly affecting
the mind and body
- Used in treatment for depression, sleep
disorders, stress symptoms and anxiety
The Bowen Therapeutic Technique - System of muscle and connective tissue
movements that gently realign the body and
balances and stimulates energy flow
- Soft tissue injuries, musculoskeletal
problems, back and neck aches, arthritic
symptoms, stress, migraines, asthma, sinus.
Chiropractor - Based on relationship between spine and
functioning of nervous/musculoskeletal
system
- Adjust the spine, using specific rapid thrusts
delivered by the hand/small instrument
- Aimed at correcting subluxations, removing
interference to nervous system and control of
bodily function
Herbalism - Plants and herbs exclusively
- Oldest form of medicine and still is used for
over 75% of the worlds population
- Use the whole plant form rather than extracts
- Restore and support bodys own defence
systems
Homeopathy - Recognises the symptoms unique to each
person
- Stimulate the individuals healing powers to
over come a condition
Iridology - Analysis of human eye to detect signs of
individuals physical, emotional and spiritual
wellbeing
- Treatments can then be prescribed to improve
general and immune health system
Massage - Oldest and simplest forms
- Reduce blood pressure, stress and anxiety
levels and is beneficial for immune system
Mediation - State of inner stillness
- Strengthens immune system, improved sleep,
lowers blood pressure, increased
motivation/self esteem
Naturopathy - Holistic treatment of individual
- Seek to address symptoms as well as resolve
underlying causes of illness
How to make informed consumer choices
The best way to evaluate any supportive evident is to ensure it is evidence based and:
- Recent (within 5 years)
- Detailed description of all available treatment options
- Description of information that relates to quality of life issues of effect on survival
rates
- List of both beneficial and adverse effects
What do you need to make informed decisions?

1) What will happen if I do nothing?
2) What are the intervention options?
3) What are the positive/negatives of these (how important are they? How long
lasting? How probable?)
4) How do these weigh up for me?
5) Do I have enough information to make a decision?
Other questions may include:

- What is the treatment you offer? How can it benefit me?
- What experience and training do you have?
- What are your qualifications?
- How much will the treatment cost?
- Can this treatment be combined with conventional medicine?
WHAT ACTIONS ARE NEEDED TO ADDRESS AUSTRALIAS HEALTH
PRIORITIES?
Developing Personal Skills

- Supports the personal and social development of the individual
- Educate, provide information on health and enhance skills such as decision
making and communication
- Endeavours to empower people, increasing the options available to them, which
allows them to exercise more control over their health and environments
Modifying Personal Skills

- Important in reducing morbidity and mortality
- Development of decision-making, communicating, assertiveness, time
management and planning and problem solving.
- Can be best facilitated in the school, at home, at work and in community settings
Gaining Access to Information and Support

- Access to information and support groups is not evenly distributed
- This is attributed to:
o Physical isolation
o Lack of financial aid to provide health facilities and education programs
o Poor literacy skills
o Language Barriers
o Cultural Barriers
- Important to find ways to provide equitable access to information and support for
all
Creating Supportive Environments

- Focuses on where people live, work and play and on increasing peoples ability,
within these, to make health-promoting choices
- Concerned with lifestyles, social and physical environments
- Need to take care of, protect and support each other, environment and community
from threats to health.
Identifying personal support networks and community services

- Personal support networks are invaluable in the promotion of health, having
emotional/social/financial support from people can greatly influence an
individuals ability to change
- Community can also help promote health through the provision of community
support networks
Identifying sociocultural, physical, political and economic influences on

health
- The social environment in which the individual lives plays a significant role in
determining that persons level of health
- For health promotion to be effective it must address the
social/cultural/physical/political and economic factors that affect peoples lives.
Strengthening Community Action
Empowering communities to take action
- Giving communities the chance to identify and implement actions that address
their health concerns
- Community empowerment to promote health involves:
o Setting health priorities
o Making decisions collaboratively
o Planning health-promoting strategies
o Identifying and effectively using resources
o Implementing and evaluating strategies
- Resources include
o Schools
o Workplaces
o Self help groups
o Local Governments
o Doctors
o Media
o Community Health centres
Reorienting Health Services

- Focus has changed from an emphasis on the clinical and curative aspects of health
to one that promotes health, prevents illness and supports wellbeing
- Requires a change in the attitude and organization of health services and changes
to professional education, training and research
- Eg: Health professionals working and supporting schools in promoting health
through programs such as asthma management
Identifying the Range of Services Available
- Primary health care services are ideal for health promotion because of their large
usage, widespread locations, they include:
o Hospitals
o Psychiatric Hospitals
o Nursing Homes
o Surgeries
o Community Health Centres
- Can promote health through a range of strategies:
o Providing clinical services
o Providing patient education
o Giving support and counselling
o Providing information
o Creating links with other health services
o Ensuring equitable access
Gaining Access to Services
- Access to health services depends on: requirements of each service, physical
location, community awareness of its availability and the affordability of the
service
- Due to Medicare and public health scheme, most Australians can access services
offered by GPS
- Depends on persons geographical location
Building Healthy Public Policy
- Refers to the decisions made at all levels of government and by organizations that
work towards health improvement
- Legislation/policies/taxation/organisational change in areas such as
recreation/welfare/transport/education/housing
Identifying the impact of policies on health
- Some legislation is difficult to enforce
- Seatbelt law have been useful as they enshrined by legislation and are actively
monitored by police
- The implementation of organisational changes can also have a positive impact on
health I.e. No hat no play
Influencing Policy
- Gain community support and influence public health policy through advocacy
- Advocacy includes lobbying about a particular issue
Deciding where to spend the money
- Expenditure is predominately allocated to health-care services and facilities whose
primary function is to treat illness
- Currently money is being demanded into hospitals but the government is trying to
implement preventative services
- Allocation of financial resources must also address the inequities in health that
exist between groups within the Australian population
PDHPE NOTES
Core Two
Factors Affecting Performance
HOW DOES TRAINING AFFECT PERFORMANCE?
Energy Systems
Alactacid System (ATP/PC)
- ATP supplies are very limited, have enough for one explosive muscular
contraction
- An explosive movement causes ATP molecule to split, providing energy for
muscular contraction
- Further muscular work relies on creatine phosphate (CP) breaking down to
creatine and phosphate, releasing energy in the process
- The energy is used to drive free phosphate back to ADP so it can become ATP
- Once reformed, ATP can break down again and so the process goes on
- CP supplies will be exhausted within 10-12 seconds, 2 mins to restore
Lactic Acid System

- Carbohydrate foods are broken down into glucose (the simplest sugar) which
circulates in the blood
- Extra glucose can be stored in the muscles and liver there it is called glycogen
- Much more Glycogen in the body than there is PC.
- Glycolysis in the break down of glycogen as fuel for activity. When this happens,
energy is released to resynthesise ADP back into ATP. This happens without
oxygen and is therefore called anaerobic glycolysis.
- This would allow a 400m runner to run at 90-95% of their maximum speed
- When anaerobic glycolysis is taking place in the muscles, lactic acid is produced.
As lactic acid levels rise in the muscles, the athlete will start to feel fatigued.
Eventually this means the athlete must stop running or slow down because lactic
acid cannot be removed from the muscles quickly enough.
- The lactic acid system is fuelled up by carbohydrates in the form of glycogen.
Depending on the intensity of the activity, it can supply energy for between 30
seconds (at maximum effort) and 2-3 minutes (at 70-80% at maximum effort)
- Lactic acid is the by-product of the energy system.
- It can take 30 mins- 2 hours for lactic acid to be removed from the muscles (active
recovery improves the speed of recovery.)
- Used in activities such as 100m, 200m, 400m running and cycling
Aerobic System
- Activity lasting longer than a few minutes requires oxygen to resynthesise ATP so
that movement can continue
- The process of oxygen being used to produce energy is called aerobic metabolism,
because glucose, fats (and sometime protein) are broken down to produce energy
- Lactic acid is not produced because oxygen is present.
- Carbohydrate (in the form of glycogen and glucose) is the preferred source of fuel
for aerobic metabolism.
- Glycogen and oxygen break down to produce energy, which resynthesise ATP.
- Carbon dioxide and water are waste products.
- When glycogen store are depleted (after an hour or so) fats are used with oxygen
to produce energy. In very rare circumstances, protein can be used to supply
energy.
- Aerobic system is very efficient at producing ATP. Glycogen can be used to
supply much more energy where oxygen is present.
- It takes several minutes from the onset of an activity for muscles to become rich
with oxygen. With oxygen, the body has virtually unlimited supplies of energy as
long as the activity is low moderate.
- After about an hour of activity, when glycogen runs out and fats supply the energy
to the muscles, an athlete will feel fatigued and slow down, hitting the wall
Alactacid System Lactic Acid System Aerobic System
How does the After movement ATP During high intensity During continuous
energy system forms ADP. Creatine exercise activity to the
work? phosphate is broken (approximately 80- muscles, oxygen can
down to form 95% maximum be used to break
creatine and effort) the body down glycogen into
phosphate. It can breaks down ATP. This process
then combine with glycogen without can be continually
ADP to produce ATP oxygen present to repeated.
and movement can form ATP.
occur again.
Fuel Creatine Phosphate Carbohydrate is Carbohydrates are
broken down into the main fuel source.
muscle glycogen and Fats and to a limited
is the only fuel extent protein, can be
source. also be used.
Amount of Energy Very limited Limited Unlimited at a low
Supplied intensity
Duration At 95-100% of Depending on the Virtually unlimited at
maximum effort, will level of intensity, 30 a low intensity.
only last for 10-12 seconds to 2-3
seconds minutes. At 90-95%
of maximum effort,
duration would be
approximately 30
seconds.
Causes of Fatigue Creatine phosphate is Lactic acid (a waste The aerobic system
exhausted after product) builds up in will continue until
approximately 10-12 the muscles leading muscle glycogen or
seconds to fatigue and stored energy in the
exhaustion form of
carbohydrates, fats
and protein have
been utilised.
Waste Products Nil. Lactic Acid Carbon dioxide and
water
Recovery Time 30 seconds 2 20 minutes 2 hours Sufficient time to
minutes depending on the replace diminished
intensity and fuel supplies. Up to
duration of exercise 24 hours
Sports mainly using 100 m sprint, javelin, 100m swimming, Triathlon, marathon
the energy system long jump, 400m running, running, 1500m
weightlifting cycling swimming, cycling
road race.
Principles of Training
Progressive Overload
- The overload principle implies that gains in fitness (adaptations) will only occur
when training load is greater than normal and is progressively increased as
improvements in fitness occur.
- Aerobic Training application of the overload principle is reflected in the hearts
ability to pump more blood to the working muscles (increased cardiac output).
Also, the ability of the working muscles to take up more of the oxygen as it is
delivered to the cells (increased oxygen uptake.)
- Strength training application of the overload principle results in an increase in
the cross-sectional area of a muscle, commonly called muscle hypertrophy. This is
usually directly related to an increase in strength.
- Flexibility Training application of the overload principle results in the ability of
a muscle to stretch further than its normal length.
Specificity
- Training programs should be designed specifically to meet the fitness
requirements and energy systems of the sport you participate in.
- Applied to muscle groups, this suggests that groups used for the activity need to
be the same groups that are used during training.
- Metabolic specificity refers to identifying the energy system or systems most
appropriate to the activity and developing these systems through related training
procedures.
- Aerobic Training An athlete training for a marathon must target the aerobic
system in training. Most activity will ensure that the third energy pathway is used
for 95% of the time or more.
- Strength Training if increased leg power is required to improve a persons ability
to sprint, the training program must correctly address the speed and number of
repetitions, load and time between sets correctly. Eg: if the load is too high and
repetitions too low, the program will cause bigger improvements to muscle bulk
than muscle power.
- Flexibility Training to increase flexibility of the shoulder muscles required for
javelin throwing, each muscle group involved in the throw must be stretched
beyond its normal range.
Reversibility
- If training program is stopped, components of fitness will decline
- In the same way that the body responds to training by improving the level of
fitness, lack of training can cause the opposite to occur. This is referred to as the
detraining effect.
- This applies equally to aerobic, strength and flexibility training gains.
- In general, greater losses will follow discontinuation of training where greater
gains have been made, as there is more to loose.
Variety
- Repetition without creativity leads to boredom. The coach must continually strive
to develop required attributes by using different techniques to ensure the athlete is
being challenged not only by the activity but also by initiative and
implementation.
- Aerobic training this takes many forms. We can train the aerobic system using a
variety of activities, such as swimming, running, cycling, circuit training.
- Strength training Uses a variety of methods. Isometric, isotonic and Isokinetic
methods all increase strength, but do so using different equipment.
- Flexibility training Uses a range of methods, including static, dynamic and
proprioceptive neuromuscular facilitation.
Training Threshold
- For improvements to be made, we must work at a level of intensity that will cause
our bodies to respond in a particular way.
- The lowest level that we can work and make fitness gains is called the training
threshold or aerobic threshold. This is approximately 70% of a persons maximum
heart rate.
- When one is working above the aerobic threshold but below the anaerobic
threshold, they are in the aerobic training zone, where significant training gains
are made.
- The uppermost level is the anaerobic threshold, the lactate inflection point, and a
level of intensity in physical activity where the accumulation of lactic acid in the
blood increases very quickly.
- Aerobic training the ability of the cardiorespiratory system will be improved if
the athlete works closer to the anaerobic threshold than the aerobic threshold.
Working at this level increases the athletes ability to tolerate lactic acid, which
becomes very important as speed is increased in the final stage of a race.
- Strength Training bigger gains in strength will be made as resistance is
increased.
- Flexibility training gains are greatest if muscles are safely stretched further.
Warm up/Cool Down
- Each training session requires three components warm up, training and cool
down.
- Warm up - Purpose: to reduce the risk of injury, increase body temperature,
mentally prepare the athlete, and stimulate the cardiorespiratory system.
- Should include:
o General aerobic activity (gross motor jogging)
o Specific flexibility exercises (increase range of motion and prevent
muscle tears)
o Callisthenics (push ups, star jumps)
o Skill Rehearsal
- An effective warm up will be sustained for at least 10 minutes
- Cool down Reverse of warm up. Purpose: minimise muscle stiffness and
soreness that could result. Not as intense as the warm up.
- Includes:
o Aerobic work (jogging) decreases intensity, body temp.
o Stretching of muscle groups used in the training session
- Helps disperse and metabolise lactic acid concentration. Essential to all programs.
Types of Training
Aerobic Training
Aerobic training uses the aerobic system as the main source of energy and includes a
number of training types:
o Continuos Training
This involves sustained effort without rest. The heart rate must be elevated
into the aerobic training zone (70-80% MHR) for at least 20 minutes.
Examples include jogging, cycling and aerobics. The longer the heart rate is
raised the better the training effect.
o Fartlek Training
This type of aerobic training is also continuous, but the athlete will vary the
speed for short bursts throughout the training session. Eg: 20s bursts of speed
every 2-3 minutes, or running uphill at a faster pace. Good for interchange of
systems (EG: rugby, basketball, soccer.)
o Interval Training
Involves alternating work and rest. When working, the intensity is high and
when resting the athlete is recovering, but not long enough for the heart rate to
fall below the aerobic threshold. Eg: running 200m in 35seconds with 2
minutes rest, ten times. Swimming 50m in 50 seconds, 10 s rests, 20 times.
This trains the anaerobic systems as well as aerobic. Can be easily varied to
accommodate Progressive Overload principle, by varying intensity, work time,
rest time and number of repetitions. The work rest ratio is important
consideration. For aerobic training, needs to be between 5:1 and 1:1. For
aerobic, needs to be 1:1 and 1:3.
o Circuit Training
Requires participants to move from one station to the other, performing
specific exercises at each until completed. This is best for general
improvements in fitness. Basketballers, tennis players, etc, could benefit from
this, as specific exercises for their sports would be included in the circuit.
o Aerobics
A good aerobics program involves flexibility, strength and aerobic capacity.
The heart is elevated for at least 20-30 minutes. It is a good source of variety.
Strength Training
- Ability of muscles to exert a force
- Single maximal force weightlifting, shot-put
- Repeated forces running, swimming, and football.
o Isometric Training
- Muscle develops tension, but there is no change in the length of the muscle fibres
(EG: pushing against a wall) It is useful in sports requiring isometric contractions
(downhill skiing, gymnastics.)
- Only improves strength at the joint angle trained.
o Isotonic Training
- The muscle develops tension and there is shortening (concentric) or lengthening
(eccentric) of fibres.
- Most common training, specific to most sports where strength is required
throughout a range of joint angles.
- Usually involves lifting and lowering a weight in the gym (bicep curls, squats,
lunges) but can be used for athletes one weight (sit ups, push ups.)
o Isokinetic Training
- Elaborate machines in laboratories are used to ensure resistance applied to the
muscle group is the same throughout the full range of movement.
- The muscle fatigues, or is overloaded throughout the full range of movement.
Strength training needs to be:
- Specific to the task being trained for
- Employ the progressive overload principles
Absolute Strength: Maximum amount of force generated by a muscle in a single

contraction
Relative Strength: Maximum amount of force that can be generated by a muscle
relative to the persons body weight. Eg: 50 kg person + 75kg person were both able to
squat 100kg, 50kg has higher relative strength because of lower body weight.
Power: Speed strength. Ability of the muscle to exert force quickly.
Strength Endurance: Ability of muscles to continue contracting for a period of time
without fatigue.
Purpose Intensity Repetitions Sets Exercise Recovery Sessions Per

Speed between Week
Sets
Absolute & Very Heavy 2-6 4-6 Slow 3-5 Minutes 3-4, days
Relative (2RM- rest between
6RM) sessions
Power Medium- 3-10 3-5 Fast 2-3 minutes 3-4
Heavy (60-
80% 1RM)
Strength Light to 15-30 3-6 Medium 1-3 Minutes 3-5
Endurance Medium Fast
(40-60%
1RM)
Flexibility Training (Static, Ballistic, PNF)

- Range of motion about a joint.
- Determined by the ability of the muscles to lengthen.
Needed in training programs to:
- Reduce to chance of injury
- Increase range of motion
- Decrease muscle soreness
Affected by:
- Age (flexibility decreases with age)
- Gender (females more flexible)
- Temperature (higher air & body temp = increases)
- Exercise history (active = more flexibility)
Static: Muscle stretched and held in position for 10-20 seconds

Ballistic: Stretched by bouncing action beyond normal range of motion
PNF: Stretched and held in a fixed position, then isometric contraction, followed by
another stretch.
Advantages Disadvantages
Static - Safe with little chance in injury - Not as effective
- May not decrease chance of
injury in competition
Ballistic - Increases performance, more effective - Stimulates stretch reflex
than static, can be more specific - Can cause injury
- Experienced athletes
PNF - Most effective in decreasing chance of - Can cause injury by
injury overstretching, must be done
correctly
Stretch Reflex: Involuntary muscle contraction that prevents muscle fibre damage if
muscles are lengthened beyond normal range.
HOW DOES THE BODY RESPOND TO AEROBIC TRAINING?
The Basis of Aerobic Training
Pre-screening (eg: age, health status)
Pre-screening: to assess the health status of a person before they become involved in
an aerobic training program.
Before someone starts an exercise program is important they are pre-screened. This is
especially important if the person:
- Is 40 years of age or older
- Has a medical condition, eg: asthma, heart condition, high blood pressure
- Smokes
- Is obese
- Has a family history of heart disease
- Has not exercised in a number of years
Quite often before pre-screening commences it is recommended the person undergo a
medical check up with their GP.
Can also encourage people to begin and maintain an exercise program using an
exercise prescription.
Application of FITT principle

F Frequency
I Intensity
T Time
T Type
Guidelines for Average Guidelines for Elite Marathon

Individual Runner
Frequency 3-4 times a week 6-7 times a week
Intensity Close & above the aerobic Shorter sessions need to be at an
threshold is good for general anaerobic threshold.
fitness and health Longer sessions need to be aerobic
training zone.
Time Needs to be at least 20 minutes Needs to be much longer than 20
for aerobic benefits. minutes to maintain fitness level.
Poorly conditioned people will Training time needs to be specific to
get benefits from under 20 race requirements.
minutes.
Type Any activity that uses large Must be specific (i.e.: running.)
muscle groups. Variety helps Cycling, swimming and aerobics
maintain motivation. classes are not suitable during
competition periods.
Immediate Physiological Response to Training
Heart Rate
- Number of times a heart beats per minute
- Immediate rapid increase in training and untrained
Ventilation Rate
- Depth and rate of breathing, expressed in breaths per minute
- Increases at beginning of exercise
- Gradually rises as exercise intensity increases
Stroke Volume
- Amount of blood ejected by left ventricle f heart during a contraction ml / beat
- Increases at beginning of exercise in untrained/trained
- At max at moderate intensity (does not increase much more)
Cardiac Output
- Amount of blood pumped by the heart per minute
- Increases at beginning of exercise as muscles demand more oxygen
- Continues to rise with intensity
Lactate Levels
- A salt formed from lactic acid that accumulates during intense anaerobic activity
- Always some lactate in blood
- Increases slowly with low-moderate intensity exercise
- At intensities beyond anaerobic threshold, lactate levels increase very quickly,
resulting in fatigue.
- Anaerobic threshold = Lactate Inflection Point
Physiological Adaptations in response to Aerobic Training

The body responds to aerobic training by adapting to the demands being placed on it.
How long it takes for the body to adapt depends on the individual. It usually only
takes several weeks before significant adaptations are noticed. The following
adaptations are made in response to training.
Resting Heart Rate DECREASES

- Resting heart rate is the amount of times your heart beats per minute at a state of
rest.
- Resting heart rate decreases due mainly to an increase in stroke volume
- The heart needs only to beat at a rate that delivers sufficient oxygen to the body.
Stroke Volume INCREASES

- Training increases the volume of blood circulating in the body, meaning more
blood is able to enter the left ventricle each time the heart relaxes.
- Also, training allows the left ventricle to contract more forcefully, meaning more
blood can be ejected each heartbeat.
Cardiac Output
- Cardiac output = stroke volume x heart rate
- Increases as a result of the increases of stroke volume
Oxygen Uptake Increases

- Vo2 means Volume of Oxygen that is used by the body in a given time
- Vo2 max means the max volume of oxygen that an individual is able to use
- Vo2 max decreases gradually after age 25, but can always be improved through
training
Lung Capacity Remains Unchanged
- A greater lung capacity means that more air (carrying oxygen) can be inhaled and
absorbed.
- Males have a greater lung capacity due to larger size
- Training can increase vital capacity slightly (which is the amount of air that can be
expelled after maximum inspiration)
Haemoglobin level increases

- The substance in blood that binds oxygen
- Is found in red blood cells, and carries oxygen to the body
- Higher haemoglobin levels mean that more oxygen can be transported to the
muscles during athletic exercises.
Blood Pressure Decreases

- Systolic blood pressure is the pressure placed on the arterial walls when blood
passes through it
- While there is an increase in blood pressure at the beginning of exercise, training
has the affect of lowering resting blood pressure over time
- This is one of the positive health affects of training
- Training helps increase/maintain the elasticity of the arterial walls
HOW CAN PSYCHOLOGY AFFECT PERFORMANCE?
Motivation
An internal state that activates directs and sustains behaviour towards achieving a
particular goal.
Positive and Negative
Positive
- Occurs in the form of rewards, praise and recognition after a good performance
- Reinforces the performance and encourages the athlete to reproduce it
Negative
- Performance is driven by a fear of the consequences of not achieving to
expectations.
- A player may play well to avoid being booed, ridiculed, etc.
Positive vs. Negative

Negative motivation may work from time to time, but will eventually erode a players
confidence, self-esteem and interest. Positive is better as a long-term approach to
improving performance.
Intrinsic and Extrinsic

Intrinsic
- Motivation that comes from within the individual
- I.E.: the athlete may enjoy the challenge of being the best they possibly can be
- Desire to succeed, fun.
Extrinsic
- Motivation that comes from sources originating outside the individual
- Financial rewards for winning a golf/tennis tournament
Intrinsic vs. Extrinsic

Internal provides ongoing interest in the sport/activity, but extrinsic can help direct an
athlete to perform to their potential in a given situation. Motivation needs to come
from both sources.
Social, material and internal reinforcement

Reinforcement is a form of reward (positive) or punishment/threat (negative) that
influences the probability that an action or behaviour will occur
Social reinforcement
- From coaches, other players, peers, parents, any person who influences an athlete
- E.g.: an encouraging pep talk from a coach or guest speaker (positive.) A
volleyball coach making his players do push ups each time they make an error
(negative)
Material Reinforcement
- An athlete receives tangible items such as money, trophies, prizes, etc as reward
for success
- An athlete winning a gold medal at the Olympics, a football club renewing the
contract of a star playing (positive) A football player being fined by his club for
missing training (negative)
Internal Reinforcement
- Feelings and emotions in an individual that come from pride or disappointment
following a performance
- A softball batters positive self talk following a home run, encouraging her to
repeat the performance.
Anxiety
Trait and State Anxiety
Anxiety is predominately a psychological process characterised by fear or
apprehension in anticipation of confronting a situation perceived to be potentially
threatening.
Trait Anxiety
- A general level of stress that is characteristic of each individual
- Shown in how one responds to daily situations
- Varies according to individuals conditioning to respond and to manage stress
- Increased anxiety can be dealt with through relaxation techniques
State Anxiety
- Heightened presence of distress in response to a situation
- Can be evident when the risk of failure is high
- Can contribute to a degree of physical and mental paralysis, preventing routine
actions
Sources of Stress
Stress it he non-specific response of the body to a demand placed on it
- Stress builds inside of us, produced by adrenaline which readies the body for
action
- Stress is a personal attribute depends on predisposition (how each person
perceives stressors as a result of their genetic makeup and learned coping
mechanisms)
- This reflects: past experience, routines, expectations, the amount of support, the
frequency of similar occurrences
Factors that produce stress = stressors. In practice and competitive sporting

environments they can develop from:
- Personal pressure
- Competition pressure
- Social Pressure
- Physical pressure
Can learnt to deal with these through:

- Relaxation techniques
- Developing concentration skills
- Developing confidence
- Planning strategies
Optimum Arousal
Arousal is the level of anxiety before or during a performance.
- Arousal is a physiological process
- An individual performs a skill most successfully when the level of arousal is
optimal for that particular task and that individual
- Under arousal = distraction, disinterest or depressed level of motivation
- Over arousal = Unable to perform the required movements with precision because
they are excessively tense and unable to concentrate
- These vary between individuals. Athletes who have a high disposition towards
anxiety require less arousal than those who have a lower disposition.
Good
B
Performance
A C
Poor Low High
A = under aroused performance may suffer from such factors as a lack of

motivation, disinterest, poor concentration and the inability to cope with
distractions
B = Arousal zone. Shown by a balance between level of motivation and ability co

control muscular tension, increasing as a result of the desire to perform well.
C = Excessive arousal characterised by an anxiousness and apprehensiveness,

reflecting their excessive concern about the performance increased muscular
tension, mental confusion.
- Difficult tasks including few muscle groups: shooting, archery, golf = levels of
arousal need not be high to be optimal
- Easier tasks running, weight lifting = an increase in the level of arousal for
performance to be optimal
- Optimal arousal levels for a given task vary between each individual and rely on
such factors such as: self expectation, expectations of others, experience, financial
pressures, level of competition, the degree of difficult, skill finesse
Managing Anxiety
Concentration/attention skills (Focusing)
- Concentration is the ability to link movement and awareness to the extent that the
individual can focus on doing rather than on thinking about doing
- The ability to focus on the task at hand
- When an individual thinks about doing they separate the task from themselves
as the performer Their feelings, personal reactions become the focus
- When an individual focuses on the task or activity, their thoughts relate more
directly to execution
- Can be improved through training that emphasises the PROCESS rather than the
OUTCOME
- When an individual pays attention to process, they focus on technique and try to
understand why they are not doing things right
- Improved concentration positively affects confidence and levels of arousal as
athletes realise they can rely on their physical and mental preparation to support
their performance.
Mental Rehearsal
- The technique of picturing the performance or skill before executing it
- Enhances competition performance as well as the acquisition and building of
motor skills
- The mental repetition of a movement or sequence to increase the minds
familiarity with the desired motion
- Recalling then reliving the execution of a skill/performance
- Flaws: difficult for coach to control the thoughts of their athletes, some tend to
daydream and embrace pictures in an unproductive manner, others do not back
this up with actual physical practice.
- Importance: elevates body to desired arousal, provides a clear idea of what is to be
done, heightens concentration, narrows thoughts to the task
- Vivid, realistic pictures, narrowing of thoughts to exclude distractions,
experiencing it, visualising success
Visualisation
- Incorporates skills required in mental rehearsal
- Focus on picturing a specific aspect of the performance or skill and ensuring the
image is correct
- Successful visualisation requires the athlete to be relaxed, mind trained to focus
on points or techniques that are essential for prime skill execution
Relaxation
- A series of techniques that seek to control the bodys response to stress
- Over arousal will tarnish efforts, relaxation techniques can help this
- Need to develop techniques to control the autonomic nervous system in charge
of controlling functions such as heart rate, respiration rate and blood pressure
- Progressive muscular relaxation relaxing muscle groups using special
exercises
- Mental relaxation relaxing the body through controlled breathing, relaxing the
mind
- Meditation narrow of ones thoughts using simple repetitive images and sounds
- Centred breathing controlling breathing to release tension before a
performance
Goal setting
- Targets that we direct our efforts towards performance or behaviour
- Establishing goals is important to improve individual and team preparation
- Provide focus, give direction, help people realise their aspirations
- Short term goals achieved in a limited period of time, stepping stones for long
term
- Long term achieved over a long period of time
- Behavioural goals eg: to be more punctual at training
- Performance goals relate to an athletes desired level of success
HOW CAN NUTRITION AFFECT PERFORMANCE?
Balanced Diet
Is it adequate for performance needs?
2 important features
1) Balanced intake of nutrients, ensure growth, repair, maintenance and functioning
of tissues
2) Balanced in terms of energy requirements fuel demands must match energy
intake
Adequacy for performance needs

- Assessed primarily in terms of macro nutrients (proteins, carbs, fats are the
bodys major nutrients supply energy, essential for growth and
development) and micronutrients (vitamins, minerals, water essential body
nutrients but do not supply energy)
Carbohydrates
- Ideal fuel for activity
- Complex carbs digest slowly and provide sustained energy release. This should
make up approximately 70% of carbs ingested, where as simple carbs (cakes,
sweets) should be a much smaller intake
- Complex carbs are also a valuable source of vitamins and minerals
Roles of
1) Carbohydrates ideal fuel for activity
2) Fats important source for low intensity, long distance activity (becomes
glycogen)
3) Proteins structural role of holding cells together and in growth, repair and
maintenance of body tissue. Can be fuel if all other sources are exhausted
4) Water important during physical activity, critical it lasts over extended period.
Body stores water in cells (intracellular) and outside cells (extra-cellular)
Supplementation
o Vitamins and minerals
- Maintain bodily functions
- Each has a different role iron is important for oxygen transport to the body
- Micronutrients, required in very small amounts
- Healthy diet will provide sufficient vitamins and minerals to the body and
supplements are not necessary for most
o Carbohydrate loading
- Technique of loading the muscles with glycogen in preparation for an endurance
activity (longer than 90 minutes marathons, triathlons)
- Increasing complex carbohydrates consumption and decreasing exercise in the 1-3
days leading up to an event increases the amount of glycogen stored in the
muscles and liver
- Athletes can utilize glycogen as a fuel source for longer than normal
- To be effective: requires athlete to deplete stores through exhaustive training 6-7
days before the event and consuming proteins and fats 4-6 days before the event,
in order to stimulate the liver into being able to store more glycogen when carbs
are reintroduced to the diet
Design a pre event and recovery nutritional plan for an athlete
Pre event intake

- Eat 3-4 hours before competition
- Avoid fatty and protein foods
- East mostly complex carbs
- Drink adequate fluid in days proceeding event
During Competition
- Aim is to conserve muscle glycogen and maintain blood glucose levels
- At 75% of aerobic capacity, liquid carbs feeding (sports drinks) can delay
glycogen depletion by up to 30 mins
- Adequate hydration throughout the event
Post-event intake
- Replace glycogen stores with carb heavy foods
- Re- hydrate to replace lost fluid
- Avoid alcohol
Hydration
Appropriate hydration is the most important single factor influencing endurance
work.
Principles of body temperature regulation
- Normal body temperature is 37 degrees
- Controlled by the brain
The Heat Balance Mechanism
Heat Balance
Heat Gain Heat Loss
Metabolism Radiation
Exercise Conduction
Convention
Evaporation
Balancing heat production with heat loss

- The body has two mechanisms that operate to either constrict or enhance the
dissipation of heat to the environment: vasoconstriction and vasodilation
- Vasoconstriction results in less blood and less heat being supplied. It operates
when core body temperature goes below the set point. Its functioning accelerates
if body temperature decreases rapidly as is the case with hypothermia.
- Reverse happens if the body is overheated, as such in endurance events. The
process of Vasodilatation is used to cool down the body if temperatures rise
above a set point. This ceases to function in cases of severe hyperthermia
- Vasodilatation and vasoconstriction operate reflexively during the day and in
response to movement changes such as vigorous exercise
Guidelines for fluid replacement

- We lose water through the toilet, sweating and breathing
- Exercising on a hot day means sweat loss increases by about 5 times
- Amount lost needs to be balanced by the amount consumed otherwise one will
encounter dehydration
Dehydration is characterised by:
- Increase in pulse rate
- Increase in body temperature
- Decrease in blood pressure
- Decrease of water in the cells
- Gradual decline in circulatory function
- In hot weather/exercise, we produce more sweat than normal. If this cant

evaporate (due to humidity) the body cannot cool itself and core temperature will
rise. To prevent hyperthermia an individual needs to:
1) Ensure adequate hydration through: fluid intake before, after, activity

2) Minimise fluid loss through: acclimatising, wearing suitable clothing, avoiding
activity in high heat and humidity, avoiding excess fat and salt intake, avoiding
activity when in fever.
HOW DOES THE ACQUISITION OF SKILL AFFECT PERFORMANCE?
The learning process

Cyclical process (perceiving, deciding, acting, feedback)
Perceiving input comes from information called cues. Information arrives to the
brain via cues (i.e.: watching others, etc.)
Deciding Using the stored information in the brain the learner processes it,
deciding how to use the information. The brain decides how to convert the cues into
appropriate physical responses.
Acting When the decision has been made the neuromuscular system guides the
learner into making the desires movement called output.
Feedback Learner uses information about the result of their performance from
internal/external sources and alters their actions to improve performance. The cyclic
process allows the individual to refine the skill.
Characteristics of the learner, eg: personality, heredity, confidence, prior

experience, ability
Heredity
- Individuals are endowed with certain characteristics inherited from parents
- Unchangeable and will limit the dimensions of their potential
- The environment determines if we can reach the limits set by heredity
- Somatotype is a persons body type or shape
Personality
- Refers to an individuals characteristics and way of behaving
- Due to ones social interactions and learning experiences
- Some traits include: consistency, reliability, level of motivation, ability to express
feelings
- Elite coaches choose athletes not only those with physical talent but those which
possess positive learning attributes
Confidence
- Firm belief in ones own ability
- Crucial for many tasks in every day life
- Critical for improvements in skill acquisition
Prior experience
- If there is prior experience there is an ability to accelerate the learning process
Ability
- The ease at which an individual is able to perform a movement or routine
- Incorporates factors such as: perception, reaction time, intelligence
The Learning Environment
Physical environment
The physical environment is the surrounding space and conditions under which a skill
is being performed.
It may affect the level of interest and motivation, and may even impose restrictions,
i.e.: lack of lighting.
Nature of the Skill
Open Skill occurs in an environment that is unpredictable and frequently changing
Closed Skill occurs in an environment that is stable and predictable
Gross Motor Skill requires use of large muscle groups for execution
Fine Motor Skill requires the use of small muscle groups to perform the movement
Discrete skill distinctive beginning and end that can be identified
Serial skill involves a sequence of smaller movements that are assembled to make a
total skill
Continuous skill has no distinct beginning or end
Self Paced Skills are movements for which the performer determines the timing and
speed of execution
Externally paced skills movements for which an external source controls the
timing
Discrete
Serial
Continuous
Practice methods Massed, distributed, whole, part
Massed continuos practice session, with the rest intervals being shorter than the
practice intervals
Distributed (spaced practice) involves a broken practice session, with the intervals
of rest and or alternative activities being longer than the practice intervals
- Massed is best when the learner is:

o Motivated
o Fresh and ready to learn
o Time is a factor massed results in faster improvement rates
- Distributed is best when the learner is:

o Complex/difficult skills
o Unmotivated
o The task causes fatigue and discomfort
o Best in earlier stages of training
Whole when a skill is practiced in its entirety

Part applied when a skill is broken into smaller components and each discrete sub
skill (subroutine) is practised separately
- Whole is best when:

o It is difficult to break the skill down into parts
o The skill is simple
o Parts of the skill are dependent on each other
- Part is best when

o The skill involves a combination of body parts
o Involves a sequence of movements that can be separated
o The task is complex
- Often a coach will use a combination of whole and part.

Feedback
Internal Feedback (Intrinsic)
- Embodies feelings, together with sensory information such as seeing the ball and
hearing the sound of the ball hitting the bat
- Perceived through the senses
External Feedback (Extrinsic)
- Includes various forms of external information suggestions from the coach,
video replays, judges scores and race results
- Outside sources
Concurrent (or continuous)
- Received during the performance of a skill
- Occurs simultaneously with skill execution
Delayed Feedback
- Received after the skill has been executed
- Waiting for the result of a basketball thrown not received until the ball enters or
misses the basket
Knowledge of results
- Information about the outcome of a movement
- How successfully the skill was performed
- Always external and may come from sources, i.e.: coach, other performers
- Provides information about skill execution
Knowledge of Performance
- Information about the pattern of the movement during execution
- How it is performed
- May be internal/external
Stages of Skill Acquisition
Cognitive
- The athlete needs to understand the skill in order to know what to do
- Demonstration and clear instructions on how to perform the skill are needed
- Will make many errors
- Part and distributed practice needed
- The more complex the longer the cognitive stage will continue
Associative
- Once the athlete understands what to do, practice is required to get it right
- The brain understands but the body needs practice
- Mistakes will be learned from
- Will make adjustments based on feedback or practice
- Still helped by coach/positive feedback
- May remain in this stage for a long time
Autonomous
- Athlete has mastered the basics of the skill and can perform it without much
thought
- Further practice will improve the quality of the skill so that it can be performed in
different conditions
- The athlete can perform the skill whilst thinking about other things, such as tactics
Rates of skill acquisition
Learning curves and plateaus
Pra
ctic Linear Curve
e - Performance improves directly with practice
- May result: good coaching, high motivation, simple tasks
- Unusual to find this curve in reality
Performance
Pra
ctic Negatively Accelerated Curve
e - Learns quickly and first
- Further improvements are more gradual
- May result from fatigue, disinterest, limited coaching
Performance
Pra
ctic Positively Accelerated Curve
e - Small gains at first
- Followed by rapid improvement
- May result from: learning complex tasks
- Increasing motivation
Performance
Pra
ctic
e The S-Shaped Curve
- Periods of rapid and gradual improvement
- May result from a task with simple and complex parts
- Or Varying levels of motivation
Performance
The Learning Plateau
The Learning Plateau
- A period where little improvements occurs

- This may result from an injury that interrupts practice, limits of the coach, time
given to other tasks or requirements, such as finesse.
Skilled performers VS. Unskilled performers
Kinaesthetic sense
- The system of sensitivity that exists in the muscles and their attachments
- Allows them to feel the movement as they perform it
- Inexperienced performers make mistakes as their muscle memory is not fully
developed yet
- Direct result of practice
Anticipation and timing
- Skilled performers are better able to predict what may happen in specific
situations
- This skill gives them increased time to consider their responses
- Ability to predict movements provide more opportunity to ensure the movement is
performed smoothly and with co-ordination
Mental Approach
- Skilled performers can recognise and respond to relevant cues, response to
multiple cues, develop motor imagery, develop high levels of internal motivation,
realise importance of optimum arousal, establish goals and feel a desire to achieve
them
- Use the benefits of experience to advantage, anticipate what is going to happen
Consistency
- Skilled performers are able to perform the desired movements repeatedly
Objective Measurement of Skill

More objective = more credible.
Objectivity is the extent that the measure or test is independent of the observer.
Skill-related tests
- Designed to measure how well an individual is able to execute specific motor
skills: e.g.: throwing a softball
- Coach uses these tests to assess results/improvements
- For tests to be recognised/accepted they must:
o Have a set amount of procedures (environment, activity, measuring
instruments)
o Have an established set of norms/average
o Include objective techniques
o Be valid
E.G.: Test of aerobic fitness Beep test (would be valid for: 1500 m run, not valid
for a 1500 swim)
Validity and reliability of tests
Reliability: the ability of the test to produce similar results with similar subjects
under similar test conditions.
Validity: the ability of a test to test what it says it will. E.g.: a test designed to
measure basketball skills would not be considered valid if the test was solely on
shooting ability.
Judging the quality of performance
Characteristics of skilled performance
Skilled performers demonstrate the ability to:
- Anticipate responses and react to them quickly
- Co-ordinate movements, giving the impression of fluency
- Time movements
- Focus on tactics and strategies
- Execute skills with ease
- Adapt and modify movements
- Perform consistently at a high level
Outcomes of a skilled performer

Potential outcomes include:
Positive Negative
- Financial remuneration offers of - Increased media profile
sponsorship, deals or monetary - High expectations to perform well at
support or backing every occasion
- Increased self confidence/esteem - Possibly, a feeling of pressure to use
- Increased motivation performance enhancing drugs to
- Desire to improve skills maintain or further improve their
- Improved ability to analyse and level of success
evaluate performances
- Ability to transfer proficiency and
learning to other tasks
- Ability to make informed critical
evaluation of other performers
Personal Vs. Prescribed Judging Criteria
Personal criteria are the preconceived ideas or expectations that an individual brings
to judge a performance may be used by coaches when selecting players.
Prescribed criteria are established by a sports organization or body, and form the
basis of assessment for competitions in that sport or activity, i.e. fastest runner at a
major event who meets the qualifying standard
PDHPE NOTES
HSC Option 3
Sports Medicine
Ways to classify sports injuries
Direct
- Caused by an external force applied to the body, such a collision with a person or
object
- Result in fractures, dislocations, sprains and bruises
Indirect
- Caused by an intrinsic force, that is a force within the body
- Result of an excessive strain being placed on muscles, tendons and ligaments.
- Sprinter tearing a hamstring muscle during a race.
Overuse Injuries
- Caused by overuse of specific body regions over long periods of time
- Result from intense or unreasonable use of joints or body areas
- Repetitive, low impact exercise jogging, stepping
- Anterior shin splints, tendonitis
Soft Tissue
- Injuries to all other tissue other than bones and teeth
- May be acute (occurring suddenly: fracture, sprain) or chronic (prolonged)
Hard Tissue
- Damage to bones and teeth
- Frequently more serious than soft tissue injuries
Soft Tissue Injuries
Tears, sprains, contusions
Skin abrasion, laceration, blister, calluses
Name Nature (Causes / Effects)
Tears (Strains) - Injury to muscle, often caused by overuse
- Results in pain, muscle spasm, muscle weakness
- Localized swelling, cramping or inflammation, loss of
muscle function
Sprains - Stretched or torn ligament
- Falling, twisting, getting hit = cause sprains
- Pain, swelling, bruising and being unable to move the joint
Contusions (Bruise, - Wound where skin is not broken
hematoma) - However blood vessels are injured or bleeding
- Caused when vessels are damaged or broken as a result of
blow to the skin
Skin trauma
Abrasions (Scrape) - Causes pain and shallow bleeding as a result of the skin
being scraped away
- May be embedded with dirt/debris
- Requires gentle cleansing and sterilization to prevent
infection
Lacerations (Cuts) - Irregular open wound caused by blunt impact to soft tissue
- Deeper injury than is seen in abrasions
- Larger blood vessels involved more bleeding
Blisters - Small pocket of fluid within upper layers of skin
- Caused by overexposure to UV rays, reaction to
medication, friction with skin
- Irritated cells and influx of water = stinging, pain
Calluses - Increased thickness of skin that usually occurs over bone
protuberances
- Caused by constant pressure from external sources
Inflammatory Response
- Injury to soft tissue results in inflammation begins the bodys self healing
process
1) Pain, swelling, loss of mobility
2) Formation of new fibres and scar tissue
3) Reduced swelling, increased production of scar tissue and replacement tissue
strengthens
Managing soft tissue injuries
RICER
- REST (Reduce bleeding, prevent further injury)
- ICE (Reduce pain, blood flow, swelling for 20 minutes every hour up 4 days)
- COMPRESSION (Decreases bleeding, reduces swelling, elastic bandage of
injured area at time of injury and reapplied periodically for at least 24 hours)
- ELEVATION (Decreases bleeding, raise above heart, for whenever possible
during the day and the next two or three nights)
- REFERRAL (Seek guidance for rehab, as soon as possible)
Avoid HARM Heat (do not apply for 48 hours) Alcohol, Running,
Massaging (discouraged in first 72 hours)
Immediate treatment of skin injuries
- Primary concern is to prevent infection

- Cleansed with soap and warm water
- Serious wounds require medical treatment (may need Tetanus injection)
- Minor wounds should be cleansed with antiseptic cream or solution and covered
with a dressing
Hard Tissue Injuries
Fractures
Dislocations
Injury Types Nature
Fractures Simple - Small breaks in the bone as a result of
falls, direct injuries
- Broken bone does not protrude through
skin
- Pain, selling, limited mobility result
- 6-8 weeks recovery
Compound - Bone protrudes out of skin
- Result of very hard direct injuries
- Intense pain, bleeding, swelling,
complete loss of mobility
- Urgent medical attention
Stress Fractures - Fatigue fractures
- Result from overuse injuries (running on
hard surfaces)
- Bone may have small, incomplete breaks
- Pain, swelling
- Time needed away from activity
Dislocations Common sites: jaw, What is it?
shoulder, elbow, - A joint that slips out of place
spine, hip, knee - Occurs when end of bones are forced
from their normal positions
Causes & Effects
- Blow, fall, trauma to the joint
Symptoms
- Swelling
- Intense pain
- Immobility of the affected joint
Managing Hard Tissue Injuries

Immobilisation
Medical Treatment
- Immobilisation restricts movement in the injured area by using splints and
bandages
Teeth
- If tooth is loosened, keep in place and seek immediate dental advice
- If knocked out, put back in and splint to an adjacent took using aluminium foil
- If not place tooth in milk and clean it with casualtys salvia
- Seek immediate dental assistance
Finger dislocations
- Use of DRABCD (Danger, response, airway, breathing, compression,
defibrillation)
- Securing with a splint to fully immobilise injury
- Ice, elevation and support with bandage
- Immediate medical treatment
Fractures
- Use of DRABC, controlling bleeding, treating shock
- Support using a splint and bandage to reduce movement
- Immediate medical assistance
- Medical attention will be required if: there is an obvious deformity, uncontrolled
breathing, casualty is unable to complete TOTAPS
Assessment of Injuries
TOTAPS
- Used to assess the extent of the injury to a player and determine whether or not
they can return to the field
- If they can complete all of the required they should be able to return
- If they cannot complete any of the requirements, they should only be allowed to
return after assessment from a medical practioner
TALK Find out exactly what happened

OBSERVE Any signs of deformity/swelling? Compare each side of the body
TOUCH Gently feel the area for signs of deformity/swelling pinpoint area of pain
ACTIVE MOVEMENT Ask player to perform range of joint movements
flexion, extension, rotation If this can be done, procedure can proceed
PASSIVE MOVEMENT Assessor physically mobilises the joint (flexion,
extension, rotation) using a range of movements aimed at identifying painful areas
and instability in the joint
SKILLS TEST - Player is asked to perform a skill that will be required during the
game i.e.: a sidestep. If they can perform to the satisfaction of the assessor, they can
return to the game.
HOW DOES SPORTS MEDICINE ADDRESS THE DEMANDS OF SPECIFIC
ATHLETES?
Children and Young Athletes

Medical Conditions
o Asthma
- Condition characterised by breathing difficulty where there is a reduction in the
width of the airways leading to the lungs, resulting in less air being available to
them
- Can affect performance if not managed correctly but should not be an excuse to
avoid participation except in extreme cases
- Begins with coughing and wheezing and can lead to considerable fatigue
- Significant risk of an asthma attack occurring with running, some risk with
cycling and little risk with swimming
- Exercise is of more benefit to asthmatics than no exercise at all
Asthmatics should
- Precede activity with controlled breathing and relaxation exercises
- Gradual warm up, leisurely cool down
- Exercise intensity should be steady
- Medication (if required) should be used before exercise
- Must stay hydrated
o Diabetes
- Diabetes is a condition affecting the bodys ability to take glucose from the
bloodstream to use it for energy
- If diet is inappropriate performance will decline
- May suffer decreased energy due to low blood sugar levels which made lead to
fatigue or blackouts
- Must maintain a good diet (high in carbs)
- Pre-game meals to raise blood-sugar levels
- Hourly glucose supplementation needed
- Should be able to participate in most regular physical activity
- Long endurance activities should be discouraged
o Epilepsy
- Epilepsy is a disruption to brain function, causing a brief alteration to the level of
consciousness and resulting in seizures or fits
- Seizures can occur at any time and cause loss of control
- Seizures can go unnoticed leading to serious injury or death
- Parents/players/coaches should always be present
- Collision sports (rugby league, AFL) swimming, Scuba diving and rock climbing
should be avoided
- Medications can help
Overuse injuries
Overuse Injuries Common Examples How can sports (comp +
training) be modified to
avoid these injuries?
Stress fractures - Overuse - Maintaining physical
- Shin splints (running on condition by pursuing
hard surfaces & poor activities that do not
quality footwear) involve the injured part
- Gradual onset of pain, in pounding movements,
pain increases eg: swimming
- Local swelling and - Avoid overtraining, vary
tenderness training environments
- Use of corrective devices
(orthotics in shoes) and
exercises
Growth Plate Injuries Shoulder Baseball - Balance and vary
Pitching activities
(Growth plates are a part of Very common - Experience in various
young peoples long bones. Caused from the same positions
They are soft and regulates repetitive motion - Rational approach to
growth of bones until training and participation
maturity) Shoulders Swimming - Vary workouts
Gymnastics, hyper flexion - Rest
and hyperextension of - Do not repeat the same
elbows, hips, knees motion
- Correct technique can
Elbows Tennis reduce the risk of overuse
injuries
All result from overuse and
high intensity action
Thermoregulation
Thermoregulation action of the hypothalamus in the brain responding to changes in
body temperature and initiating appropriate mechanisms to maintain core
temperature (when we are hot, we sweat and blood vessels dilate when its cold,
we shiver and blood vessels constrict.)
Hypothermia Low body temperature

Hyperthermia high body temperature
- Children cant regulate their body temperature as effectively as adults. They are
more at risk of hypo and hyperthermia.
- 10-15 year olds should intake 150-450mL prior to activity and 75-200mL every
15-20 minutes during activity
- Sports such as soccer and rugby should be played in cooler months
- Encourage sensible clothing (hats when fielding in cricket, light material
uniforms)
- Allow frequent drink breaks
Matching Opponents
- Desirable to match children with others of comparable size for safety reasons
- Inconsistency of players size and weight in contact sports such as rugby league.
- Smaller children risk injury and are less likely to participate against larger
children of the same age
- In some sports some teams are matched up against others of different skill levels
resulting in lopsided scores
- Not enjoyable for players or parents
- Children should play in teams matched by weight/skill level rather than
age/gender
Should children be matched according to age, size, weight, and skill level?
For Against
- Decreased chance of injury - Equal size does not mean equal ability
- Create a level playing field - Suitability of size to different playing
- Helps maintain participation rates positions is not realistic
- Teams of similar ability can be graded - In some places (e.g. rural towns)
against each other numbers may not be large enough to
categorize children by weight/skill
level
Appropriateness of Resistance Training

- Most literature supports the use of a safe program incorporating low resistance
with high repetitions through the use of full range of motion
- Must be an integral part of an overall program designed to improve skill and
fitness should not be competitive
Concerns for children:

- Can lead to imbalances between muscle groups
- May contribute to injury due to overloading growing bone and muscles
Guidelines for weight training in pre-pubescent children

- Basic exercises with little to no weight
- Light resistance only
- Gradually increase the number of exercises and volume
- Keep it simple
- Use own body weight and gravity as resistance (eg: push ups, sit ups)
Guidelines for weight training in pubescent and adolescent children
- Strict emphasis placed on safe lifting technique rather than load
- Continue progressive loading of exercises
- Introduce more advanced exercises with little or no resistance
- At 16 or older, move on to entry level adult programs if background knowledge
has been mastered
Adult and aged athletes
Heart conditions
- Prescribed exercises conveys considerable benefit with little risk to people with
heart conditions
- Exercise needs to be combined with a balanced diet with low fat and low salt
intake
- People with existing heart conditions should obtain medical clearance before
starting exercise programs
- Supervision might be required in early stages, especially if they have been
sedentary in the past
- Aerobic exercises walking, cycling, jogging, swimming best options for these
people
- Begin slowly and progress gradually i.e. 30 minutes per day, 3 times a week.
- Exercise intensity should steadily increase
o Initially they require medical clearance
o Exercise must be aerobic
o Progress must be gradual
o Activity needs to be of moderate intensity
o Program should be tailored to individual tastes
o Program must be sustainable as benefits will accrue only after a period of
months
- May also benefit from modified strength training programs
- Light loads and focus on major muscle groups
Fractures/Bone Density
- For those who suffer osteoporosis the most important objective is to reduce the
risk of falls and subsequent fractures
- Osteoporosis is a type of musculoskeletal condition in which there is deterioration
in the bone structure. The bones become thin and weak, leading to an increased
risk in bone fracture.
- Physical activity increases bone mass and makes bones stronger
- Particularly important in elder women because it contributes significantly to
delayed post-menopausal bone density loss
- Programs should be safe, beneficial and not cause pain
Types of exercise and sports option available include:
- Endurance activities such as walking, cycling, swimming
- Low impact and balance activities such as aerobics
- Low range strengthening exercises
- Should be guided by physician
Flexibility and joint mobility

- Positive effect on flexibility and joint mobility in older people
- Arthritis, aching joints and tight muscles respond positively to exercise programs
Programs need to:
- Be low impact
- Be specific to a persons physical limitations
- Consider existing medical conditions that may limit movement
- Include: walking, cycling, swimming, flexibility classes and aqua aerobics
Female Athletes
Eating disorders
Iron deficiency
Bone density
Pregnancy
Menstruation
How do these affect Guidelines for safe participation in sport
participation in sport? and activity
What are the risks?
Eating - Affect more than of - Expect athletes to do their best and not
Disorders athletes who compete in focus solely on winning
events with low body fat - Be better educated to detect signs of
and idealised body image eating disorders and use nutrition
- Gymnastics, synchronised experts and counsellors
swimming, diving, dance - Take action when suspicious behaviours
and running and swimming are disguised or turn into an obsession
- Exposure to peer influence - Invite parents to training sessions to
- Pressure within the athlete make sure unreasonable pressure is not
- Need to conform being placed on them
Iron Deficiency - Causes anaemia - Daily intake is very small for girls (15
- Haemoglobin forms the bulk mgs)
of red blood cells, binding - Take iron supplements
oxygen in the lungs to - Iron levels need to be monitored
transport it to the muscle constantly and increased only as
tissues required
- Without sufficient iron, the
number of red blood cells
are reduced to limited the
oxygen carrying capacity of
the blood and the degree to
which the athlete is able to
participate in sport
Bone Density - Amount of calcium in bones - Women going through menopause
- Susceptible bones to might need some form of oestrogen
fracture and structural therapy
weakening (may contribute - Be aware of bones being affected by
to spine problems) age
- Following menopause, - Choose aerobic sports such as
women lose calcium faster swimming, cycling running and
than men) aerobics
- Continuing athletes need to be aware of
the affect of age on bone density
- Keep a balanced diet (adequate
calcium)
Pregnancy - Should exercise in cool of - Maintenance of fitness and general
the day, consume adequate wellbeing
water to avoid thermal stress - Weight control in later stages
- Should do self regulated - Improved muscle tone
exercise rather than
competitive
Menstruation - The affect on performance - If undue pain or abdominal
varies from female to female cramping/difficulties do occur, should
- Some reported difficulties consult a doctor
with performing to optimal
capacity
WHAT ROLE DO PREVENTIVE ACTIONS PLAY IN ENHANCING THE
WELLBEING OF THE ATHLETE?
Physical preparation
- Enables the body to better cope with the demands of sport or activity
- Stresses physiological capacities, adapting them to the pressures required in a
competitive environment
Skill and Technique
- The efficiency with which we perform required activities
- Skilful players display temporal patterning, pacing and control.
- Acquired through effort and practice
- Correct skill development is essential to prevent injury
- Equally import for injury prevention and improved performance
Safe sporting movement
- Adequate groundwork in fundamentals must be given to ensure safety
- Safety equipment might need to be used safety belts in gymnastics.
- Difficult skills should not be expected of young players
Flexibility
- Sports people need additional, specific flexibility according to the demands of
their sport
- Muscles need to be stretched beyond range required of them in the sport prior to
performance. Achieved through a program utilising:
- Static stretches - PNF Stretches
- Must be specific to the needs of the sport
Endurance
- Ability to resist physical tiredness and recover quickly from fatigue
- Skeletal muscle system = local muscular endurance, e.g. the ability of leg muscles
to continue jogging without undue fatigue
- Cardiorespiratory endurance = ability of heart and lungs to deliver oxygen to
working muscles for cells to use and remove wastes.
- Adequate physical preparation to improve endurance means that the appropriate
energy system (aerobic or anaerobic) must be identified and developed
- Without endurance training, tissue becomes more susceptible to injury
Strength
- Ability of muscle/muscle groups to exert force against resistance
- Degree of strength needed for a sport varies
- Adequate strength development relevant to the sport is essential to prevent injury
- Demand for strength that has not been trained can lead to muscle and joint injuries
in the form of sprains, strains, fractures and dislocations
Sport specific requirements
- Each sport is different, so the demands placed on individuals vary considerably
- Once components of the sport are identified, training programs can be established
to ensure that the required components are developed appropriately
- Identifying special requirements in these areas and developing them will enhance
physical preparation and be a major factor in the prevention of injury
- Also enhances self confidence and self assurance
Individual participants needs
Individuals have specialised needs of players in relation to:
- Their genetic makeup, physical attributes and current levels of fitness
- Their role on the field of play
- The position they play in the team
- The somatotype of the player should also be taken into account with respect to the
position they play
Warm up, stretching, cool down
- Probably the most important injury prevention features of any training program
- Warm up needs to be geared towards the demands of the sport
- Time taken will vary on the activity
- 20-25 minutes is generally adequate but varies
- Cause a redistribution in blood flow
- General body warm up, stretching, callisthenics, skill rehearsal
- Cool down: maintain stretch in muscle groups, disperse lactic acid, prevent blood
pooling
Sports policy and the sports environment
Responsibilities of the club, school, sports administrator
Must ensure that:
- Players are able to compete in a safe environment
- Competitions are organised that will challenge players and provide opportunities
for reward, enjoyment, energy outlet and socialisation
- Competitions are adequately supervised, refereed by competent officials and
organised with player safety in mind
- Parents and supporters are appreciative, encouraging, understanding and do not
exert unreasonable pressure
- Highest standards of behaviour are sanctioned
Rules of spots and activities
- Protect and assist the flow of games
- Enforced by referee or umpire
- Rule infringements are punished
- Essential that athlete safety is of the highest priority
- Causes personal stress and injury and clubs have invested a lot of money in their
players and do not wish to see them sidelined due to avoidable injuries.
Even Competition
- Consideration should be given to size, gender, strength, physiological
development and skill level of competitions
- When competitions are even, skills are matched and interest is heightened
- Junior sport relatively straightforward to establish even competitions if
winning is not the major goal and all will receive the same award for participation
- Promotes desirable behaviour
Grounds and facilities
- Safety Guidelines for Children in Sport and Recreation by Sports Medicine
Australia appropriate club or association officials follow these guidelines:
- Ensure playing surface is in reasonable condition
- Clear away all rubbish
- Check corner posts cannot inure players
- Ensure permanent fixtures such as goal posts are padded
- Ensure perimeter fences are well back from the playing area
- Ensure spectators, equipment and vehicles are kept well back from sidelines
- Ensure lighting is adequate
- Ensure adequate matting when needed
Protective Equipment
Apparel and protective guards
All protective equipment must:
- Adequately protect the wearer and other players
- Allow freedom of movement
- Allow air flow as required
- Be comfortable
- Good quality equipment is important for athlete safety
Footwear
- Both supportive and protective
- Should be unique to each sport as they place varying demands on athletes
Comfort will be enhanced and injury prevented if the shoe is
- Comfortable but not too tight, firm, flexible, high heel, midsole, supportive heel
counter, in built support, quality and non-slip sole.
Safe court and field design

- Must contribute to player safety
Safe Playing Equipment

- Equipment must be checked before being used
- According to Safety guidelines for children in sport and recreation, all equipment
must be:
- Suited to the size and ability of the child
- Regularly checked and maintained
- Sufficient in number
- Padded appropriately
- Stable or movable if necessary
- Properly erected/constructed
Thermoregulation
The bodys ability to control its temperature.
Temperature Regulation (Convention, Radiation, Conduction, Evaporation)

Convention
- Body temperature is influenced by the flow of air across the skin.
Radiation
- Gain or loss of heat to the surrounding atmosphere.
- If atmosphere is cooler than the body, the body will loose heat
- If atmosphere is warmer than body, the body will gain heat
Conduction
- Skin contact with an object of a different temperature
- The body loses heat in contact with colder surfaces
- Increases temperature in contact with warmer surfaces
Radiation
- Most important avenue for heat loss from the body
- Sweat evaporates, a cooling effect is achieving, releasing heat from the body
Environmental conditions (temperature and humidity, cold and wind, cold

water)
Temperature and Humidity

- Heat exhaustion and heat stroke
- Result of dehydration when body fluid is lost at a rate quicker than it is replaced
- Prime reason for dehydration during physical activity is sweating the body can
lose 2-3 L of fluid per hour through evaporation during hod conditions
- Risk of heat injury is highest in conditions of high temperature (higher than 30
degrees)
- Children are at a higher risk of this
Cold and Wind

- Activities such as skiing, surfing, endurance running etc may occur in cold
conditions
- Cause a loss of body heat to the extent that the ability to maintain heat balance is
jeopardised
- Internal body temperature decreases result in shivering and peripheral
vasoconstriction.
- Athletes should be aware of how much clothing is appropriate for the activity
not overdress as this causes excess sweating.
- Wind is also a factor the combined effect of convention and conduction
contribute to wind chill.
Cold Water
- In water where the temperature is higher than 32 degrees, core body temperature
can be maintained if the individual is active
- In cold water, the body quickly loses the ability to conserve heat, resulting in
hypothermia
- Fats assist in heat conservation
- Swimming requires the use of large muscle groups and contributes to heat
production
Taping
Preventative Taping
- Application of non-elastic tape that provides support and restrict any excess
movement that might result in injury
- Can also be used to hold protective equipment in place
Note: Taping can never stabilize and support the joint in the same that way as that
supplied by natural support (muscles, tendons, ligaments)
Athletes should be encouraged to undertake strengthening exercises.
1) Use correct width and length tape

2) Non-elasticised tape
3) Maintain even pressure
4) Do not pull too tight
5) Overlap each strip by 1/3
6) Remove immediately after play
Taping for isolation of injury

- Taping limits movement
- If done correctly, taping can isolate the joint and prevent any extreme movements
that might impact upon the healing process
- Taping may also be required so that the athlete can participate in body
conditioning exercises to maintain fitness as much as possible during recuperation
Bandaging for immediate treatment of injury

- Dressings usually elastic, most common uses control bleeding and prevent
infection, apply pressure to reduce swelling, immobilise and support an injured
part
- Can also contribute significantly to the rehab process following injury
- Serves to limit motion of the body party, usually by securing it to another body
part
HOW IS RECOVERY FROM INJURY MANAGED?
Injury Management Procedures
- Rehab is the process of restoring the athlete to pre-injury level of physical fitness
Progressive Mobilisation
- Following use of the RICER method it is important that movement is restored to
the injury
- Progressive mobilisation gradually extending the range of movement
- Continues until the part is fully functional
Stretching
- Important to ensure it heals without scarring
- Scarring will shorten the muscle and make it prone to further injury
- PNF stretching is the most appropriate here
Conditioning
- Involves adapting the body to a range of agility, strength and power skills
running, hitting and kicking to ensure the injured area functions fully
- Experience must be pain free
Total Body Fitness
- Regaining the level of mental and physical fitness reached by the athlete before
the injury occurred
Training
- With total body fitness achieved, full training can resume
- Involves participating in warm up, conditioning, drills, skills development
exercises, tactics and cool down
Taping
- During rehabilitation, taping may be used to support the injured area and protect it
from the possibility of further injury
- Important for knee and ankle injuries
- Further develops confidence and physical support by restricting degree of
movement
Use of Heat and Cold
- When to use heat and/or cold is controversial
- Cold can be applied for up to 4 days following injury and may be required at times
following that to reduce inflammation
- Heat is not generally used for 2-3 days after injury
Specific Programs
- Some athletes require specialised programs in addition to general programs
- Specific programs are developed by the coach or trained in collaboration with the
injured athlete to stretch, strengthen and mobilise the injured area
Return to play
Indicators of readiness to return to play (Pain free, degree of mobility)
- Elasticity New tissue has been stretched, promoting lengthways elasticity and
resultant flexibility
- Strength the new tissue is strong, able to support the body in stressful
movements
- Mobility The athlete has gained full movement particularly in terms of agility
- Pain free Injury is Pain free during both light exercise and strenuous work
- Balance the injured person is able to balance his or her body on the injured limb.
Until this function is achieved, the rehabilitation process is not complete
Monitoring progress (pre-test and post-test)

- Results from a pre-test taken before the injury occurred could be compared to
those of a post-test taken after the injury was sustained
- This will establish if the athlete has lost fitness components speed, agility
- Needs to be specific to the injury
- Knee ligaments were damaged, the agility test of Illinois test would be appropriate
Taping
- May be necessary to tape the injury for a period of time, depending on extent of
damage
- Taping at this stage is preventative
- Psychological support
Specific warm up procedures

- Athletes returning from injury must ensure they are fully warmed up and muscle
groups have been fully stretched before training or a game
- Warm up may need to be more specific to injured area
- If sprinter injured hamstring additional stretching exercises to quads and
hamstrings are recommended
Progressive Involvement
- Return to play needs to be gradual to ensure undue burden and fatigue is not
placed on injured area
- Injury must be gradually exposed to stress, eg: by recommencing play in lower
grades, or by using frequent subs and interchanges
- Excessive exercise in short period may cause damage or fatigue
Playing with Injury
Pressure to participate
- Often (particularly in elite sports) services of talented players are required before
injuries have fully healed
- Some players may have injuries heavily strapped, others are given injections to
prevent pain from pressure or impact on the injured area
- Despite financial binds, it is unwise and dangerous to insist/pressure players to
resume competitive sports before injuries have fully healed
- Painkilling injections get rid of the pain, which acts as a warning that
rehabilitation is necessary for further healing. These injections desensitise injured
tissue and set an environment for further damage without the athlete being aware
of what is happening
- This prolongs the healing process
- Further rupturing could cause permanent mutilation of fibres
The role of the coach and sports medicine practioners

- In many cases, especially in junior sport, the coach is also the sports medicine
administrator
The role of the sports medicine practioners is to:
- Prepare
- Be equipped
- Educate
- Advise
- Teach
- Demonstrate
- Train
- Motivate
- Organise
- Discipline
- Plan
Use of Drugs
For STRENGTH (HGH & ANABOLIC STEROIDS)
Sports where it is Why an athlete Health risks to
more likely would use this athlete
performance
enhancement
Human Growth - Those requiring - Increases - Overgrown face,
Hormone (HGH) strength and growth rate of hands, feet
speed and/or muscles (Acromegaly)
size - With training - Diabetes
- Weightlifting, can increase - Heart disease
sprinting, strength, speed - Disfigurement
throwing, and size of - Osteoporosis
jumping muscles - Arthritis
- Can assist with - Body is able to
endurance grow to sizes
events that would be
otherwise
unattainable
Anabolic - Those requiring - With training - Testicular
Steroids strength and allows for atrophy
speed and/or increases in - Liver damage
size strength, power, - High blood
- Weightlifting, speed and pressure
sprinting aggression - Increased
nervous tension
- Increased
masculinity
- Infertility in
women
- Increased
aggressiveness
For AEROBIC PERFORMANCE (EPO)
performance
enhancement
EPO - Distance - Increases - Blood becomes
endurance number of red thicker with red
events blood cells, blood cells
- Cycling, allowing athlete - Increases in the
running, Nordic to absorb more chance of blood
skiing oxygen clots and stroke
- Increased - Interferes with
cardio- circulation
respiratory - Headache,
endurance fatigue, high
blood pressure
- Has caused
death
Blood Doping - Distance - When blood is - Same as EPO
endurance put back in, - Also risk of
events there is an HIV and other
- Cycling, increase in red viral infections
running, etc blood cells when other
- This allows the peoples blood
athlete to
absorb more
oxygen
- Increased
cardio-
respiratory
endurance
To mask other drugs (Diuretics, Alcohol)
performance
enhancement
Diuretics - Boxing, Judo, - Increases amount - Dehydration
(increases loss of horse racing, of water passing - Dizziness
fluid from the weight lifting through body - Confusion
body) - Allows fast drop - Fatigue
in body weight - Loss of co-
(only water is lost) ordination
- Allows athlete to - Heart and kidney
compete at desired failure
weight
- May also mask
the appearance of
other drugs in urine
Alcohol No serious athlete - Alcohol is a - Dizziness
would use alcohol diuretic - Confusion
to improve - Therefore may - Vomiting
performance also be used to - Unconsciousness
disguise other - Blurred vision
drugs

performance
enhancement
Beta blockers - Sports - Decreases - Low blood
requiring steady output of blood pressure
hand from heart - Feeling of
- Archery - Slows heart rate fatigue
- Allows a - Interferes with
shooter to make blood flow to
accurate shots hand/feet
between heart
beats
Drug testing
- Prior to 2000 urine samples were used but did not detect much besides steroids
- Suspected that EPO and HGH were being used which could not be tested by Urine
Samples EPO had to use blood markers, such as red blood cells
- International Olympic Committee approved the use of a blood test paired with a
urine test for EPO
- Today there is a set procedure for blood testing athletes, clubs, coaches etc are
properly informed of these features.
Urine tests/drug procedures involve:

- Selection of an athlete, who is asked to complete a form listing the medications
they have used over the last 7 years
- Collection of a urine sample under supervision of a chaperone
- Placement of a sample in two envopaks both of which are identically numbered,
distinguished by A + B
- Sending both samples to the lab for analysis
- If positive, athlete is informed and action is taken
Australian Sport Anti-Doping Authority ASADA

- Fair participation = healthy participation
- Strategy = to stay ahead of athletes who wish to cheat
HOW DO ATHLETES TRAIN FOR IMPROVED PERFORMANCE?
Training for Strength
- Important aspect of any training program Ability to develop force or speed or

to shorten the period of time over which a muscle contracts
- Essential part of any sport preparation program
- A program of repetitive, progressive exercise that uses a range of devices (such
as free weights) to increase strength and ultimately improve athletic
performance
- Individualised program with a specific aim such as:
o Improving muscular endurance
o Increasing strength
o Developing power
o Increasing body bulk
o Enhancing muscle tone
- Should also:
o Be exercise specific (Adaptations will only occur in the parts of the body that
are stressed during exercise)
o Employ the overload principle (Individuals is loaded beyond normal
requirements)
o Use progressive resistance (Resistance is increased as adaptations occur)
Absolute strength: Max force that can be generated by a muscle, eg: Hands/wrists
squeezing the grip dynameter
Relative strength: Max strength generated by a muscle relative to the persons
weight. If 70 and 80kg can both lift 100kg, the 70kg person has higher relative
strength
Strength/Muscular Endurance: Ability of muscle groups to withstand. Eg: someone
who can row for 10 minutes has greater strength endurance than someone who can
do it for only 5 minutes.
Speed strength / Power: Ability to apply force at a rapid rate. Also known as Elastic
strength and is required in explosive sports involving movement, eg: Jumping,
sprinting.
Exercise design for major muscle groups
Repetitions: Number of times an exercise is repeated without rest

Repetitions Maximum: The maximum weight that can be lifted a specific number
of times. E.G.: 1RM equals the max weight one can lift only once, 8RM = The
maximum weight one can lift eight times
Set: Number of repetitions done in succession.
Rest: Period of time between exercises, sets or sessions
Periodisation: Process of varying training load over discrete periods of time
- A muscle that is worked close to its capacity to generate peak force will
experience gains in strength
- If tension is lower than 2/3rds of muscles maximal force, the muscle will not
experience gains.
- As a muscle adapts to a particular load, the resistance must be increased,
otherwise significant gains will not be made.
- Should start with exercises involving large muscle groups early in work out and
specific exercises towards the end of the workout.
Chest: Bench Press
Back: Lats pull down, Back extensions
Shoulders: Bench press, military press, upright rowing
Biceps: Barbell curls, bench press, military press
Triceps: Military press, bench press
Quadriceps: Leg press, squats
Hamstrings: Squats, leg press
Calves: Squats, leg press
Abdominals: Crunches
In addition:
- Adequate warm up (dynamic) and cool down (static) is essential
- Should start with major muscle group exercises and specific exercises to the end
- Use of record cards to monitor progress is recommended
- Concentration on form and technique and not on increasing resistance too quickly
is essential
- Each individual must work at level appropriate, competition discouraged
- Must not hold breathe whilst lifting weights as this increases blood pressure
Types of Resistance Training (Isotonic, Isometric, Isokinetic)
Isotonic
Uses free weights with fixed resistance and tailor loads to allow completion of an
exercise a desired number of times. If more can be completed, the resistance is
increased.
- Traditional method and most extensively used
- Muscle length changes constantly as the resistance is moved through a full range
of motion
- Cheap, accessible, easy to learn
- Limitation: resistance does not remain maximal through the full range of
movement, fails to develop the muscle fibres fully
- E.g.: Last phase of a bicep curl, momentum rather than muscle strength causes the
bar or weight to complete the movement
o 8-12 RM
o 3-4 SETS
o SLOW-MODERATE SPEED
o 3 DAYS PER WEEK
o ONE DAY BETWEEN SESSIONS
Isometric
During Isometric training (or static training) muscles develop tension but do not
change in length.
- Not as popular but do have value
- Gains cannot be measured using isometric equoment, so there is a need for
alternative programs, such as free weights, to gauge success
- Typical isometric exercise = pushing against a wall
- Tension develops in the muscle because there is resistance, although the muscle
does not shorten
- 6 8 REPS
- 6 SECONDS EACH
- 4-5 DAYS A WEEK
- Must be performed at joint angles where strength is needed (beginning, middle
end of contraction.) Full development of muscle could require the application of
isometric force at 4-5 different angles through the range of motion of that joint.
Advantages Disadvantages
- Equipment minimal - Does not increase strength through full
- Helpful to overcome weaker points range of motion fo the joint unless
(sticking points) in the muscle applied at all respective angles
- Little time, simple to learn, easy to - Causes rise in blood pressure
perform - Speed is reduced through strengthening
- Valuable in rehabilitation of injury, such in a static position
as muscle tears - Other methods, such as isotonic, must be
- Can be performed in variety of places used to measure progress
- Does not produce muscular endurance
- Most benefits occur early in training
Isokinetic training
Isokinetic training involves the use of elaborate machines that allow maximum
tension to develop in the muscle through the full range of motion
- Most expensive but most beneficial
- It activates the largest number of muscle units
- Equalise tension through the full range of motion
- Does appear o offer significant strength benefits, particularly in the rehabilition of
injury
Overload Techniques (E.g. Forced repetitions, pyramid sets)
- A muscle will strengthen only if it has been forced to work beyond its customary
intensity that is, if it is overloaded. Muscles can be overloaded by progressively
increasing through any of the following
o Blitzing: Bombarding specific muscle group with a range of exercises until
the muscle is completely fatigued. Variety of exercises is recommended so that
all fibres in muscle are worked as completely as possible & through the full
range of motion
o Cheating: Only for advanced weight trainers. Requires assistance from other
muscles for a lift during the more difficult parts of an exercise. However,
while this may aid in performance of the exercise, it might not contribute to
good form, particularly if the resistance in excessive. E.G.: Using the back
muscles to straighten the body from a slightly forward position and assist with
the execution of a bicep curl.
o Pyramiding: Requires resistance to be increased with each set until a peak is
reached. E.G. If the lifter performs 5 sets of an exercise, the resistance is
increased with each set, but the number of repetitions is decreased. As the
muscle fatigues, the resistance is lowered with the lifter aiming to complete
maximal repetitions.
o Reverse Pyramiding: Requires the resistance to be progressively decreased to
permit an increasing number of repetitions. Once again, the muscle works to
fatigue.
o Forced repetitions: Use of free weights to stress a muscle group through full
range of movement. Because the maximum weight that can be lifted is never
more than the weakest points of the muscle, the sticking point. Use of forced
repetitions helps overcome this. Heaveir than normal resistances are used and
the services of spotters brought in to help lift the weight through the sticking
point. Muscles can be worked through the full range with very heavy
resistances.
o Super sets: Requires two or more exercises to be applied to a muscle without
it having the benefit of a rest period. E.g.: if the selected muscle was the
biceps, curls might be used inititally and quickly followed by chin ups using
an undergrip.
o Negative Repetitions: Commonly used in advance weight training. Requires
use of spotters or assistances to control weight when being lowered. Spotters
initially lift a heavier weight than can be pressed to a position upward of the
body. They assist as the weight is lowered and the muscle eccentrically
contracted.
Training for power and speed
Effects of training on the anaerobic energy system
- Resistance training has positive effects on the anaerobic energy supply
- Anaerobic system (ATP/PC & Lactic Acid system) is the dominant pathway for
supply of energy during explosive activites (weight lifting, throwing, sprinting)
- For these events, white muscle fibres are preferentially recruited because they
work best in the absence of oxygen
- Athletes who train for anaerobic events using exercises & practices that stimulate
what is required for the game/activitiy will further develop the capacity of the
fast-twitch fibres.
- Hypertrophy The enlargement of muscle fibres in response to exercise
- Occurs in fast twitch fibres in response to resistance training (more responsive to
weight training that slow twitch and will weild superior results in both muscle
size/strength)
- Closer the similiarity between training regimes & the activity (specificity) the
greater the adaptations will be in the fibres
- Training needs to be explicity in targeting a particular goal
- Anaerobic system resistance training program needs to apply overload and
specificity principles to ensure that most adaptation takes place in fast twitch
fibres
Power and Speed development
Power: The rate at which force is produced per unit of time

Starting strength: Ability to turn on as many muscle fibres as possible in the
performance of a movement
Explosive strength: Ability to extend the turned on period of explosiveness
- Strength training builds power

- Power = Force x Distance Time (Can be increased by manipulated any of the
three variables of force, distance, time, whilst keeping the other two constant)
- To increase power using resistance training, movements need to be performed
quickly, causing preferential recruitment of fast twitch fibres
- Strength major component of power
Resistance training for power and speed events

- Resistance training programs for power & speed will seek to enhance fast twitch
fibres involved in the activity
- If the resistance is too heavy, the exercise will be performed slowly, leading to
recruitment of slow twitch fibres
- Power dominated resistance training program for higher jumper address
general strength throughout body, giving particular attention to leg flexion and
extension exercises
- Exercise prescription for power:
- 5-10RM (60-70% of Maximal)
- 3-4 SETS
- FAST EXERCISE SPEED
- 5 MINS BETWEEN SETS
- 3-4 DAYS PER WEEK
- To develop speed, resistance is medium to high and the contractions are executed
quickly, but rhythmically
- Activities requiring application of explosive forces to propel implements (Discus,
javelin & shot put) require higher resistance and fewer repetitions
- Programs designed to develop power & endurance (basketball, soccer)
moderate resistance, more repetitions than for explosive activities
Plyometric Training
Plyometric Training
- Plyometric refers to a special range of exercises in which a muscle is lengthened
using an eccentric contraction and this is rapidly followed by a shortening or
concentric contraction
- Contributes to power development as it has been proven that if a muscle is
stretched before it is shortened, it will contract more forcefully
- E.G.: Hop, step & Jump
Training for Endurance
- Needs to target the aerobic system of energy supply
- Specificity is important
- Leads to preferential recruitment of slow-twitch fibres red in colour, have a
high capillary density and are capable of sustained contraction
- Causes changes to the bodys oxygen transport system considerable aerobic &
general health benefits
Effects of training on the aerobic energy system
- Endurance training places demands on bodys ability to deliver oxygen to muscle
cells
- Progressively increasing stress is matched by appropriate adaptations, causing the
body to vastly improve oxygen delivery, cell functioning and energy transfer
o Increased haemoglobin
o Increased myoglobin
o Increased ability to use fat Fuel storage & Utilisation
o Increased store of ATP and CP
o Increased glycogen storage
o Increased ability to use glucose
o Increased heart size
o Decreased heart rate Oxygen transport system at rest
o Increased stroke volume
o Increased cardiac output
o Increased oxygen uptake Oxygen transport system at maximal
o Increased cardiac output exercise
o Increased stroke volume
o Increased respiration efficiency Respiration
o Increased muscle size
o Decreased body fat Other
o Increased strength & power
o Increased muscle elasticity
o Increased mitochondria
Resistance training for endurance events

- For continuos type movements that form the basis of these activities (middle to
long distance running, basketball, netball, soccer, touch football) the development
of maximal power is not an advantage because the fast twitch fibres would be
recruited when slow twitch fibres are more appropriate
General resistance prescription for endurance is:
- Repetitions Maximum 15 30
- Sets 3 4
- Speed Moderate
- Frequency 3-4 days a week
- Prescription for endurance individualised
- Particularly relevant to number of repetitions required, as repetitions are raised,
strength will decrease and endurance increase
Measuring training effect (Max VO2)
- Maximum oxygen uptake (VO2 Max) refers to the maximum amount of oxygen
that can be taken up by the muscles and is achieved just prior to physical
exhaustion
- Test for Vo2 is performing on a treadmill whilst attached to machines which
measure heart rate & ventilation
- Indications that Max vo2 has been reached includes hyperventilation and
maximum heart rate
- Sub-maximal tests which predict maximal oxygen uptake: Balke 15 minutes run,
Coopers 12 minute run relatively reliable but not totally accurate
Training for flexibility
- Flexibility requires that muscles stretch or lengthen safely
- Body has an inbuilt safey mechanism stretch reflex to warn about elongating
fibres beyond safe limits and this causes the stretched muscle to contract
- Safe flexibility: slow, controlled ands sustained for periods of time
- This allows the muscle spindle to become accustomed to the new length & reduce
its signalling to the central nervous system
Types of flexibility training and the specifics of performance
DYNAMIC FLEXIBILITY or static flexibility is the ability of the muscles to move

a joint through the full range of motion
STATIC FLEXIBILITY is an indication of the range of movement at a joint or
series of joints while the body is in a fixed position
Active Flexibility (More closely related to Passive flexibility) Ability to assume

sports skills) Ability to maintain an an extended position and then
extended position using only the agonists maintain it while using the support
and stabilisers while the antagonists are of your limbs or apparatus such as a
being stretched for example, lifting the leg bench
and keeping it high without any outside
support
- Static Stretching: Commonly used as it is safe, does not require use of

equipment. Movement is smooth & performed slowly, held for a period of 10-30
seconds. Used for warm ups and cool downs and rehabilitation of injuries.
- Ballistic Stretching: (Dynamic) Involves repeated movements such as swinging,
involving repeated movements such as swinging & bouncing to gain extra stretch.
Should be used only be advanced athletes.
- PNF stretching: Progressive cycle incorporating a static & isometric contraction
and a period of relaxation in the lengthened position. Involves stretching with a
partner or an object acting as the resistance. Strengthens & Stretches the muscle.
- Range of motion stretching: Smooth repetition of the types of movements
requires in the game or activity.
Flexibility & Performance
Affected by a number of factors:
- AGE muscles shorten & tighten with age
- GENDER generally speaking, females are more flexible than males
- TEMPERATURE increased temperature, atmospheric & body, improves
flexibility
- EXERCISE Those who participate frequently in exercise are usually more
flexible than sedentary people
- SPECIFICITY Flexibility is joint specific.
Guidelines:
- 3-4 Occasions per week
- Ensure muscles are warmed up before stretching
- Stretching no further than muscles will go without pain
- Not aiming at excessive flexibility joint instability, increased risk of injury
Contraindications for flexibility training
- Contraindication: An exercise tha has the potential to cause harm. These include
hypertension, hyperflexion, excessive twisting & joint impingement.
- Hyperextension: Extending a joint beyond its normal range
- Hyperflexion: Flexing a joint beyond the normal range of movement
- Excessive twisting: application of too much twisting force while the body is in a
fixed position
- Joint impingement: Compression of a joint while in a particular position
- Eg: neck rotations, back arches, sit ups with hands behind head, the plough
Training for skill and improvement
Variety of practices/drills
- Learn skills through repetition of movements in what are called skill practices or
drills.
- During skills practice, the player focuses on executing the skill as correctly as
possible
- There will be a few errors in the beginning stages, but with practice, feedback &
refinement, the player will gradually improve
- Variety of skill practices for teaching is integral
- Individual skill development (Basic skills practiced by individuals, pairs or in
small groups) Minor Games (Fun games organised on smaller modified areas of
play, utilising the same skills) Phase practice (Repetitive practice of a specific of a
game until competitive game conditions) Functional practice (Designed to
improve the skill of a particular player or group of players i.e.: shooters in
netball) Small games (Resemble the major game with less players)
Analysis of technique, eg: video analysis, observation skills
- Effective coaching requires skilful observation of performances, analysis and
feedback to the players in order to improve performance, detect faults or
determine the cause of poor performance
- Skill needs to be broken down into observation phases
- May involve watching repeated performances through video analysis and
observation skills, in order to find strengths and weaknesses
Technique correction
- Necessary where the skill execution has a fundamental flaw
- Responsibility of the athlete to use feedback on the correct technique to modify
their performance
- Variety of feedback methods and communication are important at this stage,
because the athlete needs to understand the information, remember it, correct the
performance and practice it
- Essential that the athlete practices until the performance becomes automatic.
HOW DOES COMPETITION AFFECT PERFORMANCE?
Phases of Competition
Pre, in and post season preparation
- PRE-SEASON PREPARATION: 6-12 WEEKS, requires a high level of training at
moderate levels of intensity.
- Aims to improve all aspects of fitness, developing techniques, introducing
strategies and familiarise players with them and teach appropriate mental skills.
- Best achieved: continuos, Fartlek, intervals, circuit, resistance
- IN SEASON PREPARATION: Maintaining the fitness developed Intensity
should increase whilst volume decreases. Aim: to maintain stamina, practice &
improve strategies, perfect skill execution, gain competitive experience.
- Best achieved through: Work on fitness components (strength, flexibility, power,
agility, speed), Use of highly specific skills and practices, continuation of
conditioning training & use of small games, grids and resistance work.
- Specificity must be applied more rigidly here.
- TRANSITIONAL PHASE (OFF/POST SEASON TRAINING) Allows time for
physical and mental recovery from training and competition.
- One week of total rest, remaining weeks consisting of active rest, with training
sessions being reduced to a couple of times a week and corresponding reduction in
both volume & intensity, change in environments, diet modifications, maintenance
of strength & flexibility and working on weaknesses.
Peaking for performance
- Peaking Phase of training in which performance is optimised to meet the
demands of a race, competition or series
- To arrive at this point will usually involve months of preparation, gradual
increases in volume and intensity of training & a short tapering period
- A temporary state reached only during the competitive phase of training, when
physiological indicators will be apparent, including: a state of excellent health,
heightened rate of recovery from training, body systems tuned for optimal
functioning, heightened self confidence, ability to tolerate higher levels of
frustration, a state of mental alertness & readiness for a cation
Tapering
- A period immediately before competition where volume and intensity of training
is reduced
- Fundamental for allowing tissue to rebuild and for the full replacement of energy
stores
- Essential as intense training, while having numerous positive affects has an
adverse effect on some aspects of performance.
Dietary Considerations
Pre, during and post performance
- Important for athletic performance, particularly endurance athletes
Pre- Game
- 3-4 hours before competition if large meal
- 1-2 hours before if a snack
- Complex carbs
- Avoid foods high in fat & protein
- Avoid foods high in simple sugars
- Maintain adequate fluid levels
- Liquid meals are recommended if solid meals are hard to digest
- Patterns for pre-game eating should be established over a period of time and new
foods should not be added to the diet without a trial period
During Competition
- In endurance events there may be a need for carbohydrate supplements to avoid
glycogen depletion
- Liquid glucose may help top up glycogen and may deter or prevent
hypoglycaemia
- Maintain adequate hydration by regular fluid intake
- Not wait until thirst develops before drinking fluid
Post-Performance
- Important to replace glycogen stores by eating foods with a high carb content
- Rehydrate to replace fluid lost during the event
Dietary supplements
- Most popular dietary supplements for athletes are vitamins and minerals
- Dietary supplementation is an attempt to balance a diet that might otherwise be
lacking
- Vitamins: Do not contain energy, function as catalysts that help the body use
energy nutrients. Vitamin supplements may be expensive and wasteful, as the
body has no use for them and excretes most of the excess vitamins. Overdosing on
some vitamins can have adverse effects. Unneeded if one follows a healthy and
nutritious diet.
- Minerals are inorganic substances found in the body that are necessary for it to
function adequately. Iron and calcium are the two that are commonly deficient in
athletes and this will affect performance and cause health problems.
- IRON = found in haemoglobin. These cells collect and transport oxygen,
delivering it to where it is needed. Diminished haemoglobin levels affect
performance because the muscle cells are deprived of oxygen needed to break
down the nutrients and produce energy at risk of Sports Anaemia
- CALCIUM = More specific to health needs and not as directly related to sports.
Quality of bone structure deteriorates without adequate calcium.
Hydration & fluid replacement
- Important to consume water during & after exercise
- Athletes should attempt to replace water at the same rate at which it is lost
- Failure to replace lost fluids dehydration fatigue muscular cramps,
headaches, nausea
- Avoid caffeine, tea & alcohol before after training or games
Gender considerations, eg: calcium & iron for females
- Average adult female is: Shorter, lighter, has more fat tissue, has less muscle
- Many physiological differences between males and females not all affect
training/performance
- Physiological differences include: menstrual problems, iron deficiency and greater
requirement for calcium
Environmental Considerations
Altitude
- The height above sea levels. In reference to training, high altitudes are those
above 1500m
- The higher the altitude, the more significant the physiological effects
- The partial pressure of oxygen decreases with ascendancy
- Decreased partial pressure means less oxygen is available to the tissues, resulting
in hypoxia
- As hypoxia develops, cardiac output is increased at sub-maximal workloads, but
decreased during maximal work
Acclimatisation
Altitude
- Results in peoples gradual adaption to hypoxic conditions, 2-3 weeks for
biological effects to maximise
- Immediate effects: Increased breathing rate/heart rate, giddiness, nausea,
headaches, sleeplessness, decrease in VO2 max reduction in work capacity
- Long-term effects: Incrceased haemoglobin volume & concentration, increased
blood viscosity, increased capillarisation, continued lower vo2max.
- For short term training at altitude the various benefits associated with it can be
offset by other fundamental drawbacks such as: poor facilities, strange diets,
different surroundings and homesickness.
Temperature
- Can be done through exposure to heat and humidity in the weeks leading up to
competition
- Increased water and use of sports drinks can help prevent dehydration in training
& during competition
Time
- General effect of time changes is an upset to the bodily functions which are time
linked (sleeping, waking, eating, bowel & bladder functions) gradually adjust
- A minimum of one day for every one hours time difference is recommended
- Travel by air also has other effects on the body: digestion upset, swelling feet,
dehydration.
Psychological Preparation
The role and use of sports psychologists
- Intended to prepare the athletes mind for competition in the same way as the body
- Focus is on psychological training to establish mental toughness
- Works in broad areas of: motivation, stress management, imagery, arousal,
concentration, positive self-talk, goal setting
- Works to maximise player potential by ensuring that mind and body are working
in harmony and appreciable advantage. Aim to:
- Help athletes overcome pressure of competition tries to increase the athletes
skill in using a range of techniques that provide emotional control before and
during performance
-
Relaxation Techniques
- High levels of anxiety detrimental to sports performance
- Progressive Muscular Relaxation Individual tightens or contracts a muscle
group for a period of five seconds and then relaxes. Continued for all body.
- Mental Relaxation The focus here is on generating relaxing thoughts by
visualising tranquil experience. Feeling of relaxation the flows through the
muscles
- Mental Rehearsal Includes repeating a mental picture of the required
performance with thoughts narrowed & only successful performances
accommodated confidence increases and muscles gradually relax
- Centred breathing - Popular technique requires athlete to focus on breathing
depth & rate in preparation for next movement. Hands are placed waist whilst
slow, deep breaths are taken. Air is expelled slowly as mind & muscles try to
relax. Important to allow large abdominal section to control breathing. This takes
practice and concentration but is highly productive in triggering muscular
relaxation.
- Flotation Can be used generally or well in advance of performance. With
buoyancy vest, athletes float in water and sensations induce feelings of calm.
- Meditation Requires exclusion of interference that might come from
surrounding environment. Focused mind & key thought or word is repeated over
and over. Awareness of surroundings decrease, mind relaxes = muscles lose
tension.
- Sports massage Can be used before or after performance. Soft tissue is
manipulated by therapist (vibrating, gliding, stroking, stretching.) When stroking
used, movement towards heart whenever possible.
WHAT ARE THE COACHING CONSIDERATIONS FOR IMPROVING
PERFORMANCE?
Establishing training programs

Determined by phases of competition
Linked to long term training plans, e.g. Year, session
- Phases of competition include: pre-season preparation, competition period and
off-season or transition phase
- Coach must plan to develop: physical stamina or condition, physical attributes
such as strength & flexibility, skills running/batting, tactics that will provide an
advantage during competition and mental training to consolidate/improve.
- Yearly/annual plan is best most competitions organised on a seasonal basis
- Aim of annual plan: balance work & recovery & ensure peaking occurs at right
time
- Divided into Macrocycles (long training periods of about four weeks)
Microcycles (short training cycles of about seven days)
- Allows coaches to plan and monitor all aspects of the training program and ensure
periods of high intensity are followed by periods of unloading Periodisation
- Macrocycles allow for tracking of training volume & intensity these will
fluctuate and decrease, reflecting changes in the work-recovery ratio
- Microcycles allow focus on the specifics of individual training sessions of
which there might be many in a typical week
Optimising the performance of athletes, e.g. individual, team
- Need to ensure peaking occurs at the intended time (both individuals & teams)
- Training loads & recovery times need to be individualised evne though team
preparation is an overall objective
Data gathering and analysis of training and performance
- Effective programs based on data gained from previous seasons & current
performances
- Data is gathered in the form of
Personal and team goals
Tests and standards strength, speed, flexibility, coordination
Statistical information
Psychological needs, motivation/arousal control
Performance needs skill/techniques
Equipment needs
Positive & constructive interaction between squad members
- Information from these and other sources (assistant coaches, trainers, managers,
sports psychologists) is gathered, assessed & used to formulate the annual plan
- Provides a benchmark against which performance is measured
Elements of a training session
Providing an overview of the session to the athletes
- Brief overview of what is expected during the session
- Ensures the intentions of the coach and expectations of players are channelled in
the same direction
- Gathering players in forum situation, where specific issues can be addressed
recording of player absence or presence, assessment of injuries, discussion of
previous performance & special tactic suggestions that might need to be
considered
Warm Up
1) General body warm up until the body begins to sweat
2) Stretching especially required muscle groups
3) Callisthenics General body exercises
4) Skill rehearsal
Skill instruction
- Good instruction requires prior organisation & effective communication skills
- Should be well planned, need to give guidance on how to perform fundamental
skills and show allow these to be practiced in related drills and movements
- Effective instruction will be:
Brief Concise, factual
Well timed
Specific Specific to the skill, game & situation should not be general
Constructive Focus on positive points
Clear Should be no misunderstanding about information communicated
by the coach, questions should be encouraged if the message is not
understood
Informative All instruction should relate specifically to information that
the players need to know
Demonstrable Supported by visual aids
Skill practice
- Backbone of training session
- Once players warmed up & conditioned need to spend majority of time on
skills practices which need to specifically target:
Improvement in the fundamentals of the game
Individual needs in specific areas for examples, ball handling
Performance under gradually increasing pressure
Provision of enjoyment through competitive situations
An increase in knowledge of the game
Development of cognitive or thinking abilities
Development of communication via skills practices
- Many skills are difficult for young players broken down into subroutines
- Subroutines: individual components that collectively compromise a skill
- As Temporal Patterning (Refers to the ability to execute the subroutines in
correct sequence) increases, challenging nature of skills practices can be increased
by adding to range of skills that need to be mastered to complete a movement
Conditioning
- Fitness training is an integral part of every training session
- Short fitness session following warm up supplementary fitness in the form of
circuits, interval training, continuos training and callisthenics
- Fitness work should not be overemphasized in first session
- Essential that during fitness session heart rate reaches training zone intensity (70-
85% per cent maximal) and remain there for 20 mins
- Not totally exhausting, this leads to lactic acid build up
- Most drills requiring agility, speed, endurance, power and coordination help
development of fitness components
- About 15-20 minutes should be devoted to develop the players physical
conditioning. Some coaches prefer to complete this before they begin skills
practice. They argue that attempting skills under fatigue relates to game situations.
Cool down
- Essentially the reverse of warm up
- Not as intense and not extended for same period of time
Evaluation
- Appraisal of performances after training session
- Involves coaches & players
- Evaluation of performance outcomes, express opinions, reminders of game times
etc, address individual problems (taping)
- Preparation for future sessions
Health & safety considerations, e.g. safe facilities/equipment, minimise injury
risk
- Same as in game situations
For no injuries:
1. Warm up and cool down
2. Protective equipment
3. Appropriate progressions
4. Regular Rest intervals
5. Supervision of safety rules
6. Safe playing surfaces.
Overtraining
- Chronic psychological and physiological condition caused by training loads that
are too demanding for an athlete to manage
- Poor scheduling or high levels of dedication chronic stress, leading to
performance deterioration
- Staleness Overtraining Ultimately burnt out
Amount and intensity of training
- Must balance work requirements with an appropriate recovery period, help
athletes adapt to training programs
- Not possible to determine what levels of training are likely to lead to an injury or
illness as two athletes work capacities are the same
Physiological considerations, e.g. lethargy, injury
Stressors include:
- Environmental stress
- Sleep disorders
- Poor nutrition
- Excessive training volume
- Excessive training intensity
Could be identified by athlete exhibiting characteristics such as:
- Insomnia
- Decreased appetite
- Loss of muscle strength and coordination
- Muscle soreness and fatigue
- Elevated resting heart rate
- Colds and possible allergic reactions
- Increased susceptibility to infections
Psychological considerations, e.g. lack of motivation
Stressors include:
- Pressure to perform
- Psyching up too frequently
- Boredom
- Fear
- Lack of self-confidence
- Anxiety
- Lack of encouragement
These usually can be dealt with. But when physical stability is threatened, emotional
factors assume greater magnitude and affect health and wellbeing
Symptoms might include:
- Increased nervousness
- Poor concentration span
- Irritability or anger
- Emotional sensitivity
- Depression
Athletes suffering overtraining require one strategy or a number of stratgies

including:
- The reduction or cessation of training
- Active rest
- Change of environment
- Change of routine
- Mini Breaks
- A reduction in Pressure
Prevent is best achieved through being careful to not exceed an athletes stress
tolerance and adapting the volume & intensity of training to each individual.
The Use of Technology

- Using technology to gain advantage has gained considerable attention in recent
decades
Training innovation, e.g. tackle suits, sprinting sled
- Technology has enabled training programs to be significantly improved.
Modifications to equipment and clothing for training purposes have allowed coaches
to simulate performance conditions.
The use of heavily padded tackle suits
Training Sleds for Sprinter
BallprojectingMachines
Haveallhelpedtoimproveandenhanceperformance.
- Lycra bodysuits swimming drag component is reduced, also help flotation
- Cycling Carbon fibre components frames, pedals, wheels, gears, weigh less,
create less resistance
Video analysis of performance
- Used in range of coaching, viewing and performance appraisal situations
- Allows analysis of player movements, strategies and techniques
- Improved technique Way player executes a movement such as tennis serve,
swimming stroke, can be observed repeatedly in slow motion to locate error
- Improving visualisation By observing a skill performed repeatedly or in slow
motion, a players conceptualisation of what is required for proper execution is
enhanced
- Establishing biomechanical efficiency By observing movements of skilfull
players, coaches can gain an insight into how movements can be performed more
efficiently and demonstrate this to their players
- Analysing strategies Coaches find video replays useful for analyising
effectiveness of strategies used both by their teams and their opponents
Data gathering and analysis
- Increased professionalism of sport has made gathering and analysis of data
important in understanding performance and using it for improvement
- Data is gathered using: video analysis, statistics, results & records, personal
notations
- Modern coaches use computer programs for storage and revival
- May be used by tacticians, statisticians, coaches and athletes to improve both team
and individual performances
- Computerised handheld devices enable data to be recorded from fitness
assessments or competitive performances and then downloaded to a computers,
enabling quick and efficient feedback on performance if needed.
- Some devices can be used to enter statistics eg tackle counts, passes, missed shots
etc which can be used to provide feedback.
- The use of heart rate monitors allows data to be downloaded. Athletes can look at
workout heart rate and determine whether they have exercised at the appropriate
target zone.

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Prevalence: Number of cases of disease that exists in a defined population at one

Critique the use of Epidemiology to describe health status by considering

What can Epidemiology tell us?

Who uses these measures?

Do they measure everything about health status?

Life Expectancy Improved 40%

Major Causes of Illness and Death

Coronary Heart Disease Coronary Heart Disease

Lung Cancer Cerebo Vascular Disease

Cerebo Vascular Disease Other Heart Disease

Other Heart Disease Dementia and Related

Groups Experiencing Health Inequalities

Aboriginal and Torres Strait Islanders

People Living in Rural and Isolated Areas

People with Disabilities

Gap is closing between genders.

Social Justice Principles

Rights: Equal opportunity to achieve optimal health

Access: Ability to use a range of health services

Participation: In planning and making decisions about local and community

Equity: Fair allocation of resources and entitlements without discrimination

Priority Population Groups

Costs to the community

Potential for Change

How do socio-cultural, physical or economic environmental factors affect the

How is health status linked to gender?

What role does the principle of social justice play?

Why is it important to prioritise?

Cardiovascular Disease (CVD)

Extent of problem - Major economic and health problem in Australia

Health promotion can be targeted at 3 levels of prevention:

New Public Health:

The Shift from an Individual Lifestyle approach to Health Promotion to the

- Individual Lifestyle approach relies too heavily on the individual, with no

- The New Public Health Approach 1886 Ottawa Charter Acknowledges

Characteristics of the new public health approach

Recognition of the social determinants of health

Example of a Modern Health Promotion Campaign - Jamie

o Advantages teaches people to eat good food, which in turn leads

Major Health Promotion Initiatives

Ottawa Charter for Health Promotion (1986)

1) Developing personal skills By providing information and enhancing life skills,

2) Creating supportive environments Encouraging of reciprocal maintenance, that is

3) Strengthening Community action such as encouraging self-help, social support

Jakarta Declaration 1997

Consolidate and expand - Governments working - Government working

Increase community and - Quit line - Healthy Canteens

Australias Health (AIHW Publication) 1998 - present

A biennial report on Australias health, including information on:

Nature of Health Care in Australia

Responsibility for Health Care

2) State and Territory Governments

The Health care system in Australia involves the interrelationship of many

Health Care Providers

Institutional Care Non-Institutional Care

Public Health Insurance Medicare

Private Health Insurance

Medicare Private Health Insurance

Health care expenditure versus health promotion expenditure

What do you need to make informed decisions?

Other questions may include:

Developing Personal Skills