Triathlon Medicine PDF
Preview Triathlon Medicine
Triathlon Medicine Sergio Migliorini Editor 123 Triathlon Medicine Sergio Migliorini Editor Triathlon Medicine Editor Sergio Migliorini International Triathlon Union ITU Medical Committee Maison du Sport International Lausanne Switzerland ISBN 978-3-030-22356-4 ISBN 978-3-030-22357-1 (eBook) https://doi.org/10.1007/978-3-030-22357-1 © Springer Nature Switzerland AG 2020 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland In memory of Elisa Geranio, Springer Clinical Medicine Book Editor, who gave me the idea, the suggestions and the enthusiasm to produce this book and who supported me throughout this project. To Marisol Casado, ITU president and IOC member, for the full support that I have had as chair of the ITU Medical Committee and in particular for having improved sports science research for triathlon, including the Science+Triathlon World Conference. To my wife, Francesca, and my daughter, Lisa, who share my passion for this fantastic sport and for understanding this another commitment of mine. To all the ITU Medical Committee members and the ITU Sport Department, for all the efforts made over the years to improve race safety and protect triathlete health. I would like to sincerely acknowledge all the contributing authors for their work and dedication. It was a pleasure and a privilege to work with such an exceptional group of experts. Sergio Migliorini Foreword I am delighted to have been asked to write the foreword for Dr. Sergio Migliorini’s comprehensive book Triathlon Medicine, an indispensable reference that reaches right across our sport and into all aspects of this highly technical and demanding world. Sergio’s knowledge of physical and rehabilitation medicine is second to none. It is what prompted ITU to choose him as the medical delegate for the London 2012, Rio 2016 and Tokyo 2020 Olympic Games and preside over the ITU Medical and Anti-Doping Committee and is what makes him such an authority in an endurance sport that will always test the athletes’ bodies to their limits. It has been my great honour to have been the International Triathlon Union presi- dent since 2008, during which time the sport has enjoyed huge growth and develop- ment. Working closely with Dr. Migliorini, the IOC and our National Federations around the world, ITU will always strive to uphold the Olympic values of fair play and equality as it expands into new regions, and it is thanks to the dedication of the experts who have contributed to this book, and the triathlon family as a whole, that we have been able to do so. Today, the Olympic world is moving forward ever faster, innovating, reinventing and reaching larger audiences than ever before and bringing new generations to discover the sense of achievement, sportsmanship and belonging to a global move- ment in the way that only sport can do. ITU is proud to be one of the driving forces behind that momentum but is acutely aware of its responsibility towards athletes to keep them safe and healthy and understand the demands of our sport. For the athletes, coaches, national federations, technical officials and all those who take their tri life seriously, Triathlon Medicine offers precious insights from specialists in every field, with advice on injury prevention and recuperation, nutri- tion strategies, race day best practice and much more from those who know the sport inside out. For everyone who thought they knew everything about this great sport, I would urge you to rethink and read on. Marisol Casado ITU President, IOC Member Madrid, Spain vii Preface I am honoured with the opportunity to serve as guest editor for the book Triathlon Medicine. Triathlon Medicine is the culmination of almost 30 years of experience on the field with injuries and conditions of triathletes, working with many sports medicine doctors, orthopaedics, exercise physiologists and researchers. The cooperation with the ITU Sport Department was very useful to improve the medical assistance of the ITU races during these years, including the Olympic Games, and to continuously update the event rules to have safe races. Triathlon is the most modern of all the endurance sports, and the triathletes experience a range of environmental conditions and physiological demands, depending on the race, that must be taken into consideration when preparing for the race medical assistance. Combining research perspective with many years of experience practicing in the field, this book offers to sport medicine physicians, orthopaedics, physical thera- pists, athletic trainers, coaches and officials a comprehensive guide for the evalua- tion, treatment and prevention of all the overuse and medical conditions and to improve athletes’ performance protecting also their health. The book contains 26 chapters in which scientific and practical aspects of medicine applied to the triath- lon are analysed in depth, including the ITU medical and competition rules. The book addresses in detail the topics of cardiovascular adaptations, overuse injuries, overtraining syndrome, endurance anaemia, nutrition and the physiological aspects associated with the discipline. It provides information on the training and technical aspects on the different triathlon’ distances. Dedicated chapters also cover issues related to female, young, master and para-triathletes. It was a pleasure and a privilege to work with this exceptional group of authors, many of whom are considered leaders in endurance sports medicine; they have shared with me the passion for triathlon, transmitting their invaluable practical expertise in this matter. Very special thanks also to the ITU Sport Department and ITU Medical Committee members for their work, dedication and love for this amaz- ing sport. Lausanne, Switzerland Sergio Migliorini ix Contents 1 ITU Triathlon History. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Gergely Markus and Antonio Arimany Part I P hysiological and Epidemiological Aspects 2 Physiological Requirements of the Different Distances of Triathlon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Avish P. Sharma and Julien D. Périard 3 Epidemiological Aspects of Illness and Injury . . . . . . . . . . . . . . . . . . . . 19 Veronica Vleck and David Hoeden Part II E nvironmental Conditions 4 Heat-Related Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 David Gerrard 5 Environmental Conditions: Cold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Michael Tipton Part III A cute and Overuse Injuries 6 Iliotibial Band Syndrome (ITBS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Sergio Migliorini, Marco Merlo, and Lisa Migliorini 7 Anterior Knee Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Thilo Hotfiel, Martin Engelhardt, and Casper Grim 8 Stress Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 Sergio Migliorini and Marco Merlo 9 Operative Treatment of Tendinopathies of Achilles Tendon . . . . . . . . . 135 Sakari Orava, Lasse Lempainen, and Janne Sarimo Part IV M edical Conditions 10 Airway Dysfunction in Elite Athletes . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 James O’Donovan, Michael Koehle, and Don McKenzie xi xii Contents 11 Cardiovascular Adaptations in Triathlon . . . . . . . . . . . . . . . . . . . . . . . . 159 Sanjay Sharma and Maximiliano Moreira Accame 12 Endurance Anemia, Relevance to Triathlon . . . . . . . . . . . . . . . . . . . . . . 173 Gaetano Cairo 13 The Youth Triathlete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185 Michael F. Bergeron 14 The Master Triathlete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 Romuald Lepers 15 The Female Triathlete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207 Margo Mountjoy, Alex Thomas, and Jasmine Levesque 16 The Travelling Athlete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225 Nebojša Nikolić 17 Nutrition Strategies for Triathlon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261 Louise M. Burke and Gregory R. Cox Part V Training 18 Quantifying the Training Load in Triathlon . . . . . . . . . . . . . . . . . . . . . . 291 Roberto Cejuela and Jonathan Esteve-Lanao 19 Science-Based Criteria to Identify Talent Among Triathlon Athletes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317 Roberto Cejuela, Alberto Ferriz-Valero, and Sergio Selles-Pérez 20 Altitude Training and Endurance Performance . . . . . . . . . . . . . . . . . . 329 Paul Robach and Carsten Lundby 21 The Overtraining Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 345 Davide Susta Part VI Special Considerations 22 Triathlon Race Day Medical Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 357 W. D. B. Hiller 23 Triathlon Marine Plan in the Olympic Games and in the ITU World Triathlon Series . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 375 Thanos Nikopoulos and Sergio Migliorini 24 ITU Triathlon Water Quality Statement . . . . . . . . . . . . . . . . . . . . . . . . . 381 Sergio Migliorini Contents xiii Part VII The Paratriathlon 25 ITU Paratriathlon History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 391 Eric Angstadt Torres 26 Physiological Considerations for Paratriathlon Training and Competition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 393 Ben Stephenson and V. L. Goosey-Tolfrey
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