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Triathlon-Related Overuse Injury and Medical Issues

트라이애슬론의 과사용 부상과 의학적 위험요인에 대한 고찰

  • Park, Chan-Ho (Research Institute of Sport Science, Pusan National University) ;
  • Kwak, Yi-Sub (Department of Physical Education, Dong-Eui University) ;
  • Kim, Tae-Un (Department of Physical Education, Pusan National University)
  • Received : 2009.10.14
  • Accepted : 2009.11.14
  • Published : 2010.02.28

Abstract

As the nature of triathlons is competition in three successive sports, triathletes experience elevated levels of stress on the body that are absent in single-sport athletic events, and consequently there are more potential medical problems to prepare for. Triathletes can also experience problems such as hypothermia, heat illness, excessive exposure to ultraviolet radiation, musculoskeletal injuries and trauma, immunosuppression, and haemolysis. Depending on the potentiality of such above-listed problems occurring in any given race, race organizers will prepare preventative measures and treatments accordingly. Olympic distance is not the only triathlon racing distance. Sprints, which are normally around half the Olympic distance, are common distances, as well as Long (2 km swim, 80 km bike, 20 km run), Ironman (3.8 km swim, 180 km bike, 42 km run), and ultra-distance events varying in length. Races of longer duration normally result in a higher percentage of athletes experiencing the above-mentioned medical problems, as well as inducing additional health risks such as hyponatraemia. Minimizing the occurrences of serious health issues is possible through the following means: carefully preparing for the probable race-day weather conditions; proper management and organization of the race; preparing an extensive water-safety and ground-course safety plan; distributing necessary nutrition along the course; and stressing the importance for athletes to have proper knowledge concerning race nutrition, biomechanical technique, physical preparation, and utilization of safe equipment. While risks of competing in triathlon are many, the instances of such medical problems are not excessive, and the triathlon has a reputation of being a reasonably safe sport as long as athletes with high risk take added precautions.

트라이애슬론은 수영, 사이클, 달리기로 구성된 스포츠로 단일종목의 스포츠에 참가할 때 보다 잠재적인 의학적 위험요인을 더 많이 포함하고 있다. 과사용은 스트레스의 증가와 뼈, 관절, 근육, 건 또는 신경의 손상을 일으키며, 지금까지 트라이애슬론 훈련과 경기 중에 발생될 수 있는 과사용 부상은 목통증, 요통, 근육과 건 부상, 인대부상, 만성적인 통증 등이며, 대부분의 과사용 부상은 달리기 훈련시 가장 많이 발생된다. 또한 트라이애슬론 참가자들은 다양한 자연환경과 경기거리에서 완주해야 하는 만큼 부상 이외의 의학적 문제에 직면할 수 있으며, 현재까지 트라이애슬론과 관련하여 보고되고 있는 의학적 위험요인들은 저체온증, 저나트륨혈증, 일사병, 자외선에 과도한 노출, 면역억압, 심리적인 탈진현상, 용혈증 등을 포함하고 있다. ID 경기 중에 발생 할 수 있는 의학적 문제들 가운데 가장 빈번하게 발생하는 증상은 탈진과 탈수현상이며, 그 다음으로 나타나는 문제점들은 저나트륨혈증, 열부상, 저혈압, 화상과 물집, 근육경련 등이다. 그러나 SD와 OD 경기 중에는 달리기 속도가 빠르고 더 높은 강도에서 경기가 진행되기 때문에 일사병의 발생 위험이 더 높고, 경기 시간이 짧은 관계로 저나트륨혈증은 발생하지 않는다. 본 연구는 트라이애슬론 훈련과 경기 중에 발생 될 수 있는 과사용 부상과 의학적 위험 요인에 대한 연구문헌들을 고찰하여 스포츠 활동에 직접 참여하는 엘리트 선수 및 동호인 그리고 스포츠 현장에서 선수들을 지도하는 코치와 대회를 주최하는 관계자들에게 트라이애슬론과 관련된 과사용 부상과 의학적 위험요인에 대한 기초자료를 제공하여 이러한 위험요인들을 미연에 예방하거나 감소시키는데 도움을 줄 수 있는 기초자료를 제시하고자 한다.

Keywords

References

  1. American College of Sports Medicine Position Stand. 1998. Exercise and physical activity for older adults. Med. Sci. Sports Exerc. 30, 992-1008. https://doi.org/10.1097/00005768-199806000-00033
  2. Asplund, C., C. Webb, and T. Barkdull. 2005. Neck and back pain in bicycling. Curr. Sports Med. Rep. 4, 271-274. https://doi.org/10.1097/01.CSMR.0000306221.25551.69
  3. Burns, J., A. M. Keenan, and A. C. Redmond. 2003. Factors associated with triathlon-related overuse injuries. J. Orthop. Sports Phys. Ther. 33, 177-184. https://doi.org/10.2519/jospt.2003.33.4.177
  4. Collins, K., M. Wagner, K. Peterson, and M. Storey. 1989. Overuse injuries in triathletes. A study of the 1986 Seafair Triathlon. Am. J. Sports Med. 17, 675-680. https://doi.org/10.1177/036354658901700515
  5. Dallam, G. M., S. Jonas, and T. K. Miller. 2005. Medical considerations in triathlon competition. Sports Med. 35, 143-161. https://doi.org/10.2165/00007256-200535020-00004
  6. Egermann, M., D. Brocai, C. A. Lill, and H. Schmitt. 2003. Analysis of injuries in long-distance triathletes. Int. J. Sports Med. 24, 271-276. https://doi.org/10.1055/s-2003-39498
  7. Gleeson, M., W. A. McDonald, D. B. Pyne, A. W. Cripps, J. L. Francis, P. A. Fricker, and R. L. Clancy. 1999. Salivary IgA levels and infection risk in elite swimmers. Med. Sci. Sports Exerc. 31, 67-73. https://doi.org/10.1097/00005768-199901000-00012
  8. Gosling, C. M., B. J. Gabbe, and A. B. Forbes. 2008. Triathlon related musculoskeletal injuries: the status of injury prevention knowledge. J. Sci. Med. Sport 11, 396-406. https://doi.org/10.1016/j.jsams.2007.07.009
  9. Gosling, C. M., B. J. Gabbe, J. McGivern, and A. B. Forbes. 2008. The incidence of heat casualties in sprint triathlon. J. Sci. Med. Sport 11, 52-57. https://doi.org/10.1016/j.jsams.2007.08.010
  10. Gulbin, J. P. and P. T. Gaffney. 1999. Ultraendurance triathlon participation: typical race preparation of lower level triathletes. J. Sports Med. Phys. Fitness 39, 12-15.
  11. Hiller, W., M. O'Toole, and E. E. Fortess. 1987. Medical and physiological considerations in triathlons. Am. J. Sports. Med. 15, 164-167. https://doi.org/10.1177/036354658701500212
  12. Inoue, Y., M. Nakao, T. Araki, and H. Ueda. 1992. Thermoregulatory responses of young and older men to cold exposure. Eur. J. Appl. Physiol. Occup. Physiol. 65, 492-498. https://doi.org/10.1007/BF00602354
  13. Kerr, C. G., T. A. Trappe, R. D. Starling, and S. W. Trappe. 1998. Hyperthermia during Olympic triathlon: influence of body heat storage during the swimming stage. Med. Sci. Sports Exerc. 30, 99-104.
  14. Korkia, P., D. Tunstall-Pedoe, and N. Mafulli. 1994. An epidemiological investigation of training and injury patterns in British triathletes. Br. J. Sports Med. 28, 191-196. https://doi.org/10.1136/bjsm.28.3.191
  15. Kreider, R. B., T. Boone, W. R. Thompson, S. Burkes, and C. W. Cortes. 1988. Cardiovascular and thermal responses of triathlon performance. Med. Sci. Sports Exerc. 20, 385-390. https://doi.org/10.1249/00005768-198808000-00010
  16. Laird, R. H. 1989. Medical care at ultraendurance triathlons. Med. Sci. Sports Exerc. 1989 21, S222-225.
  17. Latzka, W. A. and S. J. Montain. 1999. Water and electrolyte requirements for exercise. Clin. Sports Med. 18, 513-524. https://doi.org/10.1016/S0278-5919(05)70165-4
  18. Manninen, J. S. and M. Kallinen. 1996. Low back pain and other overuse injuries in a group of Japanese triathletes. Br. J. Sports Med. 30, 134-139.
  19. Mayers, L. B. and T. Noakes. 2000. A guide to treating Ironman triathletes at the finishing line. Phys. Sports Med. 28, 35-50.
  20. McMurray, R. G. and S. M. Horvath. 1979. Thermoregulation in swimmers and runners. J. Appl. Physiol. 46, 1086-1092.
  21. Migliorini, S. 1991. An epidemiological study of overuse injuries in Italian national triathletes in the period. 1987-1990. J. Sports Traumatol. Rel. Res. 13, 197-206.
  22. Migiliorini, S. 2000. The triathlon: acute and overuse injuries. J. Sports Traumatol Relat. Res. 22, 186-195.
  23. Moehrle, M. 2001. Ultraviolet exposure in Ironman triathlon. Med. Sci. Sports Exerc. 33. 1385-1386. https://doi.org/10.1097/00005768-200108000-00021
  24. Nieman, D. C. 1994. Exercise, infection, and immunity. International Journal of Sports Medicine 15, S131-S141. https://doi.org/10.1055/s-2007-1021128
  25. O'Toole, M. L., W. D. Hiller, M. S. Roalstad, and P. S. Douglas. 1988. Hemolysis during triathlon races: its relation to race distance. Med. Sci. Sports Exerc. 20, 272-275. https://doi.org/10.1249/00005768-198806000-00010
  26. O'Toole, M. L., W. D. Hiller, R. A. Smith, and T. D. Sisk. 1989. Overuse injuries in ultraendurance triathletes. Am. J. Sports Med. 17, 514-518. https://doi.org/10.1177/036354658901700411
  27. Park, C. H. and T. U. Kim. 2009. The effect of different triathlon on weight, sodium and hematological changes. Journal of Life Science 19, 46-51. https://doi.org/10.5352/JLS.2009.19.1.046
  28. Park, C. H., T. G. Park, T. U. Kim, and Y. S Kwak. 2008. Changes of immunlogical markers in elite and amateur triathletes. International Sport Med. Journal 9, 116-130.
  29. Pedersen, B. K. and L. Hoffman-Goetz. 2000. Exercise and the immune system: regulation, integration, and adaptation. Physiological Reviews 80, 1055-1081.
  30. Pedersen, B. K. and H. Ullum. 1994. NK cell response to physical activity: possible mechanisms of action. Medicine and Science in Sports and Exercise 26, 140-146. https://doi.org/10.1249/00005768-199402000-00003
  31. Rehrer, N. J. 2001. Fluid and electrolyte balance in ultra-endurance sport. Sports Med. 31, 701-715. https://doi.org/10.2165/00007256-200131100-00001
  32. Rohde, T., D. A. MacLean, A. Hartkopp, and B. K. Pedersen. 1996. The immune system and serum glutamine during a triathlon. Eur. J. Appl. Physiol. Occup. Physiol. 74, 428-434. https://doi.org/10.1007/BF02337723
  33. Saiful Bachri, M., M. H. Woo, H. W. Lee, J. W. Choi, and H. S. Kim. 2009. Effects of herbal sports drinks with Omija, Maesil and Molasses on the endurance and energy metabolites of experimental animals. Journal of Life Science 19, 219-227. https://doi.org/10.5352/JLS.2009.19.2.219
  34. Shaw, T., P. Howat, M. Trainor, and B. Maycock. 2004. Training patterns and sports injuries in triathletes. J. Sci. Med. Sport 7, 446-450. https://doi.org/10.1016/S1440-2440(04)80262-7
  35. Shinkai, S, Y. Kurokawa, S. Hino, M. Hirose, J. Torii, S. Watanabe, S. Shiraishi, K. Oka, and T. Watanabe. 1993. Triathlon competition induced a transient immunosuppressive change in the peripheral blood of athletes. J. Sports Med. Phys. Fitness 33, 70-78.
  36. Simpson, G, D. Roomes, and M. D. Humphrey. 2001. Anaphylactoid reactions associated with menstruation affecting two sisters. Med. J. Aust. 175, 415-417.
  37. Sleivert, G. G. and D. S. Rowlands. 1996. Physical and physiological factors associated with success in the triathlon. Sports Med. 22, 8-18. https://doi.org/10.2165/00007256-199622010-00002
  38. Smith, J. W. and M. J. Weidermann. 1990. The exercise and immunity paradox: A neuroendocrine/cytokine hypothesis. Medical Science Research 18, 749-753.
  39. Speedy, D. B., J. G. Faris, M. Hamlin, P. G. Gallagher, and R. G. Campbell. 1997. Hyponatremia and weight changes in an ultradistance triathlon. Clinical Journal of Sport Medicine 7, 180-184. https://doi.org/10.1097/00042752-199707000-00005
  40. Speedy, D. B., T. D. Noakes, I. R. Rogers, I. Hellemans, N. E. Kimber, D. R. Boswell, R. Campbell, and J. A. Kuttner. 2000. A prospective study of exercise-associated hyponatremia in two ultradistance triathletes. Clinical Journal of Sport Medicine 10, 136-141. https://doi.org/10.1097/00042752-200004000-00009
  41. Speedy, D. B., I .R. Rogers, T. D. Noakes, S. Wright, J. M. D. Thompson, R. Campbell, I. Hellemans, N. E. Kimber, D. R. Boswell, J. A. Kuttner, and S. Safih. 2000. Exercise-induce hyponatremia in ultradistance triahletes is caused by inappropriate fluid retention. Clinical Journal of Sport Medicine 10, 272-278. https://doi.org/10.1097/00042752-200010000-00009
  42. Steerenberg, P. A., I. A. van Asperen, A. van Nieuw Amerongen, A. Biewenga, D. Mol, and G. J. Medema.. 1997. Salivary levels of immunoglobulin A in triathletes. Eur. J. Oral. Sci. 105, 305-309. https://doi.org/10.1111/j.1600-0722.1997.tb00245.x
  43. Sulzer, N. U., M. P. Schwellnus, and T. D. Noakes. 2005. Serum electrolytes in Ironman triathletes with exerciseassociated muscle cramping. Med. Sci. Sports Exerc. 37, 1081-1085. https://doi.org/10.1249/01.mss.0000169723.79558.cf
  44. Trappe, T. A., R. D. Starling, A. C. Jozsi, B. H. Goodpaster, S. W. Trappe, T. Nomura, S. Obara, and D. L. Costill. 1995. Thermal responses to swimming in three water temperatures: influence of a wet suit. Med. Sci. Sports Exerc. 27, 1014-1021. https://doi.org/10.1249/00005768-199507000-00010
  45. van Beaumont, W., S. Underkofler, and S. van Beaumont. 1981. Erythrocyte volume, plasma volume, and acid-base changes in exercise and heat dehydration. J. Appl. Physiol. 50, 1255-1262.
  46. van Mechelen, W. 1992. Running injuries. A review of the epidemiological literature. Sports Med. 14, 320-335. https://doi.org/10.2165/00007256-199214050-00004
  47. van Mechelen, W., H. Hlobil, and H. C. Kemper. 1992. Incidence, severity, aetiology and prevention of sports injuries. A review of concepts. Sports Med. 14, 82-99. https://doi.org/10.2165/00007256-199214020-00002
  48. van Mechelen, W., H. Hlobil, H. C. Kemper, W. J. Voorn, and H. R. de Jongh. 1993. Prevention of running injuries by warm-up, cool-down, and stretching exercises. Am. J. Sports Med. 21, 711-719. https://doi.org/10.1177/036354659302100513
  49. Villavicencio, A. T., S. Burneikiene, T. D. Hernandez, and J. Thramann. 2006. Back and neck pain in triathletes. Neurosurg. Focus 21, E7.
  50. Villavicencio, A. T., T. D. Hernandez, S. Burneikiene, and J. Thramann. 2007. Neck pain in multisport athletes. J. Neurosurg. Spine 7, 408-413. https://doi.org/10.3171/SPI-07/10/408
  51. Vleck, V. E. and G. Garbutt. 1998. Injury and training characteristics of male Elite, Development Squad, and Club triathletes. Int. J. Sports Med. 19, 38-42. https://doi.org/10.1055/s-2007-971877
  52. Weight, L. M., M. J. Byrne, and P. Jacobs. 1991. Haemolytic effects of exercise. Clin. Sci. 81, 147-152.

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