Core 1: Health Priorities in Australia

How are priority issues for Australia's health identified?

● Measuring health status

○ Role of epidemiology
○ Measures of epidemiology (mortality, infant mortality, morbidity, life expectancy)

Role of epidemiology Epidemiology → The study of disease or illness in a given population over a period of time. Epidemiological data identifies prevalence and incidence of disease and illness as
well as patterns and measures which may reduce the occurrence of the disease. This data enables decisions about health issues to be made based on evidence. Health
promotion and health expenditure is determined by data collected in relation to the current and future health needs of a population.
Incidence → The number or proportion of new cases arising in a particular population within a given period.
Prevalence → The number of proportion of people with a disease in a population at a given time.
Infant/Mortality → The number of people within a population which have died in a given year.
Morbidity → The measure of disease or disability rates within a given population
Burden → The impact an issue has on a population, measured by financial cost, mortality and morbidity rates and other indicators
Indicators of these aspects include life expectancy, mortality, infant mortality, and morbidity

Critique the use of What can Epidemiology can depict the health status of a population, trends in disease, prevalence and incidence of disease, death, birth, illness and injury rates, treatments provided and
epidemiology to describe epidemiology tell hospital usage, and expenditure for consumers and government. Its role is to help researchers and health authorities to:
the health status by us? ● describe and compare patterns of health in groups communities and populations
considering questions ● identify health needs and allocate health care resources accordingly
such as: ● evaluate health behaviours and strategies to help control and prevent disease
● identify and promote behaviour that can improve the health status of the overall population

Who uses these The government, researchers, health department officials, and health or medical practitioners, can use this information.
measures?

What are the Epidemiology does not suggest why people take risks, variations among subpopulations, impact of the illness on quality of life, data is incomplete or non-existent, why inequities
limitations? exist, and contribution of factors.

Use tables and graphs from health reports to Increased life expectancy for Australians over decades had increased significantly due to:
analyse current trends in life expectancy and ● Reduced infant mortality rates from improved medical diagnosis + treatment of illness
major causes of morbidity and mortality for ● Declining mortality rates for CVD, some cancers and some motor vehicle accidents
the general population and compare males ● The improved medical interventions e.g. advanced screening techniques
and females. The life expectancy for Australian males is roughly 79 and for Australian females it's about 81. Australians live longer than people in any other nation in the world except Japan
(81.4).
Most common causes of death are:
1. CVD
2. Cancer
3. Diseases of the respiratory system
4. External causes e.g. car accidents
5. Mental and behavioural Disorders
6. Diseases of the Nervous system
Diseases that are largely preventable life-style diseases have been increasing, such as CVD, obesity, Alzheimer’s, dementia and cancer. Heart disease, lung cancer and stroke
have all remained relatively stable. Significant decrease in the death rates from circulatory and respiratory diseases in males - Stable death rates for respiratory system and
genitourinary diseases have remained stable for women. Some of the leading causes of death like heart disease, stroke, and some cancers, the death rates are decreasing. This
reduction of these diseases is mainly due to:
● Improving medical technology methods + medicines
● Improved levels of education about leading a healthy life-style + consequences of inactivity, a poor diet and unhealthy behaviours like smoking.

● Identifying priority health issues

○ Social justice principles
○ Priority population groups
○ Prevalence of condition
 ○ Potential for prevention and early intervention
○ Costs to the individual and community

Argue the case for why How do we Priority health issues can be identified through; social justice principles, potential for prevention and early intervention, prevalence of a condition, cost to the individual and
decisions are made identify priority community, and priority population groups. Identifying health priority areas and managing Australia’s health are based around the principles of social justice. These principles
about health priorities by issues for include: equity, diversity, and supportive environments.
considering questions Australia’s
such as: health?

What role do the An example of the social justice priorities being applied in Medicare. Medicare is public health care for all Australians at no or little cost to the individual under Medicare. There
principles of are two major aspects; Medicare Safety Net → a predetermined amount set by the Australian Government for which medical expenses are subsidised once an individual or family
social justice have incurred the medical costs (2017 - $453), eg: going to the doctor is subsidised. Pharmaceutical Benefits Scheme (PBS) → prescription treatments considered to be life saving,
play? or for chronic illness are subsided under the PBS, eg: individuals of a low SES may not be able to afford treatment.

Why it is Priority population groups → groups in Australian society which experience health inequities and difficulties.
important to Since these groups are identified as experiencing poor health, with the implementation of the social justice principles, such groups should have equitable access to health. Thus,
prioritise health promotion and strategies must be put in place to accommodate all individuals. Epidemiological data identifies that the priority population groups are:
● First Nations Australians
● People who are socioeconomically disadvantaged
● People living in rural and remote areas
● People born overseas
● The elderly
● People with disabilities
These priority groups can be joint, eg, an elderly person can live in a rural area, increasing their exposure to health inequities.
The Royal Flying Doctor Service
The RFDS has been developed to increase the health outcomes for people living in rural and remote areas and First Nations Australian populations. The service aims to increase
access to services, facilities and health education through:
● Aeromedical health services, remote community health clinics
● Doctor and medical practitioner incentive program to encourage medical professionals to work in remote communities
● Developing culturally diverse health services
● Increasing funding for First Nation Australians health

Prevalence of condition: Priority health issues can be determined by how prevalent the health condition is. In Australia, this is generally concerned with chronic disease, injury and mental health issues.
Disease, injury and mental health issues can place a burden on a population and thus it is important to prioritise health funding and resources in these areas. It is crucial to
understand the prevalence of a condition in order to improve health quality.

Burden of disease Burden → an estimated impact of disease and injury on an individual or community. This is determined by the effect of death or disability.
● Low SES experience 1.5 times more disease burden when compared with the highest SES group
● Mental health and substance abuse contributes to 19% of disease burden in Australia
● First Nations people populations experience 2.3 times more disease burden than non First Nations people populations
● In 2011, 31% of disease burden was due to preventable and modifiable risk factors.

Potential for prevention and early Modifiable risk factors → risk factors that are able to be modified by the individuals eg: smoking, high fat diet, sedentary lifestyle.
intervention. When identifying priority health issues, it is essential to identify issues which are more likely to be preventable. This means that in the long term, resources can be used
elsewhere. Most health issues in Australia are caused by modifiable risk factors. Therefore, early intervention is possible through modification of risk, meaning the burden of
disease can be lowered. Early intervention strategies enable diseases to be identified before they become an increasing burden on a population. For example → the
implementation of the screening services, like cancer screening, has led to a decrease in mortality rates due to early detection and treatment. Breast cancer screening is now
available for women at younger ages for prevention. Risk factors include: sedentary lifestyle, high blood pressure, overweight, diabetes, stress, smoking, and high cholesterol.

Cost to the individual and community Direct cost → monetary costs of diagnosing and treating a patient.
Indirect cost → difficult to measure costs such as a patient's mental health and other effects stemming from illness, eg loss of wages when a person is unable to work.
When identifying priority health issues it is essential to identify the cost of the disease, illness or injury to the individual and the community. The cost can either be direct costs
such as financial burden, or indirect costs, including an individual's mental wellbeing as a result of cancer diagnosis. If it is considered that the health issue has a high cost to
either the individual or the community, then this gives reason as to why the health issues need to be identified as a priority.
 What are the priority issues for improving Australia’s health?

● Groups experiencing health inequities

○ Aboriginal and Torres Strait Islander peoples
○ Socioeconomically disadvantaged people
○ People in rural and remote areas
○ Overseas-born people
○ The elderly
○ People with disabilities

Research and analyse The nature and ATSI

ATSI peoples and ONE extent of the In summary, ATSI people experience health inequities in all areas of health. They have the largest health gap of all population groups in Australia. Because they experience such
other group experiencing health inequities inequities, they are identified as a priority population group. If a group is identified as a priority population group, this means that the government will invest in health promotion
health inequities by specific to the needs of the population group. The ultimate goal is to improve health for all Australians by ensuring that it is equitable and accessible.
investigating: When compared to non-ATSI individuals:
● Increased mortality rate
● Decreased life expectancy
● Increase youth suicide
● Increased kidney disease
● Increased chronic disease

RURAL AND REMOTE

People living in rural and remote areas experience more health inequities than people living in regional and city areas. In Australia, about 30% of our population are living in rural
and remote areas. Environmental location is identified as a determinant of health, this highlights that people who live in rural and remote areas are more likely to experience
poorer health outcomes than those not living in rural and remote areas.
Indicators of health → a characteristic of an individual population, or environment which can be measured and used to describe one or more aspects of the health of an individual
or population. These can be indicators of poor or good health.
When compared with people living in regional and major cities:
● Higher rates of chronic illness such as CVD, cancer and diabetes
● Higher rates of injuries and road accidents
● Higher rates of liver diseases
● Higher rates of suicide
Indicators of poor health increased:
● Obesity rates
● Smoking rates
● Inactivity
● Alcohol consumption

The sociocultural, ATSI

socioeconomic Sociocultural: increased domestic violence, disempowerment, decreased income affects family life, and 47% single parent homes.
and Socioeconomic: less than ⅔ working age population employed, low income, and decreased rates of education completion.
environmental Environmental: isolation leads to lack of access, longer waiting times due to decreased services, and lack of health literacy due to low levels of education.
determinants RURAL AND REMOTE
Sociocultural: Greater First Nations Australians population, family behaviour eg → smoking, alcohol consumption, lower activity rates and family history of obesity.
Socioeconomic: decreased access to education and employment, limited access to goods and services, exposure to ‘heavy labour’ employment eg → machinery, mines and
 farms, and a strong sense of community.
Environmental: decreased access to health professionals, decreased access to health facilities and screening, increased need for transportation for health treatment, and
decreased health education, low health literacy leads to lack of access to services.

The role of ATSI

individuals, Individuals: empowerment, increase protective behaviours
communities and Communities: involvement in design and implementation of health initiatives, Aboriginal medical services, Australian Indigenous Doctors’ Association.
governments in Governments: close the gap initiative, Indigenous Chronic Disease Package.
addressing the RURAL AND REMOTE
health inequities Individuals: empowerment, increase protective behaviours, and maintaining enrollment in educational programs
Communities: health services tailored to the community - multipurpose centres, community support groups, and community fundraisers
Government: Royal Flying Doctor Service, Rural and Remote General Practice Program

● High levels of preventable chronic disease, injury and mental health problems
○ Cardiovascular disease (CVD)
○ Cancer (skin, breast, lung)
○ Diabetes
○ Respiratory disease
○ Injury
○ Mental health problems and illness

Research and analyse The nature of the CARDIOVASCULAR DISEASE (CVD)

CVD, cancer and ONE problem CVD refers to any disease which affects the circulatory system. The circulatory system is made up of the heart, blood vessels (arteries/veins) and blood. CVD are identified as
other condition listed by preventable chronic diseases.
investigating: Atherosclerosis → when a build up of fatty tissue in the interior walls of the arteries occur
Arteriosclerosis → hardening and/or narrowing of the arteries
The most common form of CVD is coronary artery disease in Australia. It results from a poor supply of blood to the muscular walls of the heart by the coronary arteries
Stroke → the interruption of the supply of blood to the brain.
Peripheral vascular disease → diseases of the arteries, arterioles and capillaries that affect the limbs, usually reducing blood flow to the legs. Can result in the amputation of limbs
Congenital heart disease → heart disease as a child/birth

CANCER
Cancer refers to an uncontrolled growth of body cells. A mutation of a single cell or the division and multiplication of a mutated cell. Cancer can affect any part of the human
body. When cancerous cells are developed, our immune system tries to attack the cells by developing a layer around the cells, called a tumour. Cancer can stay in one part of the
body or spread, which is known as metastasis or secondary cancer. The most common cancers in Australia are lung, breast, and skin cancer.
Metastasis → is the malignant cells which invade body tissues or organs.
Neoplasm → an abnormal mass of cells that forces its way among healthy cells and interferes with their functioning
Tumour → a visible swelling or lump caused by a clump, or ‘sack’, of abnormal cells.
Carcinogen → a cancer causing agent eg: smoking, radiation, alcohol, chemicals
Benign cells → non-cancerous cells which grow slowly within a capsule
Malignant cells → cancerous cells which are not contained in a capsule. This allows them to spread to other parts of the body to invade healthy tissues.
Carcinoma: skin, respiratory, gastrointestinal, urinary tracts, breasts
Sarcoma: muscles, tendons, cartilage
Leukaemia: bones, liver, spleen
Lymphoma: infection-fighting organs, glands, spleen

DIABETES
Diabetes is a group of diseases where the body is unable to break down and use sugar. The body produces insulin, which is a hormone produced by the pancreas. Insulin helps
the body use glucose for energy. There are 3 types of diabetes: type 1 → pancreas makes little or no insulin, type 2 → glucose can not get into the cells and builds up in the
bloodstream, and gestational.
Type 1: insulin dependent, minimal or no insulin, controlled by injecting insulin, unusual thirst, excessive urine, weight loss, children and young adults.
Type 2: non insulin dependent, insulin is not sufficient, controlled by lifestyle changes, lack of symptoms, increased inactivity and poor diet are contributors, 50+ years and an
increasing number of young people.
Gestational: during pregnancy, 24th-28th week of pregnancy, usually disappears after birth, increased risk of type 2, insulin to control blood glucose levels, pregnant women.

Extent of the CVD

problem (trends) ● Leading cause of death - 29%
● ⅕ Australians had CVD in 2014-2015
● ATSI rates twice as high as non-ATSI
● 1.1 million hospitalisations in 2014-2015 due to CVD
● People living in rural and remote areas have hospitalisations and death rates from CVD that are 30% higher than people living in major cities
Decrease in prevalence due to:
● Decrease in risk factors
● Increase in prevention strategies
● Increase in medical care treatment
CANCER
● Cancer is a major cause of illness in Australia
● Death rates are decreasing and survival rates are increasing. 7-10 people survive cancer at least 5 years
● The risk of being diagnosed with cancer before 85 males of age is 1 in 2
● The risk of dying from cancer is ¼ for males and ⅙ for females
● Breast cancer is the most commonly diagnosed cancer in females
● 54% of all new cancers will be diagnosed in males
DIABETES
● 6% of Australians have diabetes
● First Nations Australians are 4x more likely to have type 2
● 75+ age group highest prevalence
● 1 in 10 deaths in 2014 had diabetes as an underlying cause of death
● 1 million hospitalisations in 2015-16
● 5.8% of pregnant women suffer from gestational diabetes
● Lowest SES are 2x more likely to have type 2 compared to the highest SES

Risk factors and Risk factors are factors and/or behaviours which can place an individual at greater risk to something.
protective factors Protective factors are factors which individuals can apply to decrease the chance of poor health outcomes
CVD
Risk factors: age, gender, heredity, smoking, high-fat diet, high blood pressure, obesity, high blood cholesterol, and a lack of physical activity.
Protective factors: regular physical activity, low-fat diet, low alcohol consumption, low saturated fat diet, low salt diet, stress management, and avoiding smoking
CANCER
Risk factors: lung → smoking, occupational exposure, air pollution. Skin → fair skin, fair or red hair, live in areas exposed to sun, prolonged exposure, number and type of moles on
skin. Breast → family history, high-fat diet, early onset of menstruation, late menopause, obesity, late-age pregnancy
Protective factors: lung → avoid exposure to tobacco smoke, avoid exposure to hazardous materials. Skin → avoid excess sunlight, reduce exposure by wearing sun protection.
Breast → regular mammograms, self-examination, diet high in fruits and veg, low fat diet.
DIABETES
Risk factors: type 1 → family history/diabetes, drinking water with increased nitrates, exposure to viruses (destructs the cells that produce insulin), low vitamin D levels, omega 3
fatty acids. Type 2 → 45+ years old, high blood pressure, heart disease or heart attack, overweight, family history, First Nations Australians, low SES populations, gestational
diabetes
Protective factors: eat a variety of nutritious foods, a low fat diet, decrease sugar and salt intake, encourage and support breastfeeding, regular physical activity, limit alcohol
intake.

The sociocultural, CVD

socioeconomic Sociocultural: family history, ATSI, rural and remote peoples and low SES, media exposure to effects of risk behaviours eg → smoking and diet, positive: people of Asian origin due
and to low fat diet.
environmental Socioeconomic: low SES or unemployed, people in stressful working roles, and people with low or no education levels.
determinants Environmental: rural and remote people have decreased access to health services and information, and peoples in cities have increased access to health services and facilities.
CANCER
Sociocultural: family history, First Nations Australians Lung cancer - smoking rates cervical cancer - access to preventative treatment, increase health promoting behaviours to
decrease risk.
Socioeconomic: low SES or unemployed, people who work outdoors, occupations exposed to carcinogens (asbestos), low education levels.
Environmental: rural and remote people have decreased access to health services and information (pre-screening), people in cities have increased access to health services and
facilities.
DIABETES
Sociocultural: family history, First Nations Australians, high saturated fat diets (type 1 among 0-14yrs).
Socioeconomic: low SES, low levels of education → increased alcohol consumption, physically inactive, diets high in fats and sugars.
 Environmental: increased access to technology has led to decreased physical activity rates, incidence increases among remote populations due to limited access to medical
testing and treatment.

Groups at risk CVD

Males, smokers, people with high cholesterol levels, people with high-fat diets, people with family history, low SES groups, and people aged over 65.
CANCER
Lung → smokers, Lung → smokers, blue collars workers, occupations exposed to carcinogens (asbestos), over 50 years of age.
Skin → people at lower latitudes, fair skinned people, outdoor occupations, people who avoid sun protection.
Breast (women) → have never given birth, are obese, are over 50 years of age, have a direct relative with breast cancer, menstruate early, experience late menopause collar
workers, occupations exposed to carcinogens (asbestos), over 50 years of age.
Skin → people at lower latitudes, fair skinned people, outdoor occupations, people who avoid sun protection.
Breast (women) → have never given birth, are obese, are over 50 years of age, have a direct relative with breast cancer, menstruate early, experience late menopause
DIABETES
Type 1 → family history, people aged 45+ years, First Nations Australians
Type 2 → overweight people, people who consume diets high in sugar, people whose mother had gestational diabetes

● A growing and ageing population

○ Healthy ageing
○ Increased population living with chronic disease and disability
○ Demand for health services and workforce shortages
○ Availability of carers and volunteers

Overview The Australian population is ageing, since the number of people living past 65+ is increasing.
● 98% of elderly people visit a doctor early
● 2x the amount of visits to specialists and hospitalisations (57% and 20%)
● 65+ higher levels of lifestyle diseases eg → diabetes, lung cancer, CVD
● 85+ living with cancer, dementia and arthritis
● 20% increase in people living in aged care facilities
HEALTHY AGEING → The process in which healthier behaviour choices are made to positively impact individuals health and wellbeing, enabling good health for longer. Healthy
ageing in Australia is promoted so that the growing ageing population can contribute to society and engage in the workforce for longer. Older people often have skills that the
younger generation does not possess, therefore their knowledge is important for the workforce. With more elderly people in the workforce, this contributes to economic growth
and the decrease in the use of health care services and facilities. Better health outcomes are directly linked to employment, thus chronic diseases and disability are lower among
elderly people who are working. Encouraging healthy ageing improves individuals quality of life as well decreasing the burden on Australia’s health care systems.

INCREASED POPULATION LIVING WITH DISABILITY & CHRONIC DISEASE

Disability → Australia’s population has increased rates of chronic disease and disability, with the elderly being most affected. Due to increased survival rates of cancer and heart
disease, more people are living longer. Thus, these people usually experience some disability or decrease in quality of life as a result. Therefore there is an increased need for
health expenditure and aged care facilities and carers.

Comorbidity → the presence of one or more additional diseases or disorders which is occurring with a primary disease or disorder eg → CVD and lung cancer. Individuals over the
age of 65 are more susceptible to comorbidity.

Assess the impact of a The health Due to Australia’s growing and ageing population, the demand for health services is increasing. This contributes to a shortage in workforce services in the health services sector.
growing and ageing system and Thus, increasing funding and workers in aged care are required to treat and care for the ageing population, requiring more individuals with training and availability of staff in aged
population on: services care. With more people living with chronic illness and disability, this also increases the demand for specialists and doctors in aged care.
Consumer directed care → a model of service delivery designed to give more choice and flexibility to consumers eg more control over the types of care and services they access
Health service and the delivery of those services, including who delivers the services and when.
workforce Addressing the issue → due to Australia’s excellent health care system, Australians are living longer lives. Therefore the government implemented the Aged Care Reform Living
longer, living better (2014). Over 10 years, the government aims to create a health care system which:
● Is sustainable and affordable
● Offers choice and flexibility for consumer
● Encourage business to invest and grow
● Provides diverse and rewarding career options.
The aim of the reform is to move towards consumer direct care. This will provide people with personal choice based on their needs. Aged care will allow elderly people to access
residential care but also services to allow them to live independently in their homes.
 Carers of the ● Home care recipients have increased by 84% in the past 10 years due to home care packages program
elderly ● 12% of the population are unpaid often working in the home of the elderly
● 3.1% of the population are paid carers 90% carers
Volunteer ● Community aged care packages → provide low-level caregiving basic support and assistance with daily activities
organisations ● Extended aged care at home → providing a higher level of care than the community aged care package
● Extended aged care at home dementia → catering for the more complex needs of those with dementia
Volunteers are an essential part of working towards healthy ageing. Volunteers can be informal, such as family and community groups, or involved with formal groups such as
Meals on Wheels, Anglicare and Alzheimer’s Australia. Between 1995-2010 volunteer rates were increasing, however, between 2010-2014 these rates decreased to 31% from 36%
of the population aged over 18 years. The Aged Care Reform aims to increase the volunteer support network by providing volunteers with training and support - similar to the
paid workforce

What role do health care facilities and services play in achieving better health for all Australians?

● Health care in Australia

○ Range and types of health facilities and services
○ Responsibility for health facilities and services
○ Equity of access to health facilities and services
○ Health care expenditure versus expenditure on early intervention and prevention
○ Impact of emerging new treatments and technologies on health care, eg cost and access, benefits or early detection
○ Health insurance: medicare and private

Evaluate health care in How equitable is The role of health care in Australia is to provide quality health facilities and services to meet the health needs of all Australians. Health care in Australia is a relationship between:
Australia by investigating the access and Commonwealth, State and Local Government, health insurance funds, public and private providers (doctors), institutions (hospitals), and community health services. These
issues of access and support for all facilities provide diagnosis, treatment, rehabilitation, and care to the population.
adequacy in relation to sections of the RANGE & TYPES OF HEALTH CARE FACILITIES & SERVICES
social justice principles. community? Allied health → health professionals who are not doctors, dentists or nurses eg physio, optical, chiro, podiatry.
Questions to explore In Australia there are two types of health care facilities; institutional and non-institutional. All levels of government and communities contribute to the services provided by the
include: various facilities.

RESPONSIBILITY FOR HEALTH CARE FACILITIES AND SERVICES

Health insurance/health care
● Public health care
○ Medicare
○ PBS (pharmaceutical benefits scheme)
● Private health insurance
○ HCF
○ Bupa
○ NIB
○ Medibank
○ Teachers health
Commonwealth Government
● State Government
○ Hospitals (women’s and mental health, First Nation Australians and dental)
○ Health promotion
○ Legislation/laws
● Local Government
 ○ Policies (WHS and community spaces)
○ Community health clinics and services
○ Support/volunteer groups
Health care providers
● Institutional
○ Hospitals
○ Nursing homes
● Non-institutional
○ Community health services
○ Medical services
○ Health promotion agencies
○ Pharmaceutical services
EQUITY OF ACCESS TO HEALTH CARE FACILITIES & SERVICES
Australia’s governments aim to provide health care that is equitable for all Australians, which can be difficult. Geographical location and low education rates can decrease access
to general health care including doctors, hospitals and specialist services. ATSI populations are more likely to decrease access to health care including dental, general
practitioners and hospital care. This is due to lack of facilities and services in rural and remote populations and the cost of health care. The government introduced Medicare and
PBS to ensure Australians have more equitable access to health care, services and treatment. The Royal Flying Doctor Service is also funded to increase health education,
practitioners and services to rural and remote populations, including ATSI specific health care.

How much HEALTH CARE EXPENDITURE VS EXPENDITURE FOR EARLY INTERVENTION & PREVENTION
responsibility This concept aims to compare the cost of health care for treatment of disease and illness with preventative measures. In Australia, chronic illnesses are identified as one of the
should the biggest contributors to health care expenditure, therefore options for early intervention and prevention as well as treatment to ensure the health care system is sustainable must
community be implemented.
assume for
individual health
problems?

Prevention in Australia is heavily focused on chronic disease, illness and injury. The determinants for chronic disease are mostly modifiable, therefore the focus is on improving
lifestyle choices. SEC and sociocultural determinants are the largest contributors to chronic disease. The implementation of Medicare aims to decrease inequity for people with
low education, language barriers, and lower SES. This is done by improving access to translators for services and decreased cost of medical services and medication (PBS). The
biggest preventative measures in Australia are cancer screening (breast, skin and colon) and immunisation (flu, whooping cough, measles, cervical cancer).
Intervention intertwines with prevention, as the aim is to implement health promotions (advertising, strategies, policies, laws) which encourage individuals and communities to
make changes to their health behaviours. In turn, this can contribute to decreasing the burden of chronic illness on the health care system.
Intervention must be cost effective, improve health outcomes and, essentially, increase life expectancy
In 2013, WHO released a list of ‘best buy’ policies which countries can implement at the primary care level, including;
● Reduce the impact of tobacco smoking, warning of the dangers and restricting advertising for tobacco
● Alcohol and tobacco tax
● Change eating habits to reduce salt intake and increase healthier diets, increased exercise
● Promotion of cancer screenings (Australia - breast, bowel and cervical)
Examples of these strategies include; slip, slop, slap, seek, slide

Describe the advantages and disadvantages IMPACT OF NEW & EMERGING TECHNOLOGIES ON HEALTH CARE
of Medicare and private health insurance, eg Improvements in medical technology and treatment assist in decreasing the burden of disease by improving early detection and treatment of diseases, illnesses and injuries.
costs, choice, ancillary benefits Consequently, the potential to improve health outcomes, specific treatments are continually added to the Medicare benefits scheme. Eg → cleft lip and palate scheme, Child
Dental Benefits Schedule. Due to the expense of most services associated with new and emerging technologies, those of low SES and rural and remote populations often miss
 out on treatment. Emerging technologies include;
● HVP vaccine - cervical cancer
● Keyhole surgery
● Ultrasound, MRI and 3D imaging
● Medication for chronic disease (HIV and cancer)
● Joint replacement
● Artificial organs (kidneys)
HEALTH INSURANCE - MEDICARE AND PRIVATE
Private health insurance → subsides the cost of hospital and general treatment (dental, optical, physio) for individuals and families. Allows buyers to select their treatment and
location eg doctor and hospital/surgery
Medicare was introduced in Australia in 1984 to address health inequities and improve the overall health status of Australia by providing health care for all Australians. Medicare
subsidised health care so individuals can access hospital care and most primary health expenses. Tax payers contribute 2% of their income to fund Medicare (Medicare levy).
Individuals who invest in private health insurance are not required to pay the Medicare levy and receive government rebates towards their insurance. This an effort to make
private health insurance more affordable. These incentives for investing in private health insurance aim to decrease government expenditure on health care. The expense and
increased access to services is a social justice issue as it allows for inequity of access between low SES and high SES populations.

● Complementary and alternative health care approaches

○ Reasons for growth or complementary and alternative health products and services
○ Range of products and services available
○ How to make informed consumer choices

Critically analyse How do you Complementary and alternative health care approaches → healing practices that do not fall within the areas of conventional medicine.
complementary and know who to REASONS FOR GROWTH OF COMPLEMENTARY & ALTERNATIVE HEALTH CARE APPROACHES
alternative health care believe? ● Effectiveness over modern medicine for some people
approaches by exploring ● Holistic nature of natural medicine is becoming increasingly popular
questions such as: What do you ● Increased empowerment and control over health choices
need to help you ● Increase in availability of natural medicines over synthetic options
make an ● Increase in migration of cultures to Australia eg Chinese
informed ● Greater globalisation and societal trends towards individualism means:
decision? ○ Increased access to information
○ Decreased use of traditional Western medicine
● 3-7 years of tertiary training required eg → health science in traditional medicine
● Regulatory bodies eg → Australian Traditional Medicine Society
● Increase in research for evidence of complementary and alternative health care eg → UTS research centre for CAM
● WHO recognise the usefulness of alternative health approaches
● Private health insurance addresses demand for services by providing cover for some services
RANGE OF SERVICES & PRODUCTS AVAILABLE
Some services which are available include biological (plants), alternative medicine (holistic approach to help the entire body), manipulative (chiropractor, massage), mind-body
interventions (relaxation, meditation), and energy therapies (use of magnets and crystals).
Acupuncture: aids in stimulating the mind and the body’s healing process, mostly used for pain management and recovery, often combined with other practices including
massage/chiropractor.
 Aromatherapy: the use of essential oils to influence or modify the mind, body or spirit, oils can be vaporised, bathed in or used during massage, used for the treatment of
depression, poor sleep, stress or anxiety.
Chiropractic: based on the relationship between the spine, nervous system and musculoskeletal system, adjustments are made to the spine to remove interference to normal
nervous system control, promoting healing and better health.
Herbalism: the oldest form of medicine which used plants and herbs as medicine or supplements to restore the body, 75% of the world’s population use herbalism, based on the
individual’s symptoms, lifestyle and overall health → empowerment for the individual, specific to each person
Iridology: analysis of the human eye to detect signs of physical, emotional and spiritual wellbeing, naturopathic (a combination of one or more alternative or complementary
health care services) treatments are prescribed to improve general and immune health.
Massage: induces relaxation and reduces blood pressure, stress and anxiety levels, becoming increasingly popular among athletes to assist with rehabilitation and decreased
recovery times.
Meditation: a state of inner stillness which focuses on an object, breathing, phrase or mantra, strengthens immune system, improved sleep, lower blood pressure and increased
motivation and self esteem, becoming increasingly popular among athletes to control anxiety and arousal → allows them to perform at peak level by enabling them to focus on
other things.
HOW TO MAKE INFORMED CONSUMER CHOICES
Due to the relatively new status of CAM health care services in Australia and inconsistent regulation of services, it is important for consumers to know how to make informed
choices. This can be done by analysing the services available and the sustainability to their needs as well as:
● Is there research to support the use of the health services?
● What treatment is available?
● What are the practitioners qualifications?
● Can the treatment be complementary and combined with modern medicine?

What actions are needed to address Australia’s health priorities?

● Health promotion based on the five action areas of the Ottawa Charter
○ Levels of responsibility for health promotion
○ The benefits of partnerships in health promotion, eg government sector, non-government agencies and the local community
○ How health promotion based on the Ottawa Charter promotes social justice
○ The Ottawa Charter in action

Argue the benefits of Individuals, 5 actions areas:

health promotion based communities and 1. Developing personal skills → improving personal and social development
on: governments 2. Creating supportive environments → increases an individual’s ability to make health promoting choices
working in 3. Building healthy public policy → decisions for health promotion made by all levels of Government and NGOs
partnership 4. Strengthening community action → empower communities to implement action to address specific health needs
5. Reorienting health services → shift from curative treatment based health care to preventative health care
The five action RESPONSIBILITY FOR HEALTH PROMOTION
areas of the Individuals, governments, community groups, and NGOs are all responsible for health promotion in their specific ways, with effective health promotion being the consequence of
Ottawa Charter all features working collaboratively. The benefits of these partnerships include;
● Addressing social determinants outside the control of the healthcare system
● Improved population health and wellbeing
● Reduced demand for health care and services
● Collection of resources, knowledge and expertise, development of networks
● Allows partner to address current problems more effectively
● Respond better to future health problems
● Helps identify individuals and community health priorities
● Better use of funding and resources
● Encourages participation for individual health - empowerment
● New collaborative and inclusive ways of community
● Improvements in social cohesion, sustainable human developments, and dynamic society
In the 1970s, deaths from CVD greatly decreased due to an increased health promotion, including smoking laws changing as well as health education in school.
Investigate the principles of social justice and Empowerment of individuals → If individuals are feeling empowered, they become more responsible for their own health. Each individual has the right to access health - despite
the responsibility of individuals, communities their race, religion, culture, SES status, gender or location.
and governments under the action areas of Promotion of: Developing personal skills Reorienting health services Strengthening community action Building healthy public policy Creating supportive environments
the Ottawa Charter
Access Increases access to health care Health professional explore Access to community health groups The increase of policies specific to By taking care of others in the community,
and services (Medicare) inequities in health to focus on increases the empowerment of improving health equity and support, empowerment and health outcomes
priority areas eg → heart disease, individuals outcomes allows for better health are increased
mental illness

Diversity Providing health information and Increase in preventative services Communities action for increased Policies ensure that there is an A diverse range of community groups and
education in various languages increases knowledge of culturally medical services and facilities from adequate minimum level for health local government support increases access
and for different cultures diverse communities government funding which are care for all Australians and specific and the diversity of health services and
specific to their communities needs policies where needed eg → Close facilities available
the Gap

Supportive Health information and skills are The introduction of multi Increased access to services and Policies are developed to support Governments and communities provide
environments shared within the functioning facilities such as facilities which promote preventative health care and a opportunities for individuals to become
community/family medical centres and remote empowerment eg → walking trails, supportive environment eg → engaged in positive health decision making
services allows for easier access public pools, mental health services smoking laws, school speeding eg → outdoor facilities and access to health
zones information

Critically analyse the importance of the five

action acres of the Ottawa Charter through a CLOSE THE GAP: The Australian government focuses their ‘Close the Gap’ on the life expectancy between First nations Australians and non-First nations Australians. This initiative aims to increase access to health
study of TWO health promotion initiatives care and facilities to these people, especially in rural and remote communities. The aim is to lessen this gap by 2030.
related to Australia’s health priorities
Developing personal skills Reorienting health services Strengthening community action Building healthy public policy Creating supportive environment

Provide primary health care services to Invest in primary health care where Involve ATSI peoples and their Close the Gap in a Generation policy Provide training to provide an adequate
ATSI population, particularly through prevention and promotion are in balance respective bodies as active participants signed in March 2008, the National number of healthcare professionals to
Aboriginal Community Controlled Health with curative services. Provide in health planning at local and regional Indigenous representative body was deliver health care services, ensure First
Services. Provide health care and access appropriate education through health levels. Delivery of culturally appropriate established, funding provided to build a nation Australians have access to fresh
to early learning support for Indigenous services to promote healthy, structured primary health services by Aboriginal skilled and professional workforce to and healthy food, provide necessary
mothers, babies, and children. lifestyles and prevent the heavy onset of Community Controlled Health Services. cope with the challenges of remote housing, waste supply systems to
chronic disease for 34-45 year olds. Indigenous education, and measurable support achievements of health equality,
Initiate the changes that will ensure ATSI targets for First Nations Australians recruitment of First nation Australians
communities have the necessary health equality are set as part of the trainees in the Australian Federal Police
housing, water supplies, and systems to Close the Gap policy. and providing adequate training and
support health equality. boosting the profile of First Nation
Australians in the AFP, and provide extra
teachers for schools located in rural and
remote communities.

NATIONAL CHRONIC DISEASE STRATEGY: Chronic disease in Australia is identified as a priority health issue. This strategy was developed in 2005. The policy specifically targets Australia’s health care system and
seeks to improve health outcomes. The policy states national directions, which aims at reducing the impact and prevention of chronic disease across Australia.

Provide health promotion for the whole Increased focus on preventing and Increase the capacity of the workforce in Develop relationships between patients
population. Develop empowerment reducing exposure to risk factors, terms of availability and skills. Focus on and health care workers to enhance
among individuals to take responsibility increased funding for health promotion the needs of priority population groups their ability to make informed decisions
for their own health, including focused on risk reduction behaviours, for chronic disease. Deliver a flexible regarding their health. Develop
decreasing risk taking behaviour, and the implementation of early health care system that can coordinate infrastructure and support which can be
medication management and informed detection and screening eg → cancer health care across all sectors, service accessed by technology. Create
decision making. screening. and settings. environments where a multidimensional
approach can be applied for people with
chronic diseases. Provide community
and disability support for families and
carers of people living with chronic
disease.
 Core 2: Factors Affecting Performance
How does training affect performance?

● Energy systems
○ Alactacid system (ATP/PC)
○ Lactic acid system
○ Aerobic system

Overview Alactacid:
Energy is produced by the breakdown of adenosine triphosphate (ATP) to adenosine diphosphate (ADP). When the muscles run out of stored ATP, ADP combines with creatine
phosphate (CP) to create more ATP. If the body does this without oxygen it uses the anaerobic energy systems. If oxygen is used to replenish ATP the aerobic system is used.
Lactic acid:
After PC stores are depleted, the lactic acid system becomes the dominant supplier of ATP. It relies on anaerobic glycolysis and lasts 30-60 seconds at maximum effort and 3 minutes
at lower efforts. The by-product is lactic acid. A trained athlete will be able to tolerate higher levels of lactate and perform for longer using this energy system. It is important to note
that lactic acid is not the cause of fatigue, rather the build up of hydrogen ions is.
Aerobic:
This energy system is the most complex system and is predominantly used for endurance athletes and when at rest. Aerobic glycolysis provides the athlete with ATP for energy
requirements. Carbohydrates, fats and protein are used as sources of fuel. Carbohydrates are the most efficient form of fuel. Fats can take longer to release energy and are usually
used when the athlete exercises beyond an hour. Proteins are rarely used as a source of energy, more in extreme endurance or exhaustion.

Analyse each energy system by

exploring: ATP-PC LACTIC ACID AEROBIC

Source of fuel Creatine phosphate ATP produced by anaerobic glycolysis Carbohydrates, protein, fat

Efficiency of ATP ATP rapidly available, without oxygen supplies ATP is produced while glucose stores are available in ATP available through aerobic glycolysis, only suitable at rest and
production muscles, oxygen supply not required. low intensity exercise

Duration that the ATP supplies are exhausted after 1-2 second 30-60 seconds, 3 minutes at 75-80% effort at maximal effort 3-7 minutes, unlimited energy supply (depending
system can operate s. CP enables resynthesis for another 10-15 seconds. At rest - CP on intensity)
supplies are restored within 2 minutes

Cause of fatigue maximum or near maximum effort causes fatigue. Fatigue is caused increased accumulation of hydrogen ions (lactic acid) depletion of glycogen, accumulation of hydrogen ions, hypothermia
by inability to continuously resynthesis ADP from CP. Fatigue is or hyperthermia.
evident in events 10-15 which require maximum effort.

By-products of energy no by-product which can cause fatigue. Muscular contractions will lactic acid carbon dioxide, water (sweat)
production produce heat.

Process and rate of quick recovery. Within 2 minutes most ATP and CP supplies are removal of lactic acid by oxygen within 15-30 minutes dependent on duration and intensity of activity → continuous - 10-48
recovery restored. 50% of CP recovery occurs in the first 30 seconds of rest. (active recovery) hours, intermittent - 5-24 hours.

Examples 100m running sprint, shot put, weightlifting, rugby tackle, netball 400m run, 50m swim triathlon, rowing, 1500m swim, marathon
intercept.

● Types of training and training methods

○ Aerobic, eg continuous, Fartlek, aerobic interval, circuit
○ Anaerobic, eg anaerobic interval
○ Flexibility, eg static, ballistic, PNF, dynamic
○ Strength training, eg free/fixed weights, elastic, hydraulic

Overview of aerobic training Aerobic training allows for improvements in aerobic performance. The training will vary in mode duration, frequency and intensity. The aim of aerobic training is to train the aerobic
training is to train the aerobic energy system to be more efficient, this can include training the anaerobic threshold. The types of aerobic training are; continuous, fartlek, aerobic
interval and circuit training.
 Continuous → training which is of a steady nature, assists in building aerobic base and is suitable for events of a continuous nature.
Fartlek → continuous training with bursts of high intensity efforts. Overloads the anaerobic threshold.
Aerobic interval → high intensity with recovery periods. Effective for anaerobic threshold overloading. Develops high levels of aerobic fitness.
Circuit → combines a series of exercises carried out with minimal or no rest in between. Develops whole body fitness (aerobic, anaerobic and strength)

Overview of anaerobic training Anaerobic training allows for improvements in anaerobic performance. The training will either target the ATP-PC or lactic acid energy system, and similar to aerobic training can
include various modes, duration, frequency and intensity. Anaerobic training targets, strength, power and speed through various training types including, anaerobic interval,
plyometric and agility.
Plyometric → involves explosive contractions, which consist of lengthening the muscle while it performs an eccentric contraction, and then quickly shortening the muscle through a
concentric contraction.

Overview of flexibility training Flexibility training decreases the chance of injury for athletes. It increases movement performance by increasing the range of motion of joints, flexibility and aesthetics. Flexibility
training can also assist with recovery when used as part of a cooldown procedure.
Static → Stretching which does not require the athlete to move, focuses on one or more muscles. The most commonly used form of stretching due to its effectiveness and safety. Each
muscle is stretched for 15-30 seconds.
PNF → Involves a static stretch followed by an isometric contraction followed by a static stretch. This is safe and effective for increasing flexibility and the body's capacity to stretch.
Dynamic → Involves progressive movements through the full range of motion. Allows for sports specific movements e.g. rotating arms at the shoulder joint for a swimmer.
Ballistic → The inclusion of bouncing movements at the end of the range of motion. Risky due to chance of injury due to less control of stretch. Used by athletes with extreme
flexibility needs e.g. gymnast.

Overview of strength training Strength training is beneficial to athletes as it assists with body composition, core support and posture. Strength training also improves performance by increasing muscular strength,
power and endurance with the goal of developing muscle hypertrophy. Free or fixed weights, hydraulic weights or elastic resistance are used to develop strength training programs.
To target the needs of the sport, the following are considered:
● Number of sets and reps and the 1 repetition maximum
● Speed of contraction
● Type of exercise to be completed
Free/fixed weights → allows for multiple muscle groups to be targeted and developed to mimic sports specific movements
Hydraulic weights → allows consistent resistance and technique through the full range of motion. Allows for the resistance to mirror that of competition
Elastic resistance → portable and easy to use to train specific muscles and movements
Muscular endurance: the ability to exert force over an extended period of time. 1 - reduced load, 2 - higher repetitions (15+)
Muscular power: requires athletes to exert force quickly. 1 - loads and repetitions are between muscular strength and endurance. 2 - quick and explosive movements.
Muscular strength: the amount of force the muscles can produce. 1 - heavy loads (weight). 2 - lower repetition (1-6)

Assess the relevance Which types of Aerobic training: sports which require the use of the aerobic energy system, eg → marathon, cycling, long distance swimming, rugby, netball, soccer.
for the types of training training are Anaerobic training: sports which require the use of the ATP-PC or lactic acid energy system, eg → athlete field events, weightlifting, sprints, tennis, rugby, netball.
and training methods for best suited to Flexibility training: all sports will benefit from this training, however, sports with greater ROM eg → gymnastics or diving, will have a higher focus on flexibility training.
a variety of sports by different Strength training: all sports, but in particular power/strength based sports eg → weightlifting, rugby, sprinting.
asking questions such sports?
as:
Which training Aerobic training: builds aerobic base and capacity, increases anaerobic threshold, increases effort at a given heart rate, promotes faster recovery (lower heart rate, quicker, when at
method(s) rest)
would be most Anaerobic training: increases capacity to exert force/power, increases acceleration speed and change of direction, increases anaerobic capacity.
appropriate? Flexibility training: allows athletes to make developments in the extent they can move their body and coordination; allows for better body awareness
Why? Strength training: allows for muscle hypertrophy in specific muscle groups, increased athletes muscular, power and endurance capacities, supports posture and joints.

How would Aerobic training: increases ability to perform for longer periods (higher VO2 Max), enables athletes to surge within continuous activity, improves technique, and develops muscular
this training endurance due to increased capacity to carry O2 to working muscles and increased blood volume. Increases use of fat as an energy source.
affect Anaerobic training: increases muscular power and efficiency of the ATP-PC and/or lactic acid energy systems. Improves acceleration and the amount of times an athlete can repeat
performance? powerful and explosive movements.
Flexibility training: provides for less tension in muscles, increased range of motion of joints, allowing for completion of more challenging movements, prevents injury, less soreness in
muscles, thus faster recovery time.
Strength training: increases speed and/or time an athlete can perform before fatigue occurs, improves technique due to increased hypertrophy of muscles around the joints.
Decreases injury due to improved body composition and skeletal support.

● Principles of training
○ Progressive overload
 ○ Specificity
○ Reversibility
○ Variety
○ Training thresholds
○ Warm up and cool down

Analyse how the Progressive Progressive overload → workload is increased over time to allow for improvements in performance, overload is not endless.
principles of training overload Progressive overload allows the athlete to continuously improve throughout the training session. Overload must be applied for performance to improve. Once adaptations have
can be applied to both occurred, a coach must make moderate changes to the training to increase performance. If overload is not progressive, this can be unsafe and cause poor technique and injuries to
aerobic and resistance the athlete.
training Periodisation → phases of training to allow for recovery, avoid injury and loss of motivation.

Resistance training:
Outline of session: 10 min rowing machine, reverse sit ups, mountain climbers.
Application of progressive overload: increase load to → 2x10 at 75% of 1RM (the maximum amount of weight an athlete can lift once, using correct technique), 2x10 70% 1RM, 60 sec
rest between sets.
Aerobic training:
Outline of session: 3km jog, dynamic run throughs and stretching.
Application of progressive overload: increase reps, decrease time taken per rep, decrease rest.

Specificity Specificity → training that is specifically targeted at muscle movements, metabolic processes and movement.
Training needs to be specific to the requirements of the sport to ensure training is beneficial. Training must be specific in relation to:
● Muscles used in movement
● Metabolic needs eg → predominant energy system
● Movement requirements.

Resistance training:
Outline of session: medicine ball twists, mountain climbers, reverse plank dips
Application of specificity: hypertrophy, core muscles
Aerobic training:
Outline of session: 3km jog, dynamic run throughs
Application of specificity: increase aerobic fitness for a runner

Reversibility Reversibility → when training stops, adaptations stop - the reverse of when training continues, adaptations continue or are maintained.
Detraining → when training stops, gains are lost overtime.
Adaptations are made as a result of training and are only maintained if training continues. If an athlete has an interruption to their training due to injury, detraining will occur.

Resistance training:
Outline of session: 10 min rowing machine, medicine ball twists, mountain climbers
Application of reversibility: implement overload and specificity to avoid detraining.
Aerobic training:
Outline of session: 3km jog, dynamic run throughs
Application of reversibility: implement overload and specificity to avoid detraining

Variety Variety → allows for athletes to be exposed to a variety of movements and stimuli to increase their performance capacity and maintain focus.
Active recovery → recovery or rest from regular training which still has an athletic component.
Variety allows athletes to make changes in their training routine. When variety is applied, and is specific, it allows for an increase in:
● Motivation
● Interest
● Performance enhancements
Variety can also affect performance in that it can allow the athlete to balance their training to allow for active recovery.

Resistance training:
Outline of session: 10 min rowing machine, reverse sit ups, mountain climbers
Application of variety: variety for exercises allows for all abdominal muscles to be used. Combine body weight, machine and free weight exercises
Aerobic training:
 Outline of session: 3km job, dynamic rub throughs
Application of variety: including, fartlek and continuous training. Explore a variety of training surfaces and training partners.

Training Aerobic training zone → the training zone between the aerobic and anaerobic threshold. Usually between moderate to high exercise. 60-80% of MHR.
thresholds Anaerobic threshold → the point where lactic acid accumulates in the muscles. Also known as the lactic threshold (high HR)
Training threshold allows the athletes to increase their performance in relation to aerobic and anaerobic capacity. For an increase in aerobic fitness to occur, athletes must train in the
aerobic training zone. Not enough intensity will cause an athlete to plateau and too much intensity will cause the athlete to fatigue.

Resistance training:
Outline of session: 10 min rowing machine, reverse sit ups, mountain climbers
Application of training thresholds: repetitions/rest and load must allow for anaerobic energy production
Aerobic training:
Outline of session: 3km job, dynamic rub throughs
Application of training thresholds: training within the aerobic training threshold (60-80% MHR). Training at anaerobic threshold increases aerobic capacity.

Warm up and Warm up → consists of aerobic activity, stretching and sports specific movements.
cool down Cool down → consists of low intensity activity to assist the heart to return to resting heart rate. It also aids in the removal of lactic acid in the muscles, thus reducing recovery time.
The warm up and cool down are essential principles of training which are often missed. The warm up enables the athlete to intrinsically and physically prepare for activity. The cool
down assists with recovery and prevention of injury.

Resistance training:
Outline of session: 10 min rowing machine, reverse sit ups, mountain climbers
Application of training thresholds: gross motor movements to increase blood circulation prior to the session. Stretching and introducing skill specific movements (low weight).
Aerobic training:
Outline of session: 3km job, dynamic rub throughs
Application of training thresholds: gross motor movements of low intensity and stretching to encourage the removal of lactic acid.

● Physiological adaptation in response to training

○ Resting heart rate
○ Stroke volume and cardiac output
○ Oxygen uptake and lung capacity
○ Haemoglobin level
○ Muscle hypertrophy
○ Effect on fast/slow twitch muscle fibres

Examine the Resting heart The human heart beats to circulate blood around the body. Blood carries oxygen which allows the body to produce energy (aerobically). When training increases, the heart rate is
relationship between rate generally lower at rest and during exercise.
the principles of At rest - decreases, due to: increased stroke volume and improved efficiency of the cardiovascular system.
training, physiological During training - lower at all intensities, due to: increased stroke volume and improved efficiency of the cardiovascular system.
adaptations and
improved Stroke volume Stroke volume
performance. and cardiac Haemogloblin → protein molecule in blood which carries oxygen from the lungs to the body’s tissues. It also returns carbon dioxide to the body’s tissues. It also returns tissues back
output to the lungs.
The stroke volume refers to the amount of blood the heart is able to pump per stroke (from the left ventricle). As an athlete increases their training, their stroke volume will increase at
rest and during exercise. An increased stroke volume allows for an increase in haemoglobin levels in the blood.
Diastole phase → the phase where the heart fills with blood.
Systole phase → the phase where the heart contracts to ‘send’ blood to the body.
At rest - increases, due to: left ventricle increasing in size, strength on contraction of the left ventricle increases, left ventricle fills more completely during the diastole phase, and
more blood is in circulation.
During training - increase, due to: same as above.

Cardiac output
Cardiac output → is the multiplication of the HR by the SV.
The cardiac output is the amount of blood that the heart can pump per minute. Cardiac output remains steady with the increase of training, however the heart becomes more efficient
as it pumps more blood in less beats.
At rest - remains relatively unchanged, due to: increased stroke volume, HR decreased accordingly.
 During training - slightly lower increases when intensity is at max, due to: increased SV, during exercise cardiac output can be high due to high HR and SV - usually at max efforts.

Oxygen uptake Oxygen uptake

and lung Oxygen uptake refers to the amount of oxygen an individual is able to consume per kilo of body weight. It is expressed as VO2 and is the most consistent way to measure the
capacity cardiorespiratory system. Oxygen uptake increases in response to training and allows for faster and more efficient transportation of oxygen to the muscles.
At rest - increases, due to: increased number of oxidative enzymes, increased blood volume, increased myoglobin and haemoglobin.
During training - increases, due to: same as above.

Lung capacity
Lung capacity refers to the total amount of air that can be inhaled or exhaled during a breath. Lung capacity works with oxygen uptake to export oxygen to the working muscles. The
lung capacity has little or no response to training.
At rest - little change, due to: increased blood volume, more red blood cells.
During training - little change, may increase at max efforts, due to: increased blood volume, more red blood cells, may increase at max effort due to increased oxygen demand.

Oxygen uptake
Oxygen uptake refers to the amount of oxygen an individual is able to consume per kilo of body weight. It is expressed as VO2 and is the most consistent way to measure the
cardiorespiratory system. Oxygen uptake increases in response to training and allows for faster and more efficient transportation of oxygen to the muscles.
At rest - increases, due to: increased number of oxidative enzymes, increased blood volume, increased myoglobin and haemoglobin.
During training - increases, due to: same as above.

Lung capacity
Lung capacity refers to the total amount of air that can be inhaled or exhaled during a breath. Lung capacity works with oxygen uptake to export oxygen to the working muscles. The
lung capacity has little or no response to training.
At rest - little change, due to: increased blood volume, more red blood cells.
During training - little change, may increase at max efforts, due to: increased blood volume, more red blood cells, may increase at max effort due to increased oxygen demand.

Haemoglobin Haemoglobin is the protein molecule in red blood cells that binds with oxygen from the lungs to the body's tissues. Haemoglobin is transported in the red blood cells and is
level responsible for the red colour of the cells. With training haemoglobin levels increase to increase the blood's capacity to carry oxygen.
At rest - increases, due to: increased number of oxidative enzymes, increased blood volume, increased myoglobin and haemoglobin.
During training - increases, due to: same as above.

Muscle Muscular hypertrophy → the growth and/or increase in size of muscular tissues.
hypertrophy Muscular hypertrophy is a physiological adaptation to training. As training increases, muscular hypertrophy increases. Muscular hypertrophy occurs the most when participating in
resistance (strength/weights) training. The actual growth of the muscles occurs at rest as the body is repairing the muscles. Thus, for the muscles to experience hypertrophy, they
must be engaged in some form of resistance training.
At rest - increases, due to: damaged muscles replaced through cellular process of fusing muscle fibres together to form new muscle protein strands, growth in size and function of
muscle, increased capacity to contract strongly and/or for longer periods of time.
During training - unchanged, due to: growth in the size of fast/slow twitch fibres, enhanced function occurs during rest and recovery phase of exercise.

Effect on Skeletal muscle fibres → muscles which are involved in the function and support of the skeletal system.
fast/slow twitch People have two types of skeletal muscle fibres in their bodies, fast twitch and slow twitch fibres. Slow twitch fibres are more suited to endurance events and fast twitch fibres for
muscle fibres more explosive and anaerobic events, as fast twitch fibres fatigue faster. These types of muscle fibres cannot be changed, however you can increase muscular hypertrophy through
resistance (weights) training to focus on the development of fast and slow twitch muscle fibres in the body.

Fast twitch fibres

At rest - increase size and function, due to: growth and repair of fibres following anaerobic resistance training, increased anaerobic enzymes for glycolysis, increased PC stores.
During training - increase strength and repetition of contraction, due to: increased muscular hypertrophy, increased anaerobic function, increased removal of lactate, which helps
reduce the acidic levels in the muscle.
Slow twitch fibres
At rest - increase size and function, due to: growth and repair of fibres following resistance training, increased glycogen stores.
During training - increase endurance and repetition of contraction, due to: increased muscular hypertrophy, increased mitochondria and capillary density, increase in aerobic function.

How can psychology affect performance?

● Motivation
○ Positive and negative
 ○ Intrinsic and extrinsic

Overview Athletes who are more motivated are more likely to succeed due to the commitment to their training and performance. Motivation can be positive or negative, and intrinsic or
extrinsic. Categorising types of motivation is important, as this assists in managing motivation and associated anxiety and/or arousal.
Positive motivation → the desire to experience and then continue to experience the rewards of achieving a successful outcome, eg: praise, financial gain, media coverage,
self-satisfaction.
Negative motivation → the desire to avoid the penalties of an unsuccessful outcome, eg: loss of prize money, disappointment, fear of failure, lack of respect from others, missing team
selection.

● Anxiety and arousal

○ Trait and state anxiety
○ Sources of stress
○ Optimum arousal

Overview Anxiety and arousal can hinder performance. However, if arousal is controlled and at optimal levels, it has the capacity to improve performance. Anxiety is sourced internally, from the
mind, therefore psychological, whereas arousal is physiological resulting from the responses to stimuli such as coaches, crowds and rewards.

Trait anxiety State anxiety

A behavioural or personality disposition to display anxiety and to perceive various situations as State anxiety, on the other hand, is a temporary emotional state that arises in response to a
threatening. A person with high trait anxiety often displays high state anxiety in competitive specific event or situation. In sports, state anxiety might be triggered by an upcoming competition,
situations. Athletes with high trait anxiety may find it more challenging to cope with stressors and a high-pressure game, or a challenging training session. State anxiety can vary in intensity and
may require additional support to manage their anxiety levels. duration, depending on the athlete's perception of the situation and their coping strategies.

Sources of stress:
When stress levels hinder performance, athletes should focus on: positive thoughts, positive outcomes, and sharing concerns.

Optimum arousal:
● Arousal raisers →
○ Increasing voice intensity
○ Loud noises eg - clapping/cheering
○ Hand gestures eg - thumbs up / high five
○ Introduction to the crowd
○ Warm up
● Arousal depressors →
○ Encouraging focus
○ Focus on performance rather than outcome
○ Task familiarity
○ Consistent routine
○ Calming techniques
Often when a sport requires a higher intensity, arousal raisers should be used eg rugby, whereas sports that require immense focus, arousal depressors should be used eg golf.

Component Impact on performance

Trait and state Trait and state anxiety can have varying impacts on an athlete's performance, depending on factors such as their coping mechanisms, support systems, and the nature of the
anxiety sport. While moderate levels of anxiety might enhance focus and performance, excessive anxiety can hinder an athlete's ability to perform at their best. By recognising and
managing their anxiety levels, athletes can optimise their performance and overall well-being in their sports pursuits.

Sources of stress Different sources of stress can have varying impacts on an athlete's performance, depending on their individual coping strategies and the support available. By recognising and
addressing these stressors, athletes can improve their ability to manage stress and perform optimally in their sports endeavours.

Optimal arousal Achieving optimal arousal is crucial for an athlete's performance, as both under-arousal and over-arousal can negatively impact their ability to perform. Under-arousal can result
in a lack of focus and motivation, while over-arousal can lead to anxiety and impaired decision-making. By finding and maintaining their optimal arousal level, athletes can
enhance their performance and overall success in their sports pursuits.
 ● Psychological strategies to enhance motivation and manage anxiety
○ Concentration/attention skills (focusing)
○ Mental rehearsal/visualisation/imagery
○ Relaxation techniques
○ Goal-setting

Overview Any athlete will require motivation to enhance their performance. Managing anxiety and arousal is also important to achieve optimum arousal for improved performance. Athletes
implement many strategies in their training and performance routines to manage their motivation, anxiety and arousal.

Concentration and attention skills (focusing)

This concept focuses on queues and elements that are specific to the athletes performance rather than the outcome of the skill.
● Intense focus → golf, table tennis, high jump
● Sustained attention → marathon, ironman
● Focus and attention → netball, rugby, football

Mental rehearsal, visualisation and imagery

These are the concepts of trying to mentally visualise movement in the athlete’s mind.
● Enhances motivation and decreases anxiety by creating familiar environments for the athlete
● Can be done prior to performance or game, and throughout the performance
● Prepares the athlete for competition and skill execution
● Done prior to performance to help improve concentration

Relaxation techniques
Are used to assist in the control of physical responses to stress ad anxiety. If these techniques are not used anxiety and stress levels can increase to a point of having a negative
impact on performance. Examples of these techniques include;
● Slow, deep breathing → helps to overcome fast breathing as a response to stress
● Stretching muscles → helps to overcome muscle tightness due to increased adrenaline secretion
● Cool towel → applying to the face and body decreases body temperature and sweating caused by stress and anxiety

Goal setting
Setting goals can increase motivation for the athlete, goals which are challenging yet realistic are essential for managing anxiety and achieving optimum arousal. Goals should be:
● Process-based and related to factors the athlete can control
● Short and long term goals with a specific time frame.
Self talk should be used, communicating with yourself to assist in achieving immediate goals, can increase confidence and decrease anxiety prior and during performance.

How can nutrition and recovery strategies affect performance

● Nutritional considerations
○ Pre-performance, including carbohydrate loading
○ During performance
○ Post-performance

Compare the dietary requirements of Nutritional considerations are often something which can set professional athletes apart from amateur athletes. Often, amateur or recreational athletes may overlook nutrition, which
athletes in different sports considering can hinder performance improvement. When considering the nutritional considerations it is important to understand that nutrition includes liquids and food. Nutritional considerations
pre-, during and post-performance needs can be made for pre-performance during performance, and post-performance. Nutrition is also considered an important part of recovery, especially for elite and professional athletes,
who are often required to train more than once a day.

Pre-performance
Before competition, it is essential for an athlete to be well hydrated and have ample glycogen stores, which are essential for energy production. It is also important for the athlete to
avoid anything new or different to regular routine to avoid an adverse reaction.
Carbohydrate loading → a strategy employed by endurance athletes to maximise glycogen storage in the muscles and liver prior to performance. This is done in conjunction with
tapering.
Tapering → the reduction of training to allow the body to recover and replenish energy stores prior to performance.

During performance
During performance it is essential the athlete stays hydrated to aid performance and replace blood glucose stores. This is especially important for endurance athletes.
 Endurance athlete → An athlete who competes in a sport which lasts for more than 60 minutes. These athletes predominantly use the aerobic energy system, hence their movements
are of a lower intensity for a longer period of time eg marathon or ironman triathlon.

Post performance
Nutrition and hydration replacement post-performance is just as important as pre- and during performance. What an athlete consumes after performance has an impact on how
quickly they can recover for consecutive training sessions or games/performances. Post-performance meals help to rehydrate, replenish lost glycogen stores, and rebuild muscle
tissue.
Complex carbohydrates → Carbohydrates which have a lower GI (slow releasing energy). These foods do not provide the body with instant glycogen and need to be processed by
the body before they can be used for energy production. Often used by endurance athletes to recover and prepare for future training eg grains, vegetables and pasta

Pre-performance

Hydration Carbohydrates loading Pre-performance

● 2-3L prior to day of competition ● Increase carbohydrate consumption in the days leading up to ● Usually consumed 3-4 hours prior to performance. Light meals
● 500mL hrs leading up to competition (morning of) performance to increase glycogen stores in muscles and liver which are familiar to the athlete
● 250mL 30 mins before competition ● Endurance athletes often taper (decrease their training) which ● Aim: To deal with current hunger, top up glycogen stores,
allows for carbohydrate loading without hydration
● Foods and fluids high in carbohydrates but low in fat eg → ● Meals may vary depending on time of performance from a light
fruits, vegetables and grains meal to a piece of fruit or bar

During performance

Fluid replacement Sports drinks Carbohydrates (glycogen) stores

● Frequent sips 200-300mL every 15 minutes ● Can be beneficial for activities lasting more than 30-60 ● Sports drinks can provide quick and minimal amounts of
● Increased temperatures and humidity increase minutes. glycogen
dehydration. Humidity decreases evaporation as a ● Contains 4-8% carbohydrates in the form of glucose and ● Endurance athletes may choose to replenish carbohydrates for
means of heat loss sucrose sustained energy production. This may be in the form of sports
● May consume sports drinks with salts, sugars and or ● Delays onset of fatigue and drinks containing electrolytes can gels, bars or something as simple as fruit
electrolytes replace electrolytes lost in sweat (salts) ● Consuming foods or gels during performances more than 60
minutes is essential for sustained performance

Post-performance

Hydration Glycogen stores Protein replacement

● 200-300mL per every 15 mins of exercise ● Helps to replenish glycogen stores in the muscles and liver. ● Should be consumed within 1- 2hrs of completion of activity
● Fluids should be replaced in first hour after activity ● High GI foods for immediate replacement and more complex ● Assists in the repair and growth of muscles.
● Sweat rate (pre performance weight minus post carbohydrates within 1-2hrs of completion of activity. ● Common practice for athletes who include resistance/strength
performance weight and any fluids taken) ● Continue to refuel 24-48 hours after for replacement and training in their routine.
increase in glycogen stores for future activity

● Supplementation
○ Vitamins/minerals
○ Protein
○ Caffeine
○ Creatine products

Overview The concept of supplementation is becoming increasingly popular among athletes due to the perceived benefits. The supplementation of vitamins and minerals, protein, caffeine and
creatine products is used by various athletes for a range of health benefits and performance enhancing aspects. Athletes usually supplement products which they cannot derive in
sufficient amounts of their regular diet. Athletes need to be aware of the impact these supplements can have on their body, how they will affect their performance, the side effects,
and if they are beneficial to their performance goals.

Vitamins/minerals Vitamins and minerals are essential as they act as a catalyst to assist in energy metabolism. A normal balanced diet will allow for sufficient intake of vitamins and minerals. Some
athletes, for various reasons, cannot consume and process enough vitamins and minerals to assist with performance. Excess vitamins and minerals are not stored in the body (they
are excreted), thus supplementation is only necessary for athletes who have deficiencies in their diet. Excess consumption of vitamins and minerals can cause a range of issues for
the athlete from excess urination to pain, headaches and fatigue. Supplementation of vitamins and minerals are common among vegetarian/vegan athletes, female athletes (iron) and
athletes who do not consume dairy (calcium).
 Vitamins
Oxidative damage → an increase in exercise increases oxygen requirement for ATP production, as a result reactive molecules are produced which cause damage to cell membranes.
B vitamins: optimise energy production, build and repair of muscle tissue, red blood cell production
Vitamin C and E (antioxidants): increased exercise increases oxygen and oxidative damage, protects cell membranes from oxidative damage.
Vitamin D: calcium absorption, promotes bone health, regulates homeostasis of nervous system and skeletal muscle

Minerals
Iron: allows for transportation of oxygen around the body and muscles (haemoglobin and myoglobin).
Calcium: bone repair, growth and development, nerve conduction and muscle contraction.
Zinc: growth and repair of skeletal muscle tissue
Magnesium: essential for glycolysis (energy production), essential for muscle contraction
Sodium, chloride, potassium: neural transmission

Protein Protein → essential amino acid chains which provide the building blocks for cells. Can be sourced naturally; meats, eggs, nuts or supplemented; powder, bars.
Protein assists the body with growth and repair of muscles and body tissues. It can also be used as a fuel (energy) source for endurance athletes. If an athlete has insufficient protein
stores they can experience symptoms such as; slower recovery, loss of muscle mass and reduced immunity. Most athletes have sufficient amounts of protein from their regular diet to
deal with regular physical activity. However some athletes may choose to supplement due to diet limitations (vegetarian/vegan), availability of natural sources or convenience.
Athletes may also consume protein post resistance training (within an hour) as this can promote muscle growth (hypertrophy). Excess consumption of protein can interfere with the
health of an athlete resulting in; weight gain, stress on the kidneys, dehydration and depletion of minerals stored in the bones.

Caffeine Caffeine → a stimulant drug which has the capacity to speed up the central nervous system. In performance it blocks adenosine to the brain, improving the athletes perception of
fatigue.
Diuretic → a substance which promotes the increase of urine to draw salts and water from the body
Caffeine is supplemented by athletes to increase their alertness and change their perceptions of fatigue. After consumption the benefits are almost immediate, however, they do not
last long. Research around the benefits of caffeine are inconclusive. Most benefits are short-lived and excess consumption can lead to over arousal, anxiety, increased heart rate,
reduction in fine motor skills and it can act as a diuretic. Athletes can source caffeine from various products including cola drinks, energy drinks, some energy gels and natural
products such as coffee. The World Anti-Doping Agency (WADA) has removed caffeine from the banned substances list as it is no longer considered to provide significant
improvements in performance.

Creatine products Creatine → a natural, organic acid which assists in the replenishment of ATP stores in the muscles through the ATP/PC energy system.
Hypertension → high blood pressure - where the force of the blood against the artery walls is too high.
Creatine supplementation is beneficial to strength and power activities of short duration and high intensity. The supplementation of Creatine can allow for increased PC stores,
increasing the lactic threshold and decreasing recovery time. Research has concluded that faster recovery times as a result of Creatine supplementation can allow for physiological
adaptations such as muscular hypertrophy and power when combined with resistance training. Athletes supplement Creatine over a 4-5 day period prior to an event or more
regularly if used with resistance training. Creatine is most effective when consumed with carbohydrates. Supplementation of Creatine increases fluid retention in the body as this is
where Creatine supplies are stored. As a result athletes may experience weight gain and a ‘puffy’ look. There are no proven long-term side effects of the supplementation of
Creatine. Short-term side effects include stomach pain, diarrhoea, nausea, hypertension and muscular cramps.

● Recovery strategies
○ Physiological strategies, eg cool down, hydration
○ Neural strategies, eg hydrotherapy, massage
○ Tissue damage strategies, eg cryotherapy
○ Psychological strategies, eg relaxation

Recovery strategies Recovery is just as important as any other aspect of performance and, like nutrition, it is often ignored. Recovery assists the athlete when training for adaptations as well as assisting
in preventing injury and illness. Recovery can also assist with motivation and fatigue levels for athletes. Recovery type and time can vary complete rest to active recovery. Recovery is
effective when the athlete has returned to the physical state they were in prior to the training session or performance. As an athlete develops fitness, meets specific training
demands, and addresses correct nutrition to support recovery, the recovery process becomes a lot more efficient and the athlete can return to training and/or performance faster.

Physiological strategies Physiological strategy → a strategy that helps the body and its systems to carry out normal functions, eg muscular system; removal of by-products.
Physiological strategies are the most commonly used for all athletes, these include: cool down, hydration

Cool down
A cool down after training or performance consists of active recovery with low intensity activity. The cool down accelerates the body’s capacity to decrease lactic acid levels in the
muscles, essentially reducing muscle soreness. Research into the effectiveness of the cool down is not conclusive; however, among elite athletes and coaches it is supported. The
 cool down may include other recovery strategies to increase the effectiveness of recovery.

Hydration
Athletes aim to hydrate post-performance through the consumption of water or sports drinks. Weighing an athlete in extreme temperature conditions can help guide the amount of
hydration required. Hydration accelerates the return to pre performance or training hydration levels and thus is preparing the athlete for the next performance or training session.
Research strongly supports the use of hydration for recovery as it increases the volume of blood in the body, assisting in the removal of waste products. Water is also essential in the
storage of glycogen in the body – allowing for the body to restore glycogen stores in preparation for the next performance or training session.

Neural strategies Neural strategy → a strategy that focuses on the nervous system by releasing tension, soreness and pressure.
Neural strategies are used heavily by professional and elite athletes as their training routines are demanding and athletes seek further ways to decrease recovery time. Neural
strategies include; hydrotherapy, massage

Hydrotherapy
Hydrotherapy is water based recovery, which can include hot or cold water, contrast water therapy, or pool or beach recovery sessions. Cold water aims to decrease the core body
temperature, soreness, and swelling. Hot water and contrast strategies cause vasoconstriction and vasodilation, to reduce muscle soreness by removing lactates (not recommended
if injury is present).
Vasoconstriction → the narrowing of blood vessels, which increases blood pressure.
Vasodilation → the widening of the blood vessels to decrease blood pressure.
Contrast strategy → a combination of hot and cold water immersion to assist with recovery.

Massage
Massage involves the manipulation of muscles to increase blood flow to the muscles. This allows for a reduction in muscle soreness and tension and increases relaxation. There are
various forms of massage, including; Swedish, hot stone, sports and trigger point. There is conflicting evidence around the effectiveness of post-activity massage. The perceived
benefits include tension release and lactate removal.

Tissue damage strategies Tissue damage strategies are the opposite of what they say - the aim of them is to repair tissue damage, mostly muscle damage. Tissue damage can happen to athletes engaged in
high-impact and strenuous sports, such as rugby union and netball. Tissue damage can also occur as a result of injury. Cryotherapy, combined with compression (bandaging), is used
to treat tissue damage and can include:
● Use of ice packs
● Cold water immersion
● Cryogenic chambers

Use of ice packs and cold water immersion

Ice packs are generally placed on the site of a soft tissue injury to assist in recovery. Athletes and sports practitioners apply ice in the first 48 hours after injury to decrease the
temperature of the area, allowing for a decrease in inflammation. Inflammation can cause secondary damage if not treated. Cold water immersion aims to decrease the body
temperature, and is commonly used among sporting teams after games and/or training. This can include the use of swimming pools, ice baths, or ocean swims. Ice packs and cold
water immersion are commonly used, and research supports that these can assist with the recovery process. In relation to the application of ice after the completion of endurance
activities and cold water submersion, research is not conclusive, but does exist, to support the use of ice for tissue repair and relaxation.

Cryogenic chambers
The chamber reduces the body temperature using bursts of nitrogenous gases every 30 seconds. The chamber is cooled to -100℃, and athletes expose themselves to the chamber
for short periods of time – between 90 seconds and 3 minutes. Cryogenic chambers claim to decrease delayed onset muscle soreness, as the burst of nitrogen gas causes the blood
to rush away from the limbs and towards the core to warm vital organs. This puts the body into survival mode and fills the blood supply with oxygen. After the session, blood returns
to the limbs, releasing oxygenated blood to assist with the removal and redevelopment of injured cells and tissues. Evidence exists that the use of cryogenic chambers can be of
assistance to avoid muscle soreness. However, there is little evidence for long-term benefits or effects on the body.

Psychological strategies Psychological strategies focus on the mind and the mindset of the athlete to assist them with recovery from activity. A positive or negative outcome can impact the athletes level of
motivation, anxiety and arousal for their next performance or training session. Hence, it is essential for the athlete to explore psychological strategies to assist with recovery and
performance. Relaxation is the main psychological strategy athletes use, but it can include:
● Rest days
● Sleep
● Counselling
● Post-performance evaluation

Relaxation
Athletes will use a wide range of relaxation techniques to reset the mind and body. It is common for elite and professional athletes to incorporate relaxation activities into their weekly
 training routine. Relaxation not only helps to reset the mind and control levels of anxiety and arousal but allows the body to recover due to rest from physical activity. Psychological
strategies may be used before or during performance to control optimum arousal and motivation but is essential in the recovery process. Because of this, sports coaches often
increase these strategies during the off season to assist the athlete in reflecting on the past season and preparing for the upcoming season. Research exists to support that
psychological strategies can have a direct impact on anxiety and arousal levels. Relaxation, especially sleep, is critical for the growth and repair of body tissues following training or
performance.

How does the acquisition of skill affect performance?

● Stages of skill acquisition

○ Cognitive
○ Associative
○ Autonomous

Examine the stages of skill acquisition by The stages of skill acquisition describe where athletes are in relation to their skill development. Obviously, an increased level of skill will lead to an increased performance. There are
participating in the learning of a new skill, various aspects of each stage which help to identify what stage of skill acquisition an athlete is at. It is essential to identify which stage an athlete is at, as this determines their training
eg juggling, throwing with the routine and other factors affecting performance, such as motivation, recovery and feedback.
non-dominant arm
The cognitive stage
At this stage athletes (learners) make errors which are frequent and often the errors are large. Subroutines need to be established to assist with the learning of whole skills. This stage
requires high levels of concentration and thinking about how to execute the skill. Often, the athlete will know something is wrong, but not be sure of how to fix it, and express
frustration.

The associative stage

At this stage athletes (learners) experience success with a decreasing number of errors. They require high levels of practice, and often spend the most amount of time at this stage.
Most athletes will stay at the associative level of skill acquisition. An athlete at this stage understands the principle and mechanics of the movement/skill required and begins to learn
anticipation. They are also able to identify errors and, at times, correct themselves. A skill may be executed well but not to the speed or distance required.

The autonomous stage

At this stage athletes (learners) make occasional errors, which can be identified by the athlete and at times adjusted mid-performance. Their performance is characterised by looking
automatic and consistent. Not all learners will reach this stage, with some learners reaching this stage for particular skills and other others. Less concentration on skill is required, and
the athlete can focus more on strategy and tactics.

● Characteristics of the learner, eg personality, heredity, confidence, prior experience, ability

Describe how characteristics of the There are many personal characteristics which can affect an individual's performance. These characteristics are most likely to affect performance. The characteristics of a learner can
learner can influence skill acquisition and impact the speed at which they can learn and master a new skill.
the performance of skills
Personality
An individual’s personality can greatly impact the rate at which they acquire new skills. There are personality traits which can contribute to performance in both positive (curiosity,
confidence, patience, risk-taking) and negative ways (impatient, emotional, poor mindset).

Heredity
Heredity can provide skill learning benefits, where genetic features are significant in the learning process. The most common heredity factors that contribute to performance are:
race, muscle type (slow or fast twitch fibres), somatotype (ectomorph, mesomorph, endomorph)

Confidence
An increase in confidence contributes to athletes being more likely to attempt new skills. Confidence builds resilience in the cognitive stage of skill acquisition thus, it is important for
coaches to provide opportunities for success during this stage. Overconfidence can lead to over arousal and decrease performance, as well as the capacity to learn new skills or
progress through skill acquisition. It can also mean that athletes are less likely to perfect a skill and progress through to the autonomous stage of skill development. Coaches must
promote confidence at all stages, to allow athletes to try new skills and improve performance.

Prior experience
Adapting a new movement pattern or skill requires a conscious thought pattern each time. Athletes often use prior experience to assist them with the learning process. Prior learning
can be either a positive or negative transfer of skills. It can also be classified as either lateral or vertical transfer of skills.
Lateral transfer → the transfer of skills from one sport to another eg - tackle in rugby league to rugby union.
Vertical transfer → the transfer of skills from a lower order skill, a progression of skills eg - a push pass to a drive in hockey.
 Positive transfer → similar motions eg - tennis serve, volleyball serve
Negative transfer → impacts in a bad way eg - tennis vs badminton player

Ability
Athletes train hard to learn new skills and compete, although ability assists with the speed at which they can learn new skills. Often, ability is a result of personality and heredity
factors. An athlete who displays a natural ability, shows grace, fluency and extra skill, sometimes with minimal practice. Athletes with ability display a kinaesthetic sense, multi-limb
coordination and perceptive sense.
Kinaesthetic sense → an awareness of body position and muscle movement during performance (coordination)
Multi-limb coordination → the capacity to structure movements that involve many body parts into a fluent and effective performance.
Perceptive sense → the capacity to receive and interpret information effectively, to enhance the quality of the response.

● The learning environment

○ Nature of the skill (open, closed, gross, fine, discrete, serial, continuous, self-paced, externally paced)
○ The performance elements (decision-making, strategic and tactical development)
○ Practice method (massed, distributed, whole, part)
○ Feedback (internal, external, concurrent, delayed, knowledge of results, knowledge of performance)

Overview The learning environment

The learning environment is not associated with the physical environment, it is based on the variables of skill acquisition. It is important for coaches to adapt the learning environment
based on the acquisition of skill level of the learner as this can heavily impact the rate and quality of skill development. A coach must understand the elements of the learning
environment and how these vary at each stage of skill acquisition. This allows for instruction and feedback which is specific to the learner’s needs.

Definition Components

Nature of the skill

Refers to the type of skill being Open → take place where the environment is unpredictable and ever-changing, need to be adapted to unknown situations, externally paced.
executed. Skills can be categorised Closed → take place when circumstances are predictable and constant, self-paced, control of the athlete.
to assist with skill acquisition,
coaching and feedback methods. Self-paced → performed in a timeframe which suits the athletes.
Externally paced → performed with influence from external source eg opposition or team members.

Serial → combination of smaller skills into one whole skill.

Continuous → no clear beginning or end, ongoing in nature.

Gross motor → large muscle groups eg - legs, arms, torso.

Fine motor → smaller muscles eg - hands, feet.

The performance elements

Training the athlete to make The athlete-centred approach: when planning coaching for the performance elements, coaches may use an athlete-centred approach. This enhances the
decisions, think strategically and athlete’s ability to make decisions. Coaches may include the following to enhance the athlete-centred approach through:
apply tactics is essential for the ● Choice with rules and limits
development of skill. The athlete’s ● Opportunities for independent work
ability to apply the performance ● Feedback to promote problem solving
elements under pressure can ● Ask questions
determine what stage of skill ● Makes athletes accountable for their performance
acquisition they are at. This is
important so that coaches and Decision making → can be improved by exposure to demonstrations or good decision making. This can be done by practicing game-like scenarios and
trainers can develop sessions exploring various options of playing during training.
specific to the stage of skill
acquisition. Strategic and tactical development → enhanced when players achieve high levels of skill, technique, understanding of the game and execution. An increased
understanding of the game leads to an increase in capacity to execute skills, tactics and decision-making. For athletes to perform, they must be exposed to
and provided demonstrations of strategy and tactics.

‘Game sense’ approach → enables learners to develop decision-making, strategy and tactics. It also allows the coach to focus on an athlete-centred approach.
Modified games encourage learners to take roles that require active thinking and decision-making. ‘Game sense’ also allows the coach to pose questions
around how movement could be changed to improve the outcome.
 Practice methods

Practice methods are used to learn Massed practice → involves practice sessions broken up by smaller rest periods. Suitable for:
and acquire skills. Skills vary in ● Continuous skills
difficulty, so different practice ● Endurance athletes
methods must be used to learn ● Skills which are repeated frequently throughout performance
easier and/or more difficult skills. ● Highly motivated athletes
Each practice method can be ● Athletes with high skill level
suitable for various athletes and Distributed practice → involves shorter periods of practice with longer periods of time/rest between practice. This type of practice provides increased
athletes at different stages of skill opportunities for feedback. Suitable for:
development. Methods can depend ● Cognitive learners
on: the stage of skill acquisition, ● When mastering skills which are physically fatiguing
nature of the skill, practical ● Athletes lacking in motivation
considerations, learner preference. ● Skills which require breaking down into parts - serial skills

Whole practice → involves the learner learning the skill as a complete movement. Suitable for:
● Discrete and continuous skills, eg archery or swimming
● Autonomous learners
● Fast learners
Part practice → skills are broken down into rub-routines to allow each section to be practiced individually before being combined to execute the whole skill.
Suitable for:
● Cognitive learners
● When learning complex skills (serial skills), eg shot on goal in soccer

Speed practice → allows the learner to practice the skill at the ideal speed. This allows the learner to practice at ‘game’ speed. Suitable for:
● Autonomous learners
● Skills which require speed, eg javelin
Accuracy practice → focuses on performing the skill with the complete correct movements. Suitable for:
● Learning new skills (cognitive)
● Skills which do not require speed to learn and develop technique, eg passing and running

Feedback

In sport, feedback is information the Knowledge of results → provides info about the outcome of the movement, occurs at the end of a performance, obtained from external sources, all learners
performer receives about a skill or require this feedback but it is most common among cognitive learners.
performance. It usually comes from Knowledge of performance → provides info about the patterns of movement in a performance, sourced internally (kinaesthetic sense) and externally (coach or
the coach or the performers video analysis), can be received during or after performance, autonomous learners use this the most effectively.
themselves. There are various
different types of feedback in sport Internal → derived from the athletes knowledge of how the skill is to be performance, kinaesthetic sense.
and they tend to come in pairs. External → derived from extrinsic sources eg teammate, coach, results can be external feedback

Concurrent → received during the performance, can be combined with other types of feedback eg internal
Delayed → received after the performance or after a skill has been executed, usually knowledge of results and external.

Design a suitable plan for teaching Understanding how the acquisition of skill, in particular the learning environment, can affect performance is critical to learner development. Teaching and training plans will be
beginners to acquire a skill through to adapted so that the nature of skill, performance elements, practice methods and feedback are appropriate to the characteristics of the stage of skill acquisition of the learner. The
mastery. example of a hitting a goal in hockey will be used. Hitting a goal in hockey can be described as:
● Open skill – external factors such as team members, opposition, receiving a pass or dribbling prior to the goal.
● Self-paced (if a break away) or externally paced if opposition in defensive position.
● Serial – broken into sub-skills – receiving a pass then hitting or dribbling and hitting.
● Gross motor – running, dribbling and hitting

Cognitive Associative Autonomous

Practice Distributed practice of each of the skills (part practice) – Massed practice can be introduced as the athlete is likely to be The athlete will most likely use massed practice to increase accuracy of
methods dribbling, receiving a pass and hitting a goal more motivated. Hitting a goal will be more effectively practiced the hit on goal and mimic fatigue experienced during a game.
as a whole skill once as running, dribbling, receiving a pass and Alternatively, if intensity is increased to mimic game pace then
hitting are acquired. distributed practice may be used to ensure quality of performance and
 allow for recovery.

Performance Focus is on skill development rather than strategy and tactics. Small sided games may be used when the whole skill is Small sided and game scenarios are heavily used to develop a range of
elements Learners may be encouraged to make decisions regarding how developed to increase difficulty and a game-like situation. This tactics and increase decision-making when under pressure. Focus will
long they dribble the ball for. Drills should be used rather than may be used to instigate decision-making for timing of the hit. be on tactical execution rather than the execution of the skills of
small sided games to focus on skill development rather than running, dribbling, receiving a pass and hitting a goal.
tactical development.

Instruction Demonstration of the skills of dribbling or receiving a pass and When skills are executed at associative level skills should be Skills will be developed during game situations and small sided games
hitting a goal. combined together, running and dribbling then hitting and will place players in position to replicate the game. This will allow for
running, receiving a pass and hitting. These will essentially be players to develop decision-making and tactical play. At this stage
joined together so that it looks ‘fluid and smooth’ rather than athletes will have progressed to being able to make their own decision
separate skills. about hitting a goal straight from a pass or to dribble closer to the goal.

Feedback Feedback should be external and focus on the performance External feedback from the coach will be used and will include Internal feedback will be more prominent as the athlete will be able to
(skills) rather than the outcome (scoring goal). Concurrent knowledge of performance, as the athlete develops knowledge adjust their body and or skills used to score the goal without external
feedback should be used to motivate learners and delayed to of results (goal) may be used. Feedback will also be concurrent feedback. Feedback will be more focused on performance elements
provide feedback specific to skill development. to assist with decision making and delayed to reflect on skill such as the positioning of the goal and success rather than
development performance of hitting of the goal.

● Assessment of skill and performance

○ Characteristics of skills performers, eg kinaesthetic sense, anticipation, consistency, technique
○ Objective and subjective performance measures
○ Validity and reliability of tests
○ Personal vs prescribed judging criteria
Develop and evaluate objective and
subjective performance measures to
Definition Components
appraise performance
Characteristics of skilled performers

Skills performers are different for Kinaesthetic sense → refers to the athletes ability to make adjustments during performance, usually as a result of internal feedback. Performers with a
many reason, they can be identified kinaesthetic sense have an awareness of their body position and muscle movements to allow for improved performance.
for their ability to demonstrate:
● Kinaesthetic sense Anticipation and timing → skilled performers are able to accurately predict what is likely to occur. Predicting movement from their opponents or team members
● Anticipation and timing means that they are able to respond appropriately in the required time to successfully execute the skills required.
● Consistency
● Technique
Consistency → Skilled performers are able to perform skills at a high standard on a regular basis. They will continue to execute skills at a high level as the
difficulty of opponents increases. They will also be more consistent as they fatigue than a performer who is not as skilled.

Technique → Skilled performers have good technique, this means that they are able to perform movements that are safe, efficient and effective. This is
important when trying to develop strategy and tactics as they are not as focused on skill execution. Good technique can also contribute to a decrease in
injury throughout the season.

Objective and subjective performance measures

These measures are used to decide Objective performance → these measures can be recorded independently of an observer or judge, eg recording the time or distance. Often sports try to
on the skill level of performers. include objective performance measures to contribute to the reliability of results.
Some sports and performances are
easier to measure, as they are Subjective performance → are based on individual judgements and opinions, eg scoring in gymnastics. While these measures are judged by using a scoring
objective, while others require an system, it is the judge who decides the score.
external opinion, being subjective.
Subjective and objective → some sports can have both measures. Team sports have scores that determine the result of the match which are objective, but the
referee's decision is subjective which can influence the objective score.

Validity and reliability of tests

These tests measure performance Validity → refers to the extent to which a text is meant to measure. An individual must ensure that the test is valid for the skill they wish to test
are critical for sport and the athlete’s
development. The tests should Reliability → refers to a test ability to indicate consistency between measures of the same skill. Individuals must ensure that the test is the same if they repeat
provide evidence that a learner can it multiple times to ensure results can be compared to previous results. Reliability can be increased to ensure that the results can be compared to previous
execute skills effectively. results as they will be more consistent regarding the external components of the test such as: the surface, temperature, duration and equipment.

Personal vs prescribed judging criteria

Some sports have a subjective Personal judging criteria → this criteria is based on an individuals’ ideas and expectations about how a performance should be measured. This is used
element, thus officials try to make commonly in the early stages of skill acquisition. This criteria is often determined by the coach as to what they think are impact aspects of the skill to focus on.
their measurements more valid,
reliable and objective. Sports which
have subjective elements have Prescribed judging criteria → this criteria is developed by the governing body of a particular sport. The governing body identifies critical components of skill
criteria to measure performance. execution which should be identified or performed. Elite athletes will work within this criteria rather than personal judging criteria.
 Option 3: Sports Medicine
How are sports injuries classified and managed?

● Ways to classify sports injuries

○ Direct and indirect
○ Soft and hard tissue
○ Overuse

Identify specific examples of CAUSES

injuries that reflect each of the Direct: direct force generated from outside of the body. Often results in fractures or strains. Example → collision with another person during a tackle in rugby union, being struck with a puck in
classifications hockey
Indirect: intrinsic force where the injury can occur from the impact site, poor technique, and/or over-stretching, excessive strain on the body. Example → a sprinter tearing a hamstring,
stretching too far in a game of tennis to hit the ball
Overuse: excessive and repetitive force is placed on the body, causing inflammation. Overuse can contribute to stress fractures (small incomplete fractures). Example → shin splints from
constant running, wrong technique when pitching a ball

TYPE OF INJURY
Soft tissue: damage to muscles, fat, tendons, ligaments, skin. 2 types = acute (sudden eg. sprain), chronic (prolonged eg. arthritis). Common types include tears and contusions. Example →
tearing a hamstring when running, achilles tendonitis, abrasions.
Hard tissue: damage to bones and teeth, therefore are more serious and must be carefully examined and treated. Example → dislodging a tooth whilst fighting, fractured wrist.

● Soft tissue injuries

○ Tears, sprains, contusions
○ Skin abrasions, lacerations, blisters
○ Inflammatory response

Types of soft tissue injuries Tear: disruption of the muscle or tendon fibres. Tears are classified as; strains, partial tears, complete tears. Example → overstretching, muscle contracts too quickly. Management = stop
movement, RICER
- Sprain (ligament): stretching/tearing a ligament occurs when the joint is extended beyond normal range of movement. Example → sprained ankle. Management = stop movement,
RICER
- Strain (tendon/muscle): when a muscle or tendon is torn or stretched. Example → strained hamstring when kicking a ball. Management = stop movement, RICER
- Contusion: impact with a player/object, changes in severity; superficial (close to skin eg. bruise), others penetrate deeply causing bone to bruise. Example → getting a bruise from
being hit during a rugby game. Management = stop movement, RICER
Abrasion: when the outer layer of the skin (epidermis) is removed, causes pain and shallow bleeding. Example → grass burn from falling. Management = clean wound and provide non-stick
covering.
Laceration: a deep, irregular tear that exposes underlying skin tissue. Example → scalp laceration, sharp object. Management = control bleeding, clean with sterile solution, lacerations longer
than 1 cm must receive a referral.
Blister: a collection of fluid underneath the top layer of the skin. Example → caused by new shoes/equipment. Management = release fluid, donut pad, if skin has peeled wash with soap.

Manage soft RICER (rest, ice, All soft tissue injuries require RICER.
tissue injuries: compression, Short term: reduce swelling, prevent further damage, ease pain
elevation, Long term: restore flexibility, regain full function, prevent reoccurance
referral) RICER Why How Time

Rest To reduce bleeding into the injury and prevent further injury. Place in a comfortable position with the injury elevated and supported. Until beginning a program of careful mobilisation.

Ice To reduce: pain, blood flow, swelling, spasm, enzyme activity, tissue Crushed ice in a wet towel around the injury, frozen gel packs using a towel 20 mins every hour for up to four days.
demand for oxygen. as an insulator.

Compression Decreases bleeding, reduces swelling Wrap an elastic bandage over the injured area, covering both above and At the time of the injury and reapplied periodically for at least
below injury. 24 hours.

Elevation Decreases bleeding, swelling, throbbing. Raise the injured area above the level of the heart. Whenever possible during the day and for the following 2-3
nights.

Referral Understand the nature of injury, construct a rehabilitation program. Appointment with a doctor or physio. As soon as possible following the injury.
 In addition to RICER, HARM can be used as a set of restrictions:
H - no heat: do not apply heat for at least 48 hours
A - no alcohol: avoid consumption of alcohol as it dilates blood vessels, which increases swelling
R - no running: weight bearing exercise can cause further injury to the site
M - no massage: do not massage the injured site for at least 72 hours
When can you use heat?
- Heat can help loosen tissues and relax areas recovering from injury after the first 72 hours
- Heat pads, hot wet towels, spas, heat creams or commercial packs can provide heat and can be applied for 20 minutes at a time

Immediate The primary concern in the immediate treatment of skin injuries is avoiding blood loss and infection control. Our skin provides protection from bacteria and any breakdown of the skin will
treatment of require cleaning and hygiene control. Some considerations when treating skin injuries include:
skin injuries - Use gloves and avoid cross infection
- Control bleeding by: rest, elevation of the injured sit above the height of the heart, pressure on the injured site
- Clean and dress the wound with sterile pad and bandage
- Seek medical attention if bleeding is excessive or if the wound requires stitching.

What is the inflammatory Signs and symptoms: swelling, limited movement, pain, redness and warmth
response The pain and swelling results in limited movement. Red blood cells provide oxygen to damaged tissue to aid in repairs, whereas white blood cells fight infection, break down damaged tissue
and begin the scar tissue.
3 stages:
1. Inflammatory stage → initial pain and swelling
2. Repair and regenerate stage → elimination of debris, production of scar tissue (3 days - 6 weeks)
3. Remodelling stage → increased production of scar tissue, replacement tissue that needs to be strengthened and develop in the direction that the force is applied, too little exercise
allows large amounts of scar tissue to form which lacks strength and flexibility (6 weeks - many months)

● Hard tissue injuries

○ Fractures
○ Dislocation

Manage hard Assessment for Hard tissue injuries occur to bones and teeth, and although the treatment may vary slightly depending on the nature and position of the injury, all treatment will involve immobilisation and
tissue injuries: medical referral for medical treatment. Because hard tissue injuries can be accompanied by significant damage to muscles, blood vessels, surrounding organs and nerves, immediate treatment is
attention required. For serious hard tissue injuries, the person should not be moved, and an ambulance should be called.
Immobilisation: restricts movement in the injured area by using splints and bandages.

Types of hard Fractures Fracture: is a break in the bone, can result from a direct force, an indirect force or repetitive smaller impacts.
tissue injuries - Simple or closed fractures: bone fractures but remains under the skin.
- Open or compound fractures: if the skin over a fracture is broken. The skin might be broken either by the force of the injury that caused the fracture or by a piece of broken bone
protruding through the skin
- Complicated: a fracture is described as ‘complicated’ if nearby tissues and/or organs are damaged
 In some cases, a simple fracture can be difficult to detect. The signs and symptoms of a fracture include: pain at the site of the injury, inability to move the injured part, unnatural movement of
the injured part, deformity of the injured part, swelling and discolouration, grating of bones.

Dislocation Dislocation: is the displacement of bones from their normal position in a joint. A dislocation is often accompanied by considerable damage to the surrounding connective tissue. Dislocations
should NOT be put back in place except by a qualified practitioner, as more damage can occur if the placement is incorrect.
Subluxation: is when bones momentarily displace from their normal position in a joint eg. momentarily ‘pop out’ and quickly return to place. Although it stretches the ligaments, it may not
cause additional damage at the time. However, the joint will be vulnerable and require rehabilitation and possibly surgery.
Signs and symptoms: loss of movement at the joint, obvious deformity, swelling and tenderness, pain at the injured site. Many dislocations result in no hard tissue damage, but soft tissue
damage to the ligaments

● Assessment of injuries
○ TOTAPS (talk, observe, touch, active and passive movement, skills test)

Perform assessment procedures It is important to follow correct assessment procedures when assisting an injured athlete. When attending to an injured athlete whois unconscious, the DRSABCD action plan must be
to determine the nature and followed. If the athlete is conscious, the TOTAPS method of injury assessment can be used. TOTAPS can provide information about the extent of the injury and will indicate whether the
extent of injury in simulated person should be permitted to continue the game/performance should be given professional medical help. It is important to note that the control of bleeding takes priority over TOTAPS.
scenarios TALK:
- Ask the athlete questions to gather information about the case, nature and site of the injury eg → how did the injury happen, where does it hurt etc.
- For a suspected concussion, the questions should be directed at discovering the athlete’s alertness and level of consciousness
- If the athlete shows signs of serious injury, the person should be immobilised and seek urgent medical attention
OBSERVE:
- After questioning the athlete, visually examine the site of the injury
- Look for deformity, swelling and redness
- If the injury is to a limb, compare it with the corresponding limb to assess for deformity
- If there is obvious deformity, there is likely to be a fracture or serious ligament/tendon damage, and urgent medical attention should be seeked.
TOUCH:
- If there is no obvious deformity and the athlete is not especially distressed, feel the site of the injury.
- Using your hands and figures, gently touch the site without moving it.
- If possible, feel the corresponding site on the other side of the body to compare the two sides, note any differences in bone shape and skin temperature
- Intense pain to touch = the injury might be serious and a medical diagnosis is necessary
- Slight plan to touch = move on the next stage of the assessment
- If there is evidence of a fracture or dislocation, the procedure is stopped at this point, as more specific management for a fracture should begin.
ACTIVE MOVEMENT:
- Ask the athlete to attempt to move the injured part
- Observe the degree of pain, also observing the extent or range of movement that is achieved by the athlete, if possible, compare with the other limb
- As the athlete moves, feel the injured site for an clicking or grating
- If the athlete cannot move or has limited range of movement, the RICER procedure should be used as well as medical assistance.
- If the athlete can move without intense discomfort, proceed to the next stage
PASSIVE MOVEMENT:
- If you have reached the passive movement stage, it is likely that the injury is not serious
- A decision needs to be made as to whether or not the athlete should continue play
 - The ‘passive movement’ stage requires the first aider to move the athlete’s injured body part and determine how much pain-free movement is possible
- If the athlete cannot have the injured part manipulated through the normal range of movement without pain, the first aider should not continue, as the RICER treatment should be
administered.
- If the range of movement is normal, the athlete should be asked to stand.
SKILL TEST:
- If the athlete can stand, have the person place pressure on the injured site by performing movements similar to those required in the activity to be resumed eg → if playing soccer,
have the athlete swing their leg.
- If these actions can be completed, the athlete may resume activity.
- For example, in the case of a touch football player being assessed for an ankle injury, you would ask the player to run forward and backward and change direction quickly as these
movements are fundamental to the game.

How does sports medicine address the demands of specific athletes?

● Children and young athletes

○ Medical conditions (asthma, diabetes, epilepsy)
○ Overuse injuries (stress fracture)
○ Thermoregulation
○ Appropriateness of resistance training

Children and young athletes Children have specific physical capabilities and special care should be taken when they are involved in sport. Intensive training can often be boring, restrictive and socially isolating for
maturing young performers. Attention should be paid to their physical, mental and social health, and the pressures of performance should be minimised. Children and young people obtain
the following benefits from participating in physical activity: enjoyment, social interaction, improved motor and communication skills, great aerobic fitness, improved coordination, increased
strength, development of self-esteem, and promotion of physical activity into adulthood.

Analyse the Medical ASTHMA:

implications conditions Asthma is a 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. Exercise
of each of induced asthma (EIA) is asthma that appears during or shortly after physical activity. Factors that make the condition worse include cold, dry air and exercise of significant intensity and
these duration. All asthmatic children should have a current asthma management plan that has been developed with a doctor, with many children being encouraged to swim because the fitness
consideratio
ns for the
ways young
gained through swimming greatly benefits asthmatics.
people
Asthma does not appear to be a serious barrier to participation if care is taken. In order to prevent EIA, an asthmatic should:
engage in
- Keep their day-to-day asthma under control
sport and
- Have an established asthma action plan, which they have devised with their doctor and is known by their coach, teammates, and first aider
how each is
- Use their blue inhaler 5-10 minutes before they warm up
managed
- Participate in an effective warm-up before exercising
- Participate in an effective cool-down following exercise
DIABETES:
Diabetes is a condition where the body produces insufficient insulin or no insulin at all. The 2 types include type I → caused by the body’s inability to produce insulin, type II → caused by the
body’s inability to produce sufficient insulin or use it efficiently (more common). Insulin is important for the regulation of blood sugar levels in the body.
- Hypoglycemia → is a condition in which your blood sugar (glucose) level is lower than normal
- Hyperglycemia → high blood glucose means there is too much sugar in the blood because the body lacks enough insulin.
Diabetic athletes should prepare themselves for the demands of training or participation by adhering to specific dietary requirements and by monitoring their blood glucose levels.

EPILEPSY:
Epilepsy is a disruption to brain function, causing a brief alteration to the level of consciousness and resulting in seizures or fits. A less severe form of the illness can cause people to have a
temporary loss of awareness without a full seizure. When participating in physical activity it is important to know that fatigue and extremes of body temperature can trigger an epileptic
seizure.
 OVERUSE INJURIES:
Overuse injuries occur when excessive and repetitive force is placed on the bones and other connective tissues of the body. Examples of overuse injuries that are common in children are
stress fractures, tennis elbow, achilles tendonitis, swimmer’s shoulder and runner’s knee. Children and young athletes are susceptible to overuse injuries because of different growth rates in
bone and soft tissue. Common causes include:
- High training volume and intensity
- High training frequency
- Inadequate warm-ups
- Biomechanical problems
- Poor technique
- Strength and flexibility imbalances leading to poor body alignment

Thermoregulatio Thermoregulation is the process that controls the body’s core temperature, which should remain at 37oC. Young children are more susceptible to both heat and cold than adults. Young
n children take a longer time to acclimate to hot conditions so they are more at risk of dehydration and hyperthermia on hot, humid days. Children take longer to register that they are hot,
thirsty or cold, so they often need to be reminded of this. Children are less metabolically efficient than adults → because of the 3 important differences between children and adults; compared
with adults, children have smaller limbs in relation to their torso size, have less-developed sweat glands and have less muscular development.
1. Smaller limbs in relation to size of torso = relatively large skin surface area to body size
➔ They have less fluid in their bodies = more opportunity to lose that small amount of fluid through their relatively large skin surface area.
2. Children have less-developed sweat glands than adults
➔ thus produce less sweat than adults → because sweating is an important means of cooling the body, children are more likely to become overheated and suffer heat stress.
3. Children have less muscular development than adults = less able to generate heat through muscular activity
Because of these 3 factors, children are more prone to dehydration and extremes of temperature than are adults. Therefore, children should not exercise for long periods of time (over 30
 mins) in any extremes of weather conditions, and should be encouraged to drink small amounts of water frequently and to wear appropriate clothing.

Appropriateness Resistance training increases muscle strength by making your muscles work against a weight or force. The best exercises for developing strength in children are body weight activities.
of resistance Resistance can be used as long as it is relative and closely supervised, with CORRECT TECHNIQUE. Maximum lifting should be avoided because it can injure growth plates. Considerations
training for:
- 7 or younger → introduce children to basic exercises with little or no weight; develop the concept of a training session; teach exercise techniques; progress from body weight
callisthenics, partner exercises, and lightly resisted exercise, with a low volume.
- 8-10 → gradually increase the number of exercises; practice exercise technique in all lifts; start gradual progressive loading of exercises; keep exercises simple; gradually increase
training volume; carefully monitor toleration to the exercise stress.
- 11-13 → teach all basic exercise techniques; continue progressive loading of each exercise; emphasise exercise techniques; introduce more advanced exercise with little resistance.
- 14-15 → progress to more advanced youth programs in resistance exercise; add sport-specific components; emphasise exercise techniques; increase volume.
- 16+ → move child to entry-level adult training programs after all background knowledge has been mastered and basic level of training experience has been gained.

● Adult and aged athletes

○ Heart conditions
○ Fractures/bone density
○ Flexibility/joint mobility

Adult and aged athletes Any adult returning to sport needs to go through pre-screening when any pre-existing injuries or medical conditions are identified, and then physical activity programs can be modified
overview accordingly. Pre-screening are the measurements that are taken by an exercise professional and help guide them in developing an exercise program for the client.

Explain the Heart conditions It is important for people suffering heart conditions to exercise only under supervision at an intensity that has been determined by medical professionals, and be constantly monitored. Heart
sports conditions include hypertension, coronary heart disease and heart attacks.
participation - Hypertension is high blood pressure → evidence shows that physical activity is beneficial for people suffering from hypertension it makes them less likely to suffer from a heart attack
options - Coronary heart disease is the narrowing and hardening of the arteries due to atherosclerosis and arteriosclerosis → evidence shows that physical activity is beneficial to heart attack
available for patients and those with CHD, as it decreases the amount of oxygen delivered to cells throughout the body.
aged people Aerobic activity such as walking or swimming is best for heart conditions, and should last approximately 30 mins per day. Gradual increases can then be made once adaptation has occurred.
with medical
conditions Fractures/bone Bone density is a medical measure of the amount of minerals per square cm of bone. It is a key measure to help determine the strength or fragility of the bone. Poor bone density is an
density indicator of osteoporosis. Osteoporosis is a disease where increased bone weakness increases the risk of a broken bone.
- Women suffer greater bone density loss than men → starts twenty years earlier than in men (at age 30)
- Loss in bone density increases risk of fractures
- Bone becomes brittle as a result of low mineral content, especially calcium.

Flexibility/joint Flexibility is the ability of a joint or series of joints to move through an unrestricted, pain free range of motion.
mobility - Ageing process leads to a decrease in flexibility → as the muscles, tendons and ligaments all become less elastic
- For safe participation, it is important that aged athletes increase their flexibility and joint mobility → can be done via a regular stretching program consisting of slow, gentle stretching
to a comfortable point
Lack of flexibility will limit some of the movements of aged athletes → which can therefore lead to instability around joints and injuries.

● Female athletes
○ Eating disorders
○ Iron deficiency
○ Bone density
○ Pregnancy

Eating disorders Eating disorders are serious mental and physical illnesses that involve complex and damaging relationships with food, eating, exercise, and body image. Eating disorders and sport are often
linked → as they share characteristics relating to weight control, foot intake and physical activity. Disordered eating leads to starvation and dehydration, both of which impair performance.
Sports that require lower levels of body fat are at greater risk of developing eating disorders, for example ballet, gymnastics, swimming and diving (being thin allows for greater artistic and
technical merit). In aerobics, marks are attributed to an athlete’s physique. Multidisciplinary approach is to use more than one form of treatment → treatment from psychologists and
nutritionists are the best ways to help females with eating disorders, with support from loved ones.

Pregnancy Mild to moderate exercise is safe and beneficial for pregnant women. Benefits of exercise whilst pregnant include controlled maternal weight gain, maternal fitness, a decreased risk of
gestational diabetes, and an increased birth weight of the baby. Gestational diabetes is a form of diabetes that occurs during pregnancy. Exercise is considered dangerous in high-risk
pregnancies; for example, women who have experienced a miscarriage, a multiple pregnancy, premature labour, or high blood pressure.
Assess the degree to which iron IRON DEFICIENCY
deficiency and bone density Iron deficiency can cause lethargy and affects performance and involvement in physical activity. Iron is an important part of haemoglobin, a protein in your blood that helps carry oxygen from
affect participation in sport your lungs to the rest of your body. Iron deficiency is common in female athletes due to loss of iron in menstrual blood and high levels of sporting activity. Loss of iron can lead to anaemia (a
medical condition characterised by insufficient red blood cells). Iron deficiency can lead to reduced rate of lactate clearance, which is the removal of waste product lactic acid from muscles.
The slower lactate clearance rate → causes early fatigue. It is clear that iron deficiency can affect athletic performance and training levels, which means it is important for female athletes to be
aware of the importance of iron and maintain correct intake. Good sources of iron include meat, seafood, legumes, whole grains, and dark green vegetables.

BONE DENSITY
Bone density loss occurs in older female athletes. Those adults who suffer from osteoporosis are at an even higher risk of bone fractures caused by falls, collisions and the impact of
equipment. Eating disorders can cause a decrease in bone density, making the individual more susceptible to fractures.

What role do preventative actions play in enhancing the wellbeing of the athlete?

● Physical preparation
○ Pre-screening
○ Skill and technique
○ Physical fitness
○ Warm-up, stretching and cool down

Analyse different sports in order The wellbeing of an athlete can be enhanced by being physically prepared. Physical preparation enables the body to be better equipped to handle the demands of their sport. The athlete
to determine priority undertakes sessions that stress physiological capacities, making them adapt to the pressures required in the competitive environment.
preventative strategies and how
adequate preparation may
prevent injuries

PRE-SCREENING
Pre-screening assesses the health status of a person before they become involved in a training program. Pre-screening helps tailor an exercise program that can be devised to suit their
needs. Pre-screening may be the form of an interview or questionnaire, and may require a full medical check if the person;
- is 40 years or older
- has pre-existing medical conditions eg asthma, high blood pressure, or cardiovascular disease
- is obese
- has a family history of heart disease
- or has not exercised in years.
Stage 1 → identifying people who are at high risk of acute cardiovascular problems. These people must first obtain medical clearance before commencing aerobic exercise or training.
Stage 2 → identifying people at low or moderate risk.
High risk factors for exercise-related complications include:
- Male: 35+ female: 45+
- Being overweight
- High blood pressure
- Diabetes
- Smoking
- Not engaging in exercise
- Pregnancy
By understanding their limitations and with guidance on appropriate levels of exercise, people can avoid muscle soreness and losing motivation, which can occur if they do too much too
soon. The FITT principle can be used to create an effective training program.
SKILL & TECHNIQUE
Skill and technique relates to the efficiency with which we perform the required activities. Many sports injuries occur as a result of poor skill or technique. The injury may be the result of a
single direct blow, for example, poor head position when making a tackle in rugby league. An injury may also be the result of repetitive minor impacts, for example, stress fractures in the foot
from poor running technique. The fact that poor technique can result in injury places extra responsibility on coaches to ensure that the players under their control are competent in the basic
skills of the game, especially those relevant to self-protection. Skillful players perform difficult movements with ease and precision. Correct skill development is essential to prevent injury.
- The footballer who is unsure of correct tackling technique is at risk each time they make a tackle
- The basketballer who is unable to rebound competently places their knees at risk of injury with each landing
Most people appreciate the importance of skill acquisition to improve performance.
 In some cases, the performer may have correct technique, but due to unsafe elements, modifications must be made to ensure safety. For example:
- Wet or slippery conditions require the athlete to move slower and with more control to prevent injury
- In gymnastics ‘spotting’ is used
The coach has a very important role to play in ensuring the safe movement of the athlete through the different stages of learning a skill. This is done by breaking down the movement into
smaller, more manageable series of actions. A safe movement is a controlled movement, and athletes should never attempt movements if they are unsure or lack confidence.
PHYSICAL FITNESS
Athletes can prevent injuries by placing emphasis on developing the physical components specific to their activities. For example, netball players need to work on their speed and agility, as
well as muscular and cardiovascular endurance. These priorities differ from a marathon runner, who mainly needs to focus on overall endurance. All athletes need a certain degree of total
body fitness, however, more specific needs of athletes vary from sport to sport, and position to position. Individuals need specific physical preparation for various reasons including:
- A previous injury
- A medical condition
- A disability
- An identified personal playing weakness
WARM-UP, STRETCHING & COOL-DOWN
Warm-up: A warm-up prepares the body for physical training or competition.
- It is important that the warm-up focuses on the muscles and movements specific to the activity, although other areas of the body should not be ignored.
- A thorough warm-up lasts between 20-35 minutes, but can be shortened or lengthened depending on climatic conditions
- The purpose of a warm-up is to:
- Increase blood flow and oxygen to active muscles
- Increase body and muscle temperature
- Stretch ligaments and muscles to permit greater flexibility and reduce the change or injury
- Assist mental preparation
- Allow the athletes to commence the activity at their physical and mental peaks.
- Three parts: warm-up → low intensity, gross motor activities to increase overall body and muscle temperatures. Stretching → gentle gradual stretching of all major muscle groups,
promotes full joint motion and lengthens muscle and tendon fibres. Game specific activities → stimulates the movements used specifically in the activity, tends to be more vigorous
and can include modified games or skill drills.
Stretching: Muscles lose elasticity with age, so everyone should participate in a general stretching program. Muscles need to be stretched beyond the range required of them in the sport
prior to the performance. This is achieved by using the following stretches:
1. Static stretches → a muscle or group of muscles is gradually stretched beyond their normal range and the stretch is held for 30 seconds
2. Proprioceptive neuromuscular stretching (PNF) → often performed with a partner, although this is not essential. A static stretch is followed by an isometric contraction and a
relaxation phase is the lengthened position. The procedure continues until the desired amount of stretch is complete.
3. Ballistic stretching → this stretching of muscles involves a dynamic, forceful movement to increase the angle of flexibility. Often a bouncing action is used. While the principle of
specificity suggests ballistic stretching may be necessary in some sports, the risk of muscle and tendon tissue damage require caution and a degree of experience for those using
ballistic stretching.
Cool-down: the cool-down process is the reverse of the warm-up; it begins with intense activity that is gradually reduced.
- The main purpose → assist the body to adjust from the intense activity back to a normal pre-exercise state.
- During exercise, fluid builds up in the working muscles and the cool-down period allows this excess fluid to be drained from the muscles and redistribute around the body
- A proper cool-down = reduce muscle soreness and tightness → will therefore allow the athlete to recover more quickly.
- For example: the cool-down could consist of 2 minutes of jogging, followed by 3-5 of walking. This is followed by stretching exercises that were similarly performed in the warm-up.

● Sports policy and the sports environment

○ Rules of sports and activities
○ Modified rules for children
○ Matching of opponents, eg growth and development, skill level
○ Use of protective equipment
○ Safe grounds, equipment and facilities

Critically analyse sports policies, Acronym to remember each point → SUMMeR

rules and equipment to - S: safe grounds, equipment and facilities
determine the degree to which - U: use of protective equipment
they promote safe participation, - M: modified rules for children
eg heat rules, rugby union - M: matching of opponents
scrum rules - R: rules of sports and activities
RULES OF SPORTS AND ACTIVITIES
Rules are designed to ensure the safety of all those involved. Rules are enforced to reduce injury, for example, rugby scrums are controlled in order to reduce head and spinal injuries. In
rugby, dangerous tackles such as the head-high, the spear tackle and the shoulder charge have been outlawed. Hockey restricts the lifting of the ball and stick. Many other sports enforce the
use of protective equipment as well, for example shin pads in soccer. Sometimes the environment can place the athlete’s safety at risk. For example, tennis has a heat policy covering on
court temperature and humidity. Marathon and distance events provide fluid stations to reduce the incidence of heat stroke.
MODIFIED RULES FOR CHILDREN
Sizes of sporting grounds or number of players are often reduced depending on the age of the individual. T-ball stands, lowered goals for netball and basketball, and smaller equipment are
used to help accommodate the needs of children. Simplified rules that are not as centred around winning are also implemented to increase participation and improve social wellbeing.
Restrictions on bowling/pitching and number of minutes played prevent overuse injuries and provide each child an equal chance to play.
MATCHING OPPONENTS
Competitions that are unbalanced due to size, age, strength, skill development or experience increase the likelihood of injury. Contact sports carry more risk of injury when opponents are not
equally matched, especially when teams are graded on age alone. The benefits of matching opponents include improving overall safety, increased confidence through achievement,
decreased susceptibility to injury, increased self-esteem, develops resilience, and increases the need for developing proper technique.
USE OF PROTECTIVE EQUIPMENT
Many sports require participants to wear protective equipment in order to reduce injuries. In order for the protective gear to be effective, it needs to be;
- Correctly fitted
- The correct size for the athlete
- In good condition
The most common pieces of protective equipment used in sport today are those designed to protect the head and neck, eyes, body, teeth and feet. Examples include, fitted mouthguards by
a dentist to protect the jaw and teeth, shoulder and shin pads to protect from direct injuries by absorbing hits, and proper footwear to protect from impact as well as provide support and
traction.
SAFE GROUNDS, EQUIPMENT & FACILITIES
Governments, sporting organisations, clubs and officials have the responsibility of ensuring a safe environment is provided for all involved in sport. The playing environment, equipment and
facilities must be regularly checked and maintained to ensure the risk of injury is minimised. Safe design ensures fields are positioned to avoid direct sun in eyes, fences and other fields a
safe distance and surfaces even and well marked. Before any activity, playing areas should be checked for any holes, rubbish or anything likely to injure players.

● Environmental considerations
○ Temperature regulation (convection, radiation, conduction, evaporation)
○ Climatic conditions (temperature, humidity, wind, rain, altitude, pollution)
○ Guidelines for fluid intake
○ Acclimatisation

Evaluate strategies an athlete TEMPERATURE REGULATION

could employ to support the Convection → when energy is transferred by the molecular movement of liquid or gas between areas of different temperatures.
body’s temperature regulation Radiation → transfer of heat via infrared waves.
mechanisms Conduction → the process of losing heat through physical contact with another object or body.
Evaporation → the transfer of heat from our body, to water (sweat), resulting in the water becoming a vapour
Thermoregulation is the process that maintains a balance between the loss of body heat and increases in body heat. The body aims to maintain a core temperature of 37oC. During activity,
there is an increased production of heat, and the body manages temperature through four main methods; convection, radiation, conduction and evaporation. Clothing insulates the body from
its surroundings, as it may decrease heat gain in hot environments or hold back conductive, convective and radiative heat loss in the cold, for example → ski jackets, wetsuits. Clothing will
also assist the body to lose heat in hot environments, singlets.

Analyse the impact of climatic THE EFFECT OF

conditions on safe sports A warm, dry day with a gentle breeze:
participation - The dry conditions with a gentle breeze will allow sweat to be evaporated, easily cooling the athlete. The breeze will also provide a cooling effect through convection of heat away
from the body.
- This will allow athletes to perform with some comfort but they should ensure that adequate water is consumed and take breaks where possible.
A hot, humid day with not breeze:
- Athletes exercising in hot, humid conditions are at much greater risk of heat exhaustion and heat stroke (hyperthermia). This is even more so for those athletes who wear heavy
clothing or equipment, for example a hockey goalie. It is difficult for evaporation to occur as the air is already saturated in water. Evaporation can only occur in relation to how much
skin is exposed, so reduce clothing if possible. Athletes should also consume plenty of water.
A cold and windy day:
- On cold and windy days heat loss is greater as the air temperature is so much less than the body temperature. Heat is radiated away from the body. Bike riders and skiers are even
 more heated because of the increased breeze they generate as they move through the air.
- These conditions make an athlete move susceptible to hypothermia. It is advisable to wear warm clothing, gloves and head coverings when exercising in these conditions.
Being in cold water:
- Heat is lost through conduction due to contact with a cold environment. Cold water dangerously accelerates the onset of hypothermia since the body heat can be lost 25 times faster
in cold water than cold air. Wearing a wetsuit or minimising time in the water will assist in preventing hypothermia.
Exercising at altitude:
- At higher altitudes, oxygen in the air exists at a much lower pressure. This means that there is less oxygen transported into the lungs of athletes and their aerobic capacity is affected.
High altitudes lead to altitude sickness, whereby athletes experience difficulty eating and sleeping, and can be nauseous and fatigued.
- Slowly acclimatising, training at altitude or using oxygen tents are advisable strategies.
Pollution:
- Pollution affects athletes much more than the general population due to their high respiratory rate when exercising.
- Exposure to high levels of pollution has been shown to lead to cough, chest pain, difficulty breathing, headaches and a decrease in lung capacity. Pollution obviously has an even
worse effect on those athletes with respiratory conditions such as asthmatics.
- Slowly acclimatising is an advisable strategy or avoid exercising when levels are high
Exercising or playing in rain:
- Rain can lead to greater risk of hypothermia due to wet clothing. Wearing thermal clothing may help reduce this.
- There is also an effect on safety as stability and balance on slippery surfaces is compromised. Wearing longer studs in boots can be of benefit
- Injury due to poor technique from both players and opposition is increased.
- The high moisture content in the air also affects evaporation if rain occurs in a tropical environment
GUIDELINES FOR FLUID INTAKE
Fluid helps regulate body temperature. It also carries nutrients and oxygen to cells. It protects organs and tissues, dissolves nutrients and minerals, reduces burden on kidneys and liver and
lubricates the joints. To avoid dehydration, Sports Medicine Australia recommends:
- Athletes drink approximately 500ml in the 2 hour period prior to exercise.
- During exercise longer than 60 minutes, 200-300ml of cool water or sports drink every 15 minutes.
- After exercise, replenish your fluid deficit to ensure that you are fully re-hydrated.
ACCLIMATISATION
Ways to acclimatise an athlete:
- Live and train in the same environment
- Train at home but create similar environments, eg → oxygen tents and climate rooms
- Stay hydrate
- Monitor heart rate.

● Taping and bandaging

○ Preventative taping
○ Taping for isolation of injury
○ Bandaging for immediate treatment of injury
Demonstrate taping and
bandaging techniques, including
taping the ankle, wrist and
thumb

Evaluate the role taping plays in TAPING OVERVIEW

both the prevention and The aims of taping include to prevent injury, reduce the severity of injury, provide support, limit pain, limit specific movements at a joint, and allow desired movements at a joint. Taping a joint
treatment of injury to prevent injury should not replace a strengthening program because taping cannot provide the same range of movement restriction as an uninjured ligament.

Preventative taping:
- This is where adhesive tape is applied over a joint to protect and support it during activity
- In sports where there are explosive movements and rapid changes of direction, eg → rugby and basketball, joints are under high stress and at high risk of injury.
- Preventative taping (aka prophylactic taping) is very useful to reduce the risk of injury
 Effectiveness: Many studies have been conducted on prevention of additional damage and promotion of recovery by isolating or immobilising a joint. Most studies have investigated taping
to prevent and reduce the severity of ankle sprains, finding that taping does not restrict range of movement. The effectiveness of the tape in reducing range of movement decreases as the
exercise duration increases. The length of time it takes for tape to be ineffective in providing support is controversial.
Kinesiotaping for isolation: By providing moderate restriction to unwanted movement, your neuromuscular system is assisted within maintaining muscles at the correct tension and joints at
their optimal alignment. Unlike rigid tape that completely blocks unwanted movement, elastic tape encourages correct movement. This is beneficial in the rehabilitation process.
Bandaging for immediate treatment: Usually performed with an elastic bandage. Common uses of bandaging include:
- To control bleeding and prevent infection
- To apply pressure that will reduce swelling
- To immobilise and support an injured part
- Bandaging reduces damage from inflammatory response, reduces swelling, allows for earlier rehabilitation and hence shorter recovery time.
Using the correct taping simultaneously with the RICER regime, the injury can be healed quicker.

How is injury rehabilitation managed?

● Rehabilitation procedures
○ Progressive mobilisation
○ Graduated exercise (stretching, conditioning, total body fitness)
○ Training
○ Use of heat and cold

Examine and justify The purpose of rehabilitation is to:

rehabilitation procedures used - Enhance recovery time
for a range of specific injuries, - Enhance the return to pre-injury fitness levels (especially strength and flexibility
eg hamstring tear, shoulder - Reduce scar tissue formation
dislocation - Reduce the likelihood of re-injury
There are certain procedures to be followed to achieve this.
PROGRESSIVE MOBILISATION
Progressive mobilisation is when the range of movement is gradually increased over time until the full range of movement is restored. This can begin soon after the bleeding stops, or after 48
hours. Injury can restrict movement at a joint. Joint 5 mobilisation is important to reduce scar tissue and ensure full range of motion (ROM) is regained. Progressive mobilisation can be done
through active or passive exercise, passive is usually the most effective when conducted by a physio or doctor.
GRADUATED EXERCISE
An important part of the rehabilitation process is the 3 step process. This involves the use of stretching, conditioning and total body fitness.
1. Stretching:
- Flexibility will improve with progressive mobilisation, however, it is important to do stretching exercises as well.
- Stretching will improve the elasticity of muscles and tends so that the chance of further injury is decreased.
- Proprioceptive Neuromuscular Facilitation (PNF) stretching is highly recommended as it does not need extensive movement and stimulates proprioceptors.
- PNF is a more advanced form of flexibility training. It involves both stretching and contracting of the muscle groups being targeted in order to achieve maximum static
flexibility, for example → a physio pushing back on an athlete's hamstring for further movement.
2. Conditioning:
- Conditioning refers to keeping an athlete's overall fitness high, especially cardiorespiratory and muscular endurance.
- Muscle atrophy (loss of muscle mass) may occur if the body part is immobilised. Isometric exercises are good to assist strength without moving the joint, for example → a
squat hold or plank.
- A graduated weight program to regain strength and muscular endurance in the muscles directly affected is important, for example → beginning with low weights, slowly
introducing progressive overload to increase muscle strength.
3. Total body fitness:
- Total body fitness aims to return the athlete to their pre-injury level of fitness
- An athlete must not wait until the injury heals before beginning a conditioning program
- They can continue to work the uninjured muscle groups by completing activities that do not stress the injured part.
- All components of fitness must be promoted especially after periods of inactivity.
- Focus should be on strength, endurance and flexibility with reference to specifics of the sport.
- Work should also be focused on building confidence so the athlete is mentally prepared for their return to competition.
TRAINING
Once the athlete has completed their treatment and rehabilitation program, they are not immediately ready to continue participation.
Key questions:
- Why might re-injury occur? Movement and game specific skills and confidence lacking
- What aspects of performance are affected by rest from competition? Timing, coordination and speed
 - What helps to determine the athlete’s readiness to return to competition? Fitness and skills test
USE OF HEAT & COLD
Heat increases blood flow. This provides more blood and nutrients to assist healing. It should not be done before 48-72 hours after injury as it may increase inflammation and lengthen
recovery time. This can decrease pain and muscle stiffness. The use of cold is an integral part of RICER. Particular benefit in the first 48-72 hours, as it reduces inflammation and swelling. This
should be done for 20 minutes every 2 hours to decrease pain.
Ice Heat

When to use? Immediately after injury. Not until at least 48 hours after injury.

How to do it? Ice packs, ice massage, ice bath. Heat packs, hydrotherapy, infra-red lamps, ultrasound.

For how long? 20 minutes every 2 hours. Up to 30 mins.

Why? Reduce swelling, relieve pain, limit injury. Decrease pain, relax muscles, increase healing.
Examine and justify rehabilitation procedures used for a range of specific injuries: eg hamstring tear
Day 1-3:
The RICER regime should be utilised in the following days of an injury. Rest the injury as much as possible, elevate the leg where possible, apply ice to the injury for 20 mins every 2 hours,
and compress the injured area using a compression bandage.
Day 4-7:
Alternate the use of a hot and cold pack for five minutes each over a 30 minutes period. Finish on old to reduce blood flow to the area. Repeat three times a day. Begin basic stretching 5
times a day. Strengthening the hip and groin muscles using a resistance band. For example, knee extensions, standing hamstring curls, and reverse straight-leg raises. Do not complete if you
experience any pain. Light sports massage might be useful if the bleeding has stopped.
Day 7+
Use a heat pack for 10 minutes prior to rehabilitation exercises to help relax the muscles. Complete light hamstring curls using a resistance band or similar, completing approximately 3 sets of
20 reps 3x per week. Complete stretching and strengthening exercises for all major muscle groups. Start slowly on those exercises that work on the injured leg and slowly build up intensity.
Sports massage every 2 days would be beneficial. Conduct fitness sessions via swimming or cycling. If you are pain free, begin jogging sessions at slow speeds for a few minutes at a time.
Day 14+
Continue with static stretching as previous and with deep massage sessions. Introduce dynamic stretching exercises as well as increasing the weight or resistance of hamstring exercise but
decrease the reps. This will focus more on building strength rather than endurance. Once you can jog for approximately 40 minutes with no problems, you can increase the speed work.
Gradually increase the intensity over the next days and weeks.

● Return to play
○ Indicators of readiness for return to play (pain free, degree of mobility)
○ Monitoring progress (pre-test and post-test)
○ Psychological readiness
○ Specific warm-up procedures
○ Return to play policies and procedures
○ Ethical considerations, eg pressure to participate, use of painkillers

Research and evaluate skill and The purpose of having return to play procedures is to:
other physical tests that could - Not just to wait a certain time period
be used to indicate readiness to - Ensure full recovery and that skill and fitness levels are back to pre-injury levels
return to play - Ensure that the athlete is confident to return
- Ensure no inappropriate decisions are made through pressures of various kinds.
Indicators of readiness:
- Pain free: no pain during physical activity
- Full ROM: elasticity is restored
- Balance: able to balance their body on the injured limb
- Strength: new tissue able to support the body in stressful movements
- Mobility: has full movement particularly agility
Monitoring progress:
- Pre and post test results
- Observations of movement
- Comparisons - ongoing test, medical appraisals
- Video analysis
- Interviews
 - Tests → full active ROM, normal strength on muscle testing, symmetrical squat and lunge movements, agility in controlled environment without pain or instability.
Psychological readiness:
- An athlete needs to be more than just physically ready to return
- Psychological readiness demonstrated by a positive outlook and confidence is vital
- Balance between a desire to return and common sense is essential to avoid re-injury and damage to confidence
- Taping may assist confidence
- Counselling is recommended after serious injury and returning to a lower level can be beneficial
Return to play policies and procedures:
- Administrators, sports med practitioners and coaches have a vital role in establishing and enforcing guidelines
- RTP policies and procedures vary with sports and the nature and severity of injury
- Medical certificate
- Pass tests
- Taping for isolation
Ethical consideration:
- Pressure to participate → how important is the competition? Is there pressure from sponsors, coaches, owners, self (financial), etc
- Use of painkillers → an attractive option to return quicker.
Specific warm-up procedures:
- The warm-up needs to be more specific to the injured area when returning from injury. For example → an athlete with a previous knee injury would need extra low impact activities,
stretching and agility exercises to the leg muscles to ensure that these have been worked in a safe environment beyond what is demanded from their activity.
- Examples of these exercises include slow slalom jog, balance on one foot, hopping, agility ladder, and taping of the joint.

Option 4: Improving Performance

How do athletes train for improved performance

● Aerobic training
○ Continuous/uniform
○ Fartlek
○ Long interval
● Flexibility training
○ Static
○ Dynamic
○ Ballistic

What are the planning considerations for improving performance?

● Initial planning considerations

○ Performance and fitness needs (individual, team)
○ Schedule of events/competitions
○ Climate and season

Describe the specific considerations of planning The purpose of initial planning is to:
for performance in events/competitions. How ● Ensure appropriate fitness and skill development
would this planning differ for elite athletes and ● Plan, organise and implement training appropriate for the level of the athlete and for the requirements of the event or season.
recreational/amateur participants? ● Consider the environmental factors that may influence performance and participation.

Performance and fitness needs

● Need for good planning, organisation, implementation, observation and evaluation of programs to meet the needs of each athlete
● May begin with data collection from past performance and may also include testing.
● Goals and aspirations will help determine the approach as well as the age and level of the athlete.
● Good planning will determine the involvement and commitment of athletes of all ages and levels.
● Well balanced programs will develop not just fitness and skills, but tactics and psychology.
Schedule of events/competition
 ● Planning will ensure that players are not underprepared or overtrained with respect to volume and intensity.
● Training is scheduled to ensure athletes are able to compete to their best at weekly events or at a specific event, eg → team sports will adapt to meet different
opponents while aiming to peak for finals.
Climate and season
● Initial planning should take into account seasonal variations and climatic influences, such as heat, rain, humidity, cold/snow, and the influence of these on the
athlete and the playing surface.
● A sensible approach is needed with strategies such as alternate venues, ‘classroom’ sessions, and acclimatisation being part of the planning.
● Encourage appropriate clothing and provide adequate support such as hydration.

Elite vs recreational/amateur
When compared to social participants, elite athletes might have:
● A much longer pre-season
● Increases frequency and higher intensity of training
● Increases focus on recovery methods, nutritional considerations and hydration.
● Improved and specialised training methods.
● Increased assessment and monitoring of fitness.

● Planning a training year (periodisation)

○ Phases of competition (pre-season, in-season and off-season phases)
○ Subphases (macro and microcycles)
○ Peaking
○ Tapering
○ Sport-specific subphases (fitness components, skill requirements)

Develop and justify a periodisation chart of the Periodisation → the organisation of a longer term training program into smaller periods of specific focus. Each of these stages has its own important differences in the
fitness and skill specific requirements of a training that occurs.
particular sport
Phases of competition
Training type Post-season/transition Pre-season/preparatory In-season/competition

Resistance training 3-4 days per week 2-3 days per week 1 day per week

Running training Low intensity, high volume High intensity, sport specific, progressive overload High intensity, low volume, specific

Skill training Skill development Skill practice Game related

Additional Recreational, social Strategic practice Tactical, game-like

Purpose Recuperate body and mind, heal Involves the period 8-12 weeks before the start of competition, Fitness levels are maintained, performance and
injuries, maintain skill and fix problem focuses on the components of fitness predominant in the sport. refining skills is the focus, tactical aspects are
areas, maintain aerobic fitness, Recovery is important for repeated training episodes and for refined through opposed training.
develop strength. Achieved through adaptations to occur, weights are needed for strength endurance.
drills.
 Subphases
Yearly training programs are broken into subphases known as macrocycles, mesocycles and microcycles.
● Macrocycles → training phases of off-season, pre-season, and in-season.
● Mesocycles → around 4 weeks in length with a macrocycle and will have a specific aim and focus.
● Microcycles → a week long and individual training sessions will be detailed.

Peaking
Peaking is the state of optimal readiness for competition, both physically and psychologically. It cannot be maintained at all times, and coaches look to sequence training in
order to peak at the appropriate times. Individual sports require peaking for key events, whereas team sports require peaks at certain times throughout the season before
peaking for finals.

Tapering
Tapering allows an athlete to feel fresh and ready to perform at their peak.
● It varies for different sports from a week to a few days.
● Muscle glycogen stores for endurance can be increased with reduced volume 3 days before an event, but must be done with a high-carbohydrate diet.
● Resistance training should not be done 24 hours before to prevent muscle soreness.
● Careful planning is required to avoid fatigue or a detraining effect.
● Reducing volume but maintaining intensity works best.

Sport-specific subphases
● Fitness components will all have their own subphase.
● Off and pre-season conditioning will be more general before specific development close to and into the season.
● Skills are developed in drills during the off-season and refined during early pre-season through sport similar activities.
● Later pre-season and in-season will see more emphasis on specific skill application and strategy practice.
● During this time, conditioning and skill can be achieved through small-sided and scenario based games.

● Elements to be considered when designed a training session

○ Health and safety considerations
○ Providing an overview of the session to athletes (goal specific)
○ Warm up and cool down
○ Skill instruction and practice
○ Conditioning
○ Evaluation

Examine different methods of structuring training Health and safety considerations

sessions ● Equipment should be well maintained
● Facilities should be regularly checked
● Protective equipment
● Extreme weather may change location of playing
Providing an overview of the session to athletes
● Feedback on previous performances
 ● Clear objectives of the session
● Outline of the activities to be performed
● Enable the athletes to be psychologically prepared
Warm up and cool down
● Athletes need to be prepared physically and mentally for the session
● Warm up → general conditioning, stretching, sport specific movements
● Cool down → reverse of warm up but less intense and generally shorter, aids in recovery
Skill instruction and practice
● Instruction should be concise and clear
● Demonstration is important for athletes to understand what is required
● Plenty of time should be available for individual, partner and group practice
● Should resemble game situations as skill level improves
Conditioning
● Can occur after skill performance to avoid fatigued learning or be incorporated to challenge players
● The amount of conditioning will depend on the phase of the season
● High intensity training for speed and power should be done first
● Other components can be done after this with flexibility done during cool down
Evaluation
● Important can be done during the cool down or while the athletes are stretching
● Feedback allows for improvements to be made, which enhances performance
● Determines if goals have been achieved and monitors intensity and timing of the session
● Allows for improved planning and motivates players for the next session

● Planning to avoid overtraining

○ Amount and intensity of training
○ Physiological considerations, eg lethargy, injury
○ Psychological considerations, eg loss of motivation

Analyse How much training is too Planning to avoid overtraining → overtraining occurs when the athlete is exposed to: excessive training volume and intensity.
overtraining by much? Amount and intensity of training
considering ● Weekling competition, intensive and long training, and poor recovery periods can lead to overtraining
questions such How do you identify an ● Monitoring athletes and training loads assist coaches to prevent this
as: overtrained athlete? ● Variety in activities, load and even expectations can help achieve optimal performance
● Programs should allow for adequate time for the body to recover and adapt.
What do you do if you identify Physiological considerations → overtrained athletes often experiencing:
an overtrained athlete? ● Reduced level of training and competing
● Onset of technique changes and errors
How can overtraining be ● Inability to finish training sessions
avoided? ● Poor time trials and fitness results decline
● Weight loss
● Occurrence of overuse injuries
Psychological considerations → often the first things indicating that an athlete is overtrained:
● Lack of energy, motivation and drive
● Lethargic and excessive tiredness
● Irritability, anxiety and depression
● Inability to concentrate, drop in academic performance

What ethical issues are related to improving performance

● Use of drugs
○ The dangers of performance enhancing drug use, eg physical effects, loss of reputations, sponsorship and income
○ For strength (human growth hormone, anabolic steroids)
○ For aerobic performance (EPO)
○ To mask other drugs (diuretics, alcohol)
○ Benefits and limitations of drug testing
Justify the reasons drugs are considered to be Dangers
unethical and carry a range of risks for the athlete ● Physical
○ Disease of the heart, liver and kidneys
○ Infections - hepatitis, HIV
○ Acne
○ Sexual dysfunction
○ Increased aggression, violence
○ social/emotional problems such as depression, anxiety or mood swings
● Loss of reputation
○ Not just the individual but also the sport itself can lose integrity
○ Other individuals in the sport can be tainted
○ Loss of respect can have a significant psychological effect on the athlete
● Loss of income and sponsorship
○ Governments and sponsors withdraw vital funding from both individuals and sport
○ Weightlifting has lost government funding
○ Bans from a sport limit athlete’s income and careers

For strength
● Human growth hormones (HGH)
○ Naturally occurring peptide hormone
○ Difficult to detect in urine
○ Increases lean muscle mass, metabolises fat, hastens recovery
○ Causes abnormal growth of bones and organs, headaches, impotence, heart disease
● Steroids
○ Steroids have both anabolic (build tissue) or androgenic (masculine) characteristics
○ Used to increase weight, strength, power and recovery, sports which require bulk and aggression
○ Stimulate protein synthesis
○ Eg → weightlifting, boxing, sprints, NFL, rugby league
○ Side effects for men → shrunken testicles, impotence, baldness, infertility
○ Side effects for women → increased body hair, irregular menstruation, baldness
○ General effects → psychological dependence, mood swings aggression, CVD

For aerobic performance

● EPO (erythropoietin)
○ A peptide hormone that increased production of RBCs
○ Improves oxygen utilisation → significantly improves performance
○ Can lead to blood thickening causing clots, heart attack and stroke
○ Risk of autoimmune reaction where natural EPO is destroyed

To mask other drugs

● Diuretics
○ Increase fluid removal from the body
○ Can assist in masking drugs by diluting urine or removing drug traces
○ Detection of diuretic is considered a positive test
○ Side effects → dizziness and fainting, dehydration, cramps, mood swings, confusion, damage to the heart
● Alcohol
○ Encourages the body to lose water
○ Used to mask drugs or remove traces before a test
○ Can lead to dehydration, loss of coordination and balance and loss of temperature regulation
○ Depressant effect may benefit by reducing nervous tension in target sports
○ Increase self-confidence may lead to increased risk taking and injury

Drug testing
● Benefits
○ Unfair advantage
 ○ Long term health risks
○ Undermines the integrity of the competition
○ Random testing forces athletes to follow guidelines
● Limitations
○ Banned substances continue to adapt, new drugs created to beat tests
○ Financially expensive
○ Invasion of privacy, especially for recreational drugs
○ Policies differ between sports

● Use of technology
○ Training innovation, eg lactate threshold testing, biomechanical analysis
○ Equipment advances, eg swimsuits, golf ball

Describe how technology has been used to Training innovation

improve performance ● Lactate threshold testing
○ Speed endurance athletes and endurance athletes need to understand the point where the body produces lactic acid quicker than it can be removed.
○ Lactate threshold testing determines this point known as the OBLA or lactate threshold.
○ Blood lactate can be tested accurately and progressively in a lab, but it is expensive.
○ Lactate threshold testing can also be done in the field with inexpensive portable devices. These allow for real-time, sport specific testing.
● Biomechanical analysis
○ Biomechanics examines how the body moves to improve technique.
○ Done through video analysis, use of images for comparison and slow motion replays.
○ Analysis allows for the most efficient movement patterns to be performed.
○ Athletes benefit through less energy used, fewer errors made and risk of injury reduced.
Equipment advances
● Swimsuits
○ The main feature was initially to reduce drag but progressed to improving buoyancy and blood flow to muscles.
○ Highly effective → banned high-tech swimsuits and restricted the amount of body covering due to suits creating more records than the swimmers
themselves.
● Golf balls
○ Greater control and a lower spin meaning straighter flight.
○ Harder shell and improved rubber core means greater durability and distance.
○ Technology has also improved clubs providing better feel, control and are easier to hit with.

Argue ethical Has technology gone too far? Technology has made sports safer, fairer and often easier to perform, as well as increased interest from spectators. Technology has made the athlete less a part of the
issues related to performance. FINA has banned certain swimsuits. Golf has restrictions on the balls and clubs used during competition. Motor racing has restrictions on vehicles.
technology use
in sports such as: Has access to technology Those able to gain initial access to technology have an unfair advantage, eg fibreglass pole vaulting poles, bikes and cycling equipment, GPS tracking technology.
created unfair competition? Technology can be unfair because individuals who come from poorer countries may not be able to afford these advantages.