Exercise Physiology in Sports Medicine

Introduction:

Exercise causes changes in muscular and cardiovascular systems, which result in changes in strength and body functions. Exercise physiology is essential in clinical sports medicine, which deals with physical activity that causes acute responses and chronic adaptations to the body. Exercise physiologists are qualified to exercise rehabilitation and manage acute and chronic injuries or conditions.

What Are the Goals of Exercise Physiology?

• Exercises rehabilitation.

• Exercises for complex medical conditions.

• Musculoskeletal rehabilitation exercises.

• Exercises for recovery from injury.

• Postural control.

• Improvements in sports performance.

What Are the Types of Exercise Physiology?

1. Sports Exercise Physiology: It deals with the body’s response to physical activity in athletes.

2. Clinical Exercise Physiology: It deals with the psychological behavior of the athletes during performance and injury and also helps in rehabilitation.

What Happens During Exercise?

1. Energy Expenditure: On sustained exertion, humans tend to expend energy for a prolonged period. However, energy expenditure varies according to age, gender, weight, and heart rate.

2. Muscle Pain: Physical exercise causes immediate and delayed pain in muscles. The immediate pain is due to the stimulation of nerve endings, and the delayed pain is due to the muscle fiber rupture. Pain may be mild to severe, depending on the intensity and level of physical activity.

What Are the Metabolic Changes That Occur During Physical Exercise?

1. Rapid Energy Sources: Energy required to perform physical activities come from muscle cells through anaerobic metabolism.

2. Plasma Glucose: Plasma glucose remains constant when the glucose enters the blood equals the removal of glucose from the blood. Plasma glucose level remains constant during moderate physical activity. Prolonged exercise results in a drop in blood glucose levels which leads to fatigue, and Epinephrine and growth hormones maintain the plasma glucose level by oxidizing fatty acids and utilizing glucose for the scarcity. In diabetic patients, moderate exercise results in a drop in glucose level- which maintains blood glucose within a normal range.

3. Oxygen: Exercise increases the body's oxygen demand and causes an increase in heart rate, breathing rate, and depth of breathing.

4. Dehydration: Dehydration is more common during exercise and causes an increase in basal body temperature and heart rate.

What Are the Physiological Changes That Occur During Exercise?

1. Exercise-Induced Physiological Changes in the Brain:

• Oxygen: The brain depends on oxygen to perform its function. Exercise causes a decrease in oxygen levels. If there is a demand for oxygen supply to the brain, it leads to unconsciousness within six to seven and disruption in motor control.

• Cerebral Autoregulation: Cerebral autoregulation usually protects the brain during oxygen deprivation by increasing the cardiac output and producing more capillary oxygen supply to the brain. Brain autoregulation is impaired during maximal exercise since increased capillary oxygen supply alone is insufficient.

• Glucose: Exercise reduces plasma glucose in the brain that compensates for it with lactate, which provides the required energy to the brain.

• Hyperthermia: During exercise, more sweat causes an increase in basal body temperature. It results in cognitive impairment, reduced cerebral blood flow, and brain hyperthermia.

2. Exercise-Induced Fatigue:

Intense Activity: During intense exercise, there occurs disturbance in ion hemostasis and causes cellular membrane depolarization, inexcitability, and muscle weakness.

Endurance Failure: Intense exercise for a prolonged time causes a collapse in body hemostasis.

Other Factors That Cause Fatigue Include:

• Brain hyperthermia.

• Depletion of glycogen in brain cells.

• Skeletal muscle function impairment.

• Ammonia uptake by the brain.

• Decreased glutamate level.

• Oxygen supply impairment.

3. Exercise-Induced Cardiac Changes:

Prolonged exercise (marathons) causes an increased release of cardiac biomarkers. In clinical conditions, increased release of biomarkers suggests irreversible muscle injury, whereas exertion induced is reversible (usually occurs within 24 hours).

Who Are Exercise Physiologists?

Developed countries give accreditation to health professionals who work with clinical and non-clinical clients as certified exercise physiologists (CEP) or accredited exercise physiologists (AEP). They may be scientists, clinical researchers, clinicians, clinical researchers, or sports trainers. They learn biochemistry, bioenergetics, cardiopulmonary function, hematology, biomechanics, skeletal muscle physiology, neuroendocrine function, and central and peripheral nervous system.

Exercise physiology prepares students in the field of health sciences and focuses on the scientific study of the physiological processes of physical or motor activity- which includes sensorimotor interactions, response mechanisms, and the effects of injury, disease, and disability. Also, studies about muscular and skeletal anatomy, molecular and cellular basis of muscle contraction, motor mechanism of neurophysiology, respiration, blood flow, endocrine secretions, fatigue, muscle and body training, exercise physiology of specific activities, physiology of injury, and the effects of disabilities and diseases.

Graduated exercise physiologists can do clinical-based research work, client-based work, and non-clinical work. They follow according to the client’s requirements and are as follows:

• Health and Risk Assessment: It is mandatory to work safely with clients. Exercise physiologists must know the benefits and risks associated with physical activity. Examples include- knowing about specific injuries that the body experiences during exercise, proper screening of the client before the session starts, and identifying the factors affecting their physical activity.

• Exercise Testing: Exercise physiologists must coordinate their clients during physical activity. They should monitor cardiorespiratory fitness, muscular endurance, and flexibility and should measure body composition. In order to understand the specific part of the body, functional tests are performed. Exercise physiologists should be able to interpret the results and decide about possible health-related outcomes.

• Exercise Prescription: Individuals’ health and goals are assessed by conducting training programs. During the program, exercise physiologists should give importance to different types of exercises, the reason for a client’s workout, and pre-screened assessments. Also, they should know what exercises can be prescribed for special populations- that include age, pregnancy, cardiac disorders, obesity, joint diseases, and pulmonary diseases.

Conclusion:

Exercise physiologists personalize the exercise routine to help the body perform at a higher level, regardless of age and current activity level. Additionally, exercise physiologists conduct programs for athletes to reduce the number of injuries and recover faster from them. In research, exercise physiology has been identified to show the important effects of exercise on the body’s systems, tissues, and cells. Ongoing research is investigating the role of exercise at the subcellular and molecular levels.