Professor, Dr.Med. O.S. Kogan¹
Associate Professor, PhD M.V. Tarasova^2
1 Ufa State Petroleum Technological University, Ufa
² Bashkir State Pedagogical University n.a. Akmulla, Ufa

Keywords: athletes, elite sports, health status, medical examination, chronic diseases, functional disorders.

Background. Modern training systems applied in elite sport are designed to persistently improve sport mastery to attain the best possible competitive success. The highest athletic accomplishments, however, are not always beneficial for athlete’s actual physical fitness and health. The existing training systems in elite sports when the training process is loosely designed or mismanaged may, in opinions of many sport specialists, result in pathologies of different body systems and organs. The reasons for many sport-specific diseases and disorders diagnosed in the physical culture and sports sector specialists following their retirement from elite sports may often be traced to the very starts of their athletic careers. It holds particularly true for athletes having at least 7-10 years-long track records in elite sports.

Modern competitive sport training systems may be particularly harmful when athletes have some chronic diseases. Non-diagnosed or untimely diagnosed pathologies tend to aggravate under intensive training and growing fatigue effects and manifest themselves later on as serious pathological transformations. The athletes diagnosed with health disorders are normally exempted from further training sessions and may come back only after full recovery. In the worst case, they have to leave sport due to diagnosed serious pathologies.

Professional sports may be described as a special field of human activity where athletes are exposed to high risks of traumas as verified by the high incidence rates of musculoskeletal system disorders provoked by overloads on some organs and systems as a result of intense training and competitive stresses giving rise to the above and many other pathological conditions of potential risk for the athletes’ health. It may be pertinent to mention that at least half of the coaching and education specialists presently working in the national sports sector are former elite athletes who left active sports and opted for the coaching jobs due to the diagnosed health conditions.

As reported by many researchers, professional careers of many leading athletes in boxing, football, artistic gymnastics, wrestling, weight lifting and many other popular sports may be generally described as a sequence of hard training work, competitions and post-traumatic rehabilitation courses. Numbers of professional athletes diagnosed with severe sport-related injuries subject to hospital treatment are estimated to come to about 10% of the total athletic population; and these severe injuries were reported to make up around 9% of the total injury rate in the national sports – and, consequently, the total share of the injured athletes (with severe, moderate and minor injuries) must total to about 90% of the total professional athletic population [Sandelin, 1988, Kannus et al., 1989].

It should be noted that the issues of the elite athletes’ training process design and management in the pre-retirement period still need to be studied in detail being of high theoretical and practical importance and interest – since a variety of health disorders are known to be triggered by abrupt cancellation of the athletic training process with reduction of the habitual physical workloads.

Objective of the study was to analyze and rate health disorders diagnosed in active and retired elite athletes in different sport disciplines and activities.

Methods and structure of the study. Subject to the study were two study groups and two reference groups. Study Group 1 was composed of 273 active professional athletes including 211 men and 62 women competing on a regular basis in the top-ranking national and international competitions, qualified Candidates for Master of Sport, Masters of Sport and International Class Masters of Sport by the Unified Russian Sport Classification System and having no income other than their sport club membership wage or stipend from the Federal Physical Culture and Sports Agency of the Russian Federation or from the Physical Culture and Sports Ministry of the Republic of Bashkortostan.

Study Group 2 was composed of 233 retired elite athletes including 164 men and 69 women having different sport titles and ranks but now working as coaches upon retirement from elite sports.

Reference Group 1 (for comparisons with the Study Group 1) was composed of 100 amateur athletes including 51 men and 49 women having no formal sport qualifications and dominated by senior students and graduates of the Coach Training Department of Bashkir Physical Culture and Sports Institute and the relevant sport departments of other universities of the Ufa municipal higher education system.

Reference Group 2 (for comparisons with the Study Group 2) was composed of 76 professional Physical Education teachers and coaches (including 52 men and 24 women) presently active in the national sport sector albeit having neither sport qualifications nor track records in elite sports.

Study results and discussion. It was the speed-strength sport disciplines including weight lifting and powerlifting sports that showed the highest chronic disease incidence rate estimated at 96.8% of the examined athletes. Going next on the disease incidence scale were the single combat disciplines with the chronic disease incidence rate of 90.3% of the examined athletes; followed by the cyclic and complex-coordination sport disciplines with the incidence rates of 85.4% and 84.8%, respectively. Team sports showed the lowest chronic disease incidence rate of 52.9%.

It was further found by the study that the musculoskeletal system (MSS) and peripheral nervous system (PNS) diseases collectively amounted to 40.6% of the diagnosed cases. Going second were the mental diseases (MD) and behavioural disorders (BD) dominated by neurocirculatory dystonia, neurosis and neurasthenia collectively accounting for 32.8% of the diagnosed cases. Less frequent were the respiratory system diseases (RD, 11.4%), urogenital system diseases (UGSD, 7.0%), digestive system diseases (DSD, 4.4%) and other health conditions (3.9%) including a few cases of anaemia and skin diseases.

Incidence rates of the diseases and their groups were found sport-specific. In the speed-strength sports group, for instance, musculoskeletal system (MSS) and peripheral nervous system (PNS) diseases were diagnosed in every second athlete as compared to the cyclic sport disciplines and team sports where they were found in every third and tenth athlete, respectively. Athletes engaged in the combat sports and complex-coordination sports were most often diagnosed with respiratory system diseases; whilst mental diseases and behavioural disorders were found evenly disseminated across the subject sports with the incidence rates varying from 23.5% in the team sports to 30.1% in the cyclic sports (see Table 1).

Table 1. Incidence rates of chronic non-infectious diseases diagnosed in active elite athletes

Note: MSSD musculoskeletal system diseases; PNS peripheral nervous system diseases; MD, BD mental diseases and behavioural disorders; RD respiratory system diseases; UGSD urogenital system diseases; DSD digestive system diseases; * statistically meaningful (р<0.01) difference versus the speed-strength sport data

The study reported no clinically expressed circulatory system diseases as verified by detailed medical examinations, albeit most of the athletes were diagnosed with different ECG changes indicative of the vegetative system imbalances including sinus arrhythmia, incomplete right bundle-branch block (fasciculus atrioventricularis); impairments in the intra-ventricle and intra-atrium conductivity, re-polarizing processes and metabolic processes in myocardium. The above disorders collectively amounted to 68.9% of the athletes examined and were found virtually gender-nonspecific as they were diagnosed in 69.7% of the men and 66.1% of the women versus 31.0% in the Reference Groups. Incidence rates of the above health disorders were the highest in the cyclic sports group (84.5%) followed by team sports (73.5%), speed-strength sports (61.3%), complex-coordination sports (57.6%) and single combat sports (52.8%).

Furthermore, the study considered separately a group of the negative ECG indications of myocardial dystrophy due to physical overstress (MDPOS) that was left beyond the list of diagnosed diseases albeit may point to severe changes in the cardiac muscle metabolism commonly acknowledged as unfavourable prognostic evidence for the circulatory system functionality. The MDPOS incidence rate for the elite athletes’ group made up 4.7% in total with 6.4% and 4.4% in the women and men’s subgroups, respectively. The highest MDPOS incidence rates were found in the cyclic and speed-strength sports (6.8% and 6.5%, respectively, with the women found to have higher MDPOS rates (11.1% to 12.5% of the women examined), i.e. one of ten women athletes was diagnosed with this health condition in fact. In the Reference Groups, the MDPOS incidence rate made up 2%.

It may be stated, therefore, the elite athletes’ health cannot be rated as good due to the high incidence rates of the chronic non-infectious diseases. The professional sport-specific activity exposes elite athletes to the high risks of musculoskeletal system (MSS) and peripheral nervous system (PNS) diseases, mental diseases (MD) and behavioural disorders (BD), neurocirculatory dystonia, neurosis and neurasthenia. Elite athletes in cyclic and speed-strength sports are exposed to high risks of myocardial dystrophy due to physical overstress (MDPOS), and the elite single combat and in complex-coordination sports the athletes have increased risks of respiratory system diseases.

Comparative analysis of the Study Group athletes’ study data versus that of their unqualified young peers of the same age group going in for body conditioning practices only (including students of coaches’ education departments) showed that the elite athletes were diagnosed with worse health conditions virtually in every sport discipline under the study.

Furthermore, the present study obtained and analyzed data on the chronic pathologies and functional disorders diagnosed via comprehensive medical examinations performed by experts of the Republican Health and Physical Culture Specialized Clinic (of the Republic of Bashkortostan). Subject to the examinations were 233 retired elite athletes having successful track records in cyclic sports, speed-strength sports, competitive combat sports, complex-coordination sports and team sports; all the athletes now working as coaches and physical education specialists.

Table 2. Incidence rates of chronic diseases diagnosed in the coaching retired athletes

Note: MSSD musculoskeletal system diseases; PNS peripheral nervous system diseases; MD, BD mental diseases and behavioural disorders; RD respiratory system diseases; DSD digestive system diseases; HT hypertension; IHD ischaemic heart disease; ED endocrinal diseases

Furthermore, most of the coaching retired athletes were diagnosed with ECG changes typical for the vegetative system imbalances including sinus arrhythmia, incomplete right bundle branch block (fasciculus atrioventricularis); impairments in the intra-ventricle and intra-atrium conductivity, re-polarizing processes and metabolic processes in myocardium. The aggregate incidence rate of the above diseases was estimated at 68.9% being virtually sex-nonspecific, with men and women’s incidence rates making up 69.7% and 66.1%, respectively, versus 31% in the Reference Group.

Overall, more than a half of the retired athletes now working as coaches and education teachers were diagnosed with a variety of ECG changes typical for imbalances of the re-polarization process in myocardium, sinus arrhythmia, incomplete right bundle branch block (fasciculus atrioventricularis); metabolic process disorders in myocardium, and myocardial dystrophy due to physical overstress. More than three of ten athletes (33.3%) were diagnosed with arterial hypertension. Not unusual were also neurosis and neurasthenia (8.2%). The medical examinations resulted in 8 retired athletes being diagnosed with stage 1-2 hypertension; two coaches were diagnosed with ischaemic heart disease; and three former elite athletes were diagnosed with stage 2-3 obesity.

The disease incidence rates profiled by the sport disciplines under the study showed the highest general rates in the speed-strength sports (154 cases per 100 subjects examined), followed by the complex-coordination, cyclic sports and single combat sports with about the same incidence rates (varying from 129 to 114 cases per 100 subjects). Less severe were the incidence rates in the team sports (80%) that were virtually the same as in the Reference Group (81.6%). The disease incidence rating data of the Study Groups were compared with those of the Reference Groups composed of the coaches and teachers having neither sport qualifications nor track records in elite sports.

The above study data and analysis were interpreted as indicative of the professional careers in elite sports resulting in severe health disorders of the athletes that may be aggravated upon their retirement from the elite sports, versus the reference health data of the coaches having neither sport qualifications nor track records in elite sports.

Conclusion. In highly competitive situations in the modern sports elite athletes are exposed significant stresses which evoke the relevant mental responses including high anxiety, agitation and fears that quite often trigger a variety of negative physiological changes that may suppress the coordination abilities of active athletes, increase the muscular stresses, contribute to the fatigue development processes, slow down the rehabilitation responses and processes, decrease the attention focusing ability etc. Upon retirement from elite sports, many former athletes face a variety of socializing problems that may contribute to their health disorders.

References

1. Bal'sevich V.K. Gumanisticheskiy vektor sporta vysshikh dostizheniy (Humanistic vector of elite sport) / V.K. Bal'sevich / Sport, dukhovnye tsennosti, kul'tura (Sports, spiritual values ​​and culture). - Moscow, 1997. - Is. 3. - P. 287-291.
2. Platonov V.N. Sistema podgotovki sportsmenov v olimpiyskom sporte. Obshchaya teoriya i ee prakticheskie prilozheniya (Olympic athletes' training system. General theory and its practical applications). – Kiev: Olimpiyskaya literatura, 2004. – 808 p.
3. Treshchina I.P. O nekotorykh morfologicheskikh i funktsional'nykh izmeneniyakh v miokarde posle prekrashcheniya vozdeystviya trenirovochnykh nagruzok (Some morphological and functional changes in myocardium after finishing with training physical loads) / I.P. Treshchina // Proc. of conference of Omsk department VRNOAGE. - Omsk, 1978. - P. 178–179.
4. Hallal P. Adolescent Physical Activity and Health: A Systematic Review / P. Hallal, C. Victora, M. Azevedo // Sports Medicine. – 2006.- № 36(12).- P. 1019-1030.
5. Kannus P. Posttraumatic anterior cruciate ligament insuffiency as a cause of osteoarthritis in a knee joint / P. Kannus, M. Jarvinen // Clin. Rheumatol. - 1989. – N 8. – Р. 251–260.
6. Kannel W.B. Left ventricular hypertrophy as a risk factor in arterial hypertens. / W.B. Kannel // Eur. J 1992. N 13: Suppl. D: P. 82 – 88.

Corresponding author: oskogan@mail.ru

Abstract

It is a matter of common knowledge for sport specialists that the modern elite athletes’ training systems may give rise to pathologies in different body organs and systems when the training process is poorly designed or mismanaged. Many health disorders diagnosed in the physical culture and sports sector professionals after their retirement from active sports were diagnosed as formed at the early stages of their sport careers. It is particularly true for the elite athletes having at least 7-10 years-long track records in elite sports. The adaptation processes of the elite athletes to new living standards upon retirement from the elite sports when they need to start up coaching and/or other business are still in need of detailed studies as a subject of special theoretical and practical interest for the labour medicine. The present study data and analyses show the professional sport careers being associated with serious health disorders in athletes upon their retirement from elite sports.