Fia Wmc Seminar

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    Medical considerations

    Dr Paul J Trafford

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    Dr Paul J Trafford

    Medical Director BTCC

    Medical Advisor FIA Institute

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    Officials, Doctors, Paramedics, Rescue,Marshalls, Organiser, Circuit Owners, Media, TV,

    Journalists, Competitors etc.

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    Concussion

    Alteration in:

    Concentration

    Memory

    Judgement

    Balance

    Coordination

    Emotion

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    Concussion

    Associated with:

    Headache

    Nausea

    Vomiting

    Visual Disturbance

    Amnesia

    Sleep Disturbance

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    Concussion

    Important Features

    Transient signs of confusion and disorientation

    Presence or absence of Amnesia

    Presence or absence of loss of consciousness ofany duration

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    Concussion

    Return to Competition aimed at reducing risk of:

    further episodes of concussion more prone to in early post-concussion phase

    second impact syndrome rare and controversial

    catastrophic consequences

    cumulative neurological damage multiple episodes of concussion

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    Concussion

    Concerns:

    POST CONCUSSION SYNDROME

    SECOND IMPACT SYNDROME

    REPETITIVE BRAIN INJURY SYNDROME

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    Concussion

    Recommendations:

    Accept what has happened

    Expect to recover

    Be honest about any symptoms

    Talk to a doctor

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    Concussion

    Concussion Rates Higher in Adult Womenin multiple studies (reporting greater inwomen)

    Recovery takes longer

    Increased incidence of Post ConcussionSyndrome

    Possible prolonged reduction inperformance testing

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    Heat Stress

    Larger surface area : mass ratio

    Increased sweat gland density in women

    Delayed onset and decreased sweating rates inwomen

    No change with Oral Contraceptive Pill

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    Heat Stress

    Acclimatisation is more important than sexdifferences

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    Motion Sickness

    No difference between the sexes

    Women report more motion sickness onquestioning than men

    Early Cycle more associated with motionsickness than late

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    Acceleration tolerance

    NASA

    Women and Men have equal tolerance to G

    force

    Women benefit by being shorter

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    Burns

    Some evidence to show survival in women ispoorer than survival in men in severe burns

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    Strength

    30y old

    75% of male equivalent

    50y old

    50% of male equivalent

    Non dominant hand shows greatest disparity

    95th percentile female equating to 5th percentile male

    Training can reduce the sex differences

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    Size

    50th percentile female = 5th percentile male

    90th percentile female = 50th percentile male

    Reduced hand and feet size for height

    Decreased arm / reach / height

    Reduced face width

    Lower centre of gravity for height

    Increased chest and hip size for height and weight

    Reduced size can be an advantage in racing

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    Oral Contraceptive Pill

    Menstruation and normal cycle does not affect

    exercise capacity and competitive success

    Oral Contraceptive Pill may minimally reduce

    aerobic capacity to exercise

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    Fractures

    Incidence

    Up until 44y old men have a higher incidence of

    fractures

    Over 44y old, rate of fractures begin to increase

    in women

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    Osteoporosis

    Lumbar vertebra

    Age 37

    Lumbar Vertebra

    Age 84

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    Change in bone density with age andoestrogen production

    Hadji P, et al. Frauenarzt. 2005;47:1000-1005.

    Age, years

    Normal

    Menopause

    Peak bone mass

    Puberty

    SD

    1.2

    1.1

    1.0

    0.9

    0.8

    00 10 20 30 40 50 60 70

    I I I I I I I

    -

    -

    -

    -

    -

    LS-BMD,g/m

    2

    Fracture risk

    Decrease

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    Osteoporosis

    Vitamin D

    Vitamin D is needed for bone formation

    Sunlight is needed for Vitamin D production

    North of Birmingham in UK sunlight too weak in

    Winter to produce sufficient Vitamin D

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    Osteoporosis

    Vertebral crush fractures more common

    Older women more prone to these

    Especially if live in Northern Hemisphere

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    Other

    Hair

    Long hair in men or women can cause problemswith helmets

    Jewellery In men and women jewellery can result in injury

    in accidents and transfer heat in burns

    Bra

    Metal stiffeners in bras can cause injury andtransfer heat in burns

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    All jobs should be open to everyone unlessthey actually require a penis or a vagina

    Florynce Kennedy

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    Winning is based on more than individualperformance indicators

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