Physiotherapy in sports. Physiotherapist: what treats and what methods he uses

Physiotherapy methods are proposed for practical use as a means of correcting factors limiting sports result, workout recovery sports qualities. Physiomethods can reduce the pharmacological burden.

Physiotherapy, having a wide range of therapeutic and preventive effects, having a homeostatic nature of action, good compatibility with other therapeutic agents, availability, cost-effectiveness, can and should be widely introduced into the medical practice of sports, used by professionals and sports fans as an effective, timely, individual, methodical exact tool.

For doctors of sports medicine, teachers of medicine and sports, coaches, athletes.

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First of all, the doctor's appointment of a program of rehabilitation measures, therapeutic effects of physical factors is agreed with the athlete's coach, since the training process and the restoration of working capacity should be planned as a single process.

The trainer and the doctor in their work must take into account the following provisions.

Physical factors used for restorative and / or therapeutic purposes by athletes are an additional burden for them. Therefore, when prescribing remedial measures at any training stage it is necessary to take into account the degree of fatigue of the athlete and calculate total load considering this factor.

Physical factors have an active effect on the body. They can not only reduce fatigue, accelerate recovery processes, increase resistance to physical activity, but also lead to a decrease in the body's reserve capacity, a decrease in its sports performance, and cause an exacerbation of the pathological process.

With development in training process acute fatigue or the appearance of signs of maladaptation and insufficient body capacity in recovery cancel (or sharply limit) the procedures of the general impact as creating an additional load, leaving or appointing methods of local action for restorative purposes. In these cases, low-intensity physical factors are chosen as having a milder effect on the body, reducing their amplitude and frequency of use.

For recovery purposes, physical factors in athletes can be used with the same or different frequency. For example, in microcycles with intensive loads, procedures can be prescribed every other day, and then two days in a row (before the day of rest and on the day of rest). With minor physical exertion (at the beginning of the preparatory period, after the competition - during recovery), procedures are prescribed at regular intervals. Most often, the number of physiotherapeutic procedures and the intervals between them are set taking into account the entire complex of rehabilitation measures for the athlete. At the same time, it also matters how quickly you need to restore the functions of the body.

As a rule, in sports they use a combination of procedures of local and general action, as well as the use of the same factor according to segmental-reflex and local methods of influence.

At the beginning of the training cycle, general impact methods, as a rule, should be prescribed before local ones, since they, having a wide range of general strengthening effects (baths, showers, total ultraviolet irradiation, air ionization, etc.), prepare the athlete's body for major physical and psycho-emotional loads.

Throughout the training cycle in preparation for competitions, all recovery activities involving physiotherapeutic methods must correspond to the periods (retracting, basic, special, pre-competitive) of preparation and planned individually. The volume of procedures, the number of courses, their frequency and the rhythm of the implementation of rehabilitation measures should be commensurate with the loads in the total amount of training.

The training process imposes certain requirements on the methods of physiotherapy. So, with two workouts a day, after a morning training session, it is better to apply procedures of predominantly local action (local massage, compresses, chamber barotherapy, etc.), after an evening workout - procedures of general action (baths, general massage, sauna, general magnetotherapy and etc.). General impact procedures require more time to develop a response and manifest their effect. At the same time, the means of local influence change more often than the means of general influence.

Competition:

- with a one-day variant of its implementation, the use of shortened restorative procedures of general action is shown;

- for multi-day - it is possible to combine physical methods of exposure, but also in a shortened version;

- the tournament version of the competition removes all restrictions.

Treatment of injuries, diseases during competitions with the involvement of physical methods is carried out in a planned manner.

The use of physical factors for restorative, rehabilitation purposes depends on the type of sport (preferential development of endurance, strength, speed, etc.), the degree of physical and emotional stress, age, gender of the athlete. The impact should be aimed at the accelerated recovery of those systems that are experiencing the main load.

Most effective complex restorative means in the practice of sports should include a combination of physical factors of influence, pharmacological means, hygiene means, psychological methods and techniques, pedagogical methods.

It is necessary to carefully monitor the reactions of the body to the procedures used.

Most often, the negative impact of physical factors is due to their inadequate choice, excessive intensity of the course, underestimation of the athlete's functional state, irrational combination of therapeutic physical factors, and the use of undeveloped physiotherapeutic techniques.

We must not forget about the effectiveness of the implementation of physiotherapy.

Not all athletes respond the same way to a course or every treatment. Below is table 1, reflecting the dynamics of possible outcomes of the use of physiotherapy techniques.

Table 1

Implementation of the physiotherapeutic effect

Note. The therapeutic effects of physical factors depend on the degree of the initial state of the functions - the lower the initial level of the function, the more pronounced the therapeutic effect of the factor. It should be borne in mind that treatment started at the peak of deterioration is more effective, since it will inevitably be followed by a period of stabilization.

Unlike patients in athletes, the recovery complex includes more methods, which increases the likelihood of polypharmacy and requires more careful monitoring of the body's response to the procedures used.

In sports medicine, it is important not only to ensure the correct selection and arrangement of physiotherapy procedures, but also to organize the monitoring of the response of the athlete's body. The impact of physical treatments should be evaluated by comparing baseline data with results obtained in the middle and end of the training period or camp, as well as with abrupt changes in the training process. Particularly careful should be the control of young athletes, as well as athletes who resume training after injuries and illnesses. It is important to consider that many physical methods treatment (radon, sulfide and carbon dioxide baths, sauna, etc.) place a significant burden on the cardiorespiratory and thermoregulatory systems of the athlete's body.

Restoration of sports performance with therapeutic physical factors should be carried out only as directed and under the systematic supervision of a physiotherapist who has experience working with athletes. When assigning physical factors in order to restore or increase physical performance the physiotherapist must consult with the coach and the team doctor.

In sports medicine, the timing of the resumption of training depends on the nature of the disease or injury and, accordingly, will be different, which will affect not only the choice of physical methods of treatment, but also their combination and arrangement.

If applied wide complex, then the number of procedures per course is no more than 2-4, and the duration of the course is only 5-7 days.

We, as usual, follow a non-standard path of development. Sports medicine is no exception. Doctors and massage therapists work in teams. Recently, they began to talk about sports psychologists, rehabilitators appeared and, quite already, a strange profession for us - a sports physiotherapist. However, they are presented in Russia, exclusively in imported versions.

Let's try to understand what kind of animal this is - a sports physiotherapist. What unusual things does he know and why, in our country, there are no such specialists.

It turns out that everything is very simple. Sport Team- a very specific field of activity and, as a dogma, medical specialists working in it must have the appropriate specialized knowledge. Fundamentals of sports traumatology, sports nutrition, dietetics, taping, rehabilitation, handling simulators and physiotherapy equipment, basic knowledge of anatomy, sports physiology, medicine. It would seem that simple areas of knowledge, but put together, they give a profession that we call a sports physiotherapist (in Europe - a physiotherapist, overseas - an athletic trainer).Specialist with special education who has a wide range of theoretical knowledge and practical skills in sports medicine and has the right to make decisions independently.

Marvelous. But, if paid education in this specialization was introduced in our country, there would be no end to those who want to get such a prestigious profession. The competition among applicants would not be a joke. Our sports medicine needs such universal masters, they are expected in teams. An intermediate link between an athlete and a doctor. A person who closely takes care of the wards and solves issues that, at times, the hands of the team doctor do not reach due to being busy.

In many foreign professional teams, only physiotherapists work on a permanent basis. A doctor who has his own practice advises athletes and appears in the team when the need arises.

We do not have such specialists. Doctors and massage therapists are used to doing things on their own, solving issues within their competence, dividing these duties in incomprehensible proportions, reaching simple truths through their mistakes.

Wealthy clubs that can afford this luxury are sending physiotherapists from abroad. Look, Spaniards, Portuguese, Germans, Dutch, Brazilians work in our football.

Time dictates its own. There is a need to organize a training system for this profession. Professionals should work in modern sports medicine. It's a matter of small. Decide.

Goals and Methods sports physiotherapy.

Real-time monitoring and control of the functional state of athletes

Work to prevent sports injuries.

Injury prevention.

Rehabilitation after injuries and diseases.

Drawing up and adjusting short-term and long-term programs to bring athletes' problematic muscle zones out of the crisis.

Hardware physiotherapy.

First and pre-medical medical aid.

Close interaction and reciprocal assistance to team specialists working in related fields.

Supervision of athletes at competitions and training sessions in order to develop their own professional recommendations and programs for adapting to loads and improving the performance of an athlete.

P.S. Six years after this article was written, a friend from Europe asked me to clarify just this issue.

I want to ask you for help and if you can let me know how the market for Physio (Physiotherapists) is organized in Russia?

Sports physiotherapist - there is no such profession in Russia. Sports doctors, massage therapists, chiropractors, rehabilitators work in the teams, recently specialists involved in kinesiology (not to be confused with kinesio taping) have appeared in clubs with money. Teamwork is limited by their competence and, as a rule, they rarely go beyond it. Nutrition is handled by the team doctor, with injured players - a rehabilitation specialist, masseurs and doctors tap, muscles and joints - kinesiologists and chiropractors, hardware physiotherapy - a doctor, etc.

The few specialists who work in clubs with money, labeled as "physiotherapists" are expats, i.e. foreigners working under a contract and educated in their home country. If there is a Russian surname among physiotherapists, then this is a massage therapist who has been promoted to a physiotherapist for some merit. But this is an exception, because there is no “sports physiotherapist” rate (i.e. such a profession).
Accordingly, the market of physiotherapists in Russian sports No.

What do you need to finish to become a physiotherapist - school, academy, medical school, medical school, courses.....? How long does the learning process take?

Sports physiotherapists, in the sense that they are in Europe or like an athletic trainer in America, are not trained anywhere in Russia.

How many Physiotherapists are there in Russia?

See the article on the site. Article written 6 years ago

Are Physiotherapists organized in associations?

There is no association for sports physiotherapy in Russia. Nominally in Europe atENPHErepresent Russian sports physiotherapistsRGUFKSMiT represented by the Department of Physical Therapy, Massage and Rehabilitation

How is the work of a physiotherapist in a team built, what are the relationships with athletes?

Foreign sports physiotherapists who come to Russia have a very vague idea of ​​professional sports, and sports medicine in a team in Russian interpretation, especially in football, generally baffles them. And if someone did not earn money on them, then these "specialists" could be expelled in a couple of months. "Survive" those who begin to feverishly look around and actively adopt the techniques, methods, behavior and relationships with the players working alongside sports masseurs, rehabilitation therapists, doctors, fitness trainers. Our "delightful" attitude towards foreign specialists helps them a lot. In short, those who quickly pick up someone else's experience, shaping their own, survive.

How to become a Physiotherapist of the National teams, the Olympic team, etc. ?

Expats - through agents. Their salaries are good, there is something to pinch off.

There is no such profession in the register of professions in Russia. There is a sister in massage (medical education - medical school), there is a doctor in sports medicine, there are massage therapists (sports education, massage courses in parallel). Accordingly, there are no sports physiotherapists in state structures. There are doctors and massage therapists, rehabilitation therapists with psychologists.

How and where physiotherapists buy their daily products sports medicine, for example, teips?

The purchase is carried out either by the chief doctor in the team, or by a special department, which, at the request of sports medicine specialists, completes the team with medicines.

Are there any special exhibitions for sports physiotherapists that sports professionals attend or attend to meet companies, each other, and learn about sports medicine products and innovations?

No. Within the framework of all-Russian forums, symposiums, conferences on sports medicine, topics are touched upon and included, master classes are held with a set of topics that are within the competence of sports physiotherapy.

With the course of various diseases, a stage may come when the use of medications is limited or becomes ineffective. In this case, one of the methods of treatment and rehabilitation can be physiotherapy, which is prescribed as monotherapy or as additional methods to the main treatment. The impact on the body of a number of physical factors contributes to the restoration of tissues and their physiological functions. In the medical clinic NAKFF is selected individual program treatment taking into account the state and characteristics of the body. Our doctors have extensive experience in managing patients of various profiles, and the procedures are performed using equipment from well-known world manufacturers.

What determines the price of physiotherapy?

The consequences of diseases of the musculoskeletal system, nervous and some other systems, as well as various injuries, are not always recoverable only by pharmaceutical means. In this case, it is useful to include physiotherapeutic methods in the treatment, which have shown their effectiveness, both in practice and in scientific research. Many of them are included in official therapeutic protocols.

Vitasite https://www.site

The most important theoretical and methodological position of the concepts modern sports is in the unity of training, competition and recovery. Recently, more and more specialists in the field of sports medicine and physiotherapy are addressing the issue of using physical means to restore and improve the physical performance of athletes. Currently, a number of methods have been developed to influence the course of adaptation and recovery processes in the body of an athlete by electro- and hydrobalneological procedures, which are successfully used both at different stages of the preparatory period of the training cycle and during competitions. The variety of physical characteristics and a wide range of these procedures, various localization options determine the feasibility of their use not only as a means of restoring or increasing performance, but in some cases as ways to increase the body's protective and adaptive reactions and prevent the occurrence of prepathological and pathological conditions in athletes.

The use of physical factors in sports medicine is justified by a number of reasons:

• sports loads increase to the limit, often athletes train on the verge of pre-pathological and pathological conditions, situations of acute and chronic overstrain of various organs and systems are frequent. This leads to the search for new methods and methods of recovery in sports, which is especially important in children's and youth sports and in sports of high achievements;
• the use of physical factors significantly increases the speed and efficiency of recovery, improves physical condition athletes, is the prevention of overwork and overstrain;
• physiotherapeutic factors are not doping: they do not have a negative effect on the athlete's body, are not legally prohibited and are not detected during doping tests,
• physiotherapeutic factors are natural for a person, due to which they are generally well tolerated, healthy athletes usually have no contraindications,
• when using physiotherapeutic factors, the drug load on the body does not increase, gastrointestinal tract, does not increase the allergization of the body;
• with the proper use of physical methods, a selective effect on various organs and systems, functions, and various links of recovery is possible; at the same time, simultaneous influence on many functional systems of the body is possible; the influence of physical factors can be specific or universal;
• there are empirically positive effects and schemes for the use of physical methods in athletes, an evidence base for the positive impact of physiotherapy is being formed.

The place of physiotherapeutic methods in the recovery system of athletes is clearly defined scientifically and organizationally and methodically. In sports, physiotherapy is used:

1. in rehabilitation after injuries and diseases;
2. in the system of restoring sports performance after intense training and competition.

According to the classification of Graevskaya et al., 1971, the system of restoration of sports performance is a complex application of three groups of means: pedagogical, which are the prerogative of the coach, psychological and medical. Medical, among others, include physiotherapy. Their use is regulated by the Order of the Ministry of Health and Social Development N 613n of 08/09/2010 "On approval of the procedure for providing medical care during physical education and sports events» . In particular, the Order also established the procedure for providing medical care during rehabilitation measures after intense physical exertion in sports, after illnesses and injuries in athletes. According to the Order, the purpose of recovery measures after intense physical exertion is to maintain and improve the functional state and sportswear athlete at any given time. A team of specialists has been identified who make up a program of rehabilitation measures after intense physical exertion, which includes a physiotherapist. Carrying out rehabilitation measures is possible at the medical center of the sports object, in the medical and physical education dispensary, the center physiotherapy exercises and sports medicine, in the rehabilitation department of a medical organization. For the organization of physiotherapy care in the medical and sports dispensary, 1 position of a physiotherapist for 5 positions of sports medicine doctors, posts of physiotherapy nurses and the organization of a physiotherapy department are provided.

The list of applied factors is wide and varies by different authors. The main physical factors in the system of post-exercise recovery of athletes:

• massage;
• hydroprocedures - underwater shower-massage, Scottish shower, bath-sauna: baths: contrast, vibration, pearl, sodium chloride, coniferous, carbonic, iodine-bromine, turpentine, etc.;
• electrolight procedures - electrical stimulation, amplipulse therapy, local pressure chamber, baromassage, electrosleep, magnetotherapy, galvanization, air ionization, electroacupuncture, laser therapy, decimeter wave therapy, laser therapy, light therapy, hypoxicators;

• athlete's functional readiness level;
• tasks facing the athlete;
• load capacity of individual physiological systems;
• the orientation of the training process and the annual cyclicity of loads;
• the whole complex of rehabilitation measures that the athlete receives; and etc.

The literature provides principles for choosing means of recovery and ready-made complexes physiotherapy procedures.

According to G.R. hyginishvilli, all means of restoring sports performance in physiotherapy are conventionally divided into three groups:

1. Means that have a general effect on the body- physiotherapeutic procedures of general action: baths, showers, electrosleep, electroprocedures, carried out according to reflex-segmental methods. These procedures are the basis of recovery measures, they are prescribed when fatigue is widespread, it captures a number of physiological systems of the body, and is accompanied by a deterioration in the course of adaptive reactions. The effect of their application has a cumulative nature, is realized later, therefore it is advisable to conduct a course of procedures, which, depending on the tasks at hand, can be both quite complete and shortened.
2. Local influences. Usually these are electroprocedures performed on the area of ​​muscles tired after physical exertion. More often, for this purpose, sinusoidal modulated currents (SMT) and a microwave electromagnetic field (EMF microwave) are used - decimeter wave therapy (UHF therapy).

The procedures mainly have a selective effect on the neuromuscular apparatus, relieve the feeling of fatigue, “clogged” muscles, pain, help to urgently restore anaerobic processes in the muscles, and improve blood circulation. Assign procedures after execution training loads speed-strength orientation or any other loads that lead to the occurrence of local muscle fatigue, preferably immediately after the end of work in the intervals between training loads. The concept of "local procedure" is rather arbitrary, since the procedures indirectly affect the cardiovascular and nervous systems.

3. Effects on biologically active areas.

For example, the effects of various physical factors on the area of ​​the adrenal glands, the thyroid gland are described - physical performance grows more actively, the immune system stabilizes, and a pronounced immunostimulating effect is manifested. However, any intrusion into the immune and endocrine systems is fraught with serious consequences and complications in the form of failures in the operation of these systems and the subtle mechanisms of neurohumoral regulation and is dangerous.

The principles of the use of physical factors in the recovery system of athletes differ significantly from the principles of private physiotherapy in the clinic and were formulated by G.R. Gigineishvilli:

1. The principle of individual approach.
2. They are especially indicated in the preparation of highly qualified athletes during periods of intense training or competitive activity, as well as after “shock” microcycles, when it is necessary to restore the functional state of the body as fully as possible and compensate for violations.
3. Long-term use of electrotherapeutic or balneotherapeutic procedures alone is not recommended, as the body adapts to them, which leads to a decrease in efficiency. Prolonged use of physical factors can impair the natural ability to recover.
4. Methodological approaches to the use of PT in athletes and in clinical practice are different.

In the practice of training athletes with a recovery purpose, they can be used both with the same and with different intervals of time.

For example, during the period of intensification of training loads, when on certain days of the microcycle a complete restoration of body functions is undesirable, physiotherapeutic procedures can be prescribed in the middle of the microcycle, and then two days in a row; before the day of rest and on the day of rest.

At regular intervals, procedures are more often prescribed at the beginning of the preparatory, pre-competitive and post-competitive periods, during rehabilitation measures for athletes who have an inadequate response to training loads or have signs of severe fatigue.

The duration of the application of the physical factor is 10-20 days, during which a course of rehabilitation therapy is carried out, consisting of 6-10 procedures.

The number of PT procedures and the intervals between them are set taking into account the entire complex of restorative measures. If a wide complex is used, the number of procedures is reduced to 2-5 per course, the duration of the course of exposure to a physical factor can be only 5-7 days. The number and frequency of taking procedures also depend on the degree of fatigue of the athlete and on how quickly you need to restore body functions.

5. Accounting for the level of fatigue of the athlete. With the development of acute fatigue and the appearance of the first signs of overwork and physical overstrain, physical factors are selected that have a milder effect on the body, reduce the dose of exposure (current value during electrical procedures, concentration of mineral, gas and aromatic baths, temperature difference during contrast baths), the duration of the procedure , frequency of alternation. In the presence of a sharp fatigue or overwork, preference is given to local procedures, or first, physical factors are used according to local methods, and then, as the functional state of the athlete improves, they switch to procedures that have a general effect on the body.
6. Combination of procedures.

• procedures of general and local action are well combined.
• a good effect - when using the same factor simultaneously according to segmental-reflex and local methods of exposure (for example, SMT or EMF microwave).
• hydrotherapy procedures and general thermal therapy (sauna) can be prescribed in combination with partial manual or vibration massage, pulsed currents and microwave therapy for muscles. Sometimes the second, local, procedure is prescribed immediately, sometimes after a few hours or 1-2 days after the general exposure.
• the possibility of combining two general procedures is not excluded, which in this case are arranged in time with a break of up to 1-3 days and they try to choose so as to obtain a multidirectional effect or one procedure complements the other (in clinical practice, 2 general procedures are usually not combined).

Assign a procedure that has a tonic effect on the body before training and a procedure that has a sedative effect after training or in the evening. In this case, the second procedure is usually carried out the next day after the first or later.

In general, it is believed that only one procedure of a general effect on the body is advisable on one day, although exceptions are possible (for example, they combine in one day the general effect in the form of a sauna and the general manual massage or underwater shower-massage).

7. Mandatory medical supervision. The complex of restorative physiotherapy is prescribed by a doctor, who subsequently controls the adequacy of the impact on the state of adaptation processes in the athlete's body.

Table 1

Differentiated use of physical factors to restore the performance of athletes:

A link in the overall functional system in need of optimization of recovery processes	Physiotherapy procedures
Cardiorespiratory system (aerobic mechanisms of energy supply)	Carbon dioxide baths, water and dry Baths from the "white" emulsion of turpentine and mixed turpentine Iodine-bromine baths SMT on the cervicothoracic region
Neuromuscular apparatus (anaerobic mechanisms of energy supply)	SMT on the most loaded muscle groups EMF microwave on the most loaded muscle groups Sodium chloride baths Baths from the "yellow solution" of turpentine and mixed turpentine
CNS (psycho-emotional state)	Sedative effect: ES with a pulse frequency of 10-20 Hz Iodine-bromine baths Coniferous baths Tonic effect: ES with a pulse frequency of 90-100 Hz Sodium chloride baths Baths from the "white" emulsion of turpentine
The immune system	EMF microwave on the projection area of ​​the thyroid gland EMF microwave on the projection area of ​​the adrenal glands EMF microwave on the collar area SMT on the cervicothoracic region paravertebral Total ultraviolet exposure

Note: CNS - central nervous system, SMT - sinusoidal modulated currents, EMF microwave - electromagnetic field of ultrahigh frequency, ES - electrosleep

Approximate complexes of the main physical and physiotherapeutic means of recovery were developed by the Research Institute of Balneology and Physiotherapy:

1. Manual massage, UHF therapy, warm shower;
2. Sauna, manual massage, amplipulse therapy;
3. Sauna, swimming pool, electrophoresis;
4. Galvanic vibration, segmental massage, acupuncture;
5. Contrast shower, baromassage, galvanization;
6. Amplipulse therapy, circular shower, local manual massage;
7. Foot baths, vibration massage, rain shower, magnetotherapy;
8. Underwater jet massage, rain shower, magnetotherapy;
9. General massage, sauna, electroacupuncture;
10. Contrast bath, local massage, diadynamic therapy;
11. Inductothermy, segmental massage, suggestion methods;
12. Baromassage, hygienic shower, ultraviolet irradiation;
13. Swimming in the pool;
14. Electrical stimulation, acupuncture, manual massage;
15. Warm shower, galvanization, segmental massage;
16. Electrical stimulation, baromassage lower extremities, warm shower;
17. Sollux, electrosleep, swimming pool;
18. Local hand massage, vibration massage, warm hand shower;
19. Warm shower, swimming pool, suggestion methods,
20. Contrast shower, baromassage, electrophoresis.

IN last years the complexes actively use magnetotherapy, cryotherapy, aeroionotherapy, chromotherapy.

The use of complexes differs taking into account the orientation of the training loads. In table. 2 shows the complexes of recovery procedures, taking into account the orientation of the loads of the previous and subsequent classes.

G.R. Gigineshvili offers his own complexes that have shown good clinical effectiveness:

1. sodium chloride baths (or contrast, “white” turpentine, carbonic) before training and electrosleep using a sedative technique in the evening or before going to bed;

2. electrosleep with a pulse frequency of 90-100 Hz before training and iodine-bromine (or coniferous, nitrogen) baths after it.

Such active sets of procedures are carried out in the most critical periods of preparation or in the case when it is necessary to achieve a quick restoration of the most important functions of the body.

table 2

The use of restorative procedures, taking into account the direction of the loads of the previous and subsequent classes

The focus of the second lesson

The focus of the first lesson	Restorative means
Speed-strength	A. Massage. Irradiation with visible rays of the blue spectrum. Warm eucalyptus bath. B. Warm bath (eucalyptus, aromatic, nitrogen, coniferous, iodine-bromine). SUV irradiation, chromotherapy, general low-frequency magnetotherapy, general cryotherapy	Aerobic
Aerobic	A. Oxygen bath. Tonic rub. Aeroionization. B. Alpha massage, aeroionotherapy, aerophytotherapy Oxygen, pearl bath.	Anaerobic
Anaerobic	A. Hyperbaric oxygenation. Carbonated bath. Hydromassage. B. Normobaric hypoxic therapy. Souls. Hydromassage, Carbonic bath (gas or dry)	Aerobic

Note: A - V.N. Platonov, 1997; B - Yu.M. Shkrebtiy, 2005; SUV irradiation - medium wave ultraviolet irradiation

Physical factors and physiotherapeutic procedures are actively used for the prevention of fatigue, the correction of overwork and for the treatment of emerging maladaptation.

For the prevention of fatigue, physical factors are used for prophylactic purposes in sports associated with a long duration of competition and repeated performances (weightlifting, gymnastics, fencing, martial arts, all-around, etc.). In this case, physical methods are divided into groups:

1. Methods of general stimulating action;
2. Psycho-emotional state modulation methods;
3. Antihypoxic and hemostimulating methods.

G.N. Ponomarenko et al. as a staged long-term prevention of fatigue, it is recommended to use the following factors that have a complex general stimulating and modulating effect:

• haemomagnetotherapy and general magnetotherapy. The method acts through the influence on the autonomic nervous system and, in particular, its higher divisions - the hypothalamic-pituitary system, the reticular formation. As a result, synchronization of the bioelectrical activity of the brain, a change in conditioned reflex activity, an improvement in cerebral circulation, and an improvement in psychomotor qualities are manifested.
• thermomagnetotherapy;
• laser irradiation of blood;
• general air cryotherapy;
• aeroionotherapy;
• extremely high frequency therapy;
• round-the-clock aerotherapy
• oxygen therapy - in the form of inhalation of oxygen at atmospheric pressure;
• hypoxic therapy - normobaric interval and periodic hypoxic therapy (inhalation of a mixture with a low oxygen content in short intervals of 5 minutes, alternating with inhalation of air and, accordingly, long-term - up to 60 minutes continuously - inhalation of an air mixture with 10% oxygen), dosed hypobaric hypoxia using a pressure chamber .
• hyperbaric oxygen therapy;
• oxygen baths.

In the correction of overwork, the first place is taken by physical factors that have a predominant influence on the function of the central nervous system and the psycho-emotional state, since the overstrain of the central nervous system is, in fact, the first phase of sports sickness.

To restore the function of the central nervous system and restore the functional state of the athlete, the following are used:

• first of all, various hydrotherapeutic factors: dry-air bath (sauna), contrast baths, showers - Charcot, Scottish, circular, Vichy, underwater shower-massage;
• selective chromotherapy,
• vibration massage relaxation, - alpha massage (alpha capsule);
• audiovisual relaxation;
• general magnetotherapy combined with music therapy;
• electrosleep therapy;

An important role is occupied by physiotherapeutic procedures in the treatment of frolicking maladaptation. The most common maladaptation in sports is chronic fatigue syndrome, manifested by a pronounced feeling of fatigue that does not go away after sleep, leading to a decrease in physical and mental performance, manifested by vivid symptoms of asthenia. In table. 3 systematizes the physical methods used for the correction of asthenic syndrome.

Table 3

Physical methods of treatment of patients with chronic fatigue syndrome

Methods	Procedures
Actoprotective	General air cryotherapy, electrosleep therapy, medium and high pressure, wet wrap
Sedatives	Electrosleep therapy, general low-frequency magnetotherapy, galvanization of the brain and segmental zones, drug electrophoresis of sedatives, tranquilizers and antidepressants, local darsonvalization of the head and collar zone, iodine-bromine, coniferous and nitrogen baths, aerophytotherapy of sedatives, round-the-clock aerotherapy.
Psychorelaxing	Selective chromotherapy, vibration massage relaxation, audiovisual and volumetric acoustic relaxation, alpha massage, lithium drug electrophoresis
Tonic	Therapeutic massage, contrast baths, thalasso-tearpy, medium pressure showers, aerophytotherapy with tonic preparations, general ultraviolet irradiation (medium and long wavelengths)
Vegetocorrective	Electrosleep therapy, transcranial electroanalgesia, galvanization of the brain and ganglia of the sympathetic trunk, low-frequency magnetotherapy, (of the head, cervical sympathetic nodes, heart), UHF therapy, (of the carotid sinus zone, solar plexus, cervical sympathetic nodes, transcerebral), infrared laser therapy, aeroionotherapy, hydrogen sulfide baths, medium and high pressure showers, climatotherapy
Immunostimulating	Heliotherapy, laser blood irradiation, inhalation therapy of immunomodulators, drug electrophoresis of immunomodulators, high-frequency magnetotherapy of the thymus.

In addition, when applying physical factors, the preparation period (annual training cycle) is necessarily taken into account.

A. In the preparatory period:

• at the beginning of the preparatory period, procedures of general action are prescribed that contribute to the effective restoration of the function of the cardiovascular system;
• during the period of increasing the volume and intensity of loads, sodium chloride and turpentine baths are indicated - they positively affect the state of vegetative functions, the state of the musculoskeletal system, increase efficiency;
• towards the middle and end of the preparatory period, more attention is paid to the development special qualities, techniques, speed-strength qualities, therefore, methods are more often used that contribute to the removal of fatigue in the most loaded organs and systems.

B. In the pre-competitive and competitive period.

• the athlete is at the peak of sports form, but high demands are placed on his psycho-emotional state, immune system. Restorative procedures are prescribed, especially electrosleep with a frequency of 10-20 Hz, iodine-bromine baths are indicated. The procedures have a positive effect on the cardiovascular and nervous system, but do not give a relaxing effect.
• it is possible to prescribe procedures that positively affect the metabolism of the heart muscle (amplipulse or decimeter wave radiation on the collar zone).
• sinusoidal modulated currents to the most loaded muscles in front of the strata - the procedure increases mobilization readiness by activating the neuromuscular apparatus, increasing the initial level of vegetative and metabolic processes. The procedure is shown to athletes cyclic species sports and is not indicated where a subtle muscular feeling is needed, which can be reduced due to the analgesic effect of the procedure.
• during the competitive period do not apply new previously untested procedures.

Physiotherapeutic procedures are also used to adapt athletes to new conditions during transmeridial flights.

Thus, the range of application of physiotherapeutic factors and methods in the system of restoring physical performance and improving the physical condition of the athlete's body is wide and varied. Proper application is possible only with a deep knowledge of the mechanisms of action of physical factors, taking into account all the features of the training process and requires the knowledge and joint work of a physiotherapist, sports medicine doctor and trainer.

First published: Topical issues of diagnosis, treatment and prevention in the system of medical rehabilitation and sports medicine: a collection of proceedings of the regional scientific and practical conference. - Chelyabinsk: ChelGMA, 2013. - 89 p. pp. 73-84

Uskov G.V., Voznitskaya O.E.,
State Healthcare Institution "Chelyabinsk Regional Medical and Sports Dispensary",
FGOU HPE "Ural State University of Physical Culture"

Oleg Semenovich Kulinenkov, Natalya Evgenievna Grechina, Dmitry Olegovich Kulinenkov

Physiotherapy in the practice of sports

Publishing house "SPORT" - member International Association Sports Literature Publishers (WSPA)

All rights reserved. No part of this book may be reproduced in any form without the written permission of the copyright holders. Legal support of copyright is provided by a law firm.

© Kulinenkov O. S., Grechina N. E., Kulinenkov D. O., 2017

© Original layout, design, Sport publishing house, 2017

List of abbreviations

AIT - aeroionotherapy

HIMT - High Intensity Magnetic Therapy

HBO - Hyperbaric Oxygen Therapy

GT - halotherapy

DDT - diadynamic currents

DUV - long-wave ultraviolet radiation

IR - infrared radiation

EHF - extremely high frequency currents

UV - short wave ultraviolet radiation

LI (LT) - laser radiation (laser therapy)

LNP - local negative pressure

LOK - laser irradiation of blood

MCP - muscular counterpulsation

MLT - magneto-laser therapy

MT - magnetotherapy

NE - low frequency electrotherapy

OAKT - general aerocryotherapy

OMT - general magnetotherapy

SMT - sinusoidal modulated currents (amplipulse)

SUV - medium wave ultraviolet radiation

UHF - ultra high frequency current

UV - ultraviolet irradiation

EECP - enhanced external counterpulsation

EMF - electromagnetic field

Foreword

Various physical factors affecting the human body can be effective means of restoring and improving the performance of an athlete.

Methods and techniques for influencing a person with physical factors have been developed for more than 200 years. Currently, the methods have been worked out in sufficient detail and are successfully applied in clinical practice. In this monograph we will talk about the practical application of physical factors of influence on the athlete's body, his psyche in order to improve professional qualities and as a means of correcting factors that limit sports results.

Modern sport is characterized by physical and emotional-psychological stress, bordering on the individual physiological capabilities of the athlete. Of great importance for professionals and sports enthusiasts is the timely, individual, methodically accurate use of physiotherapy, which sometimes cannot be replaced by anything.

Physiotherapy methods have been proposed to improve performance, eliminate specific, pathological conditions characteristic of sports activities in the same methodological vein as in the pharmacotherapy of sports (O. S. Kulinenkov, 2000–2016), and can complement each other.

Under the influence of physical factors (in appropriate doses, taking into account the initial state, the reactivity of the body), metabolic processes improve, the general background of the body's vital activity, various effects that have therapeutic value appear: general stimulation, anti-inflammatory, desensitizing effect, normalization of neurovegetative relationships, improvement of the main nervous processes. In the described effect of physical factors on the body, the principle of physiotherapy as a non-specific therapy affects.

Monitoring of loads in sports highest achievements shows their limiting values ​​for almost all age categories. Under these conditions, the friendly work of a sports physiologist (coach) and a sports doctor with his knowledge of diet, physiotherapy, pharmacology and other methods of athlete recovery should become of great importance in the preparation of a high-class athlete and an amateur athlete; who owns the methods of biochemical control, functional diagnostics, etc. and, of course, has clinical skills.

Comprehensive medical support for a particular athlete in connection with the loads used and a certain individual state of health is an indispensable condition for maintaining and increasing its level, prolonging sports longevity.

Novice athletes and amateur athletes need more medical attention. The fact is that amateurs (athletes), imitating and adopting the methods of physical activity of professional sports, very quickly acquire “sores”, to which a professional athlete goes for many years.

Perhaps the days when the main means of recovery in sports were massage and sauna have already passed. World practice has long and far advanced in the application of various physical factors in the activities of sports, being a locomotive in the promotion of new health-improving methods.

At the same time, recovery processes in sports have been skewed towards the increasing use of pharmacological agents.

Physiotherapy in the practice of sports is designed to push the use of pharmacology from some positions: avoid polypharmacy, reduce the side effects of pharmaceuticals, replace some drugs that cannot be used according to doping criteria, etc.

In the process of using physiotherapy, a combination of 3–4 procedures is possible without contraindications and side effects, which increases their potential as restorative agents.

Perhaps, we should immediately warn about the need to refrain from using physiotherapeutic methods of direct action directly on the brain with procedures such as transcranial electroanalgesia, electrosleep therapy, general galvanization of the brain, etc. It is necessary to clarify this idea: methods that have not been sufficiently studied in all aspects should be replaced by others. , less traumatic, since the choice is wide. We do not prefer pharmacological preparations with a more burdensome spectrum of side effects and complications. And the head - the head must be protected, especially among athletes. In sports best result the one whose head works better achieves. “We are only on the outskirts of understanding the functioning of the brain,” writes Academician N. P. Bekhtereva (2008).

The use of physiotherapy becomes less problematic in an environment where ever more compact physiotherapy devices (sometimes at the household level) appear than in the days of bulky stationary devices. The sports doctor's own mobile physiotherapy room becomes a reality. At the same time, large formats of technical physical impact devices appeared everywhere in commercial operation and became more accessible in use: cryotherapy chambers, oxy / hypoxic therapy, etc.

The procedures that an athlete (coach) can carry out on his own are described in more detail, using the healing factors of nature (climatotherapy) or the simplest physiotherapeutic devices and devices that are introduced into everyday ("home") practice.

The formulation and interpretation of the principles of prescribing physiotherapy methods, the individualization of parameters and gradations of individual methods are presented in the original author's presentation.

I. Fundamentals of sports physiotherapy

The specifics of physiotherapy in the practice of sports

First of all, the doctor's appointment of a program of rehabilitation measures, therapeutic effects of physical factors is agreed with the athlete's coach, since the training process and the restoration of working capacity should be planned as a single process.

The trainer and the doctor in their work must take into account the following provisions.

Physical factors used for restorative and / or therapeutic purposes by athletes are an additional burden for them. Therefore, when prescribing recovery measures at any training stage, it is necessary to take into account the degree of athlete's fatigue and calculate the total load taking into account this factor.

Physical factors have an active effect on the body. They can not only reduce fatigue, accelerate recovery processes, increase resistance to physical stress, but also lead to a decrease in the reserve capacity of the body, a decrease in its sports performance, and exacerbate the pathological process.

With the development of a sharp fatigue in the training process or the appearance of signs of maladaptation and insufficient body capabilities in recovery, the procedures of the general effect are canceled (or sharply limited) as creating an additional load, leaving or appointing methods of local action for restorative purposes. In these cases, low-intensity physical factors are chosen as having a milder effect on the body, reducing their amplitude and frequency of use.