Preliminary list of diseases and health problems
which are absolute or relative contraindications
for practice/training of martial arts and combat sports.
It is of highest importance to ask for a proper medical file or a GP's report on each new martial arts student. Unfortunately, most of martial arts teachers, instructors and coaches don't do this. This frequently happens in smaller clubs and non-sportive styles. Following is a list of health problems composed in alphabetical order. You may use it as a questioner for all your new students. Be sure that none of the listed conditions is not present in your student's medical file. This list will be expanded in time. Also, do bear in mind that martial arts and combat sports frequently have different health requirements. It is not the same coaching a high-professional sportsman active in full contact sport, and teaching self-defense to children. In some combat sports such as boxing even one carious tooth may be a contraindication; or nasal kyphosis ("vulnerable nose") - which is also a problem for anyone who wants to practice full-contact activity. These specific needs for each martial art (or group of arts and sports) will be discussed in future articles of MAIF Medical Committee. Please, report any general or specific impressions that you have to ikiliki@ptt.yu. Also, keep us informed about your experiences with certain particular diseases and health disorders seen in your practice room. Finally, you are welcomed to send all questions regarding any disease or health state and its compatibility with regular or occasional, professional or amateur martial arts/combat sports training.
1. AIDS
Acquired immuno-deficiency syndrome characterized by dysfunction of cell-mediated immunity and manifested by opportunistic infections and malignancies. Caused by HIV virus. HIV is a blood-borne virus and commonly is transmitted through exchange of body fluids during sexual contact, through parenteral exposure or fetal exposure to blood, and through select body fluids from an individual infected with HIV.
2. All Contagious diseases
(i.e. viral diseases spread through air, diseases spread by body fluids, etc.)
3. Angina Pectoris
Transient chest pain resulting from myocardial ischemia. Often a precursor to myocardial infarction! Also, Angina may follow the myocardial infarction. In all cases of angina pectoris (a.k.a. "stenocardia" patients may use nitroglycerin r similar drugs to reduce pains. This, however, is not a sufficient measure in preventing complications potentially caused by excessive or even mild physical activity.
4. Asthma
Chronic obstructive disorder of the airways characterized by airway hypersensitivity to a variety of stimuli, resulting in transient bronchospasm and constriction of the airways. Same as with Angina pectoris (and other disorders on this list), Asthma may be "silent" without proper "trigger - stress events". Drugs such as salbutamol or aminophylin may reduce symptoms or prevent obstructive attacks. However, when a major attack happens, patients frequently need oxygen therapy and more sophisticated medical procedures, available only in hospitals. Any potential martial arts student who always carries bronchodilatator aerosol pump should be observed with most precaution.
5. All Acute Inflammatory Processes
(acute brochitis, acute hepatitis, appendicitis, dermatitis (eczema), pyelonephritis, cystitis, etc.)
6. Cardiac Arrhythmia and similar disorders
Atrial flatter, ventricular extra-systolic arrhythmia (VES) with more than 6 extrasystolae per minute, WPW syndrome of "preexcitation", blocks, sick sinus syndrome, etc. Only respiratory arrhythmia and rare VES are considered "physiological".
7. Cardiomyopathy (with hard breathing and reduced EF% bellow 45)
Structural or functional abnormality of the ventricular myocardium that results in enlargement and/or ventricular dysfunction (loss of heart muscle function). Complications include mural thrombus formation, pulmonary embolus, severe heart failure, and sudden death.
8. Cerebral Aneurysm
Localized dilation of the wall of a cerebral artery, proven with Computed tomography/ magnetic resonance imaging, or angiogtapphy. Rupture often leads to residual neurologic deficits, a permanent vegetative state, or death. Aneurism can also provoke epilepsy or seizure attacks.
9. Cancers
All malignant processes, plus all benign skin changes that may be altered by repeated injuries or irritation.
10. Conjunctivitis (acute and chronic) - relative contraindication
An inflammation or infection of the conjunctiva of the eye. If left untreated, infection may spread from conjunctiva to cornea and cause ulceration, perforation, and blindness.
11. Cystic Fibrosis
Inherited disease of the exocrine glands that results in multisystem involvement primarily by affecting the respiratory and gastrointestinal systems. It typically is characterized by chronic obstructive pulmonary disease (obstructive bronchitis), abnormally high loss of electrolytes through the sweat glands (with potential dehydration, alkalosis in heat or with fever), and pancreatic enzyme insufficiency, leading to digestive impairments and malabsorption syndrome
12. Diabetes Mellitus (Type I, insulin dependent patients)
Hyperglycemia caused by insufficient insulin production or resistance to the metabolic action of insulin. Unregulated glycemia may cause diabetic ketoacidosis. If left untreated, it leads to coma and death. Both hyperglycaemia and hypoglycemia are potentially dangerous for insulin-dependent patients with unregulated doses or excessive physical stress.
13. Diarrhea
Acute or a chronic condition (in enterocolitis, infectious diseases, iritative bowel, ulcerous colitis, Chron's disease...)
14. Epilepsy (Seizures)
Paroxysmal and recurrent episodes of sudden, involuntary muscle contractions and alterations in consciousness, behavior, sensation, and autonomic functioning. The episodes may be partial (focal) or generalized (absence, tonic-clonic "Grand mall") In generalized Grand attack failure to get immediate treatment can lead to hypoxia, hyperthermia, hypoglycemia, acidosis, and death. Absence (mostly present in younger population) may lead to injuries due to transient loss of consciousness
15. Hemophilia
Hereditary bleeding disorder characterized by impaired coagulability of the blood. Joint and other musculoskeletal deformities, airway compression, pericardial tamponade, increased intracranial pressure, hemorrhagic shock, and death can result from uncontrolled or repeated bleeding.
16. Hernia (External, non-reponable )
Protrusion of an internal organ (usually bowel) through an abnormal opening or weakness in the muscle wall. Without proper surgery within 6 hours, strangulated or incarcerated hernia can be complicated with necrosis of bowel tissue, acute peritonitis and death.
17. Herniated Disk (acute episode)
Rupture and extrusion of the nucleus pulposus through the external ring of an intervertebral disk, causing back pain; the usual location is the lumbosacral region of the spine. Neurologic deficits, particularly interference with bowel and bladder functioning, are potential complications.
18. Hypertension (malignant, untreated)
An intermittent or sustained elevation in systolic blood pressure (above 140 mm Hg) or diastolic blood pressure (above 90 mm Hg) or a systolic and diastolic pressure 20 mm Hg above the individual's baseline pressure. A major factor in strokes and cardiac and renal disease.
19. Hyperthyroidism (Graves' Disease, Thyrotoxicosis)
A syndrome initiated by excessive production of thyroid hormones that results in multiple-system abnormalities, including warm, moist skin; erythema; sweating; tremor; weakness; restlessness; insomnia and increased hearth beat rate - tachycardia. . Thyroid storm is a severe, dramatic form of hyperthyroidism with an abrupt onset and rapid progression. It is a life-threatening emergency requiring immediate treatment to prevent shock, coma, cardiovascular collapse, and death.
20. Pheochromocytom
A tumor of the adrenal gland that causes too much release of two hormones (epinephrine, a.k.a. adrenalin, and norepinephrine). Signs include high blood pressure, headache, sweating, excess blood sugar, nausea, vomiting, and fainting spells. There may be weight loss and many heart problems. The tumor occurs most often in young people.
21. Posttraumatic states
(During rehabilitation after injuries, until a proper permission for spots activities from specialist is given)
22. Pregnancy
Pregnancy - normal, last 3 months
Pregnancy with complications: absolute contraindication
Pregnancy at older age - contraindication
23. Psychotic disorders
Major mental disorders with a physical or emotional source, causing "separation" from reality. Often there is also severe depression, excitement, and mistaken beliefs (illusions). There may be those with the disorder who may hold false beliefs (delusions) and see things that are not there (hallucinate). These are: schizophrenia, maniacal-depressive (bipolar) disorder, major affective disorder, paranoia, alcoholic psychosis, senile psychosis, and organic mental disorder.
24. Renal Failure (Chronic Renal Insufficiency - with hemodialysis)
Slow, insidious, and irreversible impairment of renal excretory and regulatory function.
25. Trauma and surgery
All surgery procedures done in general anesthesia, all fractures and dislocations, concussion etc.
