TEAM SPORT MEDICAL AND SCIENCE CONFERENCEJULY 2010 - LEEDS

ALAN HODSON

SPORTS MEDICINE AND SCIENCE

THE PAST…THE PRESENT…

THE FUTURE CHALLENGES!

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THE PAST TO THE PRESENT

Involved in professional football for over 20 years

Head of Medicine and Exercise Science for The Football Association for over 20 years

Witnessed many changes and advances over this time.

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THE PAST

NO SPECIFIC SPORTS MEDICINE TRAINING FOR DOCTORS AND PHYSIOTHERAPISTS (NHS & PRIVATE)

FEW STAFF EITHER ONE F/T OR P/T PHYSIO DOCTOR WAS A GP WHO CAME TO CLUB 2 DAYS PER

WEEK AND MATCH DAY DOCTOR WAS NOT ON THE BENCH ONLY

MANAGER/COACH NO PLAYER SCREENING (ORTHOPAEDIC / CARDIAC) NO EMERGENCY CARE TRAINING OR STRATEGY NO EDUCATION (COURSES OR CONFERENCES) NO SPORTS MEDICINE / SCIENCE JOURNALS NO SPORTS MEDICINE RESEARCH NO OR VERY FEW NEW INNOVATIONS

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THE PAST

MANAGER WAS GOD – RESPECT FOR MEDICAL STAFF LITTLE PREVENTATIVE MEDICINE LITTLE CLOSED SEASON FITNESS MAINTENANCE NO RECOVERY STRATEGY FOLLOWING A GAME OR HARD TRAINING NO STRUCTURE TO THE PRE-SEASON TRAINING PROGRAMME LITTLE LIASON BETWEEN MANAGER, COACHES AND MEDICAL STAFF THE TRAINING WAS UNSTRUCTURED, WITH NO SCIENTIFIC

APPROACH LITTLE PLAYER EDUCATION NO DOPING CONTROL (WELL JUST A LITTLE!) NO SPECIFIC MEDICAL INSURANCE IN PLACE NO SPECIALISING SURGEONS / PHYSICIANS NO SPECIFIC PLAYER MEDICAL RECORDS, I.E. A MEDICAL CAREER

PASSPORT A QUICK OR NO PLAYER PRE SIGNING MEDICAL NO CONCENTRATION ON THE PHYSICAL / PHYSIOLOGICAL

DEVELOPMENT OF TALENTED YOUNG / YOUTH PLAYERS NO ACADEMIES OF FOOTBALL (9-18 YEARS OLD)

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CHANGES AND ADVANCES

THE PROFESSIONAL STANDING OF SPORTS MEDICINE AND SCIENCE

SPORTS MEDICINE AND SCIENCE EDUCATION

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“THE SPORTS MEDICINE TEAM”

“THE TEAM WITHIN A TEAM”

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PAST “TEAM”

PHYSIO

MANAGER

COACHES

“DOCTOR”LOCAL SURGEON

PLAYERS

PRESENT “TEAM”

MANAGER

SPORTS SCIENTISTS

COACHES

PLAYERS

DOCTOR(S)PHYSIOS

SURGEONS - (MULTIPLE) (HOME & ABROAD)

PHYSICIANSNUTRITIONISTS

DIETICIANSOSTEOPATHS

SPORTS THERAPISTSCHIROPODISTSPODIATRISTS

RADIOLOGISTSPARAMEDICS

+

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THE EMERGENCE OF NEW SURGICAL TREATMENT AND REHABILITATION TECHNIQUES

NEW TECHNOLOGY AND EQUIPMENTTHE EMERGENCE OF NEW PROFESSIONS

AND SPECIAL INTEREST GROUPSSPECIALISATION OF SURGEONS,

PHYSICIANS AND THERAPISTS

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MEDICAL / SCIENCE REGULATIONS PUT IN PLACE BY GOVERNMENT BODIES OF SPORT

SPORTS MEDICINE / SCIENCE RESEARCH GIVES MORE KNOWLEDGE MORE DIRECTION FOR ACTION

SPORTS MEDICINE / SCIENCE EQUIPMENT ADVANCES NEW INNOVATIONS INJURY PREVENTION STRATEGIES RECOVERY STRATEGIES COMPETITOR / ATHLETE / PLAYER PERFORMANCE

MONITORING (PHYSICAL / PHYSIOLOGICAL)

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THE PAST

PHYSICAL & PHYSIOLOGICAL

ATTRIBUTES

TECHNICAL SKILLS

THE OLD PLAYER

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THE PRESENT

PHYSICAL & PHYSIOLOGICAL

ATTRIBUTES

TECHNICAL SKILLS

THE MODERN PLAYER

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YOUNG COMPETITOR / ATHLETE / PLAYER DEVELOPMENT / MEASUREMENT AND EDUCATION

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THE COMPLETE PLAYER

Injury Proneness

Motor Ability

Energy Stores

Somatotype

Agility

Power

Flexibility

Speed

Strength

Endurance

Technical Ability(Genetic + Technical Coaching)

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FITNESS COMPONENTS

Aerobic

Endurance Speed

Speed

Endurance Flexibility

Power Strength Balance Coordination

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EXERCISE SCIENCE/FITNESS AND CONDITIONING EDUCATION AND TRAINING

Development of: Strength Power Endurance Agility Balance Co-ordination Proprioception Speed Speed Endurance Acceleration

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EXERCISE SCIENCE/FITNESS AND CONDITIONING EDUCATION AND TRAINING

Each person has an in-built genetic limit for all physical and physiological attributes

Unless specific training is applied the genetic limits will not be reached

The athletic ability of the player will not have been realized

A development programme for each individual player is required to optimise performance.

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EXERCISE SCIENCE/FITNESS AND CONDITIONING EDUCATION AND TRAINING

“WINDOWS OF OPPORTUNITY” THERE ARE DEFINED DEVELOPMENT

WINDOWS OF OPPORTUNITY

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EXERCISE SCIENCE/FITNESS AND CONDITIONING EDUCATION AND TRAINING

The Physical / Physiological development begins from an early age

Development of specific athletic attributes commences at different ages to coincide with neurological and orthopaedic development of the growing player for example:Balance and Co-ordination

Development begins at a young age and the body’s central nervous system is developing

Strength and Power Addressed by a specific training

programme later in life e.g. 14, 15, 16 years old

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EDUCATION OF THE “PAYMASTERS” AND

“CONTROLLERS”

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“PAYMASTERS” AND “CONTROLLERS”

ADVANCEMENT IN SPORTS MEDICINE REQUIRES FINANCES

FOR RESEARCH AND DEVELOPMENT TO GAIN KNOWLEDGE AND DIRECTIONS FOR ACTION

IT TOOK 10 YEARS FOR ME TO REALISE I WAS PREACHING AND TRYING TO INFLUENCE THE WRONG PEOPLE…

MY MEDICAL COMMITTEE!!!

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“PAYMASTERS”

THE PREMIER LEAGUE THE FOOTBALL LEAGUE COMMITTEES OF SPORTS GOVERNING BODIES UK SPORT CHAIRMEN OF FOOTBALL / RUGBY CLUBS ETC. THE PROFESSIONAL FOOTBALLERS’ ASSOCIATION

FOLLOW THE MONEY!!!

ADVICE: ALWAYS INVITE, INCLUDE NON-MEDICAL / SCIENCE

PEOPLE OF INFLUENCE FROM THE ABOVE LIST TO SERVE ON YOUR COMMITTEE

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“CONTROLLERS”

TO INFLUENCE CHANGE, OR INTRODUCE NEW PRACTICES, OR REQUIRE INCREASED FINANCES / STAFF FOR DEVELOPMENT AND SERVICES, INFLUENCE:

CLUB MANAGER – “GOD” FINANCE DIRECTORS PERFORMANCE DIRECTORS

AS PROFESSIONALS WE NEED TO BE INCLUSIVE NOT EXCLUSIVE

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Fewer Players available Fewer Assets

Reduced Performance

Reduced Results

Players are Assets

Points Achieved

League Position

Financesthrough gate

SponsorshipOpportunities

Fans, ChairmanDirectors Unhappy

Pressure on Managerand Squad

THE IMPORTANCE OF MEDICINE AND SCIENCE

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THE PAST – “FAITH HEALERS”, “WIZARDS” AND “WALLY’S”

MYTHS – COMMON PRACTICE TO HEAR THE FOLLOWING:

“HE’S A FAST HEALER” “HE’S HAVING INTENSIVE TREATMENT” PREDICTION BY THE MANAGER – “HE WILL BE

OUT FOR ‘X’ WEEKS!” “IF HE CAN RUN, HE CAN PLAY” “HE IS HAVING A LATE FITNESS TEST”

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THE PRESENT

PUBLIC SCRUTINY OF “ON FIELD” TREATMENTS

THE MEDIA – TV CAMERAS – “UNDER THE EYE”

MEDICAL MALPRACTICE MEDICAL / INDEMNITY INSURANCE THE EMERGENCY CARE OF PLAYERS

THE SPEEDS OF THE GAME: HIGH SPEED COLLISIONS / TACKLES HIGH SPEED NON-CONTACT INJURIES MORE 1ST, 2ND AND 3RD DEGREE INJURIES?

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MORE PLAYER MEASUREMENT / MONITORING / MAINTENANCE AND DEVELOPMENT

SPEED STRENGTH ENDURANCE POWER GPS SYSTEM PROZONE

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INDIVIDUAL PLAYER IDENTIFICATION OF PHYSICAL / PHYSIOLOGICAL STRENGTH AND WEAKNESSES

SPECIFIC TRAINING FOR THE NEEDS OF THE GAME SPECIFIC INJURY PREVENTION STRATEGIES AUDITING OF INJURIES

FOR THE SPORT AND FOR THE CLUB ADVANCES IN:

SURGICAL TECHNIQUES TREATMENT TECHNIQUES EMERGENCE OF COMPLIMENTARY THERAPIES

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0

100

200

300

400

500

600

Nu

mb

er

of

Inju

rie

s

Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr

Month

Training

Matches

AUDITING INJURIES

MONTHLY DISTRIBUTION OF INJURIES

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AUDITING INJURIES

Strains, sprains and Strains, sprains and contusions represent contusions represent 69%69% of all injuriesof all injuries

81%81% of thigh injuries were of thigh injuries were muscular strainsmuscular strains

Over Over 12%12% of all injuries are of all injuries are hamstring strainshamstring strains

0

5

10

15

20

25

30

35

40

% o

f In

juri

es

MuscleStrain

MuscleContusion

Fracture

Nature of Injury

NATURE OF INJURIES

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AUDITING INJURIES

7% of injuries were re-injuries7% of injuries were re-injuries 48% strains, 18% sprains48% strains, 18% sprains

Re-injuries = 25 days missed Re-injuries = 25 days missed compared to 19 days for the initial compared to 19 days for the initial injuryinjury

A significant no. injuries were A significant no. injuries were followed by injuries to the same followed by injuries to the same localitylocality

RE-INJURIES

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AUDITING INJURIES%

of

Inju

rie

s

Time (minutes)

0

5

10

15

20

25

30

0-15 16-30 31-45 46-60 61-75 76-90

TIME OF MATCH INJURIES

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DIFFICULTIES IN AUDITING INJURIES

CHANGING EXTRANEOUS VARIABLES PROFESSIONAL STAFF CHANGES – DOCTORS,

PHYSIOTHERAPISTS, SPORT SCIENTISTS NUMBER OF PROFESSIONAL STAFF - DOCTORS,

PHYSIOTHERAPISTS, SPORT SCIENTISTS MISDIAGNOSIS CHANGES IN:

NUMBER OF SQUAD MEMBERS – HIGHER / LOWER IN NUMBER

AGE OF PLAYERS IN SQUAD PRE-SEASON TRAINING PROGRAMME (EXPOSURE) IN-SEASON TRAINING PROGRAMME (EXPOSURE) CLOSED SEASON MAINTENANCE PROGRAMME (EXPOSURE) MANAGER, COACHES PLAYER EQUIPMENT – BOOTS ETC. TRAINING GROUNDS – TURF, ASTROTURF ETC.

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AUDITING MEDICAL CONDITIONS AND ILLNESSES

IS IT DONE ANNUALLY?ARE THE RESULTS REVIEWED AGAINST

EXISTING PRACTICES / POLOCIES, E.G. INFLUENZA STOMACH COMPLAINTS ETC.

CAN AFFECT SQUAD NOT JUST AN INDIVIDUAL

NUMBER OF TRAINING DAYS LOST?NUMBER OF GAMES LOST?

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THE FUTURE – “CHALLENGES”

REDUCE CONTACT AND NON-CONTACT INJURIES REDUCE PRE-SEASON INJURIES INCREASE RESEARCH IMPROVE DIAGNOSTICS IMPROVE SURGICAL AND TREATMENT /

REHABILITATION TECHNIQUES TO REDUCE TIME TO RETURN TO PLAY

IMPROVE INJURY PREVENTION STRATEGIES “DIAGNOSTICS”

TO MONITOR THE HEALING PROCESS TO REDUCE TREATMENT TIME

HELP MEDICAL STAFF

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PREDICT THE END STATURE AND ADULT PHYSICAL / PHYSIOLOGICAL PROWESS IN YOUTH PLAYERS TO ASSIST TALENT IDENTIFICATION

ADDRESS A NEW WAVE OF INJURIES ↑ EMERGENCY CARE INCIDENTS ↑ METATARSAL FRACTURES / # FRACTURES ↑ OVERUSE INJURIES ↑ HIP INJURIES

- ACETABULAR LABRUM- LIGAMENTUM TERES

↑ CHRONDAL DAMAGE- KNEE JOINT- HIP JOINT

↑ HAMSTRING INJURIES

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THANK-YOU