From postseason injury analysis through pre-season screening risk management in the team setting

Transcription

1 From postseason injury analysis through pre-season screening risk management in the team setting Roald Bahr MD PhD Professor & Chair Oslo Sports Trauma Research Center Norwegian School of Sport Sciences Oslo, Norway Chief Medical Officer Olympiatoppen & Norwegian Olympic Training Center Oslo, Norway Head Aspetar Injury & Illness Prevention Program Aspetar, Qatar Orthopaedic and Sports Medicine Hospital Doha, Qatar

2 What is risk management?

3 Stage 1: Risk factors (intrinsic/extrinsic) Epidemiological studies Preventive interventions Stage 2: Risk estimation Risk mitigation Risk perception Acceptable level of risk Stage 3: Risk evaluation Stage 4: Communicate risks to the sports community Unacceptable level of risk Therapeutic interventions Fuller. Clin J Sport Med 17: 182 7, 2007

4 Drawer & Fuller. Br J Sports Med. 36: , 2002

5 Step 1: Risk identification Step 2: Season analysis Step 3: Athlete risk factor analysis Stage 4: Risk acceptance or mitigation McIntosh & Bahr. Sports Injury Prevention. Blackwell, 2008

6 Step 1: Risk identification Step 2: Season analysis Step 3: Athlete risk factor analysis Stage 4: Risk acceptance or mitigation Reviewing the literature on injury risks in the specific sport Reviewing injury reports from at least one season (NHL, Tippeligaen) Reviewing player turnover and availability within one or more seasons McIntosh & Bahr. Sports Injury Prevention. Blackwell, 2008

7 Severity Catastrophic SCD Severe ACL injuries Major Hamstring strains Minor Ankle sprains Insignificant Rare Cuts & bruises Unlikely Moderate Likely Almost certain Likelihood

8 Severity Catastrophic SCD Severe ACL injuries Major Hamstring strains Minor Ankle sprains Insignificant Rare Cuts & bruises Unlikely Moderate Likely Almost certain Likelihood

9 Severity Catastrophic SCD Severe Major ACL injuries ( ) Hamstring strains ( ) ACL injuries ( ) Hamstring strains ( ) Minor Ankle sprains Insignificant Rare Cuts & bruises Unlikely Moderate Likely Almost certain Likelihood

10 Severity Catastrophic SCD Severe ACL injuries Major Hamstring strains Minor Ankle sprains Insignificant Rare Cuts & bruises Unlikely Moderate Likely Almost certain Likelihood

11 But you want your own data!

12 Weekly questionnaire Athlete Project coordinator Individual follow-up Medical team Weekly report

13 So, what is the strongest risk factor for injury?

14 The coach???

15 Step 1: Risk identification Step 2: Season analysis Step 3: Athlete risk factor analysis Formal review of competition & training plan Include review of past experiences Must include full coaching staff Also include player reps/all athletes? Stage 4: Risk acceptance or mitigation McIntosh & Bahr. Sports Injury Prevention. Blackwell, 2008

16 - Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Basic training Training camp 1 Competition Recovery 1. Training camp in Portugal: Two sessions a day Change of surface & climate Everyone very keen to finally train and play on grass high tempo

17 - Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Basic training Training camp 2 Competition Recovery 2. New training camp to polish form Several practice games Hard grassy playing fields on Cyprus Competition for a spot on the team - high intensity during competition and training

18 - Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Basic training Training camp Competition 3 Recovery 3. Start of competitive season Higher tempo Packed competitive schedule Change of surface to soft grass

19 - Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Basic training Training camp 4 Competition Recovery 4. Transition to basic training Increase in running on gravel

20 Step 1: Risk identification Step 2: Season analysis Step 3: Athlete risk factor analysis Stage 4: Risk acceptance or mitigation PHE: Pre- or postseason? Full functional evaluation of all players Assess relevant risk factors Return-to-play procedures McIntosh & Bahr. Sports Injury Prevention. Blackwell, 2008

21 Periodic health evaluation Purposes A comprehensive assessment of: The athlete s current health status Risk of future injury or disease Entry point for medical care of the athlete Tool for continuous health monitoring in athletes The International Olympic Committee (IOC) Consensus Statement on periodic health evaluation of elite athletes. Ljungqvist et al. Br J Sports Med. 43: , 2009

22 Aspetar Injury & Illness Prevention Program - Athlete Screening Program Screening (PHE) Patient history Cardiac (ECG/ echo) General medical exam Musculo -skeletal exam Blood tests Pulmonary function Vision PHE tailored to sport, age, gender w/follow-up exams as indicated

23 Step 1: Risk identification Risk acceptance: Insurance Increase team roster Step 2: Season analysis Step 3: Athlete risk factor analysis Stage 4: Risk acceptance or mitigation McIntosh & Bahr. Sports Injury Prevention. Blackwell, 2008

24 Step 1: Risk identification Step 2: Season analysis Step 3: Athlete risk factor analysis Stage 4: Risk acceptance or mitigation Risk mitigation: Develop prevention program Training program Therapeutic interventions Equipment & facilities Emergency management (staff & equipment) McIntosh & Bahr. Sports Injury Prevention. Blackwell, 2008

25 Step 1: Risk identification Doable, easy Step 2: Season analysis Possible, never tested Step 3: Athlete risk factor analysis Possible, but know why? Stage 4: Risk acceptance or mitigation Possible???

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