- Email: [email protected]
Football for health – A global health initiative of FIFA
2013 ASICS Conference / Journal of Science and Medicine in Sport 16S (2013) e84–e99
4
WORKSHOP
When pictures tell more than a thousand words: The clinical role of imaging for tendinopathy and emergence of UTC S. Docking ∗ , E. Rio ∗ , J. Cook ∗ Department of Physiotherapy, Monash University, Australia This workshop will discuss the importance and relevance of imaging modalities in the diagnosis and management of lower limb tendinopathy. Included is a practical demonstration of ultrasound tissue characterisation (UTC) in imaging the Achilles and patellar tendon with detailed input from Prof Jill Cook and Ebonie Rio on the conservative and intervention management directed by findings on UTC. UTC utilises conventional ultrasound to render a 3-dimensional image of the tendon and allows semi-quantitative analysis of tendon structure and detection of subtle changes in tendon structure in response to load. Previous research utilising conventional ultrasound and MRI will be discussed as well as the emergence of UTC in the clinical setting. http://dx.doi.org/10.1016/j.jsams.2013.10.204 5
KEYNOTE
Football for health – A global health initiative of FIFA J. Dvorak 1,2,3 1
University of Zurich, Switzerland Schulthess Spine Centre, Switzerland 3 Fédération Internationale de Football Association, Switzerland The main objectives of the FIFA Medical Assessment and Research Centre (F-MARC) are to protect players’ health, ensure the respect of the FIFA Anti-Doping Regulations and use the potential of the game to improve public health. During pre-competition medical assessment and medical services at competitions, FIFA engages with all participating teams to ensure that players are not subject to any avoidable medical risks. F-MARC has developed a standardised pre-competition medical assessment (PCMA), which is mandatory prior to all competitions. FIFA also issues detailed requirements, including staff and infrastructure, for the provision of medical services to the participating teams and delegations. Furthermore, the medical teams on the touchline must be fully trained in emergency medicine and be equipped with an automated external defibrillator (AED). FIFA provided each member association with one FMEB (Football Medicine Emergency Bag) together with an educational package. In order to minimise any further potential risks, FIFA has issued several recommendations with regard to environmental factors such as heat, and, in collaboration with other international federations, FIFA has also developed a touchline assessment for players with head injuries to identify potential concussions. Fight against doping: In a significant move in the continued battle to eradicate those who seek to gain an advantage through 2
e85
doping, FIFA adopted the so-called “biological passport” profiling at the FIFA Confederations Cup Brazil 2013 and the procedure will again form part of our wide-ranging anti-doping strategy when we return for the 2014 FIFA World Cup Brazil. The FIFA 11+: The FIFA 11+ injury prevention programme is a simple, time-efficient warm-up programme for players. Scientific evidence has shown that overall injuries decreased by a third and serious injuries by half in teams using the FIFA 11+. The FIFA 11 for Health: FIFA’s 11 for Health Programme is a series of football-based sessions aimed at encouraging physical activity while educating children about healthy behaviour. Consisting of 11 simple messages to reduce communicable and non-communicable diseases, all supported by prominent footballers working as one team. The programme, which started in Africa in 2009, is now spreading its positive message around the globe and a pilot project was launched in Brazil in 2013. http://dx.doi.org/10.1016/j.jsams.2013.10.205 6 The role of ultrasound tissue characterisation in the management and prevention of tendinopathy in athletes S. Docking 1,∗ , S. Rosengarten 2 , J. Daffy 3 , H. Van Schie 1,4 , J. Cook 1 1
Monash University, Australia Carlton Football Club, Australia 3 St. Vincent’s Hospital, Australia 4 UTC Imaging, Australia Tendinopathy is a prevalent and frustrating condition in athletes and its management is complex for clinicians. At present, sports medicine practitioners are reactionary to the onset of, or changes in, pain to indicate tendinopathy as standard imaging modalities are reliant on subjective interpretation and are not sensitive enough to detect subtle fluctuations in structure. As symptoms are not directly linked to pathology, an athlete may develop substantial tendon disorganisation without symptoms. Ultrasound tissue characterisation (UTC) is a novel development in the field of ultrasound that may advance diagnosis and management of tendinopathy. UTC captures 600-contiguous transverse US images and has three clear advantages; first, UTC standardises parameters and removes user-dependency allowing direct comparison between scans. Second, it quantifies tendon structure removing the subjective interpretation of other imaging modalities. Third, it is able to detect small changes in structure, making it an ideal tool to clinically monitor tendon structure in response to overload in athletes. Previously, UTC has been used as a research tool for monitoring the progression of tendon lesions and for objective evaluation of various treatments such as intra-tendinous platelet-rich plasma. Our research group has shown changes in Achilles tendon structure despite the absence of symptoms in patients with patellar tendinopathy, and in the asymptomatic tendon in unilateral Achilles tendinopathy. Clinically, UTC has been used to quantify the amount of tendinopathic change, allowing clinicians and patients the confidence to embrace load as part of their clinical management. UTC identifies reactive tendinopathy, that has been previously undetectable using conventional imaging modalities. In addition, research showing changes in tendon structure in response to load athletes has allowed proactive clinical management before the presence of symptoms. The ability to quantify and detect subtle 2
4
WORKSHOP
When pictures tell more than a thousand words: The clinical role of imaging for tendinopathy and emergence of UTC S. Docking ∗ , E. Rio ∗ , J. Cook ∗ Department of Physiotherapy, Monash University, Australia This workshop will discuss the importance and relevance of imaging modalities in the diagnosis and management of lower limb tendinopathy. Included is a practical demonstration of ultrasound tissue characterisation (UTC) in imaging the Achilles and patellar tendon with detailed input from Prof Jill Cook and Ebonie Rio on the conservative and intervention management directed by findings on UTC. UTC utilises conventional ultrasound to render a 3-dimensional image of the tendon and allows semi-quantitative analysis of tendon structure and detection of subtle changes in tendon structure in response to load. Previous research utilising conventional ultrasound and MRI will be discussed as well as the emergence of UTC in the clinical setting. http://dx.doi.org/10.1016/j.jsams.2013.10.204 5
KEYNOTE
Football for health – A global health initiative of FIFA J. Dvorak 1,2,3 1
University of Zurich, Switzerland Schulthess Spine Centre, Switzerland 3 Fédération Internationale de Football Association, Switzerland The main objectives of the FIFA Medical Assessment and Research Centre (F-MARC) are to protect players’ health, ensure the respect of the FIFA Anti-Doping Regulations and use the potential of the game to improve public health. During pre-competition medical assessment and medical services at competitions, FIFA engages with all participating teams to ensure that players are not subject to any avoidable medical risks. F-MARC has developed a standardised pre-competition medical assessment (PCMA), which is mandatory prior to all competitions. FIFA also issues detailed requirements, including staff and infrastructure, for the provision of medical services to the participating teams and delegations. Furthermore, the medical teams on the touchline must be fully trained in emergency medicine and be equipped with an automated external defibrillator (AED). FIFA provided each member association with one FMEB (Football Medicine Emergency Bag) together with an educational package. In order to minimise any further potential risks, FIFA has issued several recommendations with regard to environmental factors such as heat, and, in collaboration with other international federations, FIFA has also developed a touchline assessment for players with head injuries to identify potential concussions. Fight against doping: In a significant move in the continued battle to eradicate those who seek to gain an advantage through 2
e85
doping, FIFA adopted the so-called “biological passport” profiling at the FIFA Confederations Cup Brazil 2013 and the procedure will again form part of our wide-ranging anti-doping strategy when we return for the 2014 FIFA World Cup Brazil. The FIFA 11+: The FIFA 11+ injury prevention programme is a simple, time-efficient warm-up programme for players. Scientific evidence has shown that overall injuries decreased by a third and serious injuries by half in teams using the FIFA 11+. The FIFA 11 for Health: FIFA’s 11 for Health Programme is a series of football-based sessions aimed at encouraging physical activity while educating children about healthy behaviour. Consisting of 11 simple messages to reduce communicable and non-communicable diseases, all supported by prominent footballers working as one team. The programme, which started in Africa in 2009, is now spreading its positive message around the globe and a pilot project was launched in Brazil in 2013. http://dx.doi.org/10.1016/j.jsams.2013.10.205 6 The role of ultrasound tissue characterisation in the management and prevention of tendinopathy in athletes S. Docking 1,∗ , S. Rosengarten 2 , J. Daffy 3 , H. Van Schie 1,4 , J. Cook 1 1
Monash University, Australia Carlton Football Club, Australia 3 St. Vincent’s Hospital, Australia 4 UTC Imaging, Australia Tendinopathy is a prevalent and frustrating condition in athletes and its management is complex for clinicians. At present, sports medicine practitioners are reactionary to the onset of, or changes in, pain to indicate tendinopathy as standard imaging modalities are reliant on subjective interpretation and are not sensitive enough to detect subtle fluctuations in structure. As symptoms are not directly linked to pathology, an athlete may develop substantial tendon disorganisation without symptoms. Ultrasound tissue characterisation (UTC) is a novel development in the field of ultrasound that may advance diagnosis and management of tendinopathy. UTC captures 600-contiguous transverse US images and has three clear advantages; first, UTC standardises parameters and removes user-dependency allowing direct comparison between scans. Second, it quantifies tendon structure removing the subjective interpretation of other imaging modalities. Third, it is able to detect small changes in structure, making it an ideal tool to clinically monitor tendon structure in response to overload in athletes. Previously, UTC has been used as a research tool for monitoring the progression of tendon lesions and for objective evaluation of various treatments such as intra-tendinous platelet-rich plasma. Our research group has shown changes in Achilles tendon structure despite the absence of symptoms in patients with patellar tendinopathy, and in the asymptomatic tendon in unilateral Achilles tendinopathy. Clinically, UTC has been used to quantify the amount of tendinopathic change, allowing clinicians and patients the confidence to embrace load as part of their clinical management. UTC identifies reactive tendinopathy, that has been previously undetectable using conventional imaging modalities. In addition, research showing changes in tendon structure in response to load athletes has allowed proactive clinical management before the presence of symptoms. The ability to quantify and detect subtle 2