Sports Injury Prevention (Olympic Handbook Of Sports Medicine)

248 Pages·2009·5.3 MB·English

by  Roald Bahr

Handbook of Sports Medicine and Science
Sports Injury Prevention
Sports Injury Prevention Edited by Roald Bahr and Lars Engebretsen
© 2009 International Olympic Committee
ISBN: 978-1-405-16244-9
Handbook of Sports
Medicine and Science
Sports Injury Prevention
EDITED BY
Roald Bahr MD, PhD
Department of Sports Medicine and
Oslo Sports Trauma Research Center
Norwegian School of Sport Sciences
Ullevål Stadion, Oslo, Norway
Lars Engebretsen MD, PhD
Orthopaedic Center
Ullevaal University Hospital and Faculty of Medicine
University of Oslo
Oslo, Norway
Department of Sports Medicine and Oslo Sports Trauma Research Center
Norwegian School of Sport Sciences
Ullevål Stadion
Oslo, Norway
A John Wiley & Sons, Ltd., Publication
This edition fi rst published 2009, © 2009 International Olympic Committee
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Library of Congress Cataloging-in-Publication Data
Sports injury prevention : Olympic handbook of sports medicine / edited by Roald Bahr
and Lars Engebretsen.
p. ; cm. — (Handbook of sports medicine and science)
Includes bibliographical references and index.
ISBN 978-1-4051-6244-9 (alk. paper)
1. Sports injuries—Prevention—Handbooks, manuals, etc. 2. Sports medicine—
Handbooks, manuals, etc. I. Bahr, Roald, 1957– II. Engebretsen, Lars, 1949– III. IOC
Medical Commission. Sub-Commission on Publications in the Sport Sciences. IV. Series.
[DNLM: 1. Athletic Injuries—prevention & control. 2. Sports Medicine—methods. QT
261 S76482 2009]
RD97.S745 2009
617.1’027—dc22
2008039504
ISBN: 978-1-4051-6244-9
A catalogue record for this book is available from the British Library.
Set in by Charon Tec Ltd (A Macmillan Company), Chennai, India
Printed and bound in Malaysia by Vivar Printing Sdn Bhd.
1 2009
Contents
List of Contributors, vi 8 Preventing low back pain 114
Foreword, viii Adad Baranto, Tor Inge Andersen and
Preface, ix Leif Swärd
9 Preventing shoulder injuries 134
1 Why is injury prevention in sports
Michael R. Krogsgaard, Marc R. Safran,
important? 1
Peter Rheinlænder and Emilie Cheung
Lars Engebretsen and Roald Bahr
10 Preventing elbow injuries 153
2 A systematic approach to sports
Mark R. Hutchinson and James R. Andrews
injury prevention 7
Willem Meeuwisse and Roald Bahr 11 Preventing injuries to the head and
cervical spine 175
3 Developing and managing an injury
Paul McCrory, Michael Turner and
prevention program within the team 17
Andrew McIntosh
Andrew McIntosh and Roald Bahr
12 Preventing tendon overuse injuries 187
4 Preventing ankle injuries 30
Jill Cook, Mads Kongsgaard,
Jon Karlsson, Evert Verhagen,
Karim Khan and Michael Kjær
Bruce D. Beynnon and Annunziato Amendola
13 Implementing large-scale injury
5 Preventing knee injuries 49
prevention programs 197
Timothy E. Hewett, Bruce D. Beynnon,
Randall W. Dick, Claude Goulet and
Tron Krosshaug and Grethe Myklebust
Simon Gianotti
6 Preventing hamstring injuries 72
14 Planning for major events 212
Geoffrey M. Verrall and Árni Árnason,
Michael Turner and Jiri Dvorak
Kim Bennell
Index,228
7 Preventing groin injuries 91
Per Hölmich, Lorrie Maffey and
Carolyn Emery
v
List of Contributors
Annunziato Amendola MD Jill Cook PhD, B App Sci (Phty)
Department of Orthopaedic Surgery and Centre for Physical Activity and Nutrition Research
Rehabilitation, University of Iowa Sports Medicine School of Exercise and Nutrition Sciences, Deakin
Center, University of Iowa, Iowa City, IA, USA University, Melbourne, Australia
Tor Inge Andersen PT Randall W. Dick MS, MS
National Center of Spinal Disorders, National Center
Research/Injury Surveillance System National
of Pain and Complex Disorders, Trandheim University
Collegiate Athletic Association, Indianapolis,
Hospital, St Olar, Norway
IN, USA
James R. Andrews, MD
Jiri Dvorak MD
Medical Director, American Sports Medicine Institute,
Birmingham, Alabama, USA; Andrews Sports FIFA Medical Assessment and Research Center
Medicine Institute, Gulf Breeze, FL, USA (F-MARC), Schulthess Clinic, Zurich, Switzerland
Árni Árnason PT, PhD
Carolyn Emery BScPT, PhD
Department of Physiotherapy, University of Iceland,
Sport Medicine Centre, Faculty of Kinesiology;
Reykjavik, Iceland
Community Health Sciences, Faculty of Medicine,
Roald Bahr MD, PhD University of Calgary, Calgary, Canada
Department of Sports Medicine, Oslo Sports Trauma
Research Center, Norwegian School of Sport Sciences, Lars Engebretsen MD, PhD
Ullevål Stadion, Oslo, Norway Orthopaedic Center, Ullevaal University Hospital and
Faculty of Medicine, University of Oslo, Oslo, Norway;
Adad Baranto MD, PhD
Department of Sports Medicine and Oslo Sports
Department of Orthopaedics, Sahlgrenska University,
Trauma Research Center, Norwegian School of Sport
Göteborg, Sweden
Sciences, Ullevål Stadion, Oslo, Norway
Kim Bennell BAppSc (Physio), PhD
Simon Gianotti BCA
Centre for Health, Exercise and Sports Medicine,
Institute of Sport and Recreation Research New
School of Physiotherapy, University of Melbourne,
Zealand, Faculty of Health and Environmental Science,
Australia
AUT, Auckland, New Zealand
Bruce D. Beynnon PhD
Department of Orthopaedics and Rehabilitation, Claude Goulet PhD
McClure Musculoskeletal Research Center, Department of Physical Education, Laval University,
The University of Vermont, VT, USA Québec, Canada
vi
List of Contributors vii
Timothy E. Hewett PhD Paul McCrory MBBS, PhD
The Human Performance Laboratory, Departments Centre for Health, Exercise and Sports Medicine,
of Pediatrics, Orthopaedic Surgery, Biomedical University of Melbourne Parkville, Australia
Engineering and Rehabilitation Sciences, The Sports
Medicine Biodynamics Center, Cincinnati Children’s Andrew McIntosh PhD, MBiomedE,
Hospital Medical Center, University of Cincinnati BAppSci (PT)
College of Medicine, Cincinnati, OH, USA School of Risk and Safety Sciences, The University of
New South Wales, Sydney, Australia
Per Hölmich MD
Department of Orthopaedic Surgery, Orthopaedic Willem Meeuwisse MD, PhD
Research Unit, Amager University Hospital, Professor and Chair,
Copenhagen S, Denmark Sport Injury Prevention Research Centre Faculty
of Kinesiology and Faculty of Medicine,
Mark R. Hutchinson MD University of Calgary,
Department of Orthopaedics, University of Illinois at Alberta, Canada
Chicago, IL, USA
Grethe Myklebust PT, PhD
Jon Karlsson MD, PhD Oslo Sports Trauma Research Center, Norwegian School
Professor of Sports Traumatology, Department of of Sport Sciences, Oslo, Norway
Orthopaedics, Sahlgrenska University Hospital,
Peter Rhein legature
Göteborg, Sweden
Clinic for Physiotherapy, Frederiksberg, Denmark
Karim Khan MD, PhD
Marc R. Safran MD
Professor, Center for Hip Health and Mobility,
Department of Orthopaedic Surgery, Stanford
University of British Columbia, Vancouver, Canada
University, Stanford, CA, USA
Michael Kjær MD, DMSci
Leif Swärd MD, PhD
Department of Rheumatology, Institute of Sports
Department of Orthopaedics, Sahlgrenska University,
Medicine, Bispebjerg Hospital, University of
Göteborg, Sweden
Copenhagen, Copenhagen, Denmark
Michael R. Krogsgaard, MD, PhD, Michael Turner MBBS, MD
Chief Medical Adviser, The British
Associate Professor, specialist in Orthopaedic
Horseracing Authority and Lawn
Surgery
Tennis Association; formerly CMA to
Department of Orthopaedic Surgery, Copenhagen British Olympic Association and
University Hospital Bispebjerg, Denmark Snowsport, UK
Tron Krosshaug PhD Evert Verhagen
Oslo Sports Trauma Research Center, Norwegian School Department of Public and Occupational Health, EMG
of Sport Sciences, Oslo, Norway Institute, VU University Medical Center, Amsterdam,
The Netherlands
Lorrie Maffey BMRPT, Dip
Faculty of Kinesiology; Community Health Sciences, Geoffrey M. Verrall MBBS
Faculty of Medicine, University of Calgary, Calgary, Sports Medicine Clinic, Adelaide, Australia
Alberta, Canada
Foreword
The objective established in 1991 by the IOC of injuries and their prevention became one of the
Medical Commission for the Handbook series was focuses of the Medical Commission and the Medical
the presentation in a clear style and format of and Scientifi c Department of the IOC.
basic clinical and scientifi c information regarding The principal objective of this Handbook on
the sports of the Olympic Summer Games and the Sports Injury Prevention is a comprehensive review
Olympic Winter Games. Each of the handbooks of the information currently available regarding
that have been published during the intervening the identifi cation of the risk factors for specifi c
years was developed by a team of authorities coor- injuries in each sport, the understanding of the
dinated by editors who had earned international injury mechanisms, the appropriate condition-
respect and recognition in the areas of sports med- ing of athletes for the particular sport, and the risk
icine and the sport sciences. management appropriate to each activity.
Since the appearance of the fi rst publication, The Handbook on Sports Injury Prevention
handbooks have appeared that have dealt with constitutes the most comprehensive review of
10 Olympic sports as well as the general top- the preclusion of the occurrence of injuries pres-
ics of strength training and nutrition for ath- ently available and each section presents highly
letes. Sections dealing with sports injuries have practical information based on published science.
appeared throughout these handbooks. Two vol- We welcome this splendid contribution by Roald
umes of the other IOC Medical Commission series, Bahr, MD, PhD, Lars Engebretsen, MD, PhD, and
Encyclopaedia of Sports Medicine, have been 36 contributing authors to the literature of sports
devoted completely to injuries in sport. medicine and sports science.
The protection of the health of the athletes is one
of the IOC’s priorities. Therefore, the understanding
viii
Preface
In sports, injuries happen. Sometimes they happen tive programs. Chapter 3 describes how an injury
by chance, sometimes by intent. Sometimes they prevention program can be developed and imple-
are diffi cult, even impossible, to explain. But fre- mented within the team. In this context, a team
quently there are clear patterns. And when there can also mean a team of athletes competing in
are patterns, there are also opportunities for reduc- individual sports, such as a team of alpine skiers.
ing the risk of injury. One choice we faced when planning this book,
The objective of this book is to describe those was whether to organize the contents per sport
opportunities – for the benefi t of everyone playing or per body part/injury type. One advantage
sports. Although it may be expected that the main of describing sports-specifi c programs is that it
readership will be physicians, trainers and physical would be possible to detail measures particular to
therapists working with sports teams, the coach- that sport, for example equipment-related meas-
ing staff is an even more important target group. ures such as alpine ski bindings. However, partly
And although it is assumed that the reader has a because some such information is available already
basic knowledge of human anatomy and physiol- (e.g. vol. V of the Encyclopedia of Sports Medicine
ogy, ultimately the main audience is of course the series: Clinical Practice of Sports Injury Prevention
athlete. With these target groups in mind, we have and Care, ed. P.A.F.H. Renström), we felt that a
attempted to create a work that is at once com- region-specifi c approach would be more appro-
prehensive in approach, practical in content, and priate. Chapters 4 through 12 therefore describes
accessible in delivery. how the most common sports injury types can
Our intention is to describe a practical approach be prevented; ankle, knee, hamstring, groin, low
to the prevention of sports injuries. The fi rst three back, shoulder, elbow, head and cervical spine
chapters describe the general principles of injury injuries. The fi nal two chapters discusses how
prevention. Chapter 1 discusses why injury preven- tendon overuse injuries, which represent a major
tion in sports is important, including perspectives problem across sports and body region, can be pre-
on short- and long term consequences for health vented (ch. 12) and how large-scale injury preven-
and performance. Chapter 2 describes the basis tion programs can be implemented (ch. 13).
for intervention, how information on risk factors Each of the region-specifi c chapters includes an
and injury mechanisms can be used to identify introduction outlining how relevant each injury
patterns. Such patterns can be used to identify type is in each of the main Olympic sports. In con-
athletes with a higher risk for injury or situations trast to previous works on sports injury epidemiol-
with a propensity for injury; information which ogy, we have attempted to keep this section brief
is critical to be able to target and develop preven- and to the point, answering the key questions:
ix
x Preface
How common is the injury in question? What is section of each of these chapters is the section on
the risk – in my sport? The next section attempts prevention methods. This section discusses pos-
to describe the key risk factors for the injury in sible ways to prevent the injury in question, and
question – how to identify athletes at risk. This although these may be relevant across sports, the
includes a description of the various internal and text provides examples from sports where injury
external risk factors suggested for the injury in prevention has been successful. We have tried to
question, emphasizing modifi able risk factors and make this section as practical as possible, with
how the coach/medical team can identify play- examples of take-home ready-to-use programs
ers at risk of injury. In some cases, simple tests or wherever possible, complete with illustrations of
screening methods which can be applied to a team exercises used.
setting are described. This section is followed by a This book is the fi rst of its kind. Never before has
description of the typical injury mechanisms for anyone attempted to provide a guide to injury pre-
the injury in question, not just the biomechan- vention – to be applied across different sports. This
ics of injury, but also the circumstances leading to represents a signifi cant challenge, since there is no
injury, such as player behavior, opponent behav- model available to guide us in the development
ior, the playing situation, or other relevant factors. of the contents. We wish to thank the authors,
We have also asked all authors to provide a section who have worked hard to not just provide an up-
identifying risks in the training and competition to-date description of injury prevention methods
program, a risk analysis to document the parts of relevant to their region and injury type, but also
the season when athletes are at the greatest risk to develop a text consistent in content and format
for sustaining injuries as a result of the training or across the various chapters. If we have succeeded,
competitive programs. For some injury types, this the credit belongs to this group of dedicated pro-
type of analysis could be an important basis for fessionals. If not, the responsibility is ours.
planning preventive measures, particularly for the
purpose of avoiding overuse injuries during tran- Oslo, September 2008
sitional periods. The fi nal – and most important – Roald Bahr & Lars Engebretsen