PEACE & LOVE: Sports medicine updates

The 37th annual GOTS congress took place in Berlin from May 19 – 20, 2022 and PHYSIO RESTART was there. I already arrived on 18.5 for the Pre-Day, which we organized as the board of the Young Academy. I have been a member of GOTS since 2015 and a representative of the Young Academy since 2020.

© Intercongress / S. Runke – Die Bildermanufaktur

The German-Austrian-Swiss Society for Orthopaedic-Traumatologic Sports Medicine (GOTS) is the world’s second largest association of sports orthopaedists and sports traumatologists. It is the first address for the treatment of sports injuries and thus a guarantee for seriousness, competence, experience as well as consulting strength and quality in sports traumatology care. © GOTS

The main topics of the congress were professional and high-performance sport, injuries to the knee, ankle and shoulder joints: Knee, ankle and shoulder joints, stem cells and “orthobiologics” (treatment with the body’s own serum), prevention and biomechanics. On Wednesday, I was able to give a presentation on concussions in rugby and on Thursday I led a workshop on the three most common taping techniques in the sport.

Due to the many exciting lectures and workshops, it was unfortunately not possible for me to attend everything, but I still gained an intensive insight into the latest scientific findings and was able to share the experiences of experts.

You can now find out what the latest news is and which of it I am putting into practice – a small excerpt:

PEACE and LOVE acute sports injuries instead of using PRICE.

Dubois B, Esculier J-F. Soft-tissue injuries simply need PEACE and LOVE. Br J Sports Med 2020;54:72-73.

What has changed in terms of acute management on the sidelines? The omission of ice, ice spray. Why? There is no evidence that the pain-relieving, cooling effect helps with healing. On the contrary. Studies have shown that applying ice to acute injuries disrupts the healing process. More specifically, it interrupts the formation of new blood vessels (angiogenesis) and the release of anti-inflammatory enzymes (neutrophils and macrophages). It can only alleviate pain. But in the long term, the healing of the injured tissue is much more important! In addition, often used but actually criticized: Anti-inflammatory drugs. These drugs also interfere with the long-term healing of the tissue. Let the body reduce the inflammation on its own.

Tendon injuries need active treatment

We have long known that passive treatment interventions for tendon injuries are not effective. Tendonitis is not an inflammation per se. There are no signs of inflammation in the tissue itself. It should rather be called a tendon disease. Healing it does not require relief, but the opposite. Strengthening with stretching in particular helps the tendon to become accustomed to the strain that could have originally caused the injury. Tendons need tensile loads to stimulate tenocytes (important cellular components of the tendon).

Valgus moment in the knee is not the decisive point of injury

The fact that the moment when the knee makes an inward movement (see image below) should lead to an isolated anterior cruciate ligament injury is the subject of controversial debate. It is questionable whether this moment of stress alone really injures the cruciate ligament. What else contributes to this injury? Higher oestrogen levels in women, muscle imbalances in the quadriceps and hamstrings, hyperlaxity, changes of direction, athlete fatigue, inadequate training or competition preparation, poor equipment, and much more. By the way: cruciate ligaments have healing potential. Not every rupture necessarily requires surgery. The latest findings prove that anterior cruciate ligaments grow together without surgical intervention.

thisisfirstaid4sport.co.uk

FIFA 11+ is also available for the shoulder

The FIFA 11+ prevention program has been available for the lower extremities for some time now and has proven to be very effective. Now there is also a program for the shoulder. A study found that 50% of upper limb injuries in football could be reduced with the help of this program. Try it out!

ResearchGate

There is so much more I learned at this congress. Next year it will take place in Luxembourg – I’m already looking forward to it.

Saved the date.

Author:

Anneke Klostermann

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References:

1.Dubois B, Esculier J-F. Soft-tissue injuries simply need PEACE and LOVE. Br J Sports Med 2020;54:72-73.

2.Murtaugh B, Ihm JM. Eccentric training for the treatment of tendinopathies. Curr Sports Med Rep. 2013 May-Jun;12(3):175-82. doi: 10.1249/JSR.0b013e3182933761. PMID: 23669088.

3.O’Neill, S., Watson, P. J., & Barry, S. (2015). Why are eccentric exercises effective for Achilles tendinopathy. International journal of sports physical therapy, 10(4), 552-562.

4.Boden, B. P., Sheehan, F. T., Torg, J. S., & Hewett, T. E. (2010). Noncontact anterior cruciate ligament injuries: mechanisms and risk factors. The Journal of the American Academy of Orthopaedic Surgeons, 18(9), 520-527.

5.Ristić V, Ninković S, Harhaji V, Milankov M. Causes of anterior cruciate ligament injuries. Med Pregl. 2010 Jul-Aug;63(7-8):541-5. doi: 10.2298/mpns1008541r. PMID: 21443155.

6.Quatman, C. E., & Hewett, T. E. (2009). The anterior cruciate ligament injury controversy: is “valgus collapse” a sex-specific mechanism? British journal of sports medicine, 43(5), 328-335.

7.Razi M, Soufali AP, Ziabari EZ, Dadgostar H, Askari A, Arasteh P. Treatment of Concomitant ACL and MCL Injuries: Spontaneous Healing of Complete ACL and MCL Tears. J Knee Surg. 2021 Oct;34(12):1329-1336.

8.Al Attar WSA, Faude O, Bizzini M, Alarifi S, Alzahrani H, Almalki RS, Banjar RG, Sanders RH. The FIFA 11+ Shoulder Injury Prevention Program Was Effective in Reducing Upper Extremity Injuries Among Soccer Goalkeepers: A Randomized Controlled Trial. Am J Sports Med. 2021 Jul;49(9):2293-2300.