PEACE & LOVE: Update Sportsmedicine
Updated: Apr 14, 2024
From 19.5 - 20.5.2022 the 37th annual congress of the GOTS took place in Berlin and with it: PHYSIO RESTART. Anneke arrived already on 18.5 for the Pre-Day, which we organized as the board of the Young Academy. Since 2015 I am a member of the GOTS, since 2020 representative of the Young Academy.
© Intercongress / S. Runke – Die Bildermanufaktur
The German-Austrian-Swiss Society for Orthopedic-Traumatologic Sports Medicine (GOTS) is the world's second largest association of sports orthopedists and sports traumatologists. It is the first address in the care of sports injuries and thus a guarantor for seriousness, competence, experience as well as consulting strength and quality in sports traumatological care.© GOTS
The main topics of the congress were professional and high-performance sports, injuries of: Knee, ankle and shoulder joints, stem cells and "orthobiologics" (treatment with the body's own serum), prevention and biomechanics. I was able to give a presentation on concussions in rugby on Wednesday and lead a workshop on Thursday that included 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 got an intensive insight into the latest scientific findings and was able to share the experiences of experts.
What news these are and which of them do I implement in practice, you will learn below:
PEACE and LOVE acute sport 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 the acute management on the sidelines? The omission of ice, ice spray. Why? There is no evidence that the pain-relieving, cooling effect helps healing. On the contrary. Studies found that applying ice to acute injury interferes with the healing process. More specifically, it interrupts the formation of new blood vessels (angiogenesis) and the release of anti-inflammatory enzymes (neutrophils and macrophages). The only thing it can do is relieve pain. But in the long run the healing of the injured tissue is much more important! Besides, always much used but actually criticized: Anti-inflammatory drugs. These drugs also interfere with the long-term healing of the tissue. Let the body break down the inflammation on its own.
Tendon injuries need active interventions
We have known for some time that passive treatment interventions are not effective for tendon injuries. Tendonitis is not an inflammation per se. There are no signs of inflammation in the tissue itself. It should rather be called tendon disease. For its healing, not rest, but the opposite is necessary. Strengthening under stretching, in particular, helps the tendon get used to the load that could have been the original cause of the injury. Tendons need tensile loads to stimulate tenocytes (cellular, important components of the tendon).
Valgusmoments in the knee are not the main cause of injury
The fact that the moment when the knee makes an inward movement (see picture below) should lead to an isolated, anterior cruciate ligament injury is in the sportsmedicine field controversially discussed. It is questionable whether this loading moment alone really injures the cruciate ligament. What else contributes to this injury? A higher estrogen level in women, muscle imbalances of the quadriceps and hamstrings, hyperlaxity, change of direction, athlete fatigue, inadequate training or competition preparation, poor equipment, and 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.
FIFA 11+ does also exist for the shoulder
The FIFA 11+ prevention program has been around for a long time for the lower extremity and is proving to be very effective. Now there is also a program for the shoulder. One study found that 50% of upper extremity injuries in football were 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 am already looking forward to it.
Saved the date.
Author:
Anneke Penny
Book appointment for Physiotherapy, Massage oder Group classes: here.
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.