1. TEAM SPORT MEDICAL AND SCIENCE CONFERENCE JULY 2010 - LEEDS ALAN HODSON SPORTS MEDICINE AND SCIENCE THE PAST… THE PRESENT… THE FUTURE CHALLENGES!

2. 2 of 39 THE PAST TO THE PRESENT Involved in professional football for over 20 years Head of Medicine and Exercise Science for The Football Association for over 20 years Witnessed many changes and advances over this time.

3. 3 of 39 THE PAST NO SPECIFIC SPORTS MEDICINE TRAINING FOR DOCTORS AND PHYSIOTHERAPISTS (NHS & PRIVATE) FEW STAFF l EITHER ONE F/T OR P/T PHYSIO l DOCTOR WAS A GP WHO CAME TO CLUB 2 DAYS PER WEEK AND MATCH DAY DOCTOR WAS NOT ON THE BENCH ONLY MANAGER/COACH NO PLAYER SCREENING (ORTHOPAEDIC / CARDIAC) NO EMERGENCY CARE TRAINING OR STRATEGY NO EDUCATION (COURSES OR CONFERENCES) NO SPORTS MEDICINE / SCIENCE JOURNALS NO SPORTS MEDICINE RESEARCH NO OR VERY FEW NEW INNOVATIONS

4. 4 of 39 THE PAST MANAGER WAS GOD – RESPECT FOR MEDICAL STAFF LITTLE PREVENTATIVE MEDICINE LITTLE CLOSED SEASON FITNESS MAINTENANCE NO RECOVERY STRATEGY FOLLOWING A GAME OR HARD TRAINING NO STRUCTURE TO THE PRE-SEASON TRAINING PROGRAMME LITTLE LIASON BETWEEN MANAGER, COACHES AND MEDICAL STAFF THE TRAINING WAS UNSTRUCTURED, WITH NO SCIENTIFIC APPROACH LITTLE PLAYER EDUCATION NO DOPING CONTROL (WELL JUST A LITTLE!) NO SPECIFIC MEDICAL INSURANCE IN PLACE NO SPECIALISING SURGEONS / PHYSICIANS NO SPECIFIC PLAYER MEDICAL RECORDS, I.E. A MEDICAL CAREER PASSPORT A QUICK OR NO PLAYER PRE SIGNING MEDICAL NO CONCENTRATION ON THE PHYSICAL / PHYSIOLOGICAL DEVELOPMENT OF TALENTED YOUNG / YOUTH PLAYERS NO ACADEMIES OF FOOTBALL (9-18 YEARS OLD)

5. 5 of 39 CHANGES AND ADVANCES THE PROFESSIONAL STANDING OF SPORTS MEDICINE AND SCIENCE SPORTS MEDICINE AND SCIENCE EDUCATION

6. 6 of 39 “THE SPORTS MEDICINE TEAM” “THE TEAM WITHIN A TEAM”

7. 7 of 39 PAST “TEAM” PHYSIO MANAGER COACHES “DOCTOR” LOCAL SURGEON PLAYERS PRESENT “TEAM” MANAGER SPORTS SCIENTISTS COACHES PLAYERS DOCTOR(S) PHYSIOS SURGEONS - (MULTIPLE) (HOME & ABROAD) PHYSICIANS NUTRITIONISTS DIETICIANS OSTEOPATHS SPORTS THERAPISTS CHIROPODISTS PODIATRISTS RADIOLOGISTS PARAMEDICS +

8. 8 of 39 THE EMERGENCE OF NEW SURGICAL TREATMENT AND REHABILITATION TECHNIQUES NEW TECHNOLOGY AND EQUIPMENT THE EMERGENCE OF NEW PROFESSIONS AND SPECIAL INTEREST GROUPS SPECIALISATION OF SURGEONS, PHYSICIANS AND THERAPISTS

9. 9 of 39 MEDICAL / SCIENCE REGULATIONS PUT IN PLACE BY GOVERNMENT BODIES OF SPORT SPORTS MEDICINE / SCIENCE RESEARCH l GIVES MORE KNOWLEDGE l MORE DIRECTION FOR ACTION SPORTS MEDICINE / SCIENCE EQUIPMENT ADVANCES NEW INNOVATIONS INJURY PREVENTION STRATEGIES RECOVERY STRATEGIES COMPETITOR / ATHLETE / PLAYER PERFORMANCE MONITORING (PHYSICAL / PHYSIOLOGICAL)

10. 10 of 39 THE PAST THE OLD PLAYER

11. 11 of 39 THE PRESENT THE MODERN PLAYER

12. 12 of 39 YOUNG COMPETITOR / ATHLETE / PLAYER DEVELOPMENT / MEASUREMENT AND EDUCATION

13. 13 of 39 THE COMPLETE PLAYER

14. 14 of 39 FITNESS COMPONENTS Aerobic Endurance Speed Endurance Flexibility Power Strength BalanceCoordination

15. 15 of 39 EXERCISE SCIENCE/FITNESS AND CONDITIONING EDUCATION AND TRAINING Development of: l Strength l Power l Endurance l Agility l Balance l Co-ordination l Proprioception l Speed l Speed Endurance l Acceleration

16. 16 of 39 EXERCISE SCIENCE/FITNESS AND CONDITIONING EDUCATION AND TRAINING Each person has an in-built genetic limit for all physical and physiological attributes Unless specific training is applied the genetic limits will not be reached The athletic ability of the player will not have been realized A development programme for each individual player is required to optimise performance.

17. 17 of 39 EXERCISE SCIENCE/FITNESS AND CONDITIONING EDUCATION AND TRAINING “WINDOWS OF OPPORTUNITY” l THERE ARE DEFINED DEVELOPMENT WINDOWS OF OPPORTUNITY

18. 18 of 39 EXERCISE SCIENCE/FITNESS AND CONDITIONING EDUCATION AND TRAINING The Physical / Physiological development begins from an early age Development of specific athletic attributes commences at different ages to coincide with neurological and orthopaedic development of the growing player for example: Balance and Co-ordination l Development begins at a young age and the body’s central nervous system is developing Strength and Power l Addressed by a specific training programme later in life e.g. 14, 15, 16 years old

19. 19 of 39 EDUCATION OF THE “PAYMASTERS” AND “CONTROLLERS”

20. 20 of 39 “PAYMASTERS” AND “CONTROLLERS” ADVANCEMENT IN SPORTS MEDICINE REQUIRES FINANCES l FOR RESEARCH AND DEVELOPMENT TO GAIN KNOWLEDGE AND DIRECTIONS FOR ACTION IT TOOK 10 YEARS FOR ME TO REALISE I WAS PREACHING AND TRYING TO INFLUENCE THE WRONG PEOPLE… MY MEDICAL COMMITTEE!!!

21. 21 of 39 “PAYMASTERS” THE PREMIER LEAGUE THE FOOTBALL LEAGUE COMMITTEES OF SPORTS GOVERNING BODIES UK SPORT CHAIRMEN OF FOOTBALL / RUGBY CLUBS ETC. THE PROFESSIONAL FOOTBALLERS’ ASSOCIATION FOLLOW THE MONEY!!! ADVICE: l ALWAYS INVITE, INCLUDE NON-MEDICAL / SCIENCE PEOPLE OF INFLUENCE FROM THE ABOVE LIST TO SERVE ON YOUR COMMITTEE

22. 22 of 39 “CONTROLLERS” TO INFLUENCE CHANGE, OR INTRODUCE NEW PRACTICES, OR REQUIRE INCREASED FINANCES / STAFF FOR DEVELOPMENT AND SERVICES, INFLUENCE: l CLUB MANAGER – “GOD” l FINANCE DIRECTORS l PERFORMANCE DIRECTORS AS PROFESSIONALS WE NEED TO BE INCLUSIVE NOT EXCLUSIVE

23. 23 of 39 Fewer Players available Fewer Assets Reduced Performance Reduced Results Players are Assets Points Achieved League Position Finances through gate Sponsorship Opportunities Fans, Chairman Directors Unhappy Pressure on Manager and Squad THE IMPORTANCE OF MEDICINE AND SCIENCE

24. 24 of 39 THE PAST – “FAITH HEALERS”, “WIZARDS” AND “WALLY’S” MYTHS – COMMON PRACTICE TO HEAR THE FOLLOWING: l “HE’S A FAST HEALER” l “HE’S HAVING INTENSIVE TREATMENT” l PREDICTION BY THE MANAGER – “HE WILL BE OUT FOR ‘X’ WEEKS!” l “IF HE CAN RUN, HE CAN PLAY” l “HE IS HAVING A LATE FITNESS TEST”

25. 25 of 39 THE PRESENT PUBLIC SCRUTINY OF “ON FIELD” TREATMENTS l THE MEDIA – TV CAMERAS – “UNDER THE EYE” l MEDICAL MALPRACTICE l MEDICAL / INDEMNITY INSURANCE l THE EMERGENCY CARE OF PLAYERS THE SPEEDS OF THE GAME: l HIGH SPEED COLLISIONS / TACKLES l HIGH SPEED NON-CONTACT INJURIES l MORE 1 ST, 2 ND AND 3 RD DEGREE INJURIES?

26. 26 of 39 MORE PLAYER MEASUREMENT / MONITORING / MAINTENANCE AND DEVELOPMENT l SPEED l STRENGTH l ENDURANCE l POWER l GPS SYSTEM l PROZONE

27. 27 of 39 INDIVIDUAL PLAYER IDENTIFICATION OF PHYSICAL / PHYSIOLOGICAL STRENGTH AND WEAKNESSES SPECIFIC TRAINING FOR THE NEEDS OF THE GAME SPECIFIC INJURY PREVENTION STRATEGIES AUDITING OF INJURIES l FOR THE SPORT AND FOR THE CLUB ADVANCES IN: l SURGICAL TECHNIQUES l TREATMENT TECHNIQUES l EMERGENCE OF COMPLIMENTARY THERAPIES

28. 28 of 39 AUDITING INJURIES MONTHLY DISTRIBUTION OF INJURIES

29. 29 of 39 AUDITING INJURIES Strains, sprains and contusions represent 69% of all injuries Strains, sprains and contusions represent 69% of all injuries 81% of thigh injuries were muscular strains 81% of thigh injuries were muscular strains Over 12% of all injuries are hamstring strains Over 12% of all injuries are hamstring strains NATURE OF INJURIES

30. 30 of 39 AUDITING INJURIES 7% of injuries were re-injuries 7% of injuries were re-injuries l 48% strains, 18% sprains Re-injuries = 25 days missed compared to 19 days for the initial injury Re-injuries = 25 days missed compared to 19 days for the initial injury A significant no. injuries were followed by injuries to the same locality A significant no. injuries were followed by injuries to the same locality RE-INJURIES

31. 31 of 39 AUDITING INJURIES % of Injuries Time (minutes) TIME OF MATCH INJURIES

32. 32 of 39 DIFFICULTIES IN AUDITING INJURIES CHANGING EXTRANEOUS VARIABLES PROFESSIONAL STAFF CHANGES – DOCTORS, PHYSIOTHERAPISTS, SPORT SCIENTISTS NUMBER OF PROFESSIONAL STAFF - DOCTORS, PHYSIOTHERAPISTS, SPORT SCIENTISTS MISDIAGNOSIS CHANGES IN: l NUMBER OF SQUAD MEMBERS – HIGHER / LOWER IN NUMBER l AGE OF PLAYERS IN SQUAD l PRE-SEASON TRAINING PROGRAMME (EXPOSURE) l IN-SEASON TRAINING PROGRAMME (EXPOSURE) l CLOSED SEASON MAINTENANCE PROGRAMME (EXPOSURE) l MANAGER, COACHES l PLAYER EQUIPMENT – BOOTS ETC. l TRAINING GROUNDS – TURF, ASTROTURF ETC.

33. 33 of 39 AUDITING MEDICAL CONDITIONS AND ILLNESSES IS IT DONE ANNUALLY? ARE THE RESULTS REVIEWED AGAINST EXISTING PRACTICES / POLOCIES, E.G. l INFLUENZA l STOMACH COMPLAINTS ETC. CAN AFFECT SQUAD NOT JUST AN INDIVIDUAL NUMBER OF TRAINING DAYS LOST? NUMBER OF GAMES LOST?

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35. 35 of 39 THE FUTURE – “CHALLENGES” REDUCE CONTACT AND NON-CONTACT INJURIES REDUCE PRE-SEASON INJURIES INCREASE RESEARCH IMPROVE DIAGNOSTICS IMPROVE SURGICAL AND TREATMENT / REHABILITATION TECHNIQUES TO REDUCE TIME TO RETURN TO PLAY IMPROVE INJURY PREVENTION STRATEGIES “DIAGNOSTICS” l TO MONITOR THE HEALING PROCESS TO REDUCE TREATMENT TIME l HELP MEDICAL STAFF

36. 36 of 39 PREDICT THE END STATURE AND ADULT PHYSICAL / PHYSIOLOGICAL PROWESS IN YOUTH PLAYERS TO ASSIST TALENT IDENTIFICATION ADDRESS A NEW WAVE OF INJURIES l ↑ EMERGENCY CARE INCIDENTS l ↑ METATARSAL FRACTURES / # FRACTURES l ↑ OVERUSE INJURIES l ↑ HIP INJURIES - ACETABULAR LABRUM - LIGAMENTUM TERES l ↑ CHRONDAL DAMAGE - KNEE JOINT - HIP JOINT l ↑ HAMSTRING INJURIES

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39. 39 of 39 THANK-YOU