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2013 ISAKOS Congress Wrap Up

Prevention of Effective Prevention Program

1 Sport specific exercises
Sports Injuries
2 Variation and progression of exercises

3 Warm-up program
4 Strength

5 Balance
6 Plyometrics

Lucio Ernlund, MD, MSc
Results Coritiba FC
ISAKOS Newsletter Editorial Board 1 Decrease 21% of overall injury rate
Medical Director Coritiba FC
2 Decrease 60% overall injury rate Coritiba FC 2006 – 2010
Instituto de Joelho e Ombro 3 Increase injury rate after program was left aside, due to
Curitiba, Parana, BRAZIL
increase on games calendar (76 last season)

Conclusion

1 Injury rate in football (soccer) is too high
Injury prevention is the number one role of the Sports Medicine 2 Muscle injuries and ankle sprains are most
Doctor. Prevention has low cost as compared to treatment.
frequent injuries
Prevention starts with a systematic screening protocol, PPPE 3 Mid season most dangerous moment
(Pre participation Physical Examination), when doctors get to
4 Low cost / high efficacy
know the athlete and his/her predisposing factors.
5 Program should involve all team from athletes to coach

Accordingly to van Mechelen, 1992, prevention should follow 6 On the practical point of view, not so ease to perform on
this sequence:
a professional Brazilian Team. Too many championships,
long season (State tournament, Brazilian Cup, Brazilian

1 Establish the extent of the injury: incidence and severity;
Championship, Libertadores da America), 76 games last
2 Establish the etilogy and mechanisms of the injury;
season (10 months)

3 Introduce a prevention measure;
7 Long trips (Brazil huge country), more than 60,000 Km
4 Assess its effectiveness by repeating step 1
driving / flying every season. Last year athletes slept over

150 days away from home.
The multifactorial nature of sports injuries makes it difficult to 8 Most of the teams change at least 30% of their players
prevent with 100% success. Meeuwisse, Bahr, Holme and
Krosshaug (on different publications) showed an interesting from one season to the other (new comers may not
have been involved on prevention programs before,
model of potential causative factors for injuries.
expect delays on the progression)
The overall level of injury to professional footballers has been 9 Although all the difficulties team doctors may face,
he/she should proceed emphasizing the importance
showed to be around 1000 times higher than for industrial
occupations generally regarded as high risk. (Hawkins and of the injury prevention programs

Fuller Br J Sports Med 1999.)
ABOVE ALL: IT IS GREAT TO BE A WINNER

A variety of injury specific and sport specific preventive
exercise programs exist. Various authors have established a

strong relationship between the frequent use of standardized
warm-up programs and reduction of the risk of injuries to up

to 50%. (Myklebust, 2003; Mandelbaum,2005; Olsen, 2005;
Soligard, 2008; Kiani, 2010; LaBella, 2011; Walden, 2012)

Although all published data on the efficacy of prevention
protocols, Doctors must struggle to convince team coach and

trainers that these exercises are as important as the technical
training itself.

It is important to show not only the medical

point of view but also the economical
point of view. The real costs involved with

an athlete on the Medical Department
(salaries, consequencial damage, etc) are

extremely high.

22 ISAKOS NEWSLETTER 2013: Volume II