From Medicine for Football to Football for Health
3rd international Football Medicine Conference 19 - 21 February 2010 | Sun City | South Africa
Contents | 3rd International Football Medicine Conference; Sun City
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Contents
Message of the FIFA President
4
Message of the Chief Executive Officer 2010 FIFA World Cup Organising Committee South Africa
5
Welcome to the 3rd International Football Medicine Conference
6
Organisation
8
Programme
9
Invited presentations
13
Free submissions
31
Workshops
43
Faculty
51
FIFA Medical Code of Ethics
61
FIFA Medical Assessment and Research Centre
65
FIFA Medical Network
69
Pre-announcement of 4th International Football Medicine Conference
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Preface | 3rd International Football Medicine Conference; Sun City
3rd international Football Medicine Conference 19 - 21 February 2010 | Sun City | South Africa
Dear participants, Football is the favourite sport of millions worldwide. It is not
game safer. The knowledge and tools you take home from
just a beautiful game - football is and needs to remain as a
this conference will benefit players far beyond the 2010 FIFA
school of life. In Africa, football is the one sport that unites
World Cup™.
people and communities all across the continent, transcending social status, gender, religion, culture and language.
However, this conference will take you beyond football medicine. FIFA’s Football for Health programme makes use of
The conference you will be participating in the coming three
the game’s unique power and we invite you to explore with us
days is an important part of the legacy FIFA wants to leave
football’s potential to improve the health of communities – in
behind for African football - and for African communities.
Africa and the rest of the world.
Health is our most precious property, and our medical legacy is therefore of special importance. Considering today’s reality
We wish you most fruitful and inspiring days here in Sun City.
in health care system all around the world, and particularly
Your attendance will enable you to contribute to the medical
on this continent, it is clear that the key to protecting players’
legacy of the 2010 FIFA World Cup South Africa™. For the
health and potential is prevention. You will learn about
Game. For the World.
F-MARC’s effective injury prevention programme “The 11+” and the Pre-Participation Medical Assessment to make the
Joseph S. Blatter FIFA President
Preface | 3rd International Football Medicine Conference; Sun City
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3rd international Football Medicine Conference 19 - 21 February 2010 | Sun City | South Africa
Dear participants, I am proud to welcome you to Sun City and to this football
The opening of the first FIFA Medical Centre of Excellence
medicine conference, which has been organised by F-MARC
in Africa at Wits University two years ago was the first
and the FIFA Medical Office with the support of the South
important milestone in building a medical legacy far beyond
African Organising Committee for the 2010 FIFA World
the 2010 FIFA World Cup™. Now, this 3rd International
Cup™. South Africa is among the world’s leaders in the field
Football Medicine Conference will be another important
of sports medicine and therefore an ideal host for this event.
landmark, further contributing to the sustainable development of football medicine in Africa. However, FIFA’s Football for
As a former professional player, I know about the importance
Health goes beyond the game and I am looking forward to an
of qualified care, but also about the difficulties in finding it,
engaging experience about football’s potential to improve the
particularly in Africa. Every year, Africa loses many promising
health of African communities.
players because of a lack of access to proper injury treatment. Football medicine contributes to the standard of football in
I wish you a successful conference and trust you will take
every country by helping to optimise performance and training
home the knowledge and tools to implement preventive
strategies, by ensuring the best possible treatment and
programmes that will benefit African players far beyond the
adequate rehabilitation and so much more besides. Improving
2010 FIFA World Cup™.
standards of care sustains the potential of a nation’s players. But prevention of injuries and illnesses protects this potential much better than any treatment ever could.
Dr Irvin Khoza
Dr Danny Jordaan
Chairman
Chief Executive Officer
2010 FIFA World Cup Organising Committee South Africa
2010 FIFA World Cup Organising Committee South Africa
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Preface | 3rd International Football Medicine Conference; Sun City
3rd international Football Medicine Conference 19 - 21 February 2010 | Sun City | South Africa
Dear colleagues, On behalf of the FIFA Medical Committee and the FIFA
prescribed as therapy for the treatment of obesity, diabetes,
Medical Assessment and Research Centre (F-MARC), we are
cardio- pulmonary and musculoskeletal disease, cancer and
pleased to welcome you to the 3rd International Football
depression.
Medicine Conference in Sun City and invite you to share our knowledge of football medicine.
Exactly this now allows us to explore the potential of football as a uniquely powerful tool to improve not only the health
For the last fifteen years, we have been working persistently
of individuals, but of communities worldwide. The Football
to make football a safe sport, our focus always being on
for Health initiative is based on the unique advantages of
prevention and education. F-MARC’s “The 11+ - a complete
delivering health education through football. By sharing with
warm-up to prevent injuries”, FIFA’s Pre-Competition Medical
you our first research results in Africa, we aim to define an
Assessment, optimal nutrition and hydration, considering
African approach to football medicine and health.
special target groups and environmental factors – all of this
We therefore hope that these days will inspire you to tap into
helps to minimise possible negative influences on players’
the underlying power of your speciality. Become part of the
health. We have also established that playing football as
worldwide FIFA football medical network and help us protect
a leisure activity is a very effective disease prevention in
and improve the health of players and communities alike.
itself. Furthermore, we know that exercise can even be
Dr Michel D’Hooghe, MD
Prof. Jiri Dvorak, MD
FIFA Medical Committee chairman
FIFA Chief Medical Officer
Executive Committee member
F-MARC chairman
Bruges, Belgium
Zurich, FIFA, Switzerland
Organisation & Programme
3rd international Football Medicine Conference 19 - 21 February 2010 | Sun City | South Africa
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Programme & Organisation | 3rd International Football Medicine Conference; Sun City
Organisation FIFA Medical Committee Chairman
Michel D’Hooghe, MD
Belgium
Deputy Chairman
Worawi Makudi
Thailand
Prof. Lars Peterson, MD
Sweden
Prof. Jiri Dvorak, MD
Yacine A. Zerguini, MD
Raúl Horacio Madero, MD
Lidio Toledo, MD
Prof . Hosny Abdelrahman Ahmed, MD
Terence James Babwah, MD
Trinidad & Tobago
Gurcharan Singh, Dato’ MD
Malaysia
Tony Edwards, MD
Masoud Al-Riyami, MD
Oman
Prof. Haruhito Aoki, MD
Japan
Selina Fusimalohi, MD
Tonga
Bert Mandelbaum, MD
Carlos Palavicini, MD
Victor Ramathesele, MD
Jean-Marie Debruyne, MD
Jiri Chomiak, MD
Switzerland Algeria Argentina Brazil
Mohamed Ga l Maadheed
Switzerland
New Zealand
USA Costa Rica South Africa Tahiti Czech Republic Qatar
Programme Committee Honorary Chairman Chairman
Michel D’Hooghe, MD Prof. Jiri Dvorak, MD Victor Ramathesele, MD Abdelmadjid Yacine Zerguini, MD Astrid Junge, PhD Demitri Constantinou, MD Prof. Martin Schwellnus, MD James Sekajugo, MD
Belgium Switzerland South Africa Algeria Germany South Africa South Africa Uganda
Organising Committee Chairman
Prof. Jiri Dvorak, MD
Astrid Junge, PhD
Switzerland Germany
Katharina Grimm, MD
Germany
Demitri Constantinou, MD
South Africa
FIFA Medical Conference Office
Anja König
Germany
Programme & Organisation | 3rd International Football Medicine Conference; Sun City
Programme Friday, 19 February – Medicine for Football Time
Subject
07.30 - 08.30
Registration
08.30 - 09.00
Opening ceremony and welcome
09.00 - 09.30
Key note lecture – Medicine for Football
09.30 - 10.00
Pre-Competition Medical Assessment
10.00 - 10.30
On-pitch treatment of football injuries
10.30 - 11.00
Head injuries and concussion
11.00 - 11.30
Break
11.30 - 12.00
Minimising debilitating consequences of injuries
12.00 - 12.30
The child player
12.30 - 12.50
The 11+ warm-up programme to prevent injuries
12.50 - 13.20
Nutrition for football
13.20 - 13.50
The “Big Three” and the team
13.50 - 15.00
Lunch break
15.00 - 16.30
Workshop I
Workshop II
Cardiac risk assessment Thomas Lüscher / Christian Schmied
Hip and groin examination and injuries Mark Ferguson / Terence Babwah
Workshop III
Workshop IV
Head and spine injury assessment and emergency care Jiri Dvorak / Paul McCrory
The 11+ – a complete warm-up programme to prevent injuries Mario Bizzini / Enos Karani
Workshop V
Workshop VI
Ankle examination and injuries Yacine Zerguini/Tony Edwards/Masoud Al Riyami
Knee examination and injuries Bert Mandelbaum / Sello Motaung / Christa Janse van Rensburg
Workshop VII
Workshop VIII
Implementing The 11 for Health Colin Fuller / Ryan Jankelowitz / James Donald / Sipheni Dladla
Emergency situations in football medicine Demitri Constantinou / Efraim Kramer
16.30 - 17.00
Break
17.00 - 18.30
Workshops I-VIII repeats
Speaker
Danny Jordaan / Molefi Sefularo Michel D’Hooghe Jiri Dvorak / Thomas Lüscher Sello Motaung Paul McCrory Demitri Constantinou Bert Mandelbaum Astrid Junge Ron Maughan James Sekajugo All workshops are conducted simultaneously.
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Programme & Organisation | 3rd International Football Medicine Conference; Sun City
Programme Saturday, 20 February – Football for Health Time
Subject
09.00 - 09.30
Key note lecture – Football for Health
09.30 - 10.00
The 11 for Health in Africa
10.00 - 10.15
Respect for women through the game
10.15 - 10.30
Promoting hygiene through football
10.30 - 10.45
Football in preventing chronic disease
10.45 - 11.15
Break
11.15 - 13.45
From Medicine for Football to Football for Health – the African perspective · Physical fitness of footballers in the Cameroonian league
Jiri Dvorak Colin Fuller Souadou Diabaté/AMPJF Henry Majale/MYSA Karim Khan Free papers: Samuel H. Mandengue
· Common lower extremity injuries amongst footballers at the University of Johannesburg
Aboobaker Sayed
· A prediction model for the prevention of football injuries amongst youth players
Johann Serfontein
· Traditional African medicines and the prohibited list: Can I use Umhlabelo?
Winton Hawksworth
· How to plan the provision of health services for a major football event in Africa: a review of the policies, protocols and standard operating procedures for the provision of essential medical services at the 2008 MTN Africa Cup of Nations in Ghana
Adedayo Osholowu
· An effective multi-professional national medical committee based on volunteerism: the Botswana experience
Basadi Akoonyatse
· Health benefits of social football in a select group of male players: a pilot study · Football fights four aggressive African A‘s · Alcohol use and risky sexual behaviour among South African professional footballers: implications for the life skills intervention · Empowering professional footballers in South Africa – an evaluation of the Ithuseng project 13:45 - 14.45
Speaker
Lunch break
Wesley Deavall Teboho Lekanya Sibusiso Ntshangase Catherine Draper
Programme & Organisation | 3rd International Football Medicine Conference; Sun City
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Programme Saturday, 20 February – Football for Health Time
Subject
Speaker
14.45 - 16.15
Workshop I
Workshop II
Cardiac risk assessment Thomas Lüscher / Christian Schmied
How to conduct a scientific study Astrid Junge
Workshop III
Workshop IV
Management of acute soft tissue injuries Martin Schwellnus/Louis Holtzhausen
The 11+ – a complete warm-up programme to prevent injuries Mario Bizzini/Enos Karani
Workshop V
Workshop VI
Ankle examination and injuries Yacine Zerguini / Tony Edwards / Masoud Al Riyami
Knee examination and injuries Bert Mandelbaum / Sello Motaung / Christa Janse van Rensburg
Workshop VII
Workshop VIII
Implementing The 11 for Health Colin Fuller / Ryan Jankelowitz / James Donald / Sipheni Dladla
How to treat asthma in football Demitri Constantinou / Wayne Derman
16.15 - 16.45
Break
16.45 - 18.15
Workshops I-VIII repeats
18.15 - 18.45
Conclusions – Football for Health beyond 2010 Presentation of Football for Health award
All workshops are conducted simultaneously.
Michel D’Hooghe / Jiri Dvorak
Sunday, 21 February – Strategies in fighting doping in football Time
Subject
9.30 – 11.30
FIFA strategies against doping in football Beyond sample collection … Doping control in countries with limited health resources Traditional medicine and remedies Glucocorticosteroid overuse in football Performance enhancement by allowed means The player – victim, scapegoat or sinner?
11.30 - 12.00
WADA’s view on controlling doping in Africa
12.00 - 12.15
Official closure
Speaker Jiri Dvorak Gurcharan Singh / Bwalya Kalusha Martin Schwellnus Yacine Zerguini Mike Lambert Lucas Radebe Rodney Swigelaar Michel D’Hooghe / Jiri Dvorak
Invited Presentations
3rd international Football Medicine Conference 19 - 21 February 2010 | Sun City | South Africa
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Invited presentations | 3rd International Football Medicine Conference; Sun City
Pre-Competition Medical Assessment
Jiri Dvorak Prior to the 2006 FIFA World Cup Germany™, F-MARC
Thomas F. Lüscher Although physical exercise is generally healthy
developed a standardised pre-competition medical assessment
and provides protection against many diseases,
(PCMA) for the world’s elite football players. The objective of
competitive sport is associated with rare but sometimes
this PCMA was to maximise the probability of detecting the
fatal cardiovascular complications in individuals with
risk factors that challenge players’ health, not only with regard
unrecognised clinical conditions. Sudden cardiac death
to sudden cardiac death (SCD) but also other serious health
in competitive sportsmen may be due to a variety of
risks and severe injuries. As a pilot study, all teams were asked
cardiac conditions including hypertrophic cardiomyopathy,
to perform the PCMA in their players and the completed
biventricular arrhythmagenic cardiomyopathy,
forms were analysed by F-MARC. Based on these results, the
channelopathies of the cardiac conduction systems,
PCMA was reviewed and updated*. While the original PCMA
coronary anomalies as well as premature coronary artery
for these international elite players at FIFA’s flagship event is
disease. Long-term studies have clearly demonstrated that
a comprehensive examination including personal and family
pre-competition screening is safe and efficient in detecting
history, physical examination, a resting 12-lead ECG and
individuals at risk. Indeed, thanks to the implementation
transthoracical echocardiography, this might not be realistic
of such measures, the incidence of sport-associated
for larger target groups at all levels of play and in settings
mortalities has been significantly decreased.
with less developed infrastructure and health care facilities. In view of the many millions of football players worldwide and
Based on these studies, it is currently recommended
the considerable discrepancies in access to medical care, a
to perform a series of examinations. First of all, thorough
standard pre-competition medical assessment might indeed
clinical examinations are of the utmost importance
prove difficult to be implemented on an international scale. It
and may reveal chest deformations, cardiac murmurs,
is important to note however that in this context a stepwise
anomalities in blood pressure and pulse as well as other
implementation represents a valid alternative option. As
abnomalities. Furthermore, a resting ECG proved to be
medical history alone can identify up to 75% of the problems
useful. In the presence of any abnormalities in the clinical
that affect athletes / players, history taking is the crucial first
examination and/or the ECG, an echocardiography is
step with further examinations only conducted based on the
recommended. In subjects with abnormal examinations,
findings and according to an examiner’s skills and the facilities
further tests may be indicated such as exercise tests,
at his disposal.
computer tomography, mainly to detect coronary abnormalities, or MRI.
Reference: * Dvorak J, Grimm K, Schmied C, Junge A. Pre-competition
Thus, in summary, pre-competition screening has
medical assessment of international elite football players
proved to be extremely useful in preventing sudden cardiac
– 2006 FIFA World Cup Germany™. Clin J Sports Med
death as well as other severe cardiovascular complications
2009;19:316-321
that may occur in competitive sportsmen.
Junge A, Grimm K, Feddermann N, Dvorak J Precompetition orthopaedic assessment of international elite football players. Clin J Sports Med 2009; 19: 326-328
Invited presentations | 3rd International Football Medicine Conference; Sun City
On-pitch treatment of football injuries
Sello Motaung Field-side treatment of injuries requires adequate
remove the injured player off the field.
preparation. The team physician must know all common injuries that can be encountered on the field of play. He/
The general guiding principle in allowing players
she must possess the necessary expertise/experience
continue with play is that there should be no possibility
in managing football injuries. The prevailing pitch and
of the injury getting worse or adversely affecting
environmental conditions must also be known. The
performance.
team physician must have appropriate equipment and medication to deal with any possible injury or emergency condition. A pre-inspection of available facilities is also necessary as part of preparation. The team physician needs to know what types of facilities are available for minor surgical procedures such as suturing of wounds. It would also be necessary to have knowledge of and details of prearrangements for nearby major medical centres to refer seriously injured players, if need be. Commonly encountered acute injuries in football can be classified into contact and non-contact type injuries/ conditions. Most are musculoskeletal injuries involving mainly the lower extremities (ankle, lower leg and knee). The majority of these injuries are minor. However there may be, less commonly, severe and career-threatening contact injuries such as cervical spine injuries or lifethreatening conditions such as a cardiac arrest. Minor musculoskeletal injuries are assessed and treated off the pitch and the decision to allow the player to continue with play made within a short space of time. Treatment usually depends on the anatomical area affected and the severity of the injury. Most of these respond to immediate cryotherapy and compression and the player is usually able to continue with play. Severe injuries, e.g. a suspected unstable cervical vertebral fracture, need to be carefully handled and the player’s spine appropriately stabilised before attempting to
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Invited presentations | 3rd International Football Medicine Conference; Sun City
Head Injuries and Concussions
Paul McCrory The risk of traumatic brain injury is low in football
Reference:
when compared with other sports. Based on data from
McCrory P, Meeuwisse W, Johnston K, Dvorak J, Aubry M,
both US Collegiate sports as well as surveys conducted
Molloy M, Cantu RC. Consensus Statement on Concussion
by FIFA, the risk is approximately 0.4 (elite) – 1.7 (non-
in Sport – the 3rd International Conference on Concussion
elite) concussions per 1000 athlete hours. This translates
in Sport held in Zurich, November 2008. Br J Sports Med
to approximately one concussion with time loss per FIFA
2009; 42: i76-i84
tournament. Interestingly the risk of concussion is higher in women and there are gender differences in the mechanism of injury seen. Concussion is a complex patho-physiological process which, if managed incorrectly, has the potential for a number of problems including future injury, persistent symptoms, brain swelling (particularly in children/ adolescents) and possible long term cognitive impairment. Prevention of concussion is based upon rule enforcement to avoid contact to the head during game play. Helmets, head protectors and mouthguards have little or no scientific evidence with regard to preventing brain injury Current management strategies are based on international consensus guidelines and follow a clinical pathway with an assessment tool (SCAT2) for both doctors and lay public as well as stepwise rehabilitation guidelines. In general terms, all concussion injuries should be assessed by a medical doctor as soon as possible following the injury and athletes need to be cleared by medical personnel prior to return to sport. These are freely available through both the FIFA and IOC medical websites as well as being widely published.
Invited presentations | 3rd International Football Medicine Conference; Sun City
Minimising debilitating consequences of injuries
Demitri Constantinou The presentation will start by briefly discussing the incidence of injuries amongst football players. Acute and chronic injuries that are debilitating, which include musculoskeletal, head injuries and spinal injuries, will be demonstrated as cases for the approach and principles in minimising long term negative outcomes of any injury. The approach will be specifically highlighting means to achieve this in the African context, noted to be of great importance. The principles of the topic include: 1.
Managing acute injuries - assessment of acute
injuries, knowledge in emergency medical
procedures, what to do with acute joint dislocations
and managing these on the field or at the field-side.
2.
Managing chronic injuries – appropriateness, best
practise, timelines.
3.
Return to play criteria to reduce the debilitating
consequences of injuries.
4.
Principles of rehabilitation in second and third
phases.
5.
The role of nutrition, prehabilitation, psychology and
rehabilitation.
6.
Summary of the concept of Minimising debilitating
consequences of injuries.
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Invited presentations | 3rd International Football Medicine Conference; Sun City
The Child Player
Bert Mandelbaum Football Medicine for youth focuses on (1) Prevention of disease and injury through optimised Pre-competition medical assessment and programmes like “The 11+”. (2) Injury Care non-surgical and surgical, rehabilitation and return to play. (3) Optimal performance which includes nutrition, hydration and heat adaptation. Fitness including aerobic and anaerobic, strength, agility, balance and proprioception. It is important to comprehensively define the benefits and risks of youth football. The benefits of football include (1) Psychologically: team enhancement, greater self esteem, better school performance, less use of alcohol and drugs, depression, teen suicide and legal problems. (2) Physiological and Medical: greater fitness and strength, improvement in bone densitiy, improved immune response and less infectious and cardiovascular disease. (3) Physical greater muscle, bone and cartilage density with less sarcopenia, osteopenia and chondropenia. (4) Sociological: team sports are the best global diplomacy. (5) Lastly football can be a therapeutic Intervention and an opportunity to improve mal-nutrition, hypertension, depression, cystic fibrosis, diabetes, Down’s syndrome and recovery from infectious disease.The principle risks for youth football in Africa include (1) Physiological dehydration and heat issues especially in extreme environments. (2) Overuse and traumatic injury which includes muscle, joint, growth plate and cartilage injuries are relatively uncommon in young but in adolescent females knee and ACL injuries can be common and are a challenge in face of limited access to expert medical care. Prevention programmes like “The 11+” have significant impact to reduce injuries. Repetitive overuse and stress injury to bone including stress fractures can be very common. Overall football, is an excellent tool for personal and social development of African youth, is a quality of life enhancing activity – and fun.
Invited presentations | 3rd International Football Medicine Conference; Sun City
“The 11+” warm-up programme to prevent injuries
Astrid Junge Playing football requires various skills and abilities,
“The 11+” is available in four languages (English,
including endurance, agility, speed and a technical and
French, German and Spanish) on DVD, on a poster and
tactical understanding of the game. All of these aspects
in the form of handy information cards. All material can
are taught and improved during training sessions, but
be viewed and downloaded on http://extranet.fifa.com/
playing football also entails a certain risk of injury. Thus,
medical.
optimal training should also include exercises to reduce the risk of injury. “The 11+” is a complete warm-up programme to reduce injuries among male and female football players aged 14 years and older. The programme was developed by an international group of experts under the leadership of F-MARC. The programme’s effectiveness was proven in a large study involving 2,000 female youth players in Norway. After a year of practising “The 11+”, overall injuries had decreased by a third and serious injuries by half. It is important to note that the more regularly the programme was completed, the fewer injuries were sustained. The programme has three parts with a total of 15 exercises, which should be performed in the specified sequence at the start of each training session. Parts one and three are running exercises, while part two focuses on improving strength, neuromuscular control, plyometrics and balance. Each exercise in part two has three levels of intensity. This allows the programme to be adapted to address the strengths and weaknesses of individual players or teams. The programme should be performed at the start of each training session (at least twice a week) and takes around 20 minutes to complete. Prior to matches, only the running exercises (parts one and three) should be performed.
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Invited presentations | 3rd International Football Medicine Conference; Sun City
Nutrition for Football
Ron Maughan Good nutrition cannot compensate for lack of skill, speed, stamina or motivation, but an inadequate diet prevents players from realising their potential. The major causes of fatigue in training and match play are depletion of muscle glycogen, and problems with thermoregulation and fluid balance. A high carbohydrate diet - 400-500g per day or even more - during periods of hard training or when games are close together should ensure that the muscle and liver glycogen stores are refilled effectively. The diet should include a variety of different carbohydrate foods, including simple sugars and complex carbohydrates. About 50-100 g of convenient and palatable carbohydrate should be eaten as soon as possible after exercise. Hard exercise also leads to significant sweat loss even in cold weather. Dilute carbohydrate-electrolyte drinks are effective for rehydration in hot weather training and competition. The optimum formulation varies between individuals and depends on climatic conditions. The requirement for other nutrients, including protein, vitamins and minerals is increased during periods of hard training or frequent match play, but needs will generally be met if a varied diet is eaten in sufficient quantity to meet the energy demand. Supplements will not normally be necessary, but deficiencies may occur, however infrequently. Players should prepare for competition by ensuring adequate rest together with a high carbohydrate diet for 2-4 days prior to major games. Pre-game meals should normally be consumed about 3-4 hours before the game, and should focus on providing carbohydrates and fluids. Drinks should be taken when possible during the game as well as at half time. Many players have limited understanding of their nutrition needs, and Federations, clubs and players must work together to improve this situation. Educational programmes should be aimed at players and management, but catering staff and those who purchase and prepare food for the players should also be targetted.
Invited presentations | 3rd International Football Medicine Conference; Sun City
The “Big Three” and the team
James Sekajugo HIV/AIDS, Tuberculosis, and Malaria are 3 major global public health threats that cause substantial morbidity, mortality, negative socioeconomic impact, and human suffering. HIV/AIDS, Tuberculosis and Malaria “The Big Three”, are responsible for about three million deaths in Africa every year. Football thrives best in a healthy population. “The Big Three” have been identified as areas of concern to football as they seriously threaten the health and productivity of football manpower; footballers, officials and fans. While football may play an important role in intervention programmes aimed at prevention and reducing the incidence of the “The Big Three”, this presentation describes the problem from the perspective of the team physician – how do these diseases affect a player and the team? Questions to be discussed include for example what preventive measures have to be taken to prevent infection of team mates in a player who is HIV-positive, e.g. with regard to open wounds, drinking bottles, sanitary facilities; dealing with a player who is contagious for TB; the question of malaria prophylaxis and its influence on performance, return-to-play schemes and use of medication in the context of anti-doping issues.
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Invited presentations | 3rd International Football Medicine Conference; Sun City
The 11 for Health in Africa
Colin Fuller
in Cape Town, South Africa amongst two groups of school children aged 11/14 years and 12/15 years. Finally,
A World Health Organisation report published in 2009 identified that the major risks for global mortality included high blood pressure, use of tobacco and alcohol, high blood glucose levels, physical inactivity, obesity and poor hygiene. These health risks affect people in low, middle and high-income countries. Managing these health risks is complex because the risks affecting individual countries change with both time and the level of national development: the focus of attention usually shifting from communicable to non-communicable diseases as countries develop. A report published by the United Nations in 2003 concluded that participation in sport had significant physical benefits and could also contribute to people’s ability to lead long and healthy lives, improving well-being, extending life expectancy and reducing the prevalence of a number of non-communicable diseases. Unfortunately, a lack of knowledge about the causes and consequences of communicable and non-communicable diseases severely limits the adoption of positive attitudes and behaviours towards health risks. In 2006, F-MARC began to look at ways in which football could be utilised to increase knowledge about communicable and non-communicable diseases. The outcome of these deliberations led to the development of ‘the 11 for Health’, which is an interactive educational programme linking 11 football skills with 11 health messages. ‘The 11 for Health’ programme was primarily intended for implementation amongst school children aged from 11 to 16 years. In this presentation, the structure of the programme will be discussed together with how the programme has been implemented. The benefits of the programme will be illustrated using the results obtained from trials of the programme conducted in 2009 in Khayelitsha township
future directions of how the programme is currently being evaluated by F-MARC will be discussed.
Invited presentations | 3rd International Football Medicine Conference; Sun City
Promoting women‘s development through football
Souadou Diabaté Adolescence, a period of physical and sexual immaturity, of underage pregnancies that may lead to secret abortions, high-risk pregnancies, difficult childbirth, the abandonment of children, infanticide, young girls becoming mothers, prostitution, a prevalence ratio of STDs/HIV-AIDS 75% greater than the national ratio of 1.7%, and exclusion from families/society. As part of its football-based programme to effect positive and lasting social change, the AMPFJ is using peer education, which consists of putting a system in place in which youngsters inform, communicate with and educate their peers. This highly effective strategy has enabled the AMPJF to tackle various issues that have become taboo in society, such as sexuality, forced marriage and female circumcision. It gives adolescent girls greater insight into STDs/HIV-AIDS and the means of preventing and combating them. Peer education encourages adolescent girls to take responsibility for their sexual behaviour through women’s football.
Women‘s Football
Encouraging healthy development of adolescent girls
FFH centre village
Peer education
Raising awareness among parents and authorities
AMPJF
Culture of excellence
Female entrepreneurship
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Invited presentations | 3rd International Football Medicine Conference; Sun City
Promoting Hygiene Through Football
Henry Majale MYSA’s mission is “Linking Sports, Community Leadership and Sustainable Development in Africa”
D) Advancement of proper sports hygiene practices; All football stakeholders should actively participate in formulation of guidelines that will help reduce the
Hygiene is the set of practices associated with the
occurrences and outbreaks of infectious diseases within
preservation of health and healthy living, employed to
football camps, thus creating a healthy environment that
reduce the incidence and spreading of disease. It’s related
will allow the athlete to optimally compete and hence
to medicine and personal/ professional care for cleanliness
reduce the risk of being sidelined.
& disease prevention measures. E) Setting up/ erecting proper facilities; Football Football can be used to improve hygiene through:
administrators should erect proper facilities like eco-toilets, latrines and clean water sources to ensure proper sanitary
A) Sensitization and community outreach; where
and hygienic conditions are observed thus reducing risks
its many avid fans & players can be reached through
of an outbreak of diseases such cholera, dysentery and
awareness seminars and activities that teach hygiene.
diarrhea in a community.
Footballers can be used as ambassadors of proper hygiene to their fans, community and families.
F) Poverty eradication; The poor’s primary concern is food rather than the environment. While football groups
B) Cooperate Social Responsibility and Community
can help in provision of amenities like water, unblocking
Service; Since firms and organizations have a corporate
drainage systems, garbage collection, they can as well set
social responsibility to help the community in which they
up entrepreneurial self help groups. Football can also be
operate to overcome certain impediments, football teams
used to generate income and ultimately pay salaries to the
and organizations have a duty to undertake such CSR
players
activities pegged on environment improvement and/or community development C) Sports and slum cleanups; Football groups can collectively or individually undertake to help their societies embrace proper hygienic practices especially when it comes to waste management especially in slums (informal urban-poor settlement areas), where provision of government services is minimal precipitating widespread unplanned garbage collection, insecurity, poverty, diseases, etc.
Invited presentations | 3rd International Football Medicine Conference; Sun City
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Football in Preventing Chronic Disease
Karim Kahn
I will also argue that these benefits will extend to mental health (avoidance of depression), bone health (preventing
Physical activity is arguably the best public health
osteoporosis) as well as preventing other chronic
intervention available to the world. Of course education,
conditions. However, the maxim ‘use it or lose it’ applies so
sanitation and nutrition are also critical sociocultural
football needs to be played for life.
determinants of health. Unfortunately, our health professions tend to emphasize the role of medications much more strongly than they teach about the form of medicine that is effective, cost-effective and has relatively few side-effects. Physical activity. Historically, physical activity was inherent in essential daily activities. However, work-related and ‘incidental’ activity has been engineered out of the daily routine. Even in Africa, the least urbanized continent, the population is gravitating to cities at an unprecedented rate. In a recent study of 7 African studies, the prevalence of urban overweight/obesity increased by nearly 35% during the recent decade (Ziraba, 2009). Data on physical activity are equally striking – in Nigeria, for example, various studies reported that 25-57% of the population as physically inactive (Abubakari 2007). Cape Town researchers concluded that South African adults have a particularly high prevalence of physical inactivity (Joubert, 2007). That is where exercise comes in – exercise is fun! Playing football is fun! Think of children all over the world playing football not because they have to but because they want to. Similarly think of men, women and seniors engaged in the beautiful game. In this 15-minute presentation, I will summarise the health benefits of playing football. I will focus on the benefits of playing for 60 minutes daily – even allowing for 30 minutes of substitution. I will share data that football promotes cardiovascular health and improves blood lipid profile, it drives body composition toward healthier proportions of muscle and fat (Krustrup, 2009).
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Invited presentations | 3rd International Football Medicine Conference; Sun City
Doping Control in Countries with limited health resources
Gurcharan Singh The anti-doping code encompasses an extensive set
Publicity and sanctions act as a strong deterrent that
of regulations coupled with an exhaustive list of banned
instil shame and fear. Team of knowledgeable personnel
substances / methods with continuous amendments. Anti-
in result management and disciplinary commission is
doping activities are complex, expensive and may lead to
essential.
legal consequences. It requires a collective effort. Countries are confronted with untrained personnel, financial budgets
Finally governments have an obligation under the
and legislation not in conformity to anti-doping code.
UNESCO Convention to amend / rectify legislation to be
Governments tend to focus on health related issues as a
compliant with the Code.
priority rather than anti-doping activities. Governments have an obligation to be code compliant and there must be a minimum mechanism in place for anti-doping activities. The four pillars in fight against doping in sport are education, testing, deterrent and sanctions. Education is the cornerstone in fight against doping. It is an effective low cost high output activity. Anti-doping educational activities seek assistance from related sports bodies (NOC, NADO, RADO, FIFA, etc.). It increases the pool of trained personnel an essential tool in anti-doping activities. Awareness through educational paraphernalia and charts at venues is a step in this direction. Private sector participation, such as drug companies and manufacturers of medical equipment as partners in fight against doping. Start early and start young. Inclusion into the school curriculum is an effective preventive measure to create awareness esp. in youths who are high risk group. Controls or testing is an expensive activity. Prioritize and identify high risk sport / events to conduct limited doping controls. Not volume but quality is essential. Team up with NADO to budget and conduct controls e.g. Malaysia (ADAMAS) and Japan (JADA). Resources can be shared esp. during regional games.
Invited presentations | 3rd International Football Medicine Conference; Sun City
Traditional medicines and remedies
Martin Schwellnus It is estimated that 60% of the world’s population
aids. However, there is concern about the potential for
rely on traditional medicines for health care needs.
doping offences when athletes use these substances,
Traditional medicine use is not only confined to the African
and there may be negative health effects of the use of
continent; 30-50% of total consumption of medicines
these substances. Finally, further research in this area
in China is traditional medicines, while > 70% of the
is important, but any activities or projects need to be
population in India uses traditional medicines. Traditional
culturally and socially sensitive.
medicines and remedies are also potentially used by athletes to 1) improve sports performance (ergogenic aids), 2) treat of sports injuries and medical conditions. In this presentation the results of three studies that have examined the relationship between traditional medicine and use in sports are presented. In the first study, the beliefs of 69 health professionals on the pattern of use, reasons for use, and type of traditional medicines by athletes in Africa was examined. The main findings from this study were that more than 30% of respondents indicated that athletes use traditional medicines in sport. In addition, there is considerable secrecy surrounding the use of traditional medicines by athletes, athletes do not generally share their information regarding the use of traditional medicines, and do not generally appreciate the potential health and doping risks associated with the use of traditional medicines. Administration was by self administration, family members or traditional healers associated with the team. In a second study among 2170 adolescent schoolchildren (males=58%) the prevalence (%) of use of traditional medicines in sports was reported as 2.1% (males=2.8% and females=1.2%). Herbs were mostly used (54% of users) and 85% of the users of traditional medicines experienced apparent benefits during sports. In the third study, data on the specific traditional medicines that are used by athletes from 6 different countries in Africa were obtained through structured interviews. In summary, traditional medicines are an integral part of general and sports health care in many countries and they may be used by athletes as ergogenic
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Invited presentations | 3rd International Football Medicine Conference; Sun City
Glucocorticosteroids overuse in football
Yacine Zerguini Glucocorticosteroids are widely used in sports
Tendon and fascial ruptures are reported
medicine for the treatment of medical conditions such as
complications of injected glucocorticosteroids, whereas
asthma, injuries and musculoskeletal disorders. There is
tibial stress fractures and multifocal osteonecrosis were
abundant literature on their use, especially in the latter
described with systemic glucocorticosteroids.
indications. However, to date there has not been a review summarising their beneficial potential on the one hand
In this respect, the potential benefit, which in
and their adverse effects on the other hand with respect to
selected cases may be evidence-based, should always be
the various sporting indications.
considered in relation to the potential side-effects and complications of glucocorticosteroid use.
Glucocorticosteroids possess potent antiinflammatory pharmacological properties and so they are
In the case of sport-related injuries, appropriate
indicated in chronic diseases such as rheumatoid arthritis
rehabilitation and physiotherapeutic approaches should
or clinically diagnosed asthma.
be considered as the treatment of choice before the use of intra-articular and/or intramuscular glucocorticosteroid
For the same reason, they are essential in the
injections.
treatment of medical emergencies, such as necrotising vasculitis, asthmatic state and anaphylactic shock. These
According to FIFA’s new TUE policy,
conditions are all characterised by either inflammation or a
glucocorticosteroids administrated by non-systemic and
high number of lymphocytes as the primary pathology.
non-inhaled routes, namely intraarticular, periarticular, peritendinous, epidural and intradermal injections, are
Conversely, the inflammatory reaction in the
frequently used to treat medical conditions encountered in
course of football injuries is a secondary reaction to the
football players. These substances, for which the route of
musculoskeletal trauma and part of the healing process.
administration is not prohibited, require a declaration of use.
As a consequence, the use of glucocorticosteroids, particularly intra-articular or intramuscular injections,
As a result, any TUE for glucocorticosteroids has
has to be carefully assessed and these drugs used only
to be carefully evaluated by the respective granting
if there is a rational, evidence-based indication. Nichols’
body in order to reduce or even avoid the misuse of
critical review in 2005 revealed that the existing medical
glucocorticosteroids. With regard to the prevention of
literature does not provide precise estimates of the rates of
misuse and for educational purposes, it has to be stressed
complications following the therapeutic use of injected or
that a measurable performance-enhancing effect of
systemic glucocorticosteroids in the treatment of athletic
glucocorticosteroids cannot be proved by the results of
injuries.
scientific studies conducted to date.
Invited presentations | 3rd International Football Medicine Conference; Sun City
Performance enhancement by allowed means
Mike Lambert Performance in football is dependent on the skill, health and fitness of the players and the tactical acumen of the coaching staff. Players may use illegal substances with the goal of improving their fitness, particularly if they find the challenges of the physical preparation overwhelming. For example, a challenge is that the long season makes it difficult for the conditioning coach to periodise the programme with sufficient precision to enable the players to peak coinciding with big matches. Furthermore, players do not adapt to training loads at the same rate and the physical demand of different playing positions varies. Despite these challenges, a strong case can be made that the gains in fitness following a carefully constructed fitness programme are more meaningful than any gains in fitness which may be sought by using illegal pharmaceutical agents. However for this claim to be made the fitness programme needs to incorporate features which are based on scientific evidence and which strives to impose a challenging training load while at the same time being cognizant of reducing the risk of injury. A fundamental feature of the fitness programme is daily monitoring of symptoms of fatigue so that the training load can be customized and titrated in accordance with the development of fatigue. Information gathered from each player should be subjective (i.e. session RPE, DALDA, muscle soreness and recovery index) and objective. It is recommended that recovery heart rate can be used as an objective measure because it is a measure of the functioning of the autonomic system, it is non-invasive and can easily be incorporated into a training session. A carefully constructed monitoring programme linked to the prescription of the training will increase the chance of the players’ maintaining acceptable levels of fitness throughout the season and decrease the desire to boost performance by using doping agents.
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Invited presentations | 3rd International Football Medicine Conference; Sun City
WADA‘s view on controlling doping in Africa
Rodney Swigelaar The World Anti-Doping Agency is celebrating its 10th Anniversary. This is a very special time for WADA as it affords the Agency the opportunity to take stock of its achievements and the many challenges facing anti-doping, globally. Anti-doping and the success thereof, rely heavily on the formation and strengthening of partnerships. Partnerships between the governments of the world and the Sports Movement, between different sports, as well as the critical relationships between those responsible for the well-being of athletes, including those entrusted with the evolution of the medical field and scientific research. This paper will explore some of the objectives of the World Anti-Doping Code and the roles and responsibilities of the various interest groups with specific reference to the role of the Sports Movement in ensuring compliance and the successful enforcement of the Code. Furthermore, the presentation will give a brief overview of the responsibilities of WADA and also provide more specific information regarding the development of anti-doping in Africa. Issues that will be addressed include, the extent of the partnerships between governments and the sports movement as well as the development, advances and the challenges facing the six (6) Regional Anti-Doping Organizations (RADO’s) operating in the region. Factors hindering progress will also be highlighted and the paper will raise suggestions on how to address some of these challenges and the role that both the Sports Movement and the governments in the region can play in tackling these. In conclusion, the presentation will briefly focus on the way forward in the fight against doping as new and innovative approaches to addressing this scourge are explored and developed.
Free Submissions
3rd international Football Medicine Conference 19 - 21 February 2010 | Sun City | South Africa
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Free submissions | 3rd International Football Medicine Conference; Sun City
Physical Fitness of Cameroon League on Soccer Players
Mandengue SH1*, Etoundi-Ngoa SL2, Lehman LG1, Cissé F3 1
Sport and Exercise Physiology Unit, Faculty of Sciences,
University of Douala,
Conclusion: The differences in anthropometric and physiological values are related to the environmental poor
2
Department of Biology, ENS, University of Yaounde l,
nutritional conditions status known in poor countries; and
3
Laboratoire de Physiologie, de Médecine du Sport et
to an insufficient level of training of Cameroonian local
d’Explorations Fonctionnelles, Faculté de Médecine,
soccer league one players who are amateurs compared to
Université Cheikh Anta Diop, Dakar
Western’s. This study justify the established fact of a total absence of local football players in the final selection of
Purpose: To determine some anthropometric and
Cameroon national team in continental and international
physiological parameters of Cameroon league one soccer
competitions; selection which is generally constituted only
players and predict their performance.
by professional players evolving in European’s football championships
Methods: Thirty league one soccer players (23 ± 3 yrs) performed an incremental test on a treadmill for the
Key words: Soccer players - Anthropometric
determination of maximal oxygen consumption (VO2max),
parameters - Physiological parameters-Physical fitness
maximal ventilation (VEmax), maximal heart rate (HRmax),
–Cameroon
and energy cost (EC). The values obtained were compared to those of studies undertaken in England, Canada, Norway and Saudi Arabia. Results/Discussion: Anthropometric and physiological values were: Height, 174.6 ± 4.6 cm, weight, 70.4 ± 4.7 kg, HRmax, 178 ± 11 beats.min-1, VEmax
References:
133.6 ± 15.7 L.min-1, VO2max 56.9 ±3.7 mL.kg-1.min-1,
1- Al-Hazzaa HM, Almuzaini KS, Al Refaee SA., et al.
EC, 5.5 ± 0.1 kJ.km-1.kg-1. VO2max of Cameroonian
(2001) J Sport Med Phys Fitness, 41: 54-61.
players was significantly lower (p<0.01) than Norwegian’s
2- Reilly T, Bangsbo J, Franks A. (2000) J Sports Sci, 18:
of same category (63.7± 5.0 mL.kg-1.min-1) and England
669-683.
under-16 (59.3 ± 3.8 mL.kg-1.min-1) (p<0.01). VO2max
3- Reilly T, Williams AM, Neville A, Franks A. (2000) J
corresponded more to Canadian under-18 (57.7 ± 6.8
Sports Sci, 18: 695-702.
mL.kg-1 min-1) and to the Saudi Arabia payers of same category (57.7 ± 6.8 mL.kg-1.min-1. The EC was higher than recommended norms. *Contact details: Phone: +237 74 95 04 67 Email: shmandengue@yahoo.fr Postal Address: PO Box 7064 Douala, Cameroun
Free submissions | 3rd International Football Medicine Conference; Sun City
Common Lower Extremity Injuries amongst Soccer Players at the University of Johannesburg
M. M Rantoa1 , A. Sayed2*, B. Zipfel3 1
Department of Emergency Medical Care and Podiatry,
University of Johannesburg
Results: Sixty two percent of the participants reported that they experienced lower extremity injuries.
2
Podiatrsit in Private Practice, Sandton Medi-Clinic
The ankle was the most commonly affected, followed
3
Bernard Price Institute for Palaeontological Research
by the knee and the foot. Injuries were found to be
and Institute for Human Evolution, University of the
more common amongst male soccer players holding the
Witwatersrand
defending position. It was reported that tackling was the most common mechanism causing lower limb injuries.
Background: Soccer is the one of the most popular team sports in the world and at tertiary institutions in
Conclusion: Foot and ankle injuries are common
South Africa. Lower extremity injuries are common in
amongst soccer players; these results show that foot and
many contact sports, especially soccer. Documentation of
related injuries are very common in soccer players at the
the patterns of injury, anatomical location, mechanism of
University of Johannesburg. Even though these data by
injury and severity can be used to plan injury prevention
no means predict the same trend at other institutions, it
and intervention.
is not unreasonable to suggest that this may be the case, presuming similar training and competition scenarios.
Aims: 1. To determine common lower extremity injuries in a group of soccer players at the University of Johannesburg. 2. To identify the distribution of lower extremity injuries and mechanism of injury. 3. To determine associations between positioned played and injury. Methodology: Sixty six soccer players (males and females) from four high performance teams at the University of Johannesburg were invited to participate in the study. An interview was conducted by the researcher. The interview was divided into three sections: personal profile, activity profile and injury profile. The activity profile focused on positions played, amount of practice sessions per week, experience playing soccer and use of safety equipment. The injury profile determined if the participant had experienced any lower extremity injury, the location of injury, severity of injury, treatment and rehabilitation
*Contact details:
process.
Phone: 011 680-0562 / 0720979587 Fax: 0866361542 Email: info@drfoot.co.za Postal Address: P.O Box 2716, Lenasia,1820
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Free submissions | 3rd International Football Medicine Conference; Sun City
A Prediction Model for the Prevention of Football Injuries Amongst Youth Players
Dr JH Serfontein* / Prof EJ Spamer Platinum Stars FC
Conclusion: It was possible to predict the risk of
School for Continuing Education
non contact injuries as well as non contact groin injuries
North West University, South Africa
in youth football players using a pre-season test battery containing previous injury history, a biomechanical
Aim: The creation of a prediction model for the prevention of football injuries amongst youth players.
assessment and proprioceptive and plyometric testing. These injuries could be prevented by a specific preseason training programme addressing the shortcomings
Methodology: A pre-season injury history
identified in the prediction model.
questionnaire, biomechanical-, proprioceptive- and plyometric evaluation was done 110 youth football players from the U/16 and U/18 teams at 2 schools from the North West Province, South Africa and the U/17, U/18 and U/19 teams at a club from the South African Premier soccer league. All injuries at the schools and club were recorded during the following season. Logistical regression analysis was used to establish the possibility of creating prediction models for non contact injuries based on the pre-season evaluation and recorded non-contact injuries. Findings: A prediction model was created for non-contact injuries containing variables of toe positional dysfunction, previous ankle injury, ankle dysfunction, SIJ dysfunction, Lumbar extension, straight leg raise, psoas length, Patella squint, Gluteal muscle length and Lumbar dysfunction. this model correctly classified 86.91% of players correctly as either ‘injured’ or ‘not injured’. A further prediction model was created for non contact groin injuries specifically. This model contained variables of SIJ dysfunction, previous knee injury, previous hip injury, Lumbar extension, straight leg raise, limb dominance and the plyometric ratio of non dominant limb: dominant limb jump height. This model correctly classified 96.26% of players as ‘injured’ or ‘not injured’ for non-contact groin
*Contact details:
injuries.
Phone: +27 82 325 1505 Email: johann@serfonteinphysio.co.za Postal Address: PO Box 131056, Bryanston, SA
Free submissions | 3rd International Football Medicine Conference; Sun City
Traditional African Medicines and the Prohibited list Can I use uMhlabelo
Prof. Winton Hawksworth* South African Institute for Drug-Free Sport The WADA Prohibited List identifies those Prohibited Substances and Prohibited Methods that are prohibited because of their potential to enhance performance or mask their potential detection. The substances appearing on the List are derived from medications and chemical agents familiar to the developed world. Little attention is paid to the traditional medications used by a traditional rural society. These medications are derived from plant material and the potions that result have traditional African names. African sports persons are aware of the WADA List and they often ask the National Anti-Doping Agency whether a traditional medicine is allowed in sport. Hence the title of this presentation â&#x20AC;&#x201C; Can I use uMhlabelo? Before attempting to answer the question, a selection of traditional known plant medications will be examined, their likely active ingredients identified and an opinion will be expressed as to whether they could be prohibited in terms of the WADA List.
*Contact details: Phone: 082 883 6498 / +27 39 975 1758 Postal Address: P.O. Box 36, Kelso, 4183, SA
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Free submissions | 3rd International Football Medicine Conference; Sun City
How to plan the Health Services of a Major Football Event in Africa: A review of the policies, protocols and standard operating procedures for provision of essential medical services at the Ghana 2008 MTN African Football Cup of Nations. Osholowu A.G.*, Owo C. Special Olympics Nigeria
Conclusions: While there is still need to conduct other studies to document the planning of medical
Introduction: I hypothesized that there was room
services at other Football events in Africa to share best
for improving the quality of health services at sporting
practices. Information gathered during this study provide
events in Africa by applying scientific methods in
a framework to work with in planning a major football
planning medical care for football tournaments. This study
tournament in Africa.
documents medical services at the 26th edition of the Africa Cup of Nations, the biennial football tournament for nations affiliated to the Confederation of African Football. Future studies will review medical services planning methods in other parts of the Africa. Results from the study will provide data for use in planning future health services at football events. Methods: Findings are reported from information gathered by participant observation, open-ended interviews with members of the medical team and medical management committee members, and information from event planning documents. Results: An initial assessment of the needs and variables (e.g weather, stadium capacity, proximity to referral centers, age, crowd mood and density, attendance, and alcohol and drug use) were identified during the planning of the AFCON 2008. After these variables were considered, a thorough needs analysis was performed and resource allocation was based on objective data. The results also suggested that extra attention was given to ensuring health services met up to international standards set by the Confederation of African Football. Pre event planning documents stressed the importance of training all health professionals before the event, a centralized communications control system and proper coordination
*Contact details:
of all stadiums with referral centers in partnership with the
Phone: +23480 370 800 31
law enforcement and road traffic monitoring agencies.
Email: d.osholowu@yahoo.com Postal Address: P.O. Box 52259 Nipost Falomo Ikoyi, Lagos, Nigeria
Free submissions | 3rd International Football Medicine Conference; Sun City
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An Effective Multi-Professional National Medical Commission Based on Volunteerism The Botswana Experience Basadi Akoonyatse*, Agnes Mothobi Botswana Football Association
help of FIFA capacity building programs, boosts of some of the best Sports Medicine practitioners in the country.
FIFA is committed to protect the health of players at all levels of play. This encompasses both mental and
Maybe the Botswana experience could be a solution
physical health; with programs covering areas of injury
for many African countries where Football Medicine fall
prevention and management, mental preparedness, Anti-
much below the expected standards and practices.
doping, nutrition and hydration as well as safe methods of training and maximizing performance. Implementation of a comprehensive football medicine program calls for an interaction of various disciplines in the area of Sports Medicine and Sports Science for provision of an evidence based, integrated and efficient care within a broader scope of health services. Health sector in many African countries is still operating under strenuous conditions of limited human and material resources. Public health burdens of major diseases like HIV / AIDS and outbreaks of pandemics like malaria, diarrhea and cholera further places stress on health systems. As such, issues of provision of health care to the athletes is seen as a matter of luxury than basic need to the higher decision makers, managers of sports as well as health personnel. This is more compounded by the fact that Football Medicine is a relatively new discipline in Africa, with few, including health professionals and Football managers not fully understanding and appreciating its role and importance. Due to these factors, many African national associations provide health services to footballers in an inconsistent, non-specific and sporadic manner at the convenience of the health care system. Botswana was among such countries until 2007 when it established a
*Contact details:
Multi-Professional National Medical Commission under the
Phone: +267 71492253
auspices of Botswana Football Association. This committee
Fax: +267 3953492
is entirely based on the spirit of volunteerism and with the
Email: bakoonyatse@yahoo.co.uk
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Free submissions | 3rd International Football Medicine Conference; Sun City
Health Benefits of Social Football in a Select Group of Male Players - A Pilot Study
Wesley Deavall*, Prof. Demitri Constantinou and Prof. Yoga Coopoo Centre for Exercise Science and Sports Medicine, FIFA
Conclusion: The study provided evidence that
Medical Centre of Excellence, University of Witwatersrand,
regular participation in recreational football training and
Johannesburg
match play had improvements in physiological fitness, even in the last 6 weeks of a competitive season. Recreational
Background: This study examined the variations
football could be used as a means to maintain and
in physiological fitness areas over the last 6 weeks of a
improve the health of the football player. A study including
competitive season of male recreational football players.
a larger number of subjects is required in order to confirm
Ten players (aged 18-36) participated in the study. All
these results.
players were monitored for 6 weeks, which included one training session and a match each week. Aim: To determine if there were changes in player fitness levels over a 6 week period. Methods: The following measurements were taken: anthropometric with skin folds; modified sit and reach for flexibility; one minute push up test for upper body endurance; the bleep test for aerobic capacity (predicted VO2max); vertical jump test for the assessment of leg power; and speed test to assess power of the lower body, to measure physiological fitness and monitor variations. Standard deviations, means and t-tests were computed for the data. The level of significance was at the 5% level. Results: The results indicate that mean body mass, BMI and lean body mass were significantly lower (p<0.05), and vertical jump was significantly higher (p<0.05) after 6 weeks of training. No significant differences in the body fat percentage, modified sit reach scores, speed over 40m, number of push-ups and predicted VO2max was found.
*Contact details: Phone: +27117173372 Fax: +27117173379 Email: sports.medicine@wits.ac.za Postal Address: P.O.Box Wits 2050, South Africa
Free submissions | 3rd International Football Medicine Conference; Sun City
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Football Fights for Aggressive African A‘s
Dr T Lekhanya* Koeneng Surgery and KGC; Lesotho Football Association (LeFA)
in this district that was in 2004, found to have the highest hypertension prevalence in Lesotho, probably related to helplessness. 7) a webpage that guides
Aim: Koeneng Golden Champs (KGC) has, since 2004/5, tackled the SADC epidemics (AIDS & HIV & gender
sportspeople on drugs in sport, is emerging. 8) a Sports Quiz is envisaged, to assess comprehension of the lessons.
violence, Alcoholism & drugs, Accidents & assaults, and Allergic & autoimmune disorders). Through football, Lesotho’s Qacha district is mobilized and educated about these adversities, allowing their prevention and control, especially at vacation times. Method: Year-round football activities are held for both sexes, across the rugged and impoverished district. An annual theme is chosen. Inspirational music, HIV and diabetes testing, communications’ improvement project through raffling of cellphones, radios, etc, augment the events. Participants lose raffle prizes if they are over the roads’ legal alcohol limit, thus combating the epidemics, and raising awareness of the legal limit. The KGC Raffle teaches the community self-help. Children get fortified snacks and anthelmintics at the games. KGC reports are broadcast on national radio, thus passing proactive health messages to millions of people in Lesotho and SADC. Sports medicine lessons for different seasons, with an emphasis on doping, trauma, and climate changes, augment the reports. Outcomes: 1) after only four years, the author was elected to LeFA’s NEC, and chairs its Medical Committee. 2) LeFA’s Sports Medicine Plan 2009-12 was influenced by KGC. 3) sporting activity in Qacha is novel and envied. 4) young people have been rescued from risky lifestyles, and partnerships with relevant structures have been formed. 5)
*Contact details:
publications have resulted, including a Gospel CD, and an
Phone: +266 229 503 10
A-Z guide of HIV prevention. 6) hundreds of prizes have
Email: lekhate@yahoo.co.uk
been raffled; this and point 3) have important implications
Postal Address: P.O. Box 71, Qacha’s Nek. 600, Lesotho, SA
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Free submissions | 3rd International Football Medicine Conference; Sun City
Alcohol Use and Risky Sexual Behaviour Among the South African Professional Soccer Players-Implications for the Life Skills Intervention Sibusiso Ntshangase*, Patricial Tau University of Limpopo, Medunsa campus This study aimed at exploring the nature and the extent of alcohol use and risky sexual behaviour among professional soccer players in South Africa. It also aimed at exploring the implications of players’ alcohol use and risky sexual behaviour on life skills education rendered to professional soccer players. The sampling procedure was designed to require survey responses from professional soccer players employed by soccer clubs affiliated to the Professional Soccer League (PSL) in South Africa, using a questionnaire adapted from the one developed by the National Collegiate Athletic Association Committee on Competitive Safeguards and Medical Aspects of Sport (NCAA)(1985). One section of the questionnaire required the participant to report on their alcohol use and another section asked them to report on their sexual behaviour. In addition, one-on-one interviews were conducted with the members of the management staff of the selected professional soccer clubs, which required them to report on their understanding and awareness of the players’ at-risk behaviour as well as on the life skills programmes offered to players in their clubs. A total of 78 players from four different clubs and three managers from three different clubs participated in this study. The data was analysed using descriptive statistics. The results indicated a distinctive role of the South African socio-cultural dynamics on soccer players’ susceptibility to at-risk behaviour. The detailed results will be presented and discussed during the conference presentation.
*Contact details: Phone: +27 12 521 4804 Email: sntshangase@ul.ac.za
Free submissions | 3rd International Football Medicine Conference; Sun City
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Empowering Professional Soccer Players in South Africa Evaluation of Project Ithuseng
Dr Catherine Draper*, Jared Forbes, Prof. Mike Lambert UCT/MRC Research Unit for Exercise Science and Sports Medicine, University of Cape Town
implementation was team management buy-in. A paired sample t-test (n=123) showed a significant difference between pre- and post-implementation scores
Background: In response to the recognised need
on the life skills questionnaire (p=0.046).
for life skills amongst professional soccer players in South Africa (SA), Project Ithuseng, a life skills programme, was
Conclusions: Evaluation recommendations include
implemented by the Sports Science Institute of South
offering this programme to academy teams, younger
Africa (SSISA). The programme was offered to Premier and
players and other women’s clubs, and that, in the interests
First Division men’s teams, women’s national teams and
of sustainability, a second phase is implemented to train
nine top women’s clubs. Evaluation of Project Ithuseng
soccer stakeholders to take over life skills facilitation.
included formative, process and outcome evaluation
Through encouraging collaboration between soccer
components.
stakeholders in SA, Project Ithuseng has created a platform for future work in this area.
Methods: Prior to implementation, a needs assessment questionnaire was administered to all participating players, and seven focus groups were conducted with players (n=55). A life skills questionnaire was administered to all participating players pre- and post-implementation. Post implementation, seven focus groups were conducted to assess players’ perceptions of the programme (n=62) and process evaluation data were collected via key informant interviews (n=9). Results: Seven Premier and 6 First Division clubs, 13 women’s clubs, and 16 men’s clubs from other divisions and academy teams completed the programme. Priority issues identified in the formative evaluation were planning for the future, leadership, communication, teamwork, self-confidence, taking responsibility and financial skills. Post-implementation focus groups revealed that Project
*Contact details:
Ithuseng was generally perceived as beneficial for
Phone: +27 21 650 4567 / +27 84 6575448
players, and that fewer implementation challenges were
Fax: +27 21 686 7530
experienced with women’s clubs. Most valuable topics
Email: scatherine.draper@uct.ac.za
identified were finances, nutrition, conflict resolution and
Postal Address: Sports Science Institute of South Africa, Boundary
time management. The main factor influencing successful
Road, Newlands, 7700, SA
Workshops
3rd international Football Medicine Conference 19 - 21 February 2010 | Sun City | South Africa
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Workshops | 3rd International Football Medicine Conference; Sun City
Workshops
Cardiac risk assessment
Hip and groin examination and injuries
Although sudden cardiac death (SCD) in sport is
The objectives of this workshop are to:
relatively rare, the prevention of these tragic events is a major objective when providing medical care for athletes.
1.
create awareness of the various conditions affecting
Competitive sports in particular seem to bear a risk for
the footballer’s hip and groin,
sudden cardiac arrest (SCA) and consequently may lead to
2.
provide information about the possible causes of pain in
SCD. Vigorous exercise can trigger SCA in the presence of an
the groin area,
abnormal underlying substrate or condition, mostly structural
3.
enable the participant to perform a thorough
cardiac changes (such as hypertrophic cardiomyopathy) or
examination of the involved structures,
conduction anomalies. Above 35 years of age, SCD is mainly
4.
make a diagnosis based on examination and special
due to atherosclerotic coronary artery disease.
investigations,
5.
provide the footballer with a management plan,
6.
institute a programme to prevent hip and groin
injuries.
FIFA, world football’s governing body, has declared the prevention of SCD to be one of its major objectives. The football-specific Pre-Competition Medical Assessment (PCMA) developed by the FIFA Medical Assessment and Research Centre (F-MARC) is based on the current guidelines of the European Society of Cardiology (ESC) and the International Olympic Committee (IOC) and includes a systematic medical history (including personal and family history), a physical examination, a 12-lead resting electrocardiogram (ECG) and trans-thoracic echocardiography. Applying all of these diagnostic tools aims to achieve maximum probability of detecting SCD risk factors. However, football players worldwide underlie various ethnic, socio-economic and specific local conditions and the implementation of standard screening recommendations is difficult. Therefore, a step-bystep implementation, with escalation only in case of suspicious findings as required, represents a more feasible and practical approach. This workshop highlights all parts of the FIFA PCMA. Every component will be theoretically explained and practically demonstrated “live”, and case reports and discussions will serve to further illustrate the value of the different diagnostic tools.
Workshops | 3rd International Football Medicine Conference; Sun City
45
Workshops
How to conduct a scientific study
Head and spine injury assessment and emergency care
In the first part of this workshop, the different steps
The aim of this workshop is to give participants a
in planning, conducting and presenting a scientific study
hands-on practical on the approach to the examination of
in football medicine will be outlined. This includes a review
the head and spine in a football player.
of the literature, aims, design, characteristics and sample The workshop will have the following format:
size, assessment methods, statistical analysis, results and publication. Based on illustrating examples from previous epidemiological and intervention studies on football
1.
Awareness-raising of the most important injuries to
injuries, the problem of a possible bias and further pitfalls
the head and spine that might occur in football,
will be discussed.
including concussion.
2.
Anatomy of the cervical, thoracic and lumbar spine,
including surface anatomy.
present their own research questions/hypothesises, and
3.
History-taking – what questions to ask, including
two of the topics will be selected to exemplify the detailed
sideline concussion assessment.
planning process. The participants will then work in groups
4.
Observation – what to look out for – e.g. symptoms
on one of the two research questions, and each group will
and signs of concussion, spontaneous movements,
draft a research proposal following the steps presented in
etc.
the first part of the workshop. The working groups will
5.
Physical examination – range of motion, zones of
then present their proposals, and all participants will be
irritation, reflexes, etc.
In the second part, the participants will be asked to
a. practical demonstration of the examination
asked for their input to further enhance the proposal. The aim of this is is to create recommendations and guidelines
procedure of the head and spine, giving participants
for proposals for epidemiological and intervention
a hands-on opportunity. b. injuries can be discussed throughout – e.g. what
studies that participants can follow when planning and conducting their own research projects in future.
signs in the examination may indicate which injuries.
6.
Demonstration of the evacuation of patients with
suspected spine injuries.
7.
General discussion – questions.
46
Workshops | 3rd International Football Medicine Conference; Sun City
Workshops
Management of acute soft-tissue injuries Soft-tissue (muscle, tendon, ligament) injuries are
The 11+ - a complete warm-up to prevent injuries Research in amateur football has shown that specific
very common in football, and also have a high risk of
exercise programmes can be successfully implemented as a
recurrence. There are a variety of diagnostic and treatment
standard warm-up prior to the normal routine of a training
modalities available for the management of soft-tissue
session. In cooperation with the Oslo Sports Trauma &
injuries. However, there is also some controversy in the
Research Center and the Santa Monica Orthopaedics and
type and timing (following injury) of different treatment
Sports Medicine Group, F-MARC has developed “The 11+
strategies. The aim of this workshop is to provide the team
– a complete warm-up to prevent injuries”. “The 11+”
physician and other medical staff with a practical clinical
programme represents an advanced version of the previous
approach to the diagnosis and management of soft-
“The 11” programme. It aims to teach key elements of
tissue injuries in football using both established and novel
injury prevention: core stabilisation, eccentric strength,
strategies that could improve the healing of tissue and
neuromuscular control, agility and plyometrics. Good
reduce the risk of recurrence of injury. Specific strategies
body control and proper technique while performing the
and their appropriate application over time during the
exercises are vital to enhance sensorimotor awareness and
healing of soft-tissue injuries in football will be discussed
performance. In a large randomised controlled study, “The
and demonstrated. The treatment modalities that will
11+” reduced injuries in general by a third and severe
be discussed and demonstrated include the following:
injuries by a half. “The 11+” programme consists of three
diagnostic ultrasound, cryotherapy, therapeutic ultrasound,
parts: a running part in the beginning to warm up for
corticosteroid injections, non-steroidal anti-inflammatory
the exercises and at the end to warm up for training, and
medication (injectable, oral and topical), anti-fibrotic
six exercises focusing on core and leg strength, balance,
agents, growth factors, extracorporeal shock wave therapy
plyometrics and agility. Each exercise is presented in three
and other modalities.
levels of increasing difficulty to provide progression and variety.
The workshop will have the following format: 1.
General introduction (15 min)
2.
Station 1 – Assessment/field-side management (0-1
and performing “The 11+” under the supervision of
hrs after injury) (10 mins)
F-MARC experts in order to provide participants with
3.
Station 2 – Immediate management (including acute
a basic knowledge of the programme to support its
inflammatory phase) (0-48 hours after injury)
implementation.
(10 mins)
4.
Station 3 – Early repair phase (2-7 days after injury)
(10 mins)
5.
Station 4 – Late repair phase (> 7 days after injury)
(20 mins)
6.
Station 5 – Return to play guidelines (10 mins)
7.
Discussion (15 mins)
The workshop will focus on explaining, learning
Workshops | 3rd International Football Medicine Conference; Sun City
47
Workshops
Ankle examination and injuries
To conclude, there will be a review of the rationale for injury prevention, ankle taping and preventive bracing.
This workshop is designed as an interactive forum to address ankle injuries, especially as it applies to the game of football. An introductory review will present the history of ankle rehabilitation and injury prevention over
Knee examination and injuries
the last 50 years, including the “Bostroem conservative The aim of this workshop is to give participants a
treatment”, the “Freeman mechanoreceptors and functional instability” study and the “Tropp ankle disk
hands-on practical on the approach to the examination of
training”.
the knee in a football player. The workshop will have the following format:
The workshop will address the clinical anatomy of the ankle and review the biomechanics of ankle function. We will look at the static and dynamic stabilisers of the
1.
Anatomy of the knee, including surface anatomy.
ankle and the bony anatomy as it relates to injury. A
2.
History-taking – what questions to ask, what pointers
review of the common injury sites will be undertaken as
in the history may suggest which injuries.
they relate to the most frequent football injuries. We will
3.
Observation – what to look out for – e.g. gait,
investigate the mechanics of ankle injury through video
swelling, etc.
analysis and relate these injuries to the rules of football.
4.
Physical examination – signs of muscle wasting,
We will learn how rule changes have made the game of
swelling, signs of infection, ROM, ligament stability
football safer for every player.
tests, etc. a. practical demonstration of the examination
The workshop will then review the radiographic findings of ankle injury using plain films, ultrasound, CT
procedure, giving participants a hands-on
opportunity. b. injuries can be discussed throughout – e.g. what
scanning and MRI, and discuss each of their roles in the investigation process. We will discuss which modality is
signs in the examination may indicate which injuries.
best to examine certain injuries and how to interpret the
5.
General discussion – questions.
various findings. The clinical examination will include assessment of gait, local palpation, stability and strength testing, special examination techniques and stress tests. We will discuss treatment options including the basic PRICE regime, proprioceptive retraining, strength rehabilitation and a graduated “return to play” programme. Furthermore, the role of surgery in the treatment of ankle injuries will be discussed, including the role of early arthroscopic intervention in diagnosing missed injuries or chronic pain.
48
Workshops | 3rd International Football Medicine Conference; Sun City
Workshops
Implementing “The 11 for Health”
Emergency situations in football medicine
The “11 for Health” programme is aimed at
The workshop will provide an introduction to the model
improving children’s knowledge, attitude and behaviour
course on “Football Emergency Medicine” offered by F-MARC
towards communicable and non-communicable diseases.
in collaboration with the FIFA Medical Centre of Excellence and
Eleven messages are delivered in 90-minute training
the Division of Emergency Medicine at Wits University. The course
sessions. Each session is made up of two halves: the first
is mainly aimed at team, stadium and event physicians, local
half relates to “Play football”, where children learn a
organising committee medical teams, sports physicians, ACLS
football skill; the second half relates to “Play fair”, where
providers, and pre-hospital and related healthcare providers, and
children learn about a specific health issue.
it presents the specifics of emergency medicine at football events, from severe injuries and sudden cardiac arrest on the pitch to VIP
The workshop will provide participants with a practical insight into the unique educational nature of
medical care, disaster and mass-gathering medicine within the confines of a football stadium.
the “11 for Health” programme and the way in which The workshops aims to:
the programme has been developed to deliver simple but important health messages to schoolchildren. During the
1.
present the FIFA model course “Football Emergency
workshop, participants will have the opportunity to take
Medicine” for implementation in its member
part in one full training session.
associations worldwide, local organising committees
and other FIFA Medical Centres of Excellence in
In the first half of the session, participants will
relation to immediate medical care for teams,
be taught a “Play football” skill. Participants will see
officials and spectators for football events;
how F-MARC’s “The 11+” has been incorporated into
2.
create an awareness and appreciation of the
a warm-up session to teach the importance of injury
emergency medical issues around national and
prevention. Participants will then be taught a specific
international football events and to plan accordingly.
football skill. This first part of the programme will show how basic football skills can be delivered while at the
During the course, physicians are empowered with the basic
same time teaching children the important message that
principles and practice of anticipated medical management issues
football is a fun and effective way to stay fit and healthy.
involved in and around stadiums during football matches. They
Simultaneously, they will learn the importance of fair play
will be provided with a basic understanding and safe working
in football and in life.
knowledge in the areas of
In the second half of the session, participants will be shown the specific health message that is linked to the football skill learnt during the first half of the session.
3.
emergency medicine
4.
mass gatherings
5.
disaster medicine and emergency football medicine during football competitions at all levels of play.
Participants will be provided with basic information about the health condition and ways in which they can prevent and manage the condition in their community.
Participants will take part in practical demonstrations and perform exercises on emergency procedures such as cardiac events, spinal immobilisation and strapping.
Workshops | 3rd International Football Medicine Conference; Sun City
Workshops
How to treat asthma in football The workshop will briefly discuss asthma and exercise-induced asthma/bronchospasm using the format of: • History • Symptoms • Signs • Investigations • Management With each of the above, we will discuss and demonstrate using examples from daily practice. We will demonstrate and explain the value of the various methods of administration of treatment. We will discuss medication use and TUEs in relation to the FIFA TUE policy and we will demonstrate ADAMS online uploading of an athlete’s file as required by the World Anti-Doping Agency. We will discuss challenge tests and demonstrate lung-function tests before and after exercise on a treadmill with an asthmatic athlete who has a positive test to emphasise practical issues.
49
Faculty
3rd international Football Medicine Conference 19 - 21 February 2010 | Sun City | South Africa
52
Short Bios | 3rd International Football Medicine Conference; Sun City
Faculty
Masoud Al-Riyami
Cups (Germany 2006, China 2007) and the Olympic Football Tournament Beijing 2008. He is currently a part-
Masoud Al-Riyami, MD, PhD (Oman) is a Senior
time PhD student at the Oslo Sports Trauma and Research
Consultant & Head of Orthopaedic Department at the
Center at the Norwegian School of Sports Sciences in Oslo
Khoula Hospital in Muscat, Oman. He is the Chairman
(Norway). His research interests focus on injuries of football
of the Sports Medicine committee of the Oman
referees and players, and on injury prevention.
Olympic Committee and a member of the FIFA Medical Committee.
Terence Babwah
Demitri Constantiou Demitri Constantinou, MD (South Africa) is currently an adjunct professor at the University o the
Terence Babwah, MD (Trinidad and Tobago) is
Witwatersrand, where he is the Director of the Centre for
the Team Physician for the Trinidad & Tobago Football
Exercise Science and Sports Medicine and FIFA Medical
Team and medical advisor for the Trinidad & Tobago
Centre of Excellence. In his career he has and still serves
Football Federation. He is a member of the FIFA Medical
on numerous university committees, sports and sports
Committee. He is a sports medicine physician and Medical
medicine associations. He is a past Board member and
Director for Sports Medicine and Injury Rehabilitation
current Chairperson of the South African Institute for
Clinic in Trinidad and Tobago. Publications to date several
Drug Free Sport (SAIDS TUEC) and TUEC member of
chapters in F-MAC books. Current research interest:
the International Cricket Council. He has been awarded
Biochemical and haematological indices in athletes and
Life Membership of the South African Sports Medicine
team physician matters.
Association, and is a Fellow of the International Sports
Mario Bizzini
Medicine Federation. He has been team physician or Chief Medical Officer for South Africa in a number of sports competitions; including menâ&#x20AC;&#x2122;s hockey, World Swimming
Mario Bizzini, MSc (Switzerland) is as a research
Championships, All Africa Games, Commonwealth
associate at the Schulthess Clinic, a private orthopaedic
Games, Paralympic Games, and Olympic Games. He has
and sports medicine center. He works for the orthopaedic
written several scientific and lay papers and has presented
department (lower extremity) and for F-MARC. He
many invited and submitted presentations to local and
earned a Master of Science degree from the University of
international conferences. He is the Venue Medical Officer
Pittsburgh (School of Health and Rehabilitation Sciences),
for Ellis Park in Johannesburg for the 2010 FIFA World
and did a research fellowship at the Department of
Cupâ&#x201E;˘.
Physical Therapy and at the UPMC Center for Sports Medicine (2000-2001). He is also a specialist in sports physiotherapy (committee member of the Swiss Sports Physiotherapy Association and of the International Federation of Sports Physiotherapy), a rehabilitation consultant for professional ice hockey and football teams, and has functioned as a physiotherapist at two FIFA World
Short Bios | 3rd International Football Medicine Conference; Sun City
Faculty
Wayne Derman Wayne Derman, MD (South Africa) is Professor of
Sipheni Dladla Siphe Dladla (South Africa) completed his education
Sport Science and Sports Medicine at the University of
in Cape Town where he matriculated in 2007. He then
Cape Town’s Sport Science Institute of South Africa. He
joined the YMCA of Cape Town where he was trained
is co-director of the MRC/UCT Clinical Sports Medicine
in basic life skills. Sipheni worked in a school and
Research and Service Division encompassing the FIFA
rehabilitation center and was the leader of his YMCA
Medical Centre of Excellence and IOC Research Centre for
team. In early 2009 he joined Grassroot Soccer and
Prevention of Injury and Promotion of Athlete Health in
implemented the 11 For Health program at a primary
Cape Town.
school in Khayelitsha. Siphe has excelled in F-MARC’s “The 11 for Health” programme; so much so that he has
He was Chief Medical Officer for the South African
been selected as assistant trainer for the second phase
Olympic Team for the Sydney 2000 and Athens 2004
of the pilot study on this programme to be conducted in
Olympic Games and Medical Officer for the Paralympic
Zimbabwe.
Games in Beijing 2008. He is the Venue Medical Officer for Cape Town for the 2010 FIFA World Cup™.
Michel D‘Hooghe
James Donald James Donald (South Africa) is a Grassroot Soccer Programme Manager focusing on Gauteng and the
Michel D’Hooghe, MD (Belgium) is a sports medicine
Western Cape. He is passionate about programmes that
physician specialised in rehabilitation and physical
give young people the opportunity to put their energy to
medicine. He is Member of the Executive Committee
work in their communities while developing themselves.
of FIFA since 1988 and Chairman of the FIFA Medical
He became interested in this kind of work as a Clinton
Committee since 1988 and of UEFA since 2006. He is a
Democracy Fellow in 2002, served as President of the
Member of the FIFA World Cup Organising Committee
SRC at Wits University in 2003, and has been a leader in
and has been President of the Euro 2000. He is also the
national youth service programmes and other initiatives
Vice President of the FIFA Women’s Football Committee
ever since. Over the last year he has worked on football
and Vice President of the UEFA Media Committee. Michel
for development projects in Namibia, Tanzania, Zambia,
D’Hooghe is further the Head of the Rehabilitation and
Rwanda and South Africa, and led the development of
Sports Medicine Department AZ Sint-Jan Bruges. He
the business plan for the first Football for Hope Centre in
has been President of the Belgian Royal Football Union
Khayelitsha in Cape Town.
1987-2001. He received the title of Baron in 2000 and is Honorary Consul of Mexico since 2004. He was the President of Club Brugge K. V. (F.C.B) for several years and became Honorary President of Club Brugge K.V. (F.C.B) in 2009. He is an extra ordinariy lecturer at the University of Gent (R.U.G) .
53
54
Short Bios | 3rd International Football Medicine Conference; Sun City
Faculty
Jiri Dvorak
Knee Surgery and Orthopaedic Sports Medicine. He is an international Member of the American Academy of
Jiri Dvorak, MD (Switzerland) is the FIFA Chief
Orthopaedic Surgeons and Honorary Member of the
Medical Officer and the Chairman the FIFA Medical
Arthroscopy Association of North America and of the
Assessment and Research Centre (F-MARC) since 1994.
South African Sports Medicine Association. Furthermore,
He is Professor of Neurology at the University of Zurich
he is an Editorial Board Member of Sports Medicine,
and Senior Consultant at the Schulthess Clinic in Zurich,
Arthroscopy, Rehabilitation Therapy & Technology as well
the first FIFA Medical Centre of Excellence inaugurated
as an Editor of the South African Sports Medicine Udpate.
in 2005. he is member of the IOC Medical and Science Committee. He has completed several research fellowships
Colin Fuller
in the United States and New Zealand. He is Editor of the American Journal of Sports Medicine, Senior Editor of the
Colin Fuller, PhD (United Kingdom) worked as
British Journal of Sports Medicine and Deputy Editor Spine.
a manager in the chemical and electricity generation
He has received a number of scientific awards for his
industries for 25 years in risk management. He
achievements in neurological and spine research.
subsequently lectured in risk management at Loughborough University and originated the MSc
Tony Edwards
programme in health and safety management at the University of Leicester. Since 2005 he has been the Director
Tony Edwards, MD (New Zealand), is a specialist
of the Centre for Sports Medicine at the University of
Sports Physician. He was a founding partner of the
Nottingham. Dr Fuller has been a member of F-MARC
adidas Sports Medical Clinic and FIFA Medical Centre of
since 1998 and has collaborated with F-MARC on
Excellence, in Auckland, New Zealand. He is the Medical
numerous research projects. He has also worked with the
Director for New Zealand Football. He has been a Member
International Rugby Board since 2006 on research projects
of the FIFA Medical Committee since 2006 representing
related to player safety in rugby. He has worked with a
the Oceania Confederation. He has been a FIFA Medical
number of other sports bodies on topics related to risk
Officer at a number of FIFA Tournaments including the
management in sport, including Rugby Football Union,
2006 FIFA World Cup . He was FIFA and LOC Chief
UK Sport, Football Association, England and Wales Cricket
Medical Officer for the FIFA U-17 Womenâ&#x20AC;&#x2122;s Wrold Cup
Board and the International Tennis Federation. His main
New Zealand 2008 in Auckland 2008.
research interests relate to the management of injury risk
TM
Mark Ferguson
in professional sport and, in particular, the epidemiology of sports injuries. He has recently been working on a footballrelated health education programme for school children in
Mark Ferguson, MD (South Africa), is Principal of the Surgeon Centre for Sports Medicine and Orthopaedics in Johannesburg and Honorary Lecturer to Department of Orthopaedics University of the Witwatersrand. He is a Member of the Board of Directors and of the Arthroscopy Committee of the International Society for Arthrsoscopy,
Africa.
Short Bios | 3rd International Football Medicine Conference; Sun City
55
Faculty
Louis Holtzhausen Louis Holtzhausen, MD (South Africa) is a sports
Astrid Junge Astrid Junge, PhD (Germany) is the Head of
physician in private practice and Coordinator of the UFS
research at the Medical Assessment and Research Centre
High Performance Program.the Program Director in Sports
of the Fédération International de Football Association
Medicine of the Faculty of Health Sciences, University of
(F-MARC) since 2003. She has a master and graduated in
the Free State, Bloemfontein, South Africa and the Director
psychology at the University of Hamburg and is a licensed
of the Campus Health and Wellness Centre, University
psychotherapist. She has worked for almost 15 years as
of the Free State. He is also Senior lecturer in Biokinetics,
an research fellow and later senior research fellow at the
Dept of Human Movement Science, UFS. He is the
University Clinic Hamburg-Eppendorf and the Philipps-
President of the South African Sports Medicine Association
University of Marburg (Germany) before becoming senior
(SASMA) and Past chairperson/ vice-chairperson of the
research fellow for F-MARC in 1996. She is an associated
South African Rugby Medical Association (SARMA). Dr
professor at the University of Zurich. She has published
Holtzhausen was awarded honorary and life membership
extensively in international sports medicine journals.
of the South African Sports Medicine Association in 2009. His special interests are injury prevention, soft tissue injury
Bwalya Kalusha
management, rugby medicine, performance enhancement and development of multi-professionalism in sports
Bwalya Kalusha (Zambia) is the president of the
medicine and sports sciences. He is the Venue Medical
Football Association of Zambia since 2008 and currently
Officer for Bloemfontain for the 2010 FIFA World Cup™.
serves as a standing committee member at FIFA and the
Ryan Jankelowitz
Confederation of African Football. He has been a national team player and is Zambia’s most capped player, all-time top goalscorer, and is regarded as the greatest Zambian
Ryan Jankelowitz (South Africa) is a medical
player to play the game. He was named African Footballer
doctor currently working for the soccer-for-development
of the Year in 1988 by the magazine France Football and
organisation Grassroot Soccer (GRS). Ryan was born in
was nominated for the 1996 FIFA World Player of the Year
Johannesburg and now lives in Cape Town. He studied
where he was voted the 12th-best player in the world.
Sports Medicine at the University of Cape Town and after practicing for two years at the Sports Science Institute
Enos Karani
as an associate of Professors Schwellnuss, Derman and Noakes he worked as a medical officer in Psychiatry. Ryan
Enos Karani is a Football trainer and physiotherapist
was a professional goalkeeper for eight years at South
in Nairobi, Kenya. He is an instructor in a number of sports
African Premier League Teams Bidvest Wits University
and football coaching and instructor courses and has been
and Hellenic FC. He joined the Grassroot Soccer team in
instructor at the FUTURO III Football Medicine course in
January 2007 and in GRS he has found a way to combine
Kenya in 2009. He is the Kenyan national football team
his medical background and his love of the beautiful
physiotherapist.
game.
56
Short Bios | 3rd International Football Medicine Conference; Sun City
Faculty
Karim Khan Professor Karim Khan, MD, PhD, is an Australian-
Thomas F. Lüscher Prof. Thomas Lüscher, MD (Switzerland) is the Head
trained sports physician and academic now based in
of Cardiology and the Chairman of the Department of
Vancouver, Canada. Karim is probably best-known for his
Internal Medicine of the University Hospital in Zurich
contribution to the management of tendon problems.
and Head of Cardiovascular Research of the Institute
As well as his well over 200 peer-reviewed publications,
of Physiology at the University of Zurich, Switzerland.
Karim is a coauthor of a ‘gold-standard’ textbook – Clinical
His research interests focus on the role of endothelium-
Sports Medicine. He is editor of the British Journal of
derived mediators in the regulation of vascular tone,
Sports Medicine – an information platform of sports
platelet-vessel wall interaction, and coagulation as well as
medicine innovation, education, and implementation.
vascular structure in aging, hypertension, hyperlipidemia,
Efraim B. Kramer
and atherosclerosis. Professor Lüscher’s clinical research focuses on the translation of the applied basic research to humans, in particular, vascular dysfunction in patients with
Professor Efraim B. Kramer (South Africa) is currently
hypertension, hyperlipidemia, coronary artery disease, and
Head of the Division of Emergency Medicine, Faculty of
congestive heart failure. He has obtained research prizes
Health Sciences at the University of the Witwatersrand,
of the European Society for Clinical Investigation, the
Johannesburg. He is a member of the 2010 FIFA World
Swiss Society of Cardiology as well as the Swiss Society of
Cup Organising Committee South Africa Medical Advisory
Internal Medicine and the Young Investigator Award at the
Team and the Venue Medical Officer for Soccer City
World Congress of Cardiology in 1990. He has published
Stadium in Johannesburg. His football interests include
extensively, authoring over 400 original research articles.
being the Football Stadium Medical Director of a sports
He is member of many editorial boards and was Associate
medical management organisation, and thus he provides
Editor Europe of Circulation from 2004 – 2008. He
emergency medical services to four football stadia on a
currently is editor-in-chief of the European Heart Journal.
regular basis. He is one of the initiators of the FIFA Football Emergency Medicine course and recently developed a
Henry Majale
Football Stadium Medical Emergency Standby course for all levels of responders in football stadia.
Mike Lambert
Henry Majale is an accountant by profession and the Deputy Director of the Mathare Youth Sports Association (MYSA), since 2007. Kenya. He has been working at the National Sports Office in Uganda for more than two years
Mike Lambert is a Professor in the MRC/UCT Research Unit for Exercise Science and Sports Medicine in the Sports Science Institute of South Africa. His research interests include the management of training- induced fatigue and muscle damage and recovery. He is the Editor-In-Chief of the South African Journal of Sports Medicine and serves on the editorial boards of 4 international journals.
in the finance and admin and sports department.
Short Bios | 3rd International Football Medicine Conference; Sun City
57
Faculty
Bert Mandelbaum Bert Mandelbaum, MD (United States), is an
Paul McCrory Paul McCrory, MD (Australia), currently works
orthopaedic surgeon at the Santa Monica Orthopaedic
as a consultant neurologist at the William Angliss and
and Sports Medicine Group. He serves as the Director of
Maroondah Hospitals and in clinical research as an
the Sports Medicine Fellowship Program and the Research
Associate Professor and NH&MRC Research Fellow at the
and Education Foundation and Medical Director for
Brain Research Institute as well as at the Centre for Health,
the FIFA Medical Centre of Excellence in Santa Monica.
Exercise & Sports Medicine at the University of Melbourne.
Academically, he is well published including multiple
He is past-president of the Victorian Branch of Sports
journal articles (78) and four books. He has received
Medicine Australia. In the area of sport medicine, he is
four national awards for Excellence in Research in the
currently the past president of the Australasian College
Field of Sports Medicine. Since 1995 he has been on the
of Sports Physicians, the specialist body in this field in
editorial board of the American Journal of Sports Medicine
Australasia and serves on both the Executive Board of the
and associate editor for Current Concept Reviews and
British Association of Sports & Exercise Medicine as well as
is presently, he serves as President of the International
a member of the Board of the Institute of Sports & Exercise
Cartilage Repair Society. As a team physician he has
Medicine (UK). He also serves on the education committee
worked with UCLA Athletics (1985-1989) and MLS teams.
of the American College of Sports Medicine.
He is the US Soccer Men’s National Teams Physician since 1991, and the assistant Medical Director for Major League
Sello Motaung
Soccer since 1996, and served as USA Team Physician for the FIFA World Cups™ 1994, 1998, 2002 and 2006. He
Dr Sello Motaung, MD (South Africa), is currently part-
serves on the USA Gymnastics Sports Medicine Advisory
time lecturer at the Centre for Exercise Science and Sports
Board. He is a member of F-MARC since 2002 and of the
Medicine centre at the Wits University. He has been active
FIFA Medical Committee since 2007. He also served as
in the Sports Medicine field over the last 15 years. He has
a Olympic Medical Officer for the Sydney 2000 , Athens
been involved in football as team doctor to Orlando Pirates
2004 and Beijing 2008.
Football Club (1997 - 2001) and the senior SA National Men’s
Ron Maughan
Football team, Bafana Bafana (2001 - 2007). He has obtained further qualifications in Travel Medicine and a Diploma in Occupational Health from Wits University. He has served on
Ron Maughan (United Kingdom) has been Professor
various sports related organizations as Chairman (NOCSA
of Sport and Exercise Nutrition at Loughborough University
Medical Commission; Sports Science and Medical Committee
since 2001. He is a Fellow of the American College of
– NOCSA / SA Sports Commission); Board member (Special
Sports Medicine. He chaired the Human and Exercise
Olympics South Africa, South African Institute for Drug-Free
Physiology group of the Physiological Society for 10 years,
Sport, Regional Anti doping Organization – Africa Zone VI)
and now chairs the Sports Nutrition Working Group of
and member (SASCOC Anti-doping Commission, SASCOC
the Medical Commission of the International Olympic
Medical and Scientific Commission. He is also a FIFA Medical
Committee. He has worked with many teams and
Officer. He has delivered a number of papers at various
organisations within football.
National and International Sports Medicine conferences.
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Short Bios | 3rd International Football Medicine Conference; Sun City
Faculty
Lucas Radebe Lucas Radebe (South Africa) is a former Leeds
Martin Schwellnus Prof. Martin Schwellnus (South Africa) is Professor
United and South African national team player for eleven
in Sports and Exercise Medicine at the Department of
years, won the African Cup of Nations and participated
Human Biology, Faculty of Health Sciences at the University
in two World Cups. He has been an ambassador of FIFA
of Cape Town. He is a Sports Physician Consultant of the
for SOS Childrenâ&#x20AC;&#x2122;s Villages; he also received the FIFA
Sports Medicine Clinic, Sports Science Institute of South
Fair Play Award in December 2000 for his contribution
Africa in Cape Town and the Director of the FIFA Medical
in ridding soccer of racism as well as for his work with
Centre of Excellence in Cape Town. He is a Member of
children in South Africa. In April 2003, for recognition
the IOC Medical Commission, the Vice President of the
of his efforts both on an off the field, Radebe was given
International Sports Medicine Federation (FIMS) and the
the Contribution to the Community Award in the Premier
Representative of the African Continent on the FIMS
League 10 Seasons Awards.
Executive. He is the Vice President of the African Union
Christian Schmied
of Sports Medicin (UAMS) and the Chairman of the Medical Advisory Team for the 2010 FIFA World Cup South Africaâ&#x201E;˘. He is currently Editor-in-chief for the International
Christian Schmied, MD (Switzerland), graduated at the Medical School at the University of Zurich/Switzerland and obtained a board certification in Internal Medicine as well as in Cardiology and Sports Medicine. After working
SportsMed Journal as well as in the Editorial Board of the British Journal of Sports Medicine.
James Sekajugo
in hospitals in different parts of Switzerland, Germany and Austria he became a member of the Cardiovascular
James Sekajugo, MD (Uganda), is a Sports Physician
Center at the University Hospital in Zurich. His clinical and
and currently the Head of the Non Communicable Diseases
scientific activities mainly focus on the outpatient clinic
Prevention and Control Programme at the Ministry of
(amongst others heart-failure and heart-transplantation),
Health in Uganda. He is a Member of the Confederation of
the echocardiography lab and sports cardiology.
African Football (CAF) Medical Commission and acted as
Furthermore, he is an associate editor of the European
a FIFA Medical Officer at the FIFA U-17 World Cup 2009.
Heart Journal. He provides medical care for various
For the past 10 years he has been a strong advocate for
national (e.g. the Swiss Ski Association) and local sports
using the power of sport to educate populations on health
organisations and teams and collaborates closely with
promotion and disease prevention and contributed to the
F-MARC.
FIFA Medicine Manual (HIV/AIDS and Football). Presently, he is in collaboration with FIFA, conducting study to determine the magnitude of non communicable disease risk factors in the Uganda population.
Short Bios | 3rd International Football Medicine Conference; Sun City
59
Faculty
Dato’ Dr Gurcharan Singh
the Vrije Universiteit, Amsterdam, in the Netherlands. In 1996, he was appointed as a researcher for the Portfolio
Dato’ Dr Gurcharan Singh (Malaysia) has been
Committee on Sport and Recreation in the National
involved with football since 1983). He is a member of
Parliament of the Republic of South Africa and in 1999, he
FIFA Medical Committee, FIFA TUE Advisory Group and
joined Sport and Recreation South Africa and the Ministry
collaborates actively with F-MARC in research projects.
of Sport and Recreation as Manager for Parliamentary
In Asia, he is the Hon. Director, Medical Department,
Relations. He represented South Africa at numerous WADA
Asian Football Confederation and Chairman, AFC
Foundation Board and Executive Committee meetings
Medical Committee, AFC Doping Unit and AFC TUE
and the International Intergovernmental Consultative
Advisory Group. He has coordinated / conducted several
Group on Anti-Doping in Sport (IICGADS). He was also the
international sports medicine and anti-doping courses /
coordinator of the IICGADS IV meeting hosted by South
conferences on behalf FIFA, AFC, sister Confederations
Africa in 2001, served on the secretariat of IICGADS, and
and the IOC. He holds various positions in a host of other
occupied various coordinating roles in sport on behalf of
medical and sports bodies. In view of his vast experience
the South African Government, including the Africa Cup
and professional expertise, he has officiated at several
of Nations staged in Mali in 2002.
international events such as World Cups, Olympic Games and Sports Medicine Conferences.
Diabate Souadou
Dr Christa Janse Van Rensburg Christa Janse Van Rensburg, MD (South Africa), obtained her MBChB (Cum Laude), MMed (PhysMed) (Cum
Diabate Souadou (Mali) is an Ambassador for
Laude) and MSc Sports Medicine at the University of Pretoria.
a national non-governmental organization Malian
She was appointed Head of the Section Sports Medicine in
Association for the Promotion of Girls and Women
1999. She heads a Sports Medicine Practice at the University
(AMPJF). The AMPJF has implemented a number of
of Pretoria and runs a Rheumatology practice in her private
production units for shea butter run by women and
capacity. She has accompanied many sports teams as sports
inaugurated one of the first six FIFA Football for Hope
physician, both nationally and internationally, including the
Centres for 2010. She is active in the field of women
SA Olympic Team to Athens. She has also participated in the
promotion since 1985 and an activity leader at several
Comrades Marathon and has completed several Argus Cycle
community centers and serves several volunteer positions.
races. Dr Janse Van Rensburg has been involved in research
She has been awarded the ASHOKA social innovator price
projects and clinical trials, and has authored and co-authored
in 2002.
articles with an emphasis on rheumatological conditions and
Rodney Swigelaar Rodney Swigelaar (South Afria) has served as Director of WADA’s Africa Regional Office since 2003. He studied at the University of the Western Cape in Cape Town and pursued a post-graduate degree in Applied Linguistics at
also issues relating to sports injuries. She is the Venue Medical Officer for Pretoria for the 2010 FIFA World Cup™.
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Short Bios | 3rd International Football Medicine Conference; Sun City
Faculty
Yacine Zerguini Yacine Zerguini, MD (Algeria), is an orthopaedic surgeon and Assistant Professor at Algiers University School of Medicine. He is currently Senior Consultant Sport Traumatology, Knee Surgery, Arthroscopy Clinique Chahrazed, Cheraga (Alger) and Medical Director Centre d’Evaluation et d’Expertise en Médecine du Sport, Cheraga (Alger). He is a member of Executive Committee FAF (Fédération Algérienne de Football) and Chairman of FAF Medical Committee. He is a member of the FIFA Medical Committee and F-MARC since 1994 and the CAF Medical Committee since 2002. He has been FIAA General Medical Officer for the FIFA U-17 World Cup Nigeria 2009 and the U-20 FIFA World Cup Egypt 2009. He has worked and published with F-MARC on the effects of Ramadan fasting on football, age determination by MRI of the wrist and the pre-competition medical assessment of African youth football players.
FIFA Football Medicine Code of Ethics
3rd international Football Medicine Conference 19 - 21 February 2010 | Sun City | South Africa
62
FIFA Football Medicine Code of Ethics | 3rd International Football Medicine Conference; Sun City
FIFA Football Medicine Code of Ethics
The following Code of Ethics is applicable to your role within the football medicine community as a football medicine physician* and member of the worldwide FIFA Medical Network, which is built upon the objectives and aims of the FIFA Medical Committee and the FIFA Medical Assessment and Research Centre (F-MARC):
In particular, you commit to the following: •
Regular pre-competition medical assessment (PCMA) To ensure that each player undergoes a comprehensive general medical, cardiovascular and orthopaedic assessment prior to participation and to use the FIFA PCMA as a guide, depending on the circumstances and the resources available.
•
Implementation of “The 11+ – a complete warm-up programme to prevent injuries” To support and enforce the implementation of evidence-based injury prevention programmes in teams under your care, preferably the F-MARC programme “The 11+”, which can easily be incorporated into daily training and the match routine.
•
Adequate nutrition and hydration To continuously explain to your players that a diverse diet that is rich in nutrients and adequate hydration ensures optimal performance and is the best means of performing at the highest level.
•
Advice on supplement use To caution players against the use of supplements as these have not been proven to enhance performance in football, but instead carry a considerable risk of a positive doping test due to contamination with prohibited substances.
•
Follow high medical ethics in prescription practice To lead by example in prescription practice and never prescribe medications for other than strictly medical indications. To carefully consider the use of non-prohibited and prohibited medication as negative long-term consequences for the players’ health cannot be excluded.
•
Rid football of doping To continuously explain to players that doping has absolutely no place in football and will not be tolerated and to alert them to the considerable health risks involved as compared to the limited benefits.
•
Ensure correct age of players To advocate a level playing field also with regard to age and physical maturity, to do everything in your power to confirm that the dates specified on players’ birth certificates/passports are correct, and to inform officials about the possibilities of age determination by MRI of the wrist.
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FIFA Football Medicine Code of Ethics | 3rd International Football Medicine Conference; Sun City
63
FIFA Football Medicine Code of Ethics
•
Ensure correct gender of players To advocate a level playing field also with regard to gender, to do everything in your power to confirm that the gender specified on players’ documents is correct, and in the case of gender ambiguity to follow the FIFA policy for gender verification, particularly with regard to individual case management and protecting the privacy and dignity of players.
•
Fair play on the pitch To continuously educate players to follow the rules of fair play, in particular to explain to players that reckless movements and tackles may potentially harm fellow players and should therefore be avoided.
Finally, you commit to acknowledge the unique potential of football as a preventive tool in public health, both as a physical activity and by using the game as a platform for education, and also to spreading and supporting the FIFA’s “Football for Health” idea with all of the means at your disposal.
I, __________________________________________________________________________________
Name, country of origin
declare that I have read and acknowledged the contents of this Code of Ethics, and confirm that I will abide by the
contents to the best of my ability.
Signature
___________________________________________________________________________
* and other healthcare practitioners working with footballers 2/2
FIFA Medical Assessment and Research Centre (F-MARC)
3rd international Football Medicine Conference 19 - 21 February 2010 | Sun City | South Africa
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F-MARC | 3rd International Football Medicine Conference; Sun City
FIFA Medical Assessment and Research Centre
Prevention is better than cure – this is the main credo
serious injuries by half. “The 11+” is available on DVD in
of the FIFA Medical Committee and F-MARC. The FIFA
four languages, with an accompanying booklet and poster,
Medical Code of Ethics presents prevention as one of
and in the form of handy information cards, all available for
the main tasks and obligations of team physicians and
download at:
any other medical practitioners in football. Conference attendants are encouraged to distribute and implement
http://extranet.fifa.com/medical/en/Football-Medicine/
FIFA’s preventive programmes during the course of their
Prevention/Prevention-of-Injury/Prevention-Programmes/
own day-to-day activities.
The-11-a-complete-warm-up-programme
“The 11+” - a complete warm-up to prevent injuries F-MARC’s focus has always been on developing a football-specific injury prevention programme. After the frequency, characteristics and risk factors of injury were established, a consensus conference on the definition of injury1 was convened. Consequently, F-MARC established a standardised injury recording system at all FIFA competitions. Based on these comprehensive preparations, F-MARC also developed a simple, time-efficient prevention programme for amateur players. ”The 11+ – a complete warm-up programme to prevent injuries” can easily be incorporated into training and includes progressive levels of difficulty (Workshop IV).
1
Fuller, C.W., Ekstrand, J., Junge, A., Andersen, T.E.,
Bahr, R., Dvorak, J., Hägglund, M., McCrory, P., Meeuwisse, “The 11+” programme consists of three parts to be
W.H. (2006) Consensus statement on injury definitions and
completed in 20 minutes, ideally before each training session.
data collection procedures in studies of football (soccer)
Parts I and III consist of running exercises at different speeds
injuries. Simultaneous publication in the British Journal of
combined with either active stretching and controlled partner
Sports Medicine 40(3):193-201, the Clinical Journal of Sports
contact (I) or with planting/cutting movements (III). Part II is the
Medicine 16(2):97-106 and the Scandinavian Journal of
preventive part and consists of six exercises focusing on
Medicine & Science in Sports 16(2): 83-92
core and leg strength, balance, plyometrics and agility, each with three levels of increasing difficulty.
2
Soligard, T., Myklebust, G., Steffen, K., Holme,
I., Silvers, H., Bizzini, M., Junge, A., Dvorak, J., Bahr, R., The programme’s effectiveness was proven in a
Andersen, T.E. (2008) A comprehensive warm-up programme
large randomised controlled study involving 2,000 female
to prevent injuries in female youth football – a cluster
adolescent players in Norway . After a year of practising
randomised controlled trial. British Medical Journal Dec 9;
“The 11+”, overall injuries had decreased by a third and
337:a2469. doi: 10.1136/bmj.a2469
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F-MARC | 3rd International Football Medicine Conference; Sun City
FIFA Medical Assessment and Research Centre
The FIFA pre-competition medical assessment F-MARC has developed a standardised pre-competition medical assessment (PCMA) for the world’s elite football players with the objective of maximising the probability of detecting the risk factors that challenge players’ health, not only with regard to sudden cardiac death (SCD) but also other serious health risks and severe injuries. Based on the results of a pilot test at the 2006 FIFA World Cup Germany™, the PCMA was reviewed and updated3. While the FIFA PCMA in its original form is a comprehensive examination including a resting 12-lead ECG and transthoracical echocardiography, it may be implemented step by step to accommodate the needs of larger target groups and ensure feasibility at all levels of play. It is important to note that medical history alone can identify up to 75% of the problems that affect athletes, and further examinations can be conducted based on the findings. The FIFA PCMA form is available for download at: http://extranet.fifa.com/medical/en/Football-Medicine/ Prevention/General-medical-assessment
3
Dvorak, J., Grimm, K., Schmied, C., Junge, A. (2009)
Pre-competition medical assessment of international elite football players – 2006 FIFA World Cup Germany™. Clinical Journal of Sports Medicine 19:316-321
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F-MARC | 3rd International Football Medicine Conference; Sun City
FIFA Medical Assessment and Research Centre
Football for Health beyond the game
1. Play football regularly 2. Respect girls and women 3. Protect yourself against HIV
Football is a fun activity with a positive impact on the
4. Avoid drugs and alcohol
health of those who play it. To minimise the risk of injury or
5. Use treated bed nets
health risks when playing the game, a number of preventive
6. Wash your hands
programmes have been introduced which allow FIFA to further
7. Drink clean water
explore football’s potential to improve public health. After
8. Eat a balanced diet
all, football offers a host of key advantages when it comes
9. Vaccinate yourself and your family
to providing health education due to its unique popularity.
10. Take your prescribed medication
Interest in football transcends social status, gender, religion,
11. Fair play
culture, borders and language. Minimal equipment is required, which allows it to be played everywhere and by everyone.
Each of the messages has been linked to a specific
Moreover, football teams can function independently
football action and is presented to children in group plays
with their own dynamic. Football is also full of images and
(workshop VII). For more information and to view the first
associations that make learning about health much more
study results, go to:
memorable. Finally, football is an enjoyable activity that unites people from all backgrounds, thus creating the ideal environment for individual and group learning. Based on these aspects, F-MARC is currently creating a universally applicable and comprehensive “Football for Health” programme, based on the World Health Organization’s definition of health as physical, mental and social well-being. We invite attendees to join us in this key project, which aims to prevent communicable and noncommunicable diseases by promoting the following 11 messages:
http://extranet.fifa.com/medical/en/Football-For-Health/
F-MARC | 3rd International Football Medicine Conference; Sun City
69
FIFA Medical Network
The FIFA Medical Committee and the FIFA Medical Assessment and Research Centre (F-MARC) want to create a virtual football medicine community whose members not only apply best football medical practice with a focus on prevention, but are also aware of the bigger picture of improving public health through both playing and using football as an educational tool in prevention. The FIFA Medical Network is a non-restricted access web-based service with extensive medical and related information that is not available on FIFA.com. It is aimed at physicians, physiotherapists and other medical professionals. All material is freely available for viewing and downloading. The content corresponds to the F-MARC Football Medicine Manual and the FIFA Football Medicine courses and covers the whole spectrum of football medicine. The network offers news on FIFA and F-MARC activities in football medicine, information on the Football for Health programme, anti-doping issues in football, conferences and courses. The need for further features in the future, e.g. a distance learning programme or a discussion forum, will be determined by the users. Access data are provided upon registration at: http://extranet.fifa.com/medical/
Pre-announcement of 4th International Football Medicine Conference
The 4th International Football Medicine Conference will take place in Brazil in 2014. As with the previous conferences, it will be conducted just prior to the FIFA team workshop for the 2014 FIFA World Cupâ&#x201E;˘ and at the same location. Further information will follow.
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Impressum | 3rd International Football Medicine Conference; Sun City
Publisher Fédération Internationale de Football Association FIFA-Strasse 20 P.O. Box 8044 Zurich Switzerland Tel. +41 43 222 7777 Fax: +41 43 222 78 78 www.FIFA.com President Joseph S. Blatter Secretary General Jérôme Valcke Chairman of the Medical Committee Michel D‘Hooghe, MD Chairman of the FIFA Medical Assessment and Research Centre (F-MARC) Prof. Jiri Dvorak, MD Editing and production FIFA Medical Office & FIFA Medical Assessment & Research Centre (F-MARC) Graphic Design/Layout von Grebel Motion, Zurich, Switzerland Printing rva Druck und Medien AG, Altstätten, Switzerland
The FIFA Corporate Mark is a registered trademark.