Football Medicine Conference

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

3

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

69

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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

37

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

39

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

44

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

66

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.