Can GPS Tracking Prevent Injuries....?

So the domestic football season has finally come to an end, and if you are a good premiership club you are looking to address the injuries that your players sustained over the course of the last season, and to try and prevent them from happening again next season... But how exactly do you achieve that? Well Arsenal FC will be GPS tracking all of their players in future to find out.

The theory is that Arsenal will be able to ascertain the fatigue levels of their players by monitoring how far and fast they run during each training session, and the length of time the player has his foot on the floor during the stance phase of their running gate (load data). Essentially if the player is in good shape he will be on his toes and will be moving around quickly, and if the player is tired then their movement will be slower and their load data will increase indicating that the player is potentially at risk of being injured.

The system which is similar to one being used in aussie rules will take some time to get up and running as they will need to establish the players normal level of activity and how this changes during training and matches but if it helps predict or reduce the incidence of injury then it is a great idea. Whilst it may be some time before the benefits of this system are realised it is a bold step, it shows the dedication and investment that top flight clubs are prepared to make to reduce their ever lengthening injury lists. Will this system result in players being rested for matches based on their poor performance in training? Probably yes, and herein lies the crux of the issue with this system – are all players’ consummate professionals who always give 100% in training? No. But they will soon learn that with this system that there is nowhere to hide.

On a similar theme AC Milan have invested in perhaps the most advanced multipurpose medical centre on the planet, which they use to maintain the players’ fitness and to detect any potential injuries. As well as the more normal sports therapy/physiotherapy practitioners they have specialist’s from the fields of neurology, biochemistry, psychology, dentistry and chiropractic that contribute to overall well being of the players. The psychological element is very interesting as there is lot of evidence to suggest that there is a psychological factor involved in injury and it is less common for sports psychologists to work in football than other sports.

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Scrubs...

To coin a football phrase it’s squeaky bum time, I have two pieces of coursework due next week, dissertation due on the 14^th May, then it’s exams and then around about the 4^th June its all over. If only I could fast-forward a month…. Despite the pressing deadlines I was fortunate to be able to spend some time with one of the master class presenters at this years Society of Sports Therapists Student Conference Dr Ian McDermott. I spent Friday morning at the London Bridge Hospital where I observed an ACL reconstruction and a high tibial osteotomy. The ACL reconstruction is a relatively straightforward procedure now and estimates suggest that  in the US approximately 100,000 ACL reconstructions are carried out each year. Dr McDermott carries out in the region of 40-50 each year. To see what i'm talking about have a look at this video - not exactly the same technique but it uses an allograft and is a quite similar albeit shortened view of what I saw.

High Tibial Osteotomy

The high tibial osteotomy on the other hand is not a routine procedure. The osteotomy is essentially the breaking and realigning of the tibia in order reduce the effect of osteoarthritis on one side of the knee. During the arthroscopy the surgeon will assess the state of the articular surgery on the affected side of the knee, and possibly carry out drilling or microfracture to the affected cartilage in an attempt to stimulate cartilage regrowth. 

Normal Cartilage (left) Cartilage damage (middle) and cartilage drilling (right) 

When the arthroscopy is finished the remainder of the operation is carried out with a portable x ray machine, so everyone in the operating theater is required to lead lined aprons - lets face it none of us want to have our bits frazzled. The tibia is then drilled and a fragment of bone removed so that the tibial plateau can be realigned, it is then fixed in place with a wedge replacing the removed bone. That makes it sound remarkably simple - it wasn't. The thing that surprised me most about both operations was the heavy duty tools that were used and also the force required for elements of each procedure.

It was a great experience being able to view both operations and it gives me a better understanding of the surgical procedures involved which in the future will help shape they way I rehabilitate patients. Thanks to Ian McDermott and his team for making it a great day. If you get a chance to view some surgery I'd highly recommend it.

None of the photo's or x-rays of the operation are from my visit. 

www.fitforsportclinic.com

Snickers time...

Living just a stones throw from the start of the Virgin London Marathon has its disadvantages but it also gives unique access to one of the worlds biggest sporting events. On Sunday thousands of nervous runners will anxiously line up at the start in Blackheath hoping to make it to the finish line. For most it will be the reward for the hard winter nights running in the rain and snow, but for those who have followed the Jade Goody marathon diet it will be a cigarette and a can of beer at mile five and a trip to the St John’s ambulance at mile 10. Ok so those people are in the minority but they do exist, I’ve seen them. The organisers rightly ask that if you can’t run 15 miles two weeks before the marathon that you should give up your place and they will very generously give you a place the following year, the catch, well if you are a running for a charity they will still want the cash that you guaranteed when you accepted your place.

In 2009 approximately 32,000 runners started the marathon and around 25,000 finished. Injury is an inevitable part of the marathon but it is not as risky as the media would have you believe, obviously the very occasional death makes the headlines but the chance of that happening is very small.

Marathon Injury Stats:

Likelihood of Injury

 

    • Contact with St John’s Ambulance: 1 in 6

    • Visit to A & E: 1 in 800

    • Hospital admission: 1 in 10,000

    • Death: 1 in 67,414

Injury Classification

Social 2%

Constitutional 4%

Topical 15%

Muskoskeletal 79%

Definitions:

    • Social - Self Treatment/Request for Fluids

    • Musculoskeletal - Cramps, painful joint, bones or muscles;

    • Topical - Blisters, abrasions, runner’s nipple, skin chafing etc.

    • Constitutional - Chest or abdominal pain, diarrhea, fits, vomiting, collapse

Statistics are, as always open to interpretation but these represent the runners who have made contact with any of the medical staff along the route but it doesn’t take into account those who self refer to their own doctor/hospital or Sports Therapist etc. As expected the vast majority of injuries are musculoskeletal but unfortunately I wasn’t able to find a breakdown of the type of injuries sustained. If you are interested in reading more about the injuries and physiology of marathon runners then you should read Marathon Medicine (beware it is 350 pages) as it covers everything from the shoes you should wear, to the role of genetics and why the African nations have dominated distance running.

As an interesting aside to the marathon there are a unique band of 21 runners known as the Ever Presents who have completed every London Marathon to date, no mean feat when you realise that most of these runners are now aged between 50-70 years old. I wouldn’t want to run a marathon now let alone when I was 70. Full details on this year’s marathon can be found here and if you are thinking of watching there is a great interactive map that tells you when the elite runners will be passing by the various stages along the route.

If you are running on Sunday good luck and make sure you hydrate well in the days before the marathon and good luck also to the London Met students who are working at the marathon this weekend.

www.fitfosportclinic.com

Student Conference

Check out the fantastic line up at this years Society of Sports Therapists Student Conference that is once again being hosted by London Metropolitan University. I think one of the key highlights has to be not one, but two talks by sports medicine guru Karim Khan co author of the best sports medicine book around. Should be a great couple of days nicely rounded off with dinner at the Emirates Stadium with Greg Whyte providing the after dinner speech. I look forward to asking him about his claim that he could have have got David Beckham ready to play at the world cup. 

Full details can be found here - go and buy your ticket. 

www.fitforsportclinic.com

Back in the saddle...

Having realised somewhat belatedly that my sports first aid had run out I am now re-accredited and ready to work again. Having endured a lot of games in terrible weather since the turn of the year it was great to have a glorious day of sunshine yesterday for Glebe FC's 2-1 victory over Welling FC who have one of the best youth set ups in semi pro football. During the time that I wasn't working unfortunately Glebe's title ambitions have come unstuck but it was a good result yesterday and one that will hopefully help us finish second in the league.


Inevitably I am now starting to think about my next steps as a Sports Therapist as I only have another 45 days left as student. Scary thought. Including the foundation year I will have been a student for 5 years and I am more than ready to rejoin the world of work. At least until I find the masters course that I want to do...


www.fitforsportclinic.com