By Bente Andersen, IFSPT Board Member 

The IOC World Conference on Prevention of Injury & Illness in sport was 2014's international conference for those interested in clinical aspects of sports and exercise medicine. The diverse faculty represented the pre-eminent international authorities in injury and illness measuring, prevention and treatment/rehabilitation.

Over 120 leaders in their fields were lined up as speakers. One of many highlights was the opening lecture by the dynamic Professor Dohmnall Macauley and Professor Karim Khan, BMJ/BJSM editors. Paul McCrory spoke on concussion, Benno Nigg on running injuries, Evert Verhagen on how digital and mobile platforms will influence athlete care, Andrew McIntosh on technology and equipment in sport, Juan Manuel Alonso on hamstring injury prevention, and Caroline Finch on injury surveillance and rule changes.

Some of the delegation from the Danish Association of Sports Physical Therapy was attending this important symposium Friday morning. Taking the Lab to the Game: Towards Innovative Field-based Injury Screening and Prevention with Scott McLean from USA as a chair had a spot-on message that a timely and critical step in effective sports injury risk screening and prevention must bring the lab to the field.  

Tron Krosshaug, Norway, underlined that video analysis could integrate injury situations and kinematics in naturalistic game situations and the need for this is growing.

Uwe Kersting, Denmark, revealed a modeling-based estimation of true joint contact forces and the perspectives for injury risk estimation in real competitions concerning ankle injuries. Sensors in the athletes' socks make field assessment possible. Also, accelerometry is a way to measure these forces. He underlined that external forces alone may not be sufficient to assess overloading of internal structures.  

Grant Goulet, USA, took us through the developing of a field-based morphomechanical predictors of injury risk and performance. His research is within the topic of femuroacetabular impingement morphology and mechanics in ice hockey, and the enviromental constraints for accurate placing of the markers. The goaltenders' range of movement was measured in the butterfly movement.  

Matthias Gilgien, Norway, offered a presentation on slope injury risk assessment and biomechanical data collection in alpine ski racing, with a combined GPS and inertial sensor approach and a terrain model. He has linked injury rates with real cases in downhill skiing, and certain spots of dropping out of course. In the future, the model can predict places in courses of high injury risk.  

Scott McLean then underlined the importance of the next steps in successfully achieving real-time field-based athlete risk assessment. The goal is to benefit the athlete. Multiple sensors on the athlete are a pathway to holistic understanding of injury risk, as well as applications beyond the game in long-term rehabilitation. New technologies should be explored and strengths of new technology utilized - this may be a paradigm shift in identifying easily translatable metrics distilling complex data to simple outcome measures. We shall be aware of technology overload and how much is too much for the athlete?

Some of the delegation from the Danish Association of Sports Physical Therapy took part in the symposium on Saturday morning, where Per Holmich, Denmark, and Mark Hutchinson, USA, were chairs, with the topic The Groin Injury Iceberg: Looking Beneath the Surface. This is an injury keeping a great of athletes grounded for most or the entire season.   

Martin Hagglund, Sweden, took us through the epidemiology across sports and gender which is multifaceted.   

Adam Weir, Quatar, had the topic Acute or Overuse Injuries: When to Prevent and Is Prevention Utopia? He described the incidence primarily with a study of Holmich et al,

Incidence and clinical presentation of groin injuries in sub-elite male soccer. Per Holmich, Kristian Thorborg, Christian Dehlendorff, Kim Krogsgaard, Christian Gluud. Br J Sports Med. doi:10.1136/bjsports-2013-092627.

He concluded that the prevention is not evidence based, but we must start getting to know more about the mechanisms, and, in the meantim,e use general programs in the intention of prevention. He invited attendees to the 1st World Congress on Groin Injuries in Aspetar, in November, 2014. Follow this link. 

Mark Hutchinson, USA, took us through the aspects of Diagnostic Imaging: Is It Convincing or Confusing? He asked the question: are we missing something in the surgery as the injuries often are recurrent. We might have to look for overlapping diagnosis fx sports hernia and focus on anatomy.  

Per Holmich, Denmark/Quatar, underpinned the importance of clinical entities and the focus of prevention. The diagnostic terminology is still unspecific and we have to agree in the future. Re-injuries are very common. To concentrate on this, you could read:

Long-standing groin pain in sportspeople falls into three primary patterns, a "clinical entity" approach: a prospective study of 207 patients. Holmich P. Br J Sports Med. 2007;41:247-252 doi:10.1136/bjsm.2006.033373.

Kristian Thorborg, Denmark, concentrated on Which exercises are relevant for prevention?

How do we best protect the muscle-tendon-bone unit from overload? The importance of strength and resistance training - eccentric, isometric, stability - in one way or the other, seem to be of great importance. When we increase the cross-sectional area of the muscle-tendon-bone unit, this seems to prevent the injuries.  

They succeeded in taking us beneath the surface of the groin injury iceberg and made us aware of this very extensive injury complex.  

This triennial IOC conference was a unique opportunity for the global sport and exercise medicine and physical therapy community to meet face to face. And Monaco was a great choice of location for this meeting!

Members of sports medicine and sports physical therapy groups affiliated with BJSM (British Journal of Sports Medicine), including Swiss, UK and Norway IFSPT member organizations.   

Bakare Ummukulthoum, PT; Bente Andersen, IFSPT board member, Denmark; Marie-Elaine Grant, Ireland, IOC Physiotherapy; and Vibeke Bechtold, former IFSPT board member, Denmark, smile for the camera!