Football Traumatology Current Concepts: from Prevention to Treatment Piero Volpi (Ed.) Football Traumatology Current Concepts: from Prevention to Treatment Foreword by: Neil P. Thomas Franco Carraro Sergio Campana Giacinto Facchetti Springer - PIERO VOLPI Center for Sports Rehabilitation Galeazzi Orthopaedics Institute Milan, Italy Library of Congress Control Number: 2005937087 ISBN 10 88-470-0418-7 Springer Milan Berlin Heidelberg New York ISBN 13 978-88-470-0418-4 Springer Milan Berlin Heidelberg New York This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustra- tions, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. 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Cover design: Simona Colombo, Milan, Italy Typesetting: Graphostudio, Milan, Italy Printing: Grafiche Porpora, Cernusco SIN (MI), Italy Foreword This anthology of Football Traumatology edited by Dr. Piero Volpi comprises the collective experience of many of the leading surgeons in Europe whose practice includes footballers at all levels. By pooling this experience and clearly defining common problems and areas of current interest Professor Volpi has produced a very useful reference source for orthopaedic surgeons, sports physicians and physiotherapists. Future editions may expand on emerging areas in non-surgical fields such as dietary supplements and the effects of psychological factors on both injury itself as well as recovery. Topics in this first edition such as Epidemiology, Training Methods, Prevention, and Future Treatment are welcome adjuncts to the usual subjects and reflect recent areas of research. Neil P. Thomas President ESSKA 2000 Winchester UK With football becoming ever more relentless and intense, the role of the sports doctor has become in the last few years increasingly important in protecting footballers' health and their physical integrity. It is in this context that Dr. Volpi's in depth and wide ranging work must be viewed. His attention has focused specifically on two important aspects: the fight against doping and the preven- tion of sports traumas. Together with his scientific experience as a sports clini- cian and traumatologist, Dr. Volpi can also draw on his direct field experience as a football player, which adds considerable value to the editing of the current vol- ume, intended as a service to football. With the Football World Cup just round the corner, this book produced in collaboration with both Italian and foreign experts is particularly topical: I am convinced that the spread of medical-scien- tific knowledge and innovations is the most efficient way to safeguard the health of athletes and encourage the growth of a "better" football. Franco Carraro President of the Italian Football Federation VI Foreword This wide editorial initiative, conceived and realized by Dr. Piero Volpi, a pre- cious and not replaceable AIC consultant, brings an important scientific contri- bution to medical questions connected to football. It is noticeable in the work the importance of the Author's direct experiences, first as players and as sport and traumatic doctor then. AIC has always been strongly engaged in safeguarding the players' health, real protagonists of the sport event, and has, between his leading aims, the fight against doping and the traumas prevention. The information, the knowledge and the education are fundamental for play- ers who want to successfidly face the fight to defend their physical integrity and professional dignity. This praiseworthy editorial effort goes exactly in the direction wished by AIC and will be useful for all the football component to enrich their cultural heritage but especially to know how important is the work done by who acts in order to improve sport anyhow. Sergio Campana President AIC Italian Footballers Association As an F.C. Internazionale executive, and through dealing with the topic in UEFA and FIFA Commision meetings, I have been able to closely follow Piero Volpi's work in these past ten years. I have come to appreciate the preparation and ethics of a person who was "born" on the pitch and has since been through many experiences, first as footballer and later as a sports doctor. This interesting book is the result of an analysis of these two lives that run parallel, but which are not always necessarily linked in the professional world: theory is verified by practice, research addresses the demands and problems faced at the highest com- petitive levels. The knowledge and possibilities offered by sports medicine today are far superior to those in my generation of footballers. Piero Volpi's book is the most recent and vivid example that today's athlete has the moral and professional duty to consider his own health as one of the most important and decisive aspects of his career - at the very level and on each occasion, starting from the basis, from the decisive transition between playing for fun and playing competitively. Giacinto Facchetti President, EC. Internazionale Milano Preface Every child has a dream: to play football and become a famous footballer. When I was 10 years old, my father was used to bring me to San Siro stadium on sunday afternoons to watch the Inter team playing. The great Inter was grow- ing up. Sarti, Burnich, Facchetti . it was an absolute and sudden love. Twenty years later I was climbing that prestigious stadium through the stairs from the locker rooms wearing the shirt of Como team to play a football match of the first league Italian championship against Inter. Fifteen years later, I was sitting as a chief physician on the bench of the Moratti's Inter team, Ronaldo, Baggio, etc. Sometimes dreams come true. With the present book I accomplish today another wish. To enrich the won- derful world of football with scientific and specialistic contributions on football traumatology, a branch that has undergone important hits and progresses. Football has constant need of medical, diagnostic, clinical, therapeutic knowl- edge to counteract the increased number of traumas occurring during sport per- formance in order to defend the integrity of its players, beeing them profession- als, amateurs, young or women. Thanks to my father, to him my dearest memory, thanks for bringing me to the stadium when I was a child. Thanks to everybody that I met in the football world: players, team compan- ions and competitors, trainers, managers, physicians, physiotherapists, press reporters, fans; I learned from everyone as in a real "gym of lifeyy. Thanks to the Authors of this book, for their participation and for the high scientific level reached in their chapters. Thanks to Springer who has been recipient of this idea and was able with great skill to make it real. Piero Volpi Contents Section I General concepts Epidemiology and Risk Factor P. VOLPI Aspects of Biomechanics G. CERULLI, A. CARAFFA, G. ZAMARRA, F. FANTASIA, M. LORENZINI, D. CHECCARELLI 1 1 Training Methods C.BORDON 23 Evaluation of Whole Physical Condition F. PIGOZZI,A. GUIMBINI, F. FAGNANI,~. DI SALVO 33 Biochemical and Haematological Parameters in Football Players G.BANFI 43 Prevention of Football Injuries I. BERKES,A. KYNSBURG, G. PANICS 53 Organisation of a Professional Team's Medical Staff and the Physician's Role P.VOLPI 67 Injuries in Women's Football L. ENGEBRETSEN, K. STEFFEN 75 Referee Lesions J. ESPREIGUERA-MENDES, C. ARCE 89 X Contents Future treatmentsfor Football lnjuries M.FERRETTI,B.A.ZELLE,F.H.FU 101 Section II: Specific lnjuries Maxillo-Facial Traumatology R. BRUSATI, F. BIGLIOLI 1 13 Upper Extremity lnjuries P.VOLPI, R. POZZONI, M. GALLI, C. BAIT 123 Shoulder Dislocation R.ZINI 127 Back Problems E. ROLLAND, G. SAILLANT 143 Muscle lnjuries D. TORNESE, G. MELEGATI, P.VOLPI 153 Tendon lnjuries M.K. SAYANA, N. MAFFULLI 165 Groin Pain A. FERRETTI, A. DE CARLI, E. MONACO 183 Meniscal Lesions M.DENTI,D.LOVETERE 197 Anterior Cruciate Ligament lnjuries P. AGLIETTI, F. GIRON, P. CUOMO 205 Anteromedial Knee Instability M. MARCACCI, S. ZAFFAGNINI 2 17 Medial Side Injury of the Knee P. ADRAVANTI, A. AMPOLLINI 231 Posterior Cruciate Ligament lnjuries P.P. MARIANI, F. MARGHERITINI 245 Contents XI Articular Cartilage Lesions in Football Players L. PETERSON, C. ERNEST 255 Patellofemoral Problems A. SCHIAVONE PANNI, M. TARTARONE,A. PATRICOLA, D. SANTAITI 263 Footballer's Arthritic Knee S. LUSTIG, T. AIT SI SELMI, E. SERVIEN, G. TROTTA, P. NEYRET 275 Leg Fractures KARLP.BENEDETTO 287 Malleolar Fractures F. CASTOLDI, R. ROSSI, A. MARMOTTI, R. DEL DIN, P. ROSSI 297 Ankle Ligament Injuries A.VENTURA,A.LANZETTA 307 Osteochondral Ankle Defects M.ZENGERINK,N.VANDUK 319 Chronic Footballer's Ankle E. GIZA, B. MANDELBAUM 333 Foot Problems S. GIANNINI,A. FERRUZZI, M. MOSCA, C. BIAGINI 353 Stress Fractures F. BENAZZO, M. MOSCONI, G. ZANON 365 Rehabilitation after Football Injuries S.WERNER 375 Return to Play A. CACCHIO, G. MELEGATI, P.VOLPI 389 Protective Equipment D.T. KIRKENDALL 401 Subject Index 417 Contributors ADRAVANTI PAOLO Casa di Cura "Citti di Parma" Parma, Italy AGLIETTI PAOLO First Orthopaedic Clinic University of Florence Florence, Italy AIT SI SELMI TARIK Centre Livet Service Professeur Philippe Neyret Caluire, France AMPOLLINI ALDO Casa di Cura "Citti di Parma" Parma, Italy ARCE CARLOS Orthopaedics and Sports Trauma Department Pedro Hispano Hospital Matosinhos, Portugal ARCHILLETTI ANTONIO Laboratory of Clinical Biomechanics "Let People Move" Perugia, Italy BAIT CORRADO Center for Sports Rehabilitation Galeazzi Orthopaedics Institute Milan, Italy BANFI GIUSEPPE Facolti di Scienze Motorie Universitl di Milano Istituto Ortopedico Galeazzi Milano, Italy BENAZZO FRANCESCO Orthopaedics and Trauma Department, University of Pavia Policlinico San Matteo Pavia, Italy BENEDETTO KARL P. Trauma Surgery and Sports Medicine Academic Hospital Feldkirch Austria BERKES ISTVAN Department of Sports Orthopaedic Medicine and Rehabilitation Faculty of Physical Education and Sports Science, Semmelweis University Budapest, Hungary BIAGINI CHIARA Orthopaedics Department University of Bologna Rizzoli Orthopaedic Institute Bologna, Italy [...]... Division, Traumatology Sport Centre Orthopaedic Institute Gaetano Pini Milan, Italy MARCACCI MAURIZIO Rizzoli Orthopaedic Institute Sports Traumatology and Orthopaedics Division Biomechanics Laboratory Bologna, Italy DARIO Lo VETERE Sports Traumatology and Arthroscopic Surgery Unit Galeazzi Orthopaedics Institute Milan, Italy MARGHERITINI FABRIZIO University of Motor Sciences Unit of Sports Traumatology. .. and Traumatology Department R Silvestrini Hospital Perugia, Italy LUSTIG SBBASTIEN Centre Livet Service Professeur Philippe Neyret Caluire, France MARIANI PAOLO PIER University of Motor Sciences Unit of Sports Traumatology Rome, Italy MARMOTTI ANTONGIULIO Third Department of Orthopaedics and Traumatology University of Turin Medical School Mauriziano "Umberto I" Hospital Turin, Italy XVII Contributors... 3rd Department of Orthopaedics and Traumatology University of Turin Medical School "Umberto I" Hospital Turin, Italy Ross1 ROBERTO Orthopaedics and Traumatology University of Turin Medical School "Umberto I" Hospital Turin, Italy XVIII SAILLANT G~RARD Orthopaedic Surgery Service Piti6 Salp&tri&re Hospital Paris, France SANTAITI DANIELE ISpeO Istituto Specialistico Ortopedico Casa di Cura "San Giuseppe"... Medicine and Surgery Karolinska Institutet Stockholm, Sweden TORNESE DAVIDE Center for Sports Rehabilitation Galeazzi Orthopaedics Institute Milan, Italy STEFANO ZAFFAGNINI Rizzoli Orthopaedic Institute Sports Traumatology and XIX Conttibutoa Orthopaedics Division Biomechanics Laboratory Bologna, Italy ZAMARRA GIOVANNI University of Perugia Orthopaedics and Traumatology Department of Perugia R Silvestrini... friendlies) (Table 2), giving a training -to- match ratio of 3.6:1 This ratio itself shows how little time is devoted to preparation as opposed to playing, especially since sessions prior to a match are devoted to the tactics to be adopted rather than to training while those conducted after it are mainly concerned with unwinding It is also defective insofar as it takes into no account the matches in which... such as kicking, jumping, running, cutting, stopping, headers, and the like Biomechanical Analysis of Soccer Biomechanical analysis applied to soccer allows the implementation of studies from basic science to practical application with clear repercussions on performance, prevention, and aetiologic treatment Thanks to biomechanical analysis, it is possible to obtain objective and reproducible data on... Amsterdam The Netherlands RAUL ZINI U.O Ortopedia Azienda Ospedaliera San Salvatore Pesaro, Italy Section I GENERAL CONCEPTS Epidemiology and Risk Factor PIERO VOLPI Introduction Football is the world’s most popular sport According to the International Football Federation (FIFA), there are more than 200 club members in its 203 affiliated nations The Union of European Football Associations (UEFA) has 23 members... publications Many footballers have had to stop playing and undergo medical treatment and surgery followed by rehabilitation periods before being able to resume playing Those who have been able and lucky enough to take part in professional soccer know that a second, or even a tenth of a second, is time enough for the occurrence of an accident that may require days, weeks, or months to put right and which... Netherlands VAN VENTURA ALBERTO 1st Division, Traumatology Sport Centre Orthopaedic Institute Gaetano Pini Milan, Italy VERCILLO FABIO University of Perugia Orthopaedics and Traumatology Department R Silvestrini Hospital Perugia, Italy VOLPI PIERO Center for Sports Rehabilitation Galeazzi Orthopaedics Institute Milan, Italy TARTARONE MARIO ISpeO Istituto Specialistico Ortopedico Casa di Cura "San Giuseppe"... injuries in football players Influencing factors Am J Sports Med 28[Suppl 5]:58–68 Hawkins RD, Fuller CW (1999) A prospective epidemiological study of injuries in four English professional football clubs Br J Sports Med 33:196–203 Nielsen AB, Yde G (1989) Epidemiology and traumatology of injuries in soccer Am J Sports Med 17:803–807 Luthje P, Nurmi I, Kataja M et al (1996) Epidemiology and traumatology . Football Traumatology Current Concepts: from Prevention to Treatment Piero Volpi (Ed.) Football Traumatology Current Concepts: from Prevention. accomplish today another wish. To enrich the won- derful world of football with scientific and specialistic contributions on football traumatology, a