Preventing Injuries and Illnesses in Athletes Dr. Bill Moreau, Managing Director, USOC Sports Medicine
TRI?
BOB/SKE
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Presentation Outcomes
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Where Are We Now
• Identify current best practices in the prevention of illness and injury in elite athlete populations • Look at future opportunities in sports medicine to decrease illness and injury in the elite athlete through technology and new best practices
MEDICAL RECORD DATA MINING
EAHP’S
ATHLETE AVAILABILITY & TRAINING LOAD MONITORING
ALL 3 OTC CLINICS
ALL RESIDENT SPORTS
GETTING THERE… (NGB/NMN)
BUDGET FOR TRAVEL COSTS
APP OR PORTAL BASED?
INTEGRATE SPORT SCIENCE TEAM
SPORTS MED BUSINESS ANALYTICS
SEE EOY REPORT
NONRESIDENT SPORTS?
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Where We Are Now
Future Directions…
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ATHLETE RISK SCORES EAHP’S
ATHLETE AVAILABILITY & TRAINING LOAD MONITORING
EAHP – Elite Athlete Health Profile
MEDICAL RECORD DATA MINING
SPORTS MED BUSINESS ANALYTICS
TRAINING RELATED RISK ASSESSMENT
RISK FACTOR IDENTIFICATION
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10/30/2014
Identifying Individual Risk
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Prediction Profiler
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Variable Importance-Risk Factor Identification
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Variable Combinations – N=3,000
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Participation Availability Tracking Spreadsheet
Training Monitoring Spreadsheet
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10/30/2014
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Hours of activity a week
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Preventing Illness and Injury hrough Modified Training • A lack of variety in training stress, known as training monotony, is considered a key factor in causing Overtraining Syndrome. • There is evidence that prolonged increased training frequency results in reduced performance benefits and fatigue as opposed to tactical identical training sessions. • Training monotony can be mathematically evaluated by measuring each day's training stress, dividing the average by the standard deviation for each seven day period. • Monotony can be used to modify Training Stress Balance, a method for evaluating the effect of training over time.
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Monotony
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Training Load
Load is the RPE multiplied by the duration in minutes
Level of variation in training volume day to day (or week to week). Large amounts of variation = less monotony
RPE = Rate of Perceived Exertion
RPE (Rate of Perceived Exertion) The RPE scale measures feelings of effort, strain, discomfort, and/or fatigue experienced during both aerobic and resistance training. One’s perception of physical exertion is a subjective assessment that incorporates information from the internal and external environment of the body. The greater the frequency of these signals, the more intense are the perceptions of physical exertion. In addition, response from muscles and joints helps to scale and calibrate central motor outflow commands. The resulting integration of feedforward-feedback pathways provides fine-tuning of the exertional responses.
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Strain
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The strain is monotony x load
One approach to measuring monotony is to statistically analyze the variation in workouts. The monotony value combined with the overall training level can be used to evaluate the likelihood of Overtraining Syndrome.
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10/30/2014
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Injury and Illness Predictions Using Training Tracking
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Team Summary Programs Lightweight Rowing Pre‐hab Programs
• 84% of illnesses could be explained by preceding spike in training load above the individual training threshold
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Core Stabilization 5
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• 77% of injuries were associated with a preceding spike in training monotony
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Lower Extremity Neuromuscular Re‐education
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• 89% of illnesses could be explained by a preceding spike in training strain
Shoulder Stabilization
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EHAP Action Steps
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Collaboration with NGB’s – Rowing Additional Testing Max 100% 60'
1'
900
Power and Endurance Profiles
80% Standard Daly Duff Prendes Average Fahden Getz Gibson Hakanson King
800 60% 700
30'
2K
600
500 6K
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Team Summary
Daly
Duff
Fahden
Getz
Gibson
Hakanson
King
Kirrane
Nase
O'Leary
Prendes
Traub
Wales
Weiland
Gold Standard
400
300 Max
1'
2K
Collaboration with NGB’s – Swimming EAHPs
6K
30'
60'
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Collaborative Testing: - MSK US - Swim Specific movement screening - Allowed Team medical staff to manage health histories and physicals
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10/30/2014
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Collaboration with NGB’s – Swimming EAHPs Supraspinatus/Infraspinatus: Right
Left
91%
100%
Tear
26% partial
17% partial
Attachment site
47%
13%
47%
54%
Tendonosis
Abnormal Bursal thickening
Normal
Tendonosis
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Teams Currently Being Tracked
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Wrestling (All three disciplines) Triathlon Fencing (onboarding) Rowing Swimming (NBAC) Archery (?) Track and Field - Jumper Group (?) BMX with injury collection Sliding sports (?)
