IOC World Conference – Prevention of Injury & Illness in Sport: On the ground recap

By Liam West (@Liam_West)

IOC conference

For 3 years this conference has been firmly on my “SEM Bucket List” and it did not disappoint. Firstly, Monaco in the sun is a sight to behold and secondly to walk into a coffee break to see the “who’s who” of global sports medicine was simply inspirational. The numbers for the event were equally impressive;

  • 24 symposia
  • 5 keynotes
  • 34 workshops
  • 73 free communications
  • 233 poster presentations (unopposed in the time table)

The only downside was that I could not attend all of the sessions, although I guess that speaks volumes of the quality of presentations on offer. Below is a summary of the 3 days and some take home messages from the sessions I attended.

Dr. Richard Budgett, IOC Medical Director, reminded all the delegates at the opening ceremony that “It’s all about the athlete” and as a former Olympic gold medalist he knows this more than most! The next day the opening keynote lecture showcased a vigorous debate between Karim Khan (@BJSM_BMJ) and Dominic MacAuley (@DMacA) as to whether sports injury & illness prevention research has delivered. The answer? Yes in certain areas (e.g. ACL prevention), but there is much work to be done (or optimistically to be read as opportunities for research!!).

Using the #IOCprev2014, the interactivity between delegates and speakers both in attendance and across the globe was terrific. Perhaps this was triggered by the excellent symposium about “the power of social media” chaired by @CarolineFinch. Learning points? You can to use social media as a platform to market your message. It is now one of the best ways to signpost readers to scientific content and can improve citation rates although @DrJohnOrchard warned about the perils of engaging in non-academic discussions online. @clairebower explained the three top rules of twitter [slides can be accessed here]. 1) Know your audience, 2) keep it simple & 3) image is everything (use photos). @EvertVerghagen explained that using social media can increase subject recruitment for research and apps may be the future of sports injury prevention – you can find his talk here.

Sudden cardiac death (SCD) was an integral theme at the last IOC conference in 2011 and 2014 was no different – read the open access BJSM issue on Advances on Sports Cardiology here. After the overview by @Prof­_MatWilson, the issue of the optimum screening protocol for SCD was tackled – future efforts lie in detecting subclinical disease in older athletes. No guaranteed protocols were given by the experts but Michael Papadakis provided pro-ECG evidence and then educated delegates to the normal ECG changes associated with age, sex and ethnicity – read the Seattle Criteria here and do the online BMJ ECG interpretation module here. Shanjay Sharma (@SSharmacardio) talked about the importance of maintenance of left ventricular cavity size in the athlete’s heart that is lost in cardiomyopathy and that it isn’t the size of the heart that matters but the function. Screening will never pick up all athletes at risk of SCD – Jonathan Drezner (@AMSSM) preached the importance of sideline preparation and the role of the automated external defibrillator (AED) in preventing SCD. The big take home message – “A seizure or loss of consciousness should be assumed to be sudden cardiac arrest until proven otherwise”

Concussion is the current vogue in SEM and the keynote by Neurologist/Sports Physician & PhD Paul McCrory was well attended. He described that whilst technology has improved enabling us to measure impact & biomechanical forces, these show little correlation to rates and severity of concussion. The most recent Zurich guidelines were emphasized to be just that – guidelines. There are no definite answers so far in concussion and currently we are only looking into neurocognitive athletic function but McCrory explained that concussion is a complex systemic pathology with many components; consider mood, sleep, hormonal disturbances etc. – listen to his 4 recent BJSM podcasts on the topic here – 1,2,3, & 4. It is important to note that Chronic Traumatic Encephalopathy is a separate entity to concussion and as clinicians we must not let the media dictate the course of science – education in this area is key! You can access the BJSM journal dedicated to concussion and the 4th International Conference on Concussion in Sport (Zurich, 2012) here.

The recent IOC Consensus Statement “Beyond the Female Athlete Triad – Relative Energy Deficiency Sydrome (RED-S)” was presented and discussed in a fantastic stream led by @margomountjoy – this work has moved on from the Female Athlete Triad and the journal can be read here. RED-S acknowledges this condition affects both genders and has multisystem involvement with more complex pathophysiology than previously described. It’s all about the energy. RED-S describes the imbalance between training load and recovery as the imbalance between energy availability and expenditure. With low energy availability comes susceptibility to short term risks to illness, infection, fatigue etc and long term risks such as decrease in performance and overall health. The paper proposes a traffic light system to RTP issues for athletes with this condition – useful for clinicians.

Some other short take home messages;

  • The legend of running biomechanics, Benno Nigg, spoke on the evolution of footwear and the prevention of running injuries. He concluded from his years of research that the only thing that actually confers injury protection is the ability of athletes to use a “comfort filter” to choose the shoe/insole that works for them.
  • Injury prevention – @benclarsen presented on the difficulty with recording overuse injuries. He stated that we need to move away from the trend of only measuring time loss injuries and look to include injuries that can lead to overuse pathologies.

I’d like to thank the organisers for putting on such a fantastic event that enabled delegates to meet old friends whilst making new connections that will hopefully last for many years to come. I look forward to seeing many of you at the next IOC Conference in 2017!

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Dr. Liam West BSc (Hons) MBBCh is a junior doctor at the John Radcliffe Hospital, Oxford. He is a founder and current President of USEMS and is also the founder of Cardiff Sports & Exercise Medicine Society (CSEMS). In addition to his role as an associate editor for BJSM he also coordinates the “Undergraduate Perspective on Sports & Exercise Medicine” Blog Series. He has a passion for developing the SEM movement amongst undergraduates and sits on the Council of Sports Medicine for the Royal Society of Medicine as Editorial Representative and on the Educational Advisory Board for the British Association of Sport and Exercise Medicine. His Twitter handle (as above) is @Liam_West and you can find Liam on Facebook as well.

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