Reporting from UKsem 2011 – the largest Sports and Exercise Medicine and performance Conference in Europe. London’s Excel conference centre 23rd November – no downtime for the BJSM blog!

Richard Frobell opened with 3 major revelations. #1. ACL injuries are associated with arthritis – whether you have a reconstruction or not.  (citation classic, 103 citations to date).

#2. Give a piece of rehabilitation a chance! Not everyone needs a knee reconstruction. Really? New England Journal of Medicine RCTs demonstrating that = 1; disputing it = 0. (See Frobell, 2010, 53 citations already), THE hot topic of 2010/2011 and great to have Dr Frobell here himself. Audience experts included the IOC’s Lars Engebretsen so discussion was energetic. They were seen breakfasting together later so no risk of Scandinavian Spring just yet.

#3. There is limited return to sporting activity after ACL rupture. With or without surgery. This is where I was about to slash up. Depressing keynote stuff. Who chose him?

But then the good news. Prevention is key and possible. There are success stories. More of that tomorrow’s program. Sessions on prevention of football and tennis injuries, of knee and groin debacles. Hope springs eternal, no need to jump into the boxing ring that is available here for conference attendees. No need to walk up to the fencers, brandishing only the complimentary Prograin Minitub from maximuscle and say in true Homer Simpson fashion, ‘give it your best shot pal, I don’t need that poncy white protective gear, go on, try me!’.

Seriously though, I am a Frobell fan as BJSM readers and podcast listeners know. Great clinical insights, great presentation. Privilege to be in the shop at the same time as the KneeMaster.

Great day planned for Thursday 24th and BJSM Blog will be there. Blair, Dvorak, Daniel Coyle from the Talent Code, Bahr, Franklin-Miller. Track us on @BJSM_BMJ and you’ll be first with the updates. And competitions are in the wings!

Say hi to journal manager Claire Jura at the BJSM booth (ground floor, right side) and sign up for free stuff.

And do your ACL prevention exercises daily!

Teaser video – Richard Frobell kindly agreed to do a 20-second spot for the podcast of a conversation on ACL management he had with Lars Engebretsen. The discussion will be hosted on the BJSM podcasts – which are getting 4000 listens per month!

Looking for a world class conference bringing together sport and exercise medicine, conditioning and science with nutrition, rehabilitation and high performance coaching?. This conference will provide new knowledge for those working with elite sport and recreational athletes as well as those presenting to all clinicians for exercise prescription. See the UKsem home page including the concise video (and Andy Franklin-Miller’s very modish shirt)…Will you be there?

The UKsem site is the best place to find the conference program. Names I am looking forward to hearing from include Roald Bahr (sports injury prevention-always great value), Dan Lieberman (the ‘barefoot doctor’), Damien Comolli (the secret to Liverpool’s success), Vern Gambetta (the art and science of coaching).Vern has over 4000 followers as @coachGambetta on Twitter so you know he’s doing something right.

‘Sleepers’ for many will be Carl Askling on hamstring rehabilitation and Richard Frobell on conservative management of ACLs. The former has terrific programs for both prevention and treatment. He discovered the difference between ‘type I’ (sprinters/football players) and ‘type II’ (stretching/dancer’s) hamstring strains and their very different prognoses. Great teaching videos for both rehab and determining return to play.

Dr Frobell headed up the New England Journal of Medicine RCT which randomized ACL patients to rehab or surgery. Not every conference presenter can open up with that claim…’Thanks for coming and if you doze off during my talk you can read all about in the NEJM….’. Good one. 10 years of hard work to become the overnight sensation. BJSM comments on that paper are here in a WarmUp and here in a podcast with Dr Frobell and his research team. Do your homework and then ask him the stumper at UKsem. Or buy him beer for the great effort!

I’ll stop there as I want you to use your coffee break to go to the UKsem site, not to read this. And by ‘sleepers’ – I meant – ‘under the radar’ — not lectures to sleep in. I would reserve sleeping for Friday morning 9:35 – 10:05. Something about how Mad Men, the Marlboro Man and Freakonomics have the answer to ‘smokadiabesity‘? Weird!

The UKsem site is great but if you insist on only following BJSM pages you can see Andy Franklin-Miller’s WarmUp about the conference here and listen to two interviews with the mellifluous BBC-trained sports physician and fashionista.

July podcast – his conference highlights

October podcast – lower limb biomechanics plus a sneaky conference plug in the last 3 minutes of this 24 minute file.

Nice shirt….

This e-letter is in response to Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Abstract | Full Article

This outstanding body of research is a watershed in the fight against ACL-injuries.  This group should be richly commended for this excellent work.

The work points to (a priori) how, in the case of alpine skiing, excessive abduction loading / valgus torque of the lower leg structure relative to the upper leg (about the knee) can be truncated by ”detaching” the imposing load from the point of load application at the playing surface in the direction of the applied load.  E.G., if the medial load that applies abduction to the lower leg can be “released” from the lower leg — the abduction / valgus loading will dissipate.  An alpine ski-binding with this capability (via lateral heel release) will provide this capability when the applied load is “released” (when the applied abduction load approaches a pre-determined level that is well below the elastic limit of the acl but which level is above that which is needed to provide “controlled” skiing maneuvers).  Such a binding exists, today, and a prospective intervention study should be considered to study its merits for skiers.

Rick Howell
Dipl. Eng.
Stowe, Vermont, USA

Conflict of Interest: Inventor of alpine ski-binding with independently adjustable, non-inadvertant abduction release in response to excessive valgus loading, but am presently cut-off from financial gain in this IP due to on-going litigation re: ownership rights.