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Highlights from the 2017 future of football medicine conference

7 Jun, 17 | by BJSM

By Dr Chris Garnett

On 13-15th May 2017, the largest annual football medicine event in the world took place at the iconic Camp Nou in Barcelona.  ‘The Future of Football Medicine’ Conference, organised by the Isokinetic Medical Group in association with FIFA, brought together 2,500 delegates and 197 of the world’s most renowned speakers from 90 different countries. Over the 3 days, researchers, clinicians and sports scientists delivered talks and workshops on the latest sports medicine research, injury prevention, rehabilitation, and optimisation of player and team performance.

A top journalist meets an International Football Manager: Roy Hodgson

The footballer’s groin pain was a topic covered particularly well with expert guidance provided by Dr Per Holmich, Dr Ulrike Muschaweck and Andreas Serner. Groin pain is a common injury in football and can be challenging for clinicians to manage. In 2015 the ‘Doha agreement meeting on terminology and definitions in groin pain in athletes’ defined four clinical entities – adductor-related, iliopsoas-related, inguinal-related and pubic-related groin pain.1 Acute adductor injuries account for approximately two thirds of acute groin injuries in football and primarily involve the adductor longus muscle.2 The hip flexors, in particular the rectus femoris and iliopsoas, are the second most frequent. A similar pattern is seen in chronic groin injuries with adductor-related being the most common, followed by iliopsoas-related and inguinal-related injuries. Typically in sport, groin injuries occur during a change of direction, however, in football, kicking is the most commonly reported injury mechanism.2 For both adductor-related and iliopsoas-related groin injuries a conservative approach with an exercise treatment programme is usually effective.

Inguinal-related groin pain, previously termed sportsman’s groin or hernia, is a weakness of the posterior wall of the inguinal canal usually caused by overuse rather than a specific traumatic event. This leads to a localised protrusion of the posterior wall which compresses the genital branch of the genito-femoral nerve and can also displace the rectus abdominis muscle causing increase tension at the pubic bone.  Clinically, athletes complain of pain that is exacerbated with physical activity which can radiate to the inner upper thigh or scrotum. The pain is reported as sharp or sometimes burning in character which is a typical sign for nerve compression and disappears with rest. Dr Muschaweck recommends an initial conservative approach for managing inguinal-related groin pain focussing on rest, physiotherapy (massage, muscle strengthening and core stability training) and medication. This treatment approach should not exceed 8 weeks due to potential nerve damage. If conservative treatment fails, surgical reinforcement of the posterior wall of the inguinal canal should be performed. This can be achieved by a minimal repair technique, which is an open mesh-free technique that also allows exploration of the pain-causing nerve and replacement of the rectus abdominis muscle. Mesh implantation is not recommended due to the risk of an extensive foreign body reaction with local scar formation. The Minimal Repair technique has been shown to be an effective and safe way to treat inguinal-related groin pain and according to Dr Muschaweck can return athletes to full activity in 14 days.3

Further learning points from the conference

Hamstring injuries – Are exercises the best medicine? Askling


  • Indications for acute surgery in MCL injury – bony avulsion, intra-articular prolapse, knee dislocation and possibly combined cruciate/MCL injury and in an elite sportsperson – Professor Fares Haddad
  • Hamstring injuries that involve the intramuscular tendon result in a prolonged RTP and higher risk of re-injury – Dr Peter Brukner
  • Wait on average 7-10 days post-injury before ACL reconstruction to enable the knee to extend fully and bend freely – Mr Andy Williams
  • 80% of discogenic low back pain will resolve with conservative management within 8-10 weeks – Mr Damian Fahy
  • Avoid the use of ice and long-term NSAID use in Achilles tendinopathy as they may reduce muscle and tendon adaptation – Seth O’Neill
  • There is no evidence for the use of PRP in muscle injuries – Dr Gustaaf Reurink
  • Pubic bone oedema reflects load and not injury – Dr Per Holmich

Follow the link below for a highlights video of the conference


  1. Weir A, Brukner P, Delahunt E, et al. Doha agreement meeting on terminology and definitions in groin pain in athletes. B J Sports Med 2015; 49: 768-774
  2. Serner A, Tol JL, Jomaah N, Weir A, Whiteley , Thorborg K, Robinson M, Holmich P. Diangosis of acute groin injuries: a prospective study of 110 athletes. Am J Sports Med 2015; 43(8) 1857-1864
  3. Muschaweck U, Berger L. Minimal repair technique of sportsmen’s groin: an innovative open-suture repair to treat chronic inguinal pain. Hernia; 14(1) 27-33

Dr Chris Garnett is a Sport & Exercise Medicine registrar (ST5) based in Yorkshire. He currently works at the National Centre for Sport and Exercise Medicine in Sheffield and provides medical support for the GB boxing squad at the English Institute of Sport and Huddersfield Giants Rugby League Club.

Dr Farrah Jawad is a Sport & Exercise Medicine registrar in London and coordinates the BJSM Trainee Perspective blog.

Integrate. Accelerate. Elevate: SASMA 2017 Biennial Congress – Speaker announcement and call for abstracts

1 Mar, 17 | by BJSM


Integrate. Accelerate. Elevate.

On behalf of the 2017 Congress Committee, we are thrilled to invite you to the 17th Biennial Congress of the South African Sports Medicine Association (SASMA). The Congress will be held from 24 – 27 October 2017 at the Century City Conference Centre in Cape Town, South Africa, and promises to be a Sports Science and Exercise Medicine showstopper!

SASMA is a multidisiciplinary professional and scientific society dedicated to co-ordinating, integrating and optimising medical, scientific and educational services in sports, exercise and health in South Africa. The theme for 2017 is “Integrate – Accelerate –Elevate.” It aims to emphasise the importance of integration across various platforms in order to accelerate and improve outcome and elevate performance.

The topic of integration has never been more relevant in sport, particularly interdisciplinary integration, cultural integration and integration with technology. A thoughtfully crafted programme will thread together themed academic content, skills workshops, and panel discussions that will inspire and empower clinicians, academics, learners and leaders.

To deliver this rich and dynamic content, we are proud to announce the following confirmed international and local speakers:
Dr Aurelia Nattiv, Professor and Director at UCLA Metabolic Bone and Osteoporosis Centre. Specialist: Female Athlete Triad.
Dr Blaise Williams, Associate Professor in Physical Therapy and Director at VCU Run Lab Ms Leslie Bonci Registered Dietician (Sports Nutrition) and owner of Active Eating Advice
Dr Frank Dick, Former Director of coaching for UK Athletics
Professor Tim Noakes, Emiritus Professor in the Division of Exercise Science and Sports Medicine, University of Cape Town. Author: The Real Meal Revolution.
Dr Jon Patricios, Director at Morningside Sports Medicine, SASMA Past-President
Prof Wayne Derman, Director of the Institute of Sport and Exercise Medicine, Stellenbosch University, Co-Director of the South African IOC Research centre for Injury Prevention and Prtotection of Health of the Athlete
Prof Efraim Kramer, Professor of Emergency Medicine, FIFA Football Emergency Physician

Events include:

Pre-congress workshops (24 October)
*Advanced manual upper and lower limb techniques
*Fieldside Emergency Care
*Exercise is Medicine Congress

Highlights (25 – 27 October)
Clinical Themes at the Congress will include:
*Pre-participation screening – What’s in and what’s out? The debate continues
*Sports Cardiology Symposium
*Paediatric Sports Medicine and Kids Health
*The Female Athlete
*Paralympic Medicine and Biomechanics
*Trends in Sports Nutrition
*Sports Specific Sessions with interdisciplinary presentations and panel discussions
*Exercise for Disease Prevention, Health Promotion and Chronic Disease Management *Musculoskeletal Ultrasound Hands-On Workshop
*Eye Opening Case Studies

Calling all students!

We would like to extend a special invitation to postgraduate students, and in 2017, have committed to elevating our student game! Not only have we improved the platform for student presentations, but we have also included numerous opportunities to connect with mentors, and a social function geared to faciliate networking amongst peers. Learners can look forward to:

Student Oral Presentations
*Poster Presentations
*Future Leaders cocktail function for post graduate students
*Student Lounge

Beckoning all professionals involved in sport and exercise – clinicians, academics, learners and leaders!

Let us integrate to accelerate and elevate the future of sport.



Click here to Register

Click here for Accommodation

For more information: WWW.SASMA2017.CO.ZA


Phatho Zondi SASMA President

Pierre Viviers SASMA President-Elect

2017 Arsenal FC SEMS Conference Presented by Vitality Screening in Elite Sport: The Search for the Panacea to Optimise Player Performance 21 March 2017

26 Jan, 17 | by BJSM

Early Bird Booking Deadline – 31 January 2017 

Senior SEMS practitioner or student – a day not to be missed!!

Building on the great success of previous Arsenal FC SEMS conferences, Dr Gary O’Driscoll, Arsenal FC Medical Director, and Mr Colin Lewin, Head of Medical Services, are delighted to confirm the 2017 high level, interdisciplinary, FSEM accredited Conference will take place at Emirates Stadium. Again this year, the speakers have international reputations that will ensure high quality, current, and interactive presentations.

Comments from 2016 conference attendees: “An excellent meeting, many new ideas and methods to implement.”; “A very enjoyable meeting and lots of information gained looking forward to the next meeting.”; “The usual high quality, well organised, interesting meeting – thank you!”

Arsenal First Team Player Alex Oxlade-Chamberlain. Arsenal Training Ground, London Colney, Hertfordshire, 4th July 2016. Credit: Stuart MacFarlane / Arsenal Football Club.

Open to all medical and scientific healthcare professionals working across sports, presentations are aimed at SEM Faculty Fellows, senior doctors, physiotherapists and professional healthcare staff working with elite sportspersons. The conference presentations will focus on various aspects of screening in elite sport with presentations on cardiac, concussion, hip, groin and knee screening.

The full schedule and on-line registration are available at:

To access the conference app please search “Arsenal FC SEMS Conference.” This will help you find out about extra content, who is attending and details of our exhibitors. Any queries, please contact

Confirmed speakers:

  • Professor Roald Bahr, Norwegian School of Sports Sciences, Chair, Oslo Sports Trauma Research Center, Norway
  • Dr Michael Collins, Director of the UPMC Sports Medicine Concussion programme at University of Pittsburgh, USA
  • Professor Fares Haddad, Consultant Orthopaedic Surgeon, UCH The Princess Grace and The Wellington Hospital, UK
  • Mr Adam Meakins, Specialist Sports physiotherapist and Strength and conditioning coach, UK
  • Andrea Mosler, Senior Sports Physiotherapist at Aspetar Orthopaedic and Sports Medicine, Qatar
  • Dr Gary O’Driscoll, Medical Director at Arsenal Football Club, UK
  • Mr Des Ryan, Head of Sports Medicine and Youth Athletic Development at Arsenal Football Club, UK
  • Professor Sanjay Sharma, Professor of clinical Cardiology at St Georges University of London, UK

A limited number of early bird SEMS PG Student discounts (£90) and full BASEM member discounts (£135) remain. The early bird delegate fee of £150 ends on 31 January 2017, followed by the standard fee of £175. This fee includes attendance at all sessions, FSEM accreditation, attendance certificate, refreshments, hot lunch, a guided tour of Emirates Stadium (subject to availability), a post event flash drive (with Speaker PowerPoint presentations sessions uploaded) and a link to video taken of all presentations and discussion.

All at Arsenal FC Medical Department look forward to seeing you at Emirates Stadium in March.

International Congress on Medicine & Science in Ultra-Endurance Sports- call for submissions and funding announcement

20 Dec, 16 | by BJSM

By Martin D. Hoffman


We are pleased to announce that the 4th Annual International Congress on Medicine & Science in Ultra-Endurance Sports will be held as a 1-day pre-conference to the American College of Sports Medicine (ACSM) Annual Meeting in Denver, Colorado. The congress date is Tuesday, May 30, 2017.

With only 1 day for this Congress, we have an intense and exciting agenda.  Attendees will also find a colloquia entitled “Medical Coverage of Ultramarathons” during the ACSM meeting.  Please join us for both of these programs.  Further details on the Congress program and registration are available at:

Scientific abstract and case studies submissions for the Congress on Medicine & Science in Ultra-Endurance Sports will follow a separate process from that for the ACSM meeting.  Accepted abstracts will be published in International Journal of Sports Physiology and Performance.  Submission deadline is March 1, 2017. For process details go to:

The intent of the Congress – as the name implies-  is to bring together clinicians actively involved in providing care for ultra-endurance athletes and scientists performing research related to these activities.  The Congress has been attracting key players in this regard, particularly as related to ultramarathon running.  It’s probably fair to refer to the Congress speakers as the “rock stars” of ultramarathon science and clinical care.  Details on the programs and published abstracts from past Congresses can be found at the following site:

Introducing the Ultra Sports Science Foundation


As in other areas of exercise and sports science research, securing proper funding for research related to ultra-endurance sports is often a challenge. This limits the number and types of studies that are undertaken.  A new non-profit foundation, the Ultra Sports Science Foundation (, will hopefully provide at least some relief in this regard. An intent of this foundation is to become a viable funding source for research related to ultra-endurance sports. The foundation also has an educational mission, and now oversees the annual Congress on Medicine & Science in Ultra-Endurance Sports.  If you are aware of individual or corporate connections who might value contributions to this organization, please contact me.

Martin D. Hoffman, MD, FACSM

Congress Program Director

Founding Member, Ultra Sports Science Foundation

Pain, Performance, Rehabilitation and Life: BASRaT Symposium 2016 – 18 Nov 2016, London 

1 Oct, 16 | by BJSM

Top 5 reasons why you need to attend the BASRaT Symposium (in no particular order)

  1.  An invaluable day full of renowned experts in the field of pain and workshops to help attendees put theory into practice. Focussing exclusively on pain and all its forms and manifestations it will be vital for practitioners to manage and manipulate pain and help people from all walks of life.
  2. Key note speech by Richmond Stace: Richmond has created the Pain Coach Programme – pain neuroscience-based coaching and treatment to overcome pain.
  3. Closing speech by Professor Jones :“Pain, the brain and a little bit of Magic” Professor Jones leads the Human Pain Research Group.
  4. Gold from Rio! We welcome BASRaT’s own Sport Rehabilitator, Hannah Crowley who helped Ed Clancy’s recovery and path to gold at Rio.
  5. Gain your CPD points and help put theory, expert advice and knowledge into practice.


Focussing exclusively on pain and all its forms and manifestations, the 2016 BASRaT Symposium is a vital opportunity for practitioners to help others, from all walks of life,  better manage and manipulate pain.

Our unmissable range of speakers includes Richmond Stace who is leading advances in understanding and treating pain and has created the pain coach programme – pain neuro-science based coaching and treatment to overcome pain, he has clinics in Harley Street, Chelsea and Surrey. Richmond will look into the importance of the first point of contact, how we can gain information from the first few words.

We have a range of workshops including ‘Gold from Rio’- BASRaT Sport Rehabilitator, Hannah Crowley helped Ed Clancy on his road to recovery from a back injury and to his gold medal win at Rio.

Our closing keynote “Pain, the Brain and a little bit of Magic” will be presented by Professor Anthony Jones. Professor Jones is an MSK pain specialist and leads the Human Pain Research Group. His talk will include identifying potential mechanisms for increased resilience to chronic pain and explain how existing therapies may modify these mechanisms. He will also outline how this understanding may be used to develop new brain-focussed therapies for acute intermittent and chronic persistent pain.

This one day event on Friday 18th November will be packed full of essential speeches, presentations and seminars, enriching your knowledge and aiding your work.

Follow @BASRaTSymposium on Twitter


Crossingtheline Summit – Let’s Talk About Athlete Retirement

31 Aug, 16 | by BJSM

By Fiona Wilson

Crossingtheline ( is an exciting new initiative launched by a group of ex international athletes, led by Gearoid Towey (four time Olympian and World Champion rower). Its purpose is to provide a platform and resource to support athletes in retirement. Boxing legend Sugar Ray Leonard famously quoted, “Nothing could satisfy me outside the ring… there is nothing in life that can compare to becoming a world champion, having your hand raised in that moment of glory, with thousands, millions of people cheering you on.” Mental health issues in athletes have raised their head in the media recently as more athletes are being frank in describing their problems. However, perhaps a greater matter is mental and physical health concerns in those who are retired; or indeed those forced to retire precisely because of such problems.

Inaugural Crossingtheline Summit

I had the pleasure of leading the medical panel at the inaugural summit of Crossingtheline in May 2016; held in Dublin. The meeting was very athlete-focused with an emphasis on providing a forum for discussion around athlete retirement. Delegates were an unusual and interesting mix of athletes, physios, team managers, coaches, doctors, psychologists and any others who were involved in sport. The greatest asset of the summit was the choice of speakers from a diverse group of sports; some with catastrophic tales to report regarding their sporting experience and their subsequent retirement.

Gaylene Clews (psychologist) Greg Louganis (diver, Olympic Champion, USA), Fiona Wilson (physiotherapist) Ben Johnson (100m runner, Olympian, Canada)

Gaylene Clews (psychologist) Greg Louganis (diver, Olympic Champion, USA), Fiona Wilson (physiotherapist) Ben Johnson (100m runner, Olympian, Canada)

Greg Louganis (diver and four time Olympian and 5x medallist) described his inner torment of coping with (poorly managed) mental illness, dealing with being a gay athlete in an environment hostile to diversity but most significantly his story around living with HIV. Many of us will remember him hitting his head on the diving board in front of billions of TV viewers at the 1988 Olympics; he went on to win a gold medal. What we were unaware of was that he had a ‘secret’ HIV diagnosis and as he bled into the pool he knew the significance of his troubling secret; he would not have been admitted into South Korea for the Games if he had made his diagnosis evident. His subsequent years have been troubled by mental and financial troubles. He now has made progress in all areas, is an amazing example of living well with HIV, is married to a supportive partner and is an advocate for providing support for athletes, particularly as they transition into retirement.

As many of us who watched the 100m final of the Seoul Olympics, and its subsequent fallout as the winner Ben Johnson tested positive for doping, I had a clear opinion that dopers get what they deserve. It was actually a humbling experience to meet Ben Johnson and listen to his story. As clinicians we learn not to judge patients; smokers, obese, addicts etc. Yet we have a very different opinion of athletes. Those who have been immersed in doping cultures tell us that we need to try and understand athletes’ motivation if we really want to deal with what has become a seemingly unsolvable problem. Ben Johnson reported that he found himself in a culture where doping was normal, where he had tested positive previously and had his results ‘covered up’ by his sponsors and where he was convinced this was normal and a level playing field for all. He was blackmailed by his coach and significantly for him, tested positive for a substance at Seoul that he says he wasn’t taking. He doesn’t deny doping, but just not that substance. A very powerful part of the summit was a one-on-one interview of Ben Johnson by a journalist who has been a zealot in his rally against doping in cycling; Paul Kimmage. The general discussion before was that “Kimmage will give him a really tough time”. He didn’t. He let him tell his story as he argued that we need to accept that doping in sport is an epidemic, which will be better explained by understanding motivation. Kimmage presented the analogy that “Ben, what you are describing is that you have been stopped by the cops for speeding and as he is writing out your ticket, you watch other cars speeding by”

Niall Quinn, ex-Irish football international, Arsenal and Manchester City player and subsequent successful chairman of Sunderland also made a strong contribution to the summit. He frankly described his battle with depression upon retirement describing it as a ‘death within your life’. He reported the sobering statistic that almost half of Premier League footballers visit bankruptcy and 33% are divorced within three years of retirement. Yet there is limited support for these individuals. He has launched an initiative call ‘Catch a Falling Star’, now linking with Crossingtheline to support athletes with financial, medical and psychological advice.

Battle Wounds

My input was to host a panel discussing ‘battle wounds’. A particular interest of mine is that athletes are a vulnerable group of patients, sometimes because of their celebrity status but often because they have become a commodity that can be replaced when it’s broken. Brendan de Gallai (ex-lead dancer with Riverdance) discussed the fear of injury as a dancer. “You would be replaced by the understudy who might do a better job than you for one night as they are fresh and then you are in jeopardy”. John Carter, ex-professional rugby player (and now a psychotherapist with an interest in the athlete experience) described his history of six shoulder surgeries (same shoulder) which ultimately failed, leading to retirement. He reported a lack of empathy and inclusion in treatment decision-making and the feeling of being a product. This is no reflection on the clinicians managing him but perhaps the way sport has become. We don’t treat athletes how we treat other patients; we rush to operate sometimes and we have quite a patriarchal approach. Hands up, I have done this myself.

When we give a patient bad news, we have been provided with training. Palliative care and certain areas of medicine are excellent at this. Yet when we tell an athlete that they must retire because of injury, we have a limited body of knowledge to guide us. The athlete is about to have the very thing that defines them as a person removed and will experience a ‘kind of death’ yet we are somewhat flippant about its effects. This is becoming more common in the professional era and in some cases is based on what ‘might’ happen as in the case of TBI or ECG screening where the decision is not palpable to the athlete. Gaylene Clews (psychologist and ex-world number one triathlete) discussed the neuroscience behind the athletes’ response to both injury and retirement being akin to withdrawal from addiction and that this is very poorly understood. Indeed, we do have a problem with addiction in this population, not just to alcohol, gambling and other well-reported aspects but tragically to prescription pain medication in an effort to deal with chronic injury. Addiction to such medication has been described as reaching concerning levels with a number cases in the USA in retired footballers recently captured in the media (see for media report).

Support for all athletes

I will continue to advocate for support not just for the superstar athlete as a vulnerable person but even more so for when they fall off the radar and are now immersed back into everyday life. Sports medicine support should be available beyond retirement providing the quality of support we afforded these humans when they were everyone’s heroes. A number of sporting bodies are now recognising this issue and athletes should be encouraged to seek support, particularly from retired players unions. The next summit is planned in April 2017, Dublin.

Crossing the line can be found at


Fiona Wilson is an Assistant Professor in the School of Medicine, Trinity College Dublin and a Chartered Physiotherapist. Former lead physiotherapist to Rowing Ireland. Presently a clinician and researching measurement in sports medicine, low back pain and exercise in chronic disease.




Student interested in Sports and Exercise Medicine? Can you afford not to attend #USEMS16?!

27 Aug, 16 | by BJSM

By Tej Pandya

undergrad students

Manchester Sports and Exercise Medicine Society are proud to host the Undergraduate Sports and Exercise Medicine Society’s (USEMS) 2016 annual conference. The day will be a mix of talks and interactive workshops; from concussion & career progression to hands-on ultrasound scanning. You will also hear from professionals working in high-performance roles of all sorts (think Team Sky, Liverpool FC & England Rugby+++)! Not only that – USEMS conferences famously provide a fantastic opportunity to network among both peers & professionals in a friendly environment – so what’s there to lose?

In a world filled with expensive conferences, how many are specifically tailored at undergraduates and cost less than a tenner?

There will also be a ticket competition on the USEMS Facebook group on the 1st of September, so keep your eyes peeled – you might just get lucky!

In the meantime, early-bird tickets only £8!

Hope to see you all there & please help spread the word! #USEMS16

Tickets are available from:

Tej Pandya is an intercalating medical student at the University of Manchester and currently President of the Manchester Sports and Exercise Medicine Society (@semsocuk). All enquiries can be directed to

Financial impact of injury, biometrics, and communication: Lessons from MIT Sloan Sports Analytics Conference 2016

14 May, 16 | by BJSM

By Sean Carmody (@seancarmody1)

“We can’t win like everyone else, we have to do something different”


Those are the words of Dr David Martin, Director of Performance and Research at the Philadelphia 76ers, who featured on the Sport Science panel at the 2016 MIT Sloan Sports Analytics Conference (SSAC). The sentiment related to the 76ers’ current struggle for improvement from last position on the NBA Eastern Conference ladder, but it could easily represent what the conference as a whole stands for; the continuous search for an edge in the cut-throat industry of elite sport.

Ten years into its existence, the influence of SSAC permeates American sports. Take Daryl Morey for example, a computer science graduate and co-founder of the conference, who has been appointed General Manager of the Houston Rockets and has earned plaudits for his use of analytics to drive improvement in the Rockets’ performance and recruitment. The traditional focus of the conference has been on this ‘Moneyball’ approach to player recruitment, or in real terms: “looking for players whose surface appearance is deceiving the market place about their value”. However, with the recent success of teams such as the Golden State Warriors, who have pioneered the strategic sleep and rest of players, there has been a palpable shift towards exploring the use of analytics in optimising athlete health and preventing injuries.

With that in mind, here are some insights from the 2016 Conference which may be of use to the sports medicine community:

The Impact of Injury

Those in sports medicine often quote the financial impact of injury to demonstrate their value, and it’s difficult to argue against them. In US sports alone, $700 million per season is lost in injured player salaries in Major League Baseball, $358 million in the NBA, while NFL starters miss 1600 games a season through injury. This monetary incentive to prevent injury is now coupled with an emerging wealth of research examining the effect of injury on overall team performance- Hagglund et al’s UEFA Champions League study being a classic example.

One of the most interesting research presentations at the conference applied advanced machine learning techniques to predict the probability of injury for an NBA player. The researchers presented a model that offered a quantitative and systematic approach to injury prevention which allowed teams to forecast the likelihood that any given player will succumb to injury during the course of an upcoming game. Applying this model successfully to other sports will be game-changing.

Ray Hensberger of Booz Allen Hamilton sought to know how an injury to one player may directly affect the on-field performance of another. To illustrate his point he referred to the Baltimore Ravens’ linebacker combination of Elvis Dumervil and Terrell Suggs. In 2014, Suggs (12) and Dumervil (17) led the number of sacks in the NFL with a combined total of 29. However, following a season-ending injury to Suggs in week 1, Dumervil only managed 6 sacks for the entire 2015 season. Of course there are many confounding factors in this, but it makes for an intriguing line of research. To consider an example closer to home, when Leicester City’s N’Golo Kanté touches the ball in the middle or back of the pitch, shots on the subsequent attack are 70% likelier to yield a goal than when he isn’t involved– how might an injury to his ever-present midfield partner Danny Drinkwater affect this (and Leicester’s chances of securing the Premier League)? Answers to these questions may contribute to a greater understanding of the fascinating concept of team cohesion and winning.

But are all injuries bad? The cliché injury is an opportunity to get better is well worn, but there is anecdotal evidence pointing to its truth. Hensberger used the story of San Antonio Spurs’ Kawhi Leonard who used his time injured to develop into an all-round better athlete, while an article in ESPN Magazine’s Analytics Edition suggested that for the Golden State Warriors: “A Steph Curry who has never injured his ankles would be less preferable than the Steph Curry we actually have today”. It bodes the question, is the experience of overcoming injury key to developing the resilience of a champion? Would Jonny Wilkinson have kicked Toulon to back-to-back European Cups in the twilight of his career if he hadn’t spent several seasons before in the rehab room?

Perhaps the impact of player availability can be summed up by the vignette offered by Andy Glockner, author of Chasing Perfection, who spoke at the conference. While researching for his book, Glockner asked Keke Lyles, Director of Performance at the Golden State Warriors: “If you could guarantee Andre Iguodala was available for 75 games this season, would anything else matter?”Lyles responded with an emphatic “No”. That season, Iguodala played in 77 games and the Golden State Warriors were crowned champions.

Biometrics – The Next and Biggest Analytics Frontier?

During his talk, Glockner argued that the use of biometry represents the most significant opportunity for teams to gain an edge over their competitors. Biometrics refers to biological data which may be important for keeping an athlete healthy. Examples include the data input into personal apps by athletes (including sleep quality, soreness etc) and those collected by global positioning systems (including indicators of workload). Glockner proposed that figuring out which data is most helpful in predicting injury will be a major discussion point in the future. In light of this revelation, recent research published in the British Journal of Sports Medicine cites the acute: chronic workload ratio as a strong predictor of subsequent injury.

Big data collecting systems are now essentially ubiquitous in professional sport but as Brian Kopp of Catapult Sports suggests, “the advantage is never going to be merely in having access to the data. It will be in what you do with it”. With such widespread data available, there has inevitably been inappropriate use of technology in sport. Stephen Smith, founder and CEO of Kitman Labs, feels that the availability of such data has wrongly led to a tendency to hold athletes back – stating during the Sport Science panel at SSAC that: “Every time we hold an athlete back we limit their potential. It shouldn’t automatically be ‘we should stop the athlete from participating’, instead we should consider how else we can train and treat them, how can we do something incredibly intelligent with the data to improve the outcome”.

In sports such as basketball, with multiple games in quick succession, and large amounts of time spent on airplanes, it’s easy to see how biometrics can provide an advantage. It was reported during the conference that basket-ballers lose up to 25% of their flexibility at the end of each game, and often have to jump straight on a flight traveling across time zones which limits their opportunity to recover. Add to that the risk of being tall and flying frequently, and you have a recipe for illness and injury.

Old Lessons Die Hard

Despite the promise of expensive technology and sophisticated analytics, a recurring theme throughout the conference was the importance of good communication. The information gleaned from big data is irrelevant if it can’t be presented to coaches and athletes in a way that is understandable and specific to them (“coach speak”). This topic was touched on during the Soccer Analytics panel where it was suggested that footballers tend to be visual learners, and that insights should be packaged in a style that reflects this.


Conferences such as SSAC are inspiring days out, never lacking in insightful soundbites. But the cynic in me often wonders if in an industry as ruthless and secretive as sport, if what’s really worth knowing is not being told.

Nevertheless, it appears that we’re living in an exciting time for sports medicine with the impact analytics can have on protecting athlete health and extending sporting careers. With this in mind, we return to Daryl Morey, the man who started SSAC. During a panel session he was asked which profession he feels will play an increasingly important role in the front office of sporting organisations in the future. His response? Doctors.


Sean Carmody (@seancarmody1) is a junior doctor working in the South Thames Deanery.

Congrats to ECOSEP, MuscleTech Network, and FC Barcelona – the 2015 cover competition winners!

12 Feb, 16 | by BJSM

December 49(24)Congratulations to all of the collaborators and supporters of the ECOSEP/FC Barcelona, December 2015 BJSM issue (#24) for winning the 2015 cover competition by a landslide (honorable runner up goes to Sports Physiotherapy New Zealand 49(issue #14) Strong debut performance!).

We had the pleasure of sharing the news with two of the major contributors: Nikos Malliaropoylos (founding member of ECOSEP), and Gil Rodas (FC Barcelona Doctor):

BJSM: Congratulations! How do you feel about winning “BJSM best cover” for 2015?

We are really impressed with this award. It’s a great example of team work between ECOSEP -MuscleTech -FC Barcelona and BJSM – a genuine collaboration between the scientific community and a football club. The front cover was the tip of the iceberg: a great global sport & exercise medicine event, in the biggest football stadium in Europe (capacity of 99,354 seats that hosted more than 400 international delegates). The stadium was a real feature of the conference of course as the podium was on the hallowed turf and our listners sat in the stadium seats. The big screen hosted the shots! Winning the Best Cover rewarded all our efforts to make this venture successful for the attendees.

BJSM: What in this 24th issue of 2015, stands out for you as exemplary work?

Not easy to answer this as there are so many good articles in this issue – which is usual for the BJSM now. The Exercise-induced leg pain in sport editorial is a very good update regarding this issue in sports. Exercise for osteoarthritis of the knee: a Cochrane systematic review and MRI, does not add value over and above patient history and clinical examination in predicting time to return to sport after acute hamstring injuries: A prospective cohort of 180 male athletes, are papers that can really affect practice and benefit patients who attend physiotherapists, doctors and other sports clinicians.

BJSM: In your opinion, where do we head from here?

FC Barcelona knows that a winning team always carries on maintaining the cornerstone partners. Muscle Tech and ECOSEP with BJSM support can add more value to Sports and Exercise Medicine both in Europe and globally. We are dedicated to this exciting field so let’s spread the word of the great evidence we have now and please look out for our conference in Barcelona, October 2016!

BJSM: Thanks Nikos and Gil! 

We will select and contact our 2 individual prize winners within the next two weeks. Stay tuned.

Conference Highlights from the Concussion in Sport conference at the Sports Surgery Clinic in Dublin

21 Aug, 15 | by BJSM

By Steffan Griffin (@lifestylemedic) and Dr. Sean Carmody (@seancarmody1)

You may have seen @BJSMPlus – our conference twitter handle feeding various clinical pearls from events around the world – going into overdrive at the recent ‘Concussion: Diagnosis and Rehabilitation’ conference at the Sports Surgery Clinic in Dublin early last month #sscConcussion

This fantastic event, expertly organised by Colm Fuller and the rest of the team at SSC not only provided teaching from some of the world’s premier concussion experts, but also raised some intriguing questions and stimulated some great debate. Additionally, the conference provided an ideal opportunity to launch the innovative Post Concussion Rehabilitation Pathway that aims to improve the recovery process in concussed athletes.

In case you missed out – below are some highlights and impactful tweets – enjoy! All of the day’s stats are easily accessible via the 2012 Zurich Consensus Document, a must-read:

The Athlete’s Perspective Ruby Walsh

concussion 1


It was, perhaps, appropriate that a conference on Concussion was opened by horse-racing legend, Ruby Walsh. As Prof Paul McCrory and Dr Michael Turner later informed us, horse racing is the most high risk sport for developing concussions. During his talk, Ruby ignited a theme which was to recur throughout the day – “Concussion is not a new story and the media storm does not mean it’s a new issue, it’s simply in the news more often”.

Concussion Management – New Ideas and Global Consensus Professor Paul McCrory PhD

  • We need to resort to scientific evidence and not media speculation when considering all aspects of a concussion – a culture of fear exists which may be unfounded.
  • An example of this is the issue of suicide amongst NFL footballers in the USA – “Rate of suicide in 3049 retired NFL footballers (who played > 5 seasons) is 40% of age-matched non-footballers” – meaning that sport may confer a protective effect!
  • At the moment – scans don’t rule in concussion, only rule out more serious pathologies
  • Second Impact Syndrome should be called Single Impact Syndrome- there doesn’t have to be a second impact
  • Examples of how concussions can be prevented include: coaching (eg tackle technique in collision sports), neck muscle strengthening, and rule changes (eg NFL rule banning hits with the crown of the helmet).
  • Mouth guards have no role in preventing concussion.
  • Our understanding of the pathogenesis of concussion is still very rudimentary. Do we know all of the causative pathways? Do NSAIDs put you at increased risk?
  • The Mild/Moderate/Severe classification of concussion is inadequate in comparison to most other conditions. Breast cancer, for example, is classified according to clinical features, histological findings, hormonal receptor status and evidence of metastases- concussion has a long way to go.
  • Concussion has a wide and varied profile, with aspects stretching across many different clinical realms – it means that there is unlikely to be a single diagnostic test.

concussion 2

Taking a Targeted Approach to Concussion Rehabilitation Professor Willem Meeuwisse MD, PhD

  • Normal recovery is dependent on age – an important factor to consider with young athletes.
  • Much of the early management of concussion features reassurance and education.
  • What comprises the ‘difficult’ concussion patient?
    • Persistent symptoms
    • Multiple concussions
    • Concussions with diminishing force
    • Seizures
    • Structural brain injury
    • Paediatric injury
    • Multiple co-morbidities

concussion 3

  • Dix-Hallpike test & Walk-whilst-talk test can be used to assess the potentially concussed athlete – whilst the latter may be used as a management tool


Long Term Monitoring of the Retired Athlete Dr Michael Turner

  • Consensus statements must be taken with a pinch of salt – evidence constantly evolving and many of the recommendations are based on the ‘I just know’ principle.

concussion 5

  • Jockeys are the athletes at greatest risk of developing a concussion. In professional racing a jockey falls off a horse in 1 out of 16 rides, compared to amateur racing where jockeys fall off once every 8 rides. The difference relates to skill level. One jockey dies every 250,000 rides.

Analysis of CSF Biomarkers in Concussion Dr Sanna Neselius MD, PhD

concussion 6

  • Concussions may lead to an increased risk for chronic injuries.
  • Several concussions will lead to delayed recovery.
  • Neurofilament light (NFL) which although varies with time-of-day may correlate with amount of head trauma.
  • NFL may have more of a role to play in delayed recovery than in the initial assessment period.
  • Subdural haematoma is the most common sports-related intracranial bleeding.


A Physiological Approach to Assessment and Treatment of Concussion and mTBI Professor Barry Willer PhD

  • Return to Play can happen when the athlete can exercise fully without exacerbation of symptoms.
  • Issue with return-to-play (RTP) guidelines – return when ‘asymptomatic’ – but when are athletes, let alone controls, fully without symptoms?
  • No evidence to support ‘radical rest’, simply academic suggestion – deconditioning may even confer risks to the athlete.
  • Role for exercise testing followed by graded exercise protocol (%HRmax) in getting athletes asymptomatic faster, thus potentially accelerating RTP?
  • Poor exercise tolerance in the acute phase post concussion may be a marker of poor prognosis.


All papers available at



Dr Sean Carmody is a junior doctor working in the South Thames deanery. He tweets regularly on topics related to sports medicine and performance @seancarmody1.

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