By Liam West (@Liam_West)
The first Football Association (@FA) Medical Masterclass in Disability Football meeting at @StGeorgesPark was a resounding success. It showcased both homegrown talents and imported experts; speaker profiles are available here. Dr. Richard Weiler and Dr Osman Ahmed (@osmanhahmed) hosted the day.
Summary of key take home messages:
Introduction to the FA Disability Football Programme – Phil Heap, The FA
- In 1999 ability counts programme was rolled out and marks the beginning of the Football Association involvement in disability football.
- In 2002 the England Learning Disability (LD) team won the World Cup – how many of you can honestly say you knew that!?!
- >85,000 people per week participate in disability football in the UK.
- England has various codes of elite disability football – blind (6th in world), cerebral palsy (10th in world), partially sighted (3rd in world), power chair (2nd in world), deaf (females 4th in world) & LD (3rd in Europe).
- @StGeorgesParkwill host the Cerebral Palsy 2015 world cup – an opportunity for you to get involved?
Health and safety of the disabled footballer: using common sense in the absence of science – Dr E. Verhagen, VU University (@EvertVerhagen)
- We know a lot about able bodied athlete problems, but little about how to solve them; this discrepancy is magnified in disability sport.
- Begin with risk factor research – we often forget to simply ask questions of athletes that have been injured – they know their bodies best!
- Get to know your players – ask them about their health regularly and pick up subclinical illness – risk factor for injury & decreased performance.
- Can’t tackle all problems for your athlete, you have to prioritise and choose.
- Start a dialogue between coaches & medical team – develop understanding and agree on a common goal for injury prevention for each athlete.
- Acquire evidence along the way!
Movements and actions in match play of elite footballers with Cerebral Palsy – Craig Boyd, Sheffield Hallam University (@CraigCB11)
- 7 players on a team but the pitch size is not much smaller than 11-a-side pitch
- Full of challenges – e.g. there is constant scrutiny of classifications for Cerebral Palsy (CP) football (learn about the classification here) and ranges within each classification.
- Movement patterns vary within each classification so one broad, team-based injury prevention protocol will not be effective – needs to be individualised
Can we remove training wrinkles with Botox®? – Prof. T. Ward, Staffordshire University
- Botox can help muscle spasticity, stiffness and shortening. It can improve balance and reduce pain.
- Clinician must ask themselves the question – Is it spasticity or an underlying weakness causing the problem? If it is spasticity, Botox can be used in the long-term safely.
- Main take home message – Botox allows opportunity to relax muscles to give time for the physiotherapist to work within. It is not the answer itself. It is an adjunct to physical management / treatment – Window of opportunity.
- Botox – localized effect on specific muscles unlike oral anti-spastic drugs.
The use of smartphone applications in preparing the disabled and able bodied footballer for competitions – Dave Sims, Manchester Metropolitan University (@davesims87)
Dave Sims created the application in conjunction with the charity “Dream it, Believe it, Achieve it” and explained its uses:
- Contains gym based, home based and aerobic exercises.
- Individually tailored – baseline test results taken for each player and then fed into algorithms to get individual exercise prescriptions.
- Very easy to use therefore more likely to be used.
- Limitations were evident (cost etc.) but an exciting avenue to be aware of nonetheless for disability sport, and increasing safe exercise amongst the disabled population in general.
Sports Massage in disability football… Not just a luxury? – Chris Salvary
- The rates of muscle spasm that can be addressed by a sports masseur evidently higher in disability sport.
- Reduction of muscle tightness in these athletes can have a greater increase in performance when compared to that in able bodied athletes.
Disability football surgery – thinking outside the box – Mr J. Lavelle, Chelsea and Westminster Hospital
- Need to understand the pressures (including biomechanical intricacies of movement patterns) on the individual player.
- Involve specific disability advisors at the outset and throughout the patient journey through surgery – disability effects treatment approach, surgical decisions and rehabilitation programmes.
- For instance if doing a hamstring graft for an ACL reconstruction, is this wise in a disabled athlete where imbalance already exists? Would it cause further imbalance? Should you take the graft from the other leg?
- Surgeons love symmetry! But they must be aware that they are unlikely to attain symmetry for a disabled athlete and therefore can’t use this as a Return to Play (RTP) marker.
- Increased neuromuscular function in CP à increased energy expenditure à increased fatigue in CP à may increase injury risk.
- Blind athletes have a significantly smaller stride length during jogging + running and therefore expend more energy during these motions than able bodied athletes – could confer increased injury risk.
The highlight of the day followed the talks: watching the England CP Football team train and then doing a hands-on practical session assessing the different classifications of player. To check out the tweets from the day, search for the hashtag #FACDFR. I also recommend you glance at the fantastic BJSM editorial on enhancing performance and sport injury prevention in disability sport by the recently established “FA Centre for Disability Football Research” (FA CDFR).
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. (But he also has the @BJSM_BMJ password where he tweets as LW)