Bircher muesli, FAI and monitoring load: a recap of the 1st Swiss Sportfisio & Sports Med Conference in Bern #SportSuisse2018 [Part 2] & Hip pain consensus meeting

By Daniel Friedman @ddfriedman

It was hard to believe the outstanding quality (and quantity) of the speakers and presentations at the 1st Swiss Sportfisio & Sports Med Conference in Bern in November. After an exciting first day of engaging talks in the Swiss capital, hundreds of conference attendees couldn’t help but to come back for more on Day 2!

Wondering what happened on Day 1? Check out Part 1 of this blog here.

Day 2

After a frosty early morning group run around the old city of Bern, Day 2 started with a bang as Prof Michael Leunig presented a historical overview of FAI and our current understanding of different morphology.

Cam FAI:

  • Most frequent and best understood deformity
  • Results from eccentric closure of growth plate
  • High prevalence in males (25%) associated with osteoarthritis
  • Adjustment of athletic impact hip activities (sports) during puberty might prevent cam FAI

Pincer FAI:

  • More rare (<10%), aetiologically less well understood
  • No proven association with osteoarthritis

Dr Kay Crossley PhD @kaymcrossley shifted the focus from FAI to hip osteoarthritis, and explored some key questions in hip pain epidemiology.

  • Cam morphology can increase the risk of hip osteoarthritis, but not in all people.
  • We need to identifying factors that predict the progression of cam morphology to osteoarthritis, and more work is needed in younger people + athletes.

Prof Cara Lewis @ProfCaraLewis walked the audience through three case studies that demonstrated the biomechanical and neuromuscular considerations for patients with hip pain.

  • Small changes can have big impacts for patients. It’s not always all about structure, but rather about the interaction between structure and movement in the patient.
  • Modifying and retraining gait and movement pathways can have profound effect on symptoms. Ensure that exercises performed in the clinic are practical for the patient’s sport/life demands.

Building off Kay Crossley’s presentation, Prof May-Arna Risberg looked at the role of exercise in hip osteoarthritis.

  • Evidence suggests that exercise is good for hip osteoarthritis, but level 1 evidence is lacking for FAI.
  • We must focus on getting the exercise dose correct for each patient. Patients’ beliefs influence behaviour, and so patient education is key.

 

For something completely different,Dr Abaidia Abd-Elbasset PhD moved above the belt and spoke about recovery strategies in football (soccer).

  • Fatigue mechanisms during football matches: Number of sprints <5m + changes of direction
  • Sleep is particularly important given most matches are played at night time. Sleep <8hrs leads to 1.7 increased risk of injury!

 

With espressos in hand, the crowd was wide awake for Dr Raphael Heinzer’s talk about sleep and its effects on performance.

  • There is mixed evidence that sleep deprivation influences athletic performance. Tasks requiring short-term high power output are largely unaffected by sleep loss, but endurance performance decreases.
  • Circadian rhythm (think jet lag) has an effect on sports performance. Performance increases from morning to afternoon to evening.

After returning from lunch and an afternoon nap (recovery is key!), Karen Litzy @KarenLitzyNYC and Dr Boris Gojanavic @DrSportSante kicked off the afternoon session with an interactive talk about knowledge translation.

Prof Ewa Roos followed by talking about Good Life with Osteoarthritis in Denmark (GLA:D(R)) – Effective treatment for people with hip and knee osteoarthritis.

  • Expect pain flares when new to exercise or when increasing physical activity levels, but pain decreases with each session.
  • Neuromuscular exercise is safe, relieves pain and is overall beneficial for osteoarthritic joints.

Dr Gil Rodas underscored the importance of the sport science and medical departments within sporting clubs working together, and provided a sneak peak into what goes on at the Barça Innovation Hub. He left the crowd with a clear message: We need to perform more research that focuses on female athletes!

The conference finished on a high with a presentation from Dr Paul Dijkstra @DrPaulDijkstra about risk and decision making.

  • The three steps of shared decision-making:
    1. Team talk – provide support to patients when they are made aware of choices, and to elicit their goals.
    2. Option talk – comparing alternatives, using risk communication principles.
    3. Decision talk – arriving at decisions that reflect the informed preferences of patients, guided by the experience and expertise of health professionals.
  • When communicating risk and uncertainty to your patient, you must be caring and competent. Risk should be communicated in absolute terms, not relative, and preferably in frequency rates.

In addition to this blog, you can also check out the highlights from the conference on Twitter #SportSuisse2018.

Videos of the presentations from the conference can be viewed at:

Sportfisio Swiss Youtube
Sportfisio Swiss 2018 Conference website
Sportfisio Swiss Facebook
Sportfisio Swiss Twitter

 

Hip pain consensus meeting

Following the conference in Bern, many of the speakers continued their tour of Switzerland in Zurich, meeting for two days at the Schulthess Clinic to finalise recommendations for the 2019 consensus on hip problems in sport, to be published in the BJSM. More than 30 panel members deliberated over four themes for the upcoming consensus, including:

  • standardised measurement of physical capacity in hip-related pain
  • physical therapy management of hip-related pain
  • classification of hip-related pain
  • patient-reported outcome measures for hip pain.

***

Daniel Friedman @ddfriedman is a final year medical student at Monash University in Melbourne, Australia. He is currently based in Vancouver, working for the BJSM as an associate editor, and has previous experience working for the WHO, focusing on the prevention of noncommunicable diseases and the promotion of active healthy lifestyles. Daniel’s interests span physical activity and public health, injury prevention, and nutrition. Email: ddfriedman@gmail.com.

Competing interests

None

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