As the students´ department of the GOTS (German, Austrian and Swiss Society for Orthopaedic and Traumatologic Sports Medicine), the GOTS Young Academy introduces future physicians, physiotherapists and sports scientists to the different aspects of sports medicine. Despite the main focus on orthopaedic surgery and traumatology, the interdisciplinary character of sports medicine is given great importance. During practical and theoretical workshops, future medical professionals are invited to train and improve their own skills and exchange experiences. Hands-on training ranges from conservative treatment to surgical procedures, sonography and clinical examination. Young Academy students are also invited to attend the GOTS congresses and get in contact with current research topics as well as renowned physicians, physiotherapists and sports scientists. The following report gives a brief insight into the GOTS Young Academy program.

Report: GOTS Young Academy at the congress “Update Sports Medicine” at Danube University Krems

On December 13^th and 14^th  2019 the “Update Sports Medicine” conference was held at Danube University Krems (Austria) under the patronage of the Society for Orthopaedic and Traumatologic Sports Medicine (GOTS) and the Austrian Society for Sports Medicine and Prevention (OEGSMP). Some students of the GOTS Young Academy had the opportunity to attend the conference.

Young Investigator Programme

The conference started with an update on research in regenerative medicine. Topics such as “Clinical applications of adipose derived stem cells – current development and perspectives¹” or “miRNAs enriched in extracellular vesicles in plasma- and serum-based autologous blood-derived products for osteoarthritis therapy²” as well as current research on tendon degeneration, cartilage defect treatment and musculoskeletal tissue engineering were presented and discussed by the GOTS Young Investigators. In connection thereto, participants were offered a tour through the university´s laboratory.

Univ.-Prof. Dr. Stefan Nehrer (Dean of the Faculty of Health and Medicine at Danube University Krems) presented the interdisciplinary master course in sports medicine at Danube University Krems (https://www.donau-uni.ac.at/en/studies/sport-medicine.html). In Germany, Austria and Switzerland, sports medicine is not a separate specialty. Independent of their own medical field, physicians can specialise in sports medicine by additional trainings such as the sports medicine diploma of the Austrian medical association (OEAK-diploma, Austria), the certificate of proficiency in sports medicine (FASM, Switzerland), the GOTS Sports Doctor certificate or the additional title of Sports Physician (Germany).

Main Programme
During the conference´s main programme, renowned sports physicians talked about topics such as support of professional athletes and children in sports as well as injury prevention. Specific sports traumatological subjects included shoulder instability and biceps tendinopathy as well as the treatment of ACL rupture, fracture and cartilage repair in sports.

Physical medicine hands-on workshop
Physical medicine offers a wide range of opportunities in the treatment of different conditions and has become an important pillar of sports medicine. In a systematic review, Dingemanse et al. compared the effectiveness of electrophysical modalities for the treatment of epicondylitis³.

At the hands-on workshop, which was led by Dr. Peter Biowski (renowned specialist of physical medicine), students were acquainted with both theoretical and practical aspects of physical medicine. The focus was placed on electro- and shock wave therapy.

Transcutaneous electrical nerve stimulation (TENS) is a non-invasive stimulation technique. Electric current is passed across the surface of the skin, activating underlying nerves fibres in order to elicit pain-relieving mechanisms. Intensity and frequency are adapted depending on the indication and the patients´ subjective pain threshold⁴. Indications for TENS therapy range from muscle pain, epicondylitis to neuropathies and complex pain syndromes^3,4.

Electrical muscle stimulation (EMS) or neuromuscular electrical stimulation (NMES) induces muscle contractions and comes into use in selective muscle strengthening (e.g. as part of postoperative treatment) as well as in prevention of muscle atrophy (e.g. during long periods of immobilisation)^5,6.

High tone power therapy uses current with high amplitude alternating frequency and is mainly used in patients suffering from polyneuropathy. Generally, there is a wide range of indications including rehabilitation, degenerative joint diseases and even psychological conditions.

Extracorporeal shock wave therapy (ESWT) uses pressure waves to treat conditions like tendinopathy, heel spurs or epicondylitis^3,7. Radial shock waves (RSWT) are created by an air compressor whereas focused shock waves (FSWT) are generated in water by different methods and have more impact on deeper located tissues in comparison to radial waves^7,8.

Since some participants were affected by sports-related injuries themselves, they got the opportunity to experience shock wave- and electrotherapy from the perspectives of both physician and patient. The workshop was both practical and informative and sparked interest in physical medicine among all participants. During the whole conference, the Young-Academy students were able to make new contacts amongst one another and get in touch with renowned specialists in sports medicine in an inspiring setting.

Authors and Affiliations:

Helena Nics is past president of the GOTS Young Academy and a competitive handball player. On completion of her common trunk, she is going to specialise in physical medicine and sports medicine.
E-Mail: nics.helena@gmail.com

Simon Schedl is a fourth year medical student at the Medical University of Vienna and member of the GOTS Young Academy. Also, he is sonography tutor (Sono4You Vienna) with a special interest in musculoskeletal ultrasound and an enthusiastic sportsman.
E-Mail: simon.schedl@gmail.com

Elena Neunteufel is a fifth year medical student at the Medical University of Vienna. She is president of the GOTS Young Academy, enthusiastic about sports and plans to specialise in orthopaedics and traumatology as well as sports medicine.
E-mail: e.a.neunteufel@gmail.com

If you want to get in touch with the GOTS Young Academy or provide any kind of input, please contact us via gots.young.academy@gmail.com.

References:

1. Neubauer M, Kuten O, Stotter C, et al. The Effect of Blood-Derived Products on the Chondrogenic and Osteogenic Differentiation Potential of Adipose-Derived Mesenchymal Stem Cells Originated from Three Different Locations. Stem Cells Int. 2019;2019:1358267.
2. Otahal A, Kuten O, Kramer K, et al. Functional capacities of extracellular vesicle micro-RNA in autologous blood-derived products. Vol 282020.
3. Dingemanse R, Randsdorp M, Koes BW, Huisstede BMA. Evidence for the effectiveness of electrophysical modalities for treatment of medial and lateral epicondylitis: a systematic review. British Journal of Sports Medicine. 2014;48(12):957.
4. Johnson PM. Transcutaneous Electrical Nerve Stimulation: Mechanisms, Clinical Application and Evidence. Rev Pain. 2007;1(1):7.
5. Lake DA. Neuromuscular Electrical Stimulation. Sports Medicine. 1992;13(5):320–336.
6. Sonnery-Cottet B, Saithna A, Quelard B, et al. Arthrogenic muscle inhibition after ACL reconstruction: a scoping review of the efficacy of interventions. Br J Sports Med. 2019;53(5):289–298.
7. van der Worp H, van den Akker-Scheek I, van Schie H, Zwerver J. ESWT for tendinopathy: technology and clinical implications. Knee Surgery, Sports Traumatology, Arthroscopy. 2013;21(6):1451.
8. Wang Y-C, Chen S-J, Huang P-J, Huang H-T, Cheng Y-M, Shih C-L. Efficacy of Different Energy Levels Used in Focused and Radial Extracorporeal Shockwave Therapy in the Treatment of Plantar Fasciitis: A Meta-Analysis of Randomized Placebo-Controlled Trials. Journal of Clinical Medicine. 2019;8(9).