In “past, present, future”, we ask clinical or academic experts to reflect on selected Sports & Exercise Medicine topics. Today Sergio Fonseca on Complexity and Sports Injury.
Tell us more about yourself.
I am a full Professor at the Department of Physical Therapy of the Universidade Federal de Minas Gerais (UFMG), Brazil, and Director of the UFMG’s Sports Training Center. My research activities focus on applying Dynamic Systems and Ecological approaches to understanding human movement, especially in musculoskeletal rehabilitation and sports. After a period as an invited scholar at the Center for the Ecological Studies on Perception and Action of the University of Connecticut, I started applying concepts related to complexity to studying human movement and sports injuries. Currently, I am one of the Chief Editors of the Brazilian Journal of Physical Therapy.
What was hip and happening 10 years ago?
A few clinical trials, systematic reviews, and metanalyses were available despite the considerable interest in sports injury prediction and prevention. The importance of establishing strong studies on injury prevention and their prediction was evident, and the need to verify the viability in implementing effective preventive strategies or the ability to prevent injuries successfully was foremost. Many studies of different methodological qualities were available, and the results showed controversial results. Due to these contrasting results, some researchers were pointing out the necessity of new models and approaches. However, ideas about bringing the tools and methods of complex systems to investigate sports injuries were still incipient.
What are we doing now?
Currently, we are still struggling in understanding the role of preventive approaches to sports injuries, and questionings about our ability to predict sports injuries are rising. For this reason, complex systems approaches are gaining space, and new methods are being offered to face the challenge. Technological advances in data recording are allowing an unprecedented amount of data about the status of the athlete. We can now have continuous longitudinal data, which overcome the limitation to use discrete data on pre, mid and post-season assessments. New data analysis methods accompany this new scenario, and non-linear, complex system methods are gaining ground. However, the long-standing questions about the effectiveness of preventive approaches and the viability of sports injury prediction are still to be answered.
Where do you think we will 10 years from now?
As an optimistic researcher, I believe that the new routes we are taking now will significantly advance our understanding of sports injuries. A paradigm shift in which sports injury prevention and prediction will no longer be associated is expected. Injury prediction will be possible in a weather forecasting manner, which will allow the implementation of mitigating actions. On the other hand, prevention will focus on identifying profiles that will receive proper preventive care according to specific needs. General preventive measures will still be desirable, but individual or small groups focused programs will be necessary. The complex systems approach to sports injury will highly influence these changes. Nonetheless, much work is still required to better understand the complex nature of sports injuries.