Beijing Olympics Injury Prevention Summer Olympic Guide 2008

Beijing Olympics Injury Prevention Study Detailed information for NOC Team Physicians and Physiotherapists April 2008 Foreword Dear Colleagues, It is with great pleasure that we welcome you to Beijing for the Games of the XXIX Olympiad. We are pleased to send you this introductory booklet, which will explain to you the details of the IOC Injury Prevention Study. As you may know, the IOC is increasingly emphasising work on protection of the athletes’ health and prevention of injuries. During the 2004 Olympic Games, injuries in all team sport tournaments (football, handball, basketball, field hockey, baseball, softball, water polo and volleyball) were surveyed, and the IOC would now like to extend the project to all sports events. You, as the team physicians and physiotherapists, are important for the success of the project, and we kindly ask you to report all injuries of your athletes on a daily basis on the provided report forms and return them to the IOC Medical Commission office. All information will be treated with the strictest confidentiality. This booklet provides comprehensive information on how to fill in and return the injury forms. The IOC research group will process the data, and you will receive a formal report of the study in due course after the end of the Olympic Games. Our goal is to transfer the science into practice so that you will soon have valuable information available that will enable you to organise your work in a more efficient way to prevent sports injuries among your athletes. Thank you very much for your valuable contribution! Prof. Arne Ljungqvist Medical Commission Chairman Dr Patrick Schamasch Medical and Scientific Director Prof. Lars Engebretsen Head of Scientific Activities Introduction Injury surveillance provides not only important epidemiological information, but also direction for injury prevention. During the 2004 Olympic Games, the eight international team sports federations (FIBA, FIFA, FINA, the FIH, the FIVB, IBAF, the IHF and the ISF) participated in a study on the frequency and characteristics of injuries in all 14 team sport tournaments using an established injury-surveillance system. The acceptance and compliance of the project was excellent, as demonstrated by the response rate exceeding 90% for almost all tournaments. The findings, which were consistent with previous studies, demonstrated the high quality of the data obtained. The injury-surveillance system was slightly modified to be applicable for both individual and team sports. The modified version was implemented and proven feasible during the World Championships of the International Association of Athletics Federations (IAAF) 2007 in Osaka and the IAAF World Indoor Championships 2008 in Valencia. The IOC injury-surveillance system has recently been published in the British Journal of Sports Medicine. The aim of the present study is to record and analyse all sports injuries incurred in competitions and/or training during the Olympic Games in 2008 in Beijing. Methods This injury-reporting system can be briefly summarised as follows: the NOC physicians of all participating teams are requested to report all injuries (or the non-occurrence of injuries) daily using a specially designed, single-page injury report form. The injury report form is available in seven languages (English, French, Spanish, German, Chinese, Arabic and Russian). All information will be treated as strictly confidential. The team physicians will receive a formal report of the study in due course after the Olympic Games. What should be reported? All injuries of athletes An injury is defined as any musculoskeletal complaint newly incurred due to competition and/or training during the period of the Games of the XXIX Olympiad in Beijing that received medical attention regardless of the consequences with respect to absence from competition or training. This injury definition includes five aspects: (a) all injuries that received medical attention (not only time-loss injuries) (b) newly incurred (pre-existing, not fully rehabilitated injuries should not be reported; re-injuries (injuries of the same location and type) should be reported only if the athlete has returned to full participation after the previous injury) (c) in-competition or training injuries (d) during the period of the Games (9 to 24 August 2008) (e) exclusion of illnesses and diseases. Who reports the injury? NOC team physician Injuries should be diagnosed and reported by qualified medical personnel (team physician, physiotherapist) to ensure valid information on the characteristics of the injury and a comparable standard of the data. It is advantageous if each team designates one contact person who will take part in the instructional meeting and will be accessible for questions. In general, the national team chief physician should be responsible for reporting the injuries of their athletes. In order to receive information about injured athletes of teams without a physician or medical personnel, injuries will also be reported by Beijing 2008 LOC physicians. When is the injury reported? On a daily basis The IOC injury surveillance system requires a daily report regardless of whether or not any injury has occurred. This procedure is important to distinguish between the non-occurrence of injuries and a missing report from a team. What details should be reported? The injury report form requires documentation of the following information: accreditation number of the athlete, sport and event, round/heat/training, date and time of injury, injured body part, type and cause of injury and an estimate of the expected duration of subsequent absence from competition and/or training. Athlete’s accreditation no. 1234569587979 injured body part Code left wrist 15 Sport and event athletics, 100m (women) type of injury code sprain 9 round / heat or training Time/day of injury quarter final / 1st heat 22.8. - 2:35 pm cause of injury code absence in days slipped and fell 23 10 Definitions and codes are given on the back page of the injury report form (see appendix 2, last page of this booklet). In the situation when the diagnosis (or the duration of absence) is revised later as more information about the injury becomes available, the team physician should report the injury again (with the previous data and location of injury to indicate that this is a revised report) and state the corrected information. You will find more examples on how to fill in the injury report form in appendices 1 and 2. Confidentiality The accreditation number of the athletes will be used only to avoid double reports from team and LOC physicians, to identify the injury on video coverage and to obtain information on age, gender, nationality and national federation of the athlete from the IOC database. The accreditation number of the athletes will not be entered into the injury database; all injury reports will be stored in a locked filing cabinet and will be made anonymous after the 2008 Beijing Olympic Games. All reporting will be either for groups of athletes, or in a way that no individual athlete or team can be identified. Confidentiality of all information will be ensured. How to return the injury report forms The completed forms should be submitted daily to injury study researchers at the IOC Medical Commission office either at the Polyclinic or the Village, or sent by email (agnes.gaillard@olympic.org) or fax to the following number… Research team: Prof. Lars Engebretsen (Norway) Prof. Jiri Dvorak (Switzerland) Dr Astrid Junge (Germany) Prof. Per Renström (Sweden) Dr Juan Manuel Alonso (Spain) Dr Margo Mountjoy (Canada) Dr Mark Aubry (Canada) IOC FIFA F-MARC IOC IAAF FINA IIHF lars.engebretsen@medisin.uio.no jiri.dvorak@kws.ch astrid.junge@kws.ch per.renstrom@telia.com dir.medico@rfea.es mmsportdoc@aol.com markaubry@rogers.com If in doubt, please do not hesitate to contact any of the above. Thank you very much indeed for your valuable contribution! Examples of how to record injuries 1. A female hammer-thrower developed shoulder instability during training and sought medical attention; the condition did not prevent the athlete from taking full part in training or competition even though it caused the thrower some pain. The team physiotherapist recommended an individual training programme for the athlete to avoid aggravating the condition. athlete´s accreditation no. sport and event Code type of injury Code round / heat or training cause of injury Overuse (gradual onset) code date and time of injury uvg 34765 injured body part Hammer Throw (women) training 11 instability 5 1 10th, 08:00 am absence in days shoulder, left 0 2. A male 800m runner suffered groin pain during the first semi-final, which the team physician decided did not warrant immediate treatment; the athlete continued to take full part in training and competition. athlete´s accreditation no. sport and event round / heat or training Code date and time of injury TAM 345672 injured body part Code athletics - 800m (men) type of injury groin, left 22 strain 11 Semi-final, 1st Heat cause of injury overuse code 1 (gradual onset) 15 Aug; 6 p.m. absence in days 0 days 3. A decathlete sustained an ankle sprain during competition but continued to compete; the athlete received medical attention following the competition. The athlete completed full competition using ankle taping (with some pain) but aggravated the injury the following day; the athlete then required rehabilitation and stopping from training. Estimated duration of treatment = 15 days. First Incident should be recorded as an injury athlete´s accreditation no. sport and event round / heat or training Code date and time of injury TAM 584745279 injured body part Code Decathlon - high jump type of injury ankle, right 27 sprain 9 competition, first day code cause of injury non3 contact trauma 12 Aug; 5 p.m. absence in days 0 days Second Incident should be recorded as a new injury athlete´s accreditation no. sport and event round / heat or training Code cause of injury code date and time of injury absence in days TAM 584745279 injured body part Code Decathlon - 1500m type of injury competition, second day 13 Aug; 2 p.m. 9 recurrence of injury ankle, right 27 sprain 4 15 days 4. A basketball player caught his finger in an opponent’s jersey and sustained an injury to the 2nd MCP joint of his right hand. athlete´s accreditation no. sport and event round / heat or training date and time of injury TAM 421567695 injured body part Code basketball (men) type of injury Code competition 9 contact with other player cause of injury code 20 Aug; 15:15 absence in days finger, right 17 MCP I sprain 11 7 days 5. A beach volleyball player sprained her left ankle on 9 August during training. She received treatment by the NOC PT, and was then taken to the Polyclinic for MRI and secondary treatment. athlete´s accreditation no. sport and event Code type of injury Code round / heat or training date and time of injury TAM 24315656978 injured body part Beach volleyball (women) training 9 Aug; 10 a.m. code absence in days ankle, left 27 sprain 9 overuse (sudden onset) cause of injury 2 2 days Revised diagnosis (after MRI) should also be provided on the injury report form athlete´s accreditation no. sport and event Code type of injury Code round / heat or training date and time of injury TAM 24315656978 injured body part Beach volleyball (women) training 9 Aug; 10 a.m. code absence in days ankle, left 27 ligament rupture without instability 8 injury already reported cause of injury >20 days 6. A football player sustained a rotation injury to his right knee during the first game of the Games. He was seen by the team PT who recorded the injury and treated the patient acutely. The player was then sent to the Polyclinic where an MRI was carried out and the final diagnosis made, which was a grade III tear of the MCL with a positive valgus grade III stress test at 20 degrees. athlete´s accreditation no. sport and event round / heat or training Code date and time of injury code absence in days TAM 342567569 injured body part Code football (men) type of injury match against Germany 11 Aug; 18:42 9 contact with other player cause of injury knee, right 24 sprain 11 2 days Revised diagnosis (after MRI) should also be provided on the injury report form athlete´s accreditation no. sport and event round / heat or training Code date and time of injury code absence in days TAM 342567569 injured body part Code football (men) type of injury match against Germany 11 Aug; 18:42 7 injury already reported cause of injury knee, right 24 ligament injury with instability >180 days 7. A wrestler had a severe fall and immediately had pain in the lower right chest. First aid was given due to breathing problems; he was taken to the polyclinic where an x-ray of the chest revealed a rib fracture. athlete´s accreditation no. TAM 96565365 injured body part Code sport and event rib, right 5 round / heat or training wrestling – freestyle (women 48-55kg) competition type of injury Code cause of injury nonfracture, traumatic 2 contact trauma date and time of injury 20.8. - 7:30 pm code absence in days 3 >30 days 8. A weightlifter fell to the floor during a lift and screamed due to pain in the left thigh. He was taken to the clinic at the venue where an examination and an ultrasound made the diagnosis of a quadriceps tear. athlete´s accreditation no. sport and event round / heat or training Code date and time of injury TAM 346954275 injured body part Code weightlifting (men, 62kg) type of injury quadriceps, left 23 rupture 11 competition cause of injury overuse (sudden onset) 10Aug; 2:30 pm code absence in days 2 >30 days 9. A male 10,000m runner slipped on wet ground and sustained a laceration to the leg during a morning training session; the physician sutured the cut but the runner missed the afternoon training session. The runner was able to take a full part in competition on the following day. athlete´s accreditation no. sport and event round / heat or training date and time of injury TAM 658274 injured body part Code 10,000m (men) type of injury Code training 15 cause of injury 14Aug; 7 a.m. absence in days calf, left 25 cut slipped code 3,13, on wet ground 21 0 days 10. A male table tennis player fell down and sprained his ankle when getting off the bus on his way to the stadium. Incident should not be recorded as an injury. EXAMPLES OF HOW TO FILL IN THE DAILY INJURY REPORT FORM Nation: Norway Physician’s name: Prof. Lars Engebretsen Contact details (tel./fax or e-mail): lars.engebretsen@medisin.uio.no Date of report: 9.8.2008 Please report: All injuries (traumatic and overuse) newly incurred during competition or training regardless of the consequences with respect to the athlete’s absence from competition or training. The information provided is for medical and research purposes and will be treated confidentially. Athlete’s accreditation no. 1234569587979 injured body part wrist, left athlete´s accreditation no. Sport and event Swimming, 50m freestyle round / heat or training 1st heat Time/day of injury 7.8. - 2.35 p.m. (men) Code type of injury 15 sprain Sport and event code cause of injury 9 slipped and fell round / heat or training code absence in days 13 10 date and time of injury XZ 27 15 injured body part code track, 200m (women) type of injury code quarter-final cause of injury 16.8. – 9.40 a.m. code absence in days m. adductor, right athlete´s accreditation no. 23 code strain Sport and event type of injury 11 code non-contact round / heat or training cause of injury 3 2-3 date and time of injury bg 72989 injured body part athletics, 4x 100m relay (w) warm-up 6 code 12.8. – 8 p.m. code absence in days lower back athlete´s accreditation no. pain Sport and event 19 code overuse round / heat or training 1 0 date and time of injury aj 18 597 injured body part volleyball type of injury training cause of injury 14.8. – 7:15 a.m. code absence in days ankle, left athlete´s accreditation no. 27 code inversion trauma Sport and event type of injury 9 code landing round / heat or training cause of injury 3 7 date and time of injury 31fk 57 injured body part track 100m hurdles women 2nd heat 24 code 9.8. –11.55 a.m. code absence in days right knee athlete´s accreditation no. ACL rupture Sport and event 7 code non-contact round / heat or training cause of injury 3 >30, ca 3 months date and time of injury code absence in days g.k58664765 injured body part football (women) type of injury final against Germany 11.8. – 87min 18 code calf, right athlete´s accreditation no. 25 code cramps Sport and event heat round / heat or training 21 0 date and time of injury buo46523 injured body part discus throw type of injury qualification A cause of injury 21.8. – 9.40 a.m. code absence in days shoulder, left athlete´s accreditation no. 11 code AC joint sprain Sport and event 9 code poor warm-up round / heat or training 23 14 date and time of injury uvg 34765 injured body part tennis / women type of injury training cause of injury 17.8. – 5 p.m. code absence in days right knee athlete´s accreditation no. 24 code laceration Sport and event type of injury 15 code fell round / heat or training 3 0 date and time of injury wpei4567 injured body part wresting, freestyle (men) 28 fracture 3 semi-final cause of injury 15.8. – 6.30 a.m. code absence in days foot, right overuse 2 21 No injury in any athlete of our team today Sport and event Please state for team sports: the sport only (e.g. football, handball, basketball), for all other sports: the sport and event (e.g. swimming - 4x100m freestyle relay (women); track - 110m hurdles (men); decathlon - high jump; taekwondo - under 58kg; cycling – team sprint). Round / heat or training If the injury occurred during competition, please state: for team sports: the match number or opposing team, for all other sports: the round (e.g. first round, quarter-final, qualification, final) and heat or group (e.g. first heat, second run, first semi-final, qualifying group A). If the injury occurred on another occasion, please specify, e.g. training, warm-up. Date and time of injury Please state the date and time when the injury was incurred. Injured body part - Location of injury Head and trunk 1 face (incl. eye, ear, nose) 2 head 3 neck / cervical spine 4 thoracic spine / upper back 5 sternum / ribs 6 lumbar spine / lower back 7 abdomen 8 pelvis / sacrum / buttock Upper extremity 11 shoulder / clavicle 12 upper arm 13 elbow 14 forearm 15 wrist 16 hand 17 finger 18 thumb 11 12 13 14 15 16 17 18 19 Lower extremity 21 hip 22 groin 23 thigh 24 knee 25 lower leg 26 Achilles tendon 27 ankle 28 foot / toe strain / muscle rupture / tear contusion / haematoma / bruise tendinosis / tendinopathy bursitis laceration / abrasion / skin lesion dental injury / broken tooth nerve injury / spinal cord injury muscle cramps or spasm other Type of injury - Diagnosis 1 concussion (regardless of loss of consciousness) 2 fracture (traumatic) 3 stress fracture (overuse) 4 other bone injuries 5 dislocation, subluxation 6 tendon rupture 7 ligamentous rupture with instability 8 ligamentous rupture without instability 9 sprain (injury of joint and/or ligaments) 10 lesion of meniscus or cartilage Cause of injury 1 2 3 4 overuse (gradual onset) overuse (sudden onset) non-contact trauma recurrence of previous injury 11 contact with another athlete 12 contact: moving object (e.g. ball) 13 contact: stagnant object (e.g. net) 14 violation of rules (foul play) 21 field of play conditions 22 weather condition 23 equipment failure 24 other Estimated duration of absence from training or competition (in days) Please provide an estimate of the number of days that the athlete will not be able to undertake their normal training programme or will not be able to compete. © F-MARC 2008