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What is the IOC doing to protect the health of the Olympic Athlete?

JBJS (am) n SJMSS n KSSTA n Research grants: n Arthrex n Smith & Nephew n Fin-Ceramica n TBF-Tissue Engineering n Competitive grants: n National Institute of Health US n AOSSM

October 2007) Develop the IOC s scientific activities in the field of sports sciences so as to position the IOC as THE reference in sports medicine and sports science IOC

The IOC Medical and Scientific department is the administrative support of the Commission Increase the positioning of the IOC on the protection of health by developing research

) and the sporting community on the other hand (NOCs, IFs, etc.

1 What is the IOC doing to protect the health of the Olympic Athlete? Professor Lars Engebretsen Disclosures 2013: n Consultant n Arthrex equipment development n Fellowship grants n Smith and Nephew n Arthrex n Editor and Editorial board n BJSM n JBJS (am) n SJMSS n KSSTA n Research grants: n Arthrex n Smith & Nephew n Fin-Ceramica n TBF-Tissue Engineering n Competitive grants: n National Institute of Health US n AOSSM n National Institute of Health Norway n FIFA n IOC n NIH n Health South East Norway n Department of Culture Norway IOC Head of Scientific Activities Mission statement (start October 2007) Develop the IOC s scientific activities in the field of sports sciences so as to position the IOC as THE reference in sports medicine and sports science IOC Medical Commission was effective as from 1967 and chaired from this date until 2003 by Prince Alexander de Merode (BEL) and then by Prof Arne Ljungqvist (SWE). The IOC Medical and Scientific department is the administrative support of the Commission Increase the positioning of the IOC on the protection of health by developing research and analysis in the field of sports medicine Act as the interface between the scientific community on the one hand (scientific societies etc.) and the sporting community on the other hand (NOCs, IFs, etc.) 3 4 Richard Budgett Medical & Scientific Director Organisational Chart Medical Department current situation Lars ENGEBRETSEN Head of Scientific Activities Susan GREINIG Programme Manager Cherine FAHMY Project Officer Fiona TRABELSI Administrative Assistant Torbjorn SOLIGARD Project Officer «Through these initiatives, the IOC will increasingly emphasize protection of the atlethe`s health and prevention of injuries» IOC President J. Rogge 6/11/

and Res course + EHR IOC Research Centres Injury Prevention and of Athlete s Health 7 Background By supporting selected research centres, the IOC will promote

prevention (including studies on basic epidemiology, risk factors, injury Prevention mechanisms and intervention).

disease prevention Fostering collaborative relationships with individuals, institutions and protection organisations to improve of athlete health Implementing

IOC Setting up knowledge translation mechanisms to share scientific research results with the field throughout the Olympic Movement and sports community and

9 Annual meetings 2010/11/12 : Cape Town, Lausanne, Calgary Research areas to focus on : IOC injury & illness surveillance methodology and establishing PHE of

Targeting International Federations to translate knowledge from research and elite to recreational /kids/health related issues 10 IOC Journal Injury

2 and Res course + EHR IOC Research Centres Injury Prevention and of Athlete s Health 7 Background By supporting selected research centres, the IOC will promote injury and disease prevention and the improvement of physical health of the athlete by: Establishing long-term research programmes on injury and disease prevention (including studies on basic epidemiology, risk factors, injury Prevention mechanisms and intervention). of Consequences of sports injuries and sports-related illnesses Pathophysiology, risk factors injury mechanisms Methods for injuries sports injury and and disease prevention Fostering collaborative relationships with individuals, institutions and protection organisations to improve of athlete health Implementing (and collaborating with) applied, ongoing and novel research and development within the framework and longterm strategy of the health! IOC Setting up knowledge translation mechanisms to share scientific research results with the field throughout the Olympic Movement and sports community and to convert these results into concrete actions to protect the health of the. 9 Annual meetings 2010/11/12 : Cape Town, Lausanne, Calgary Research areas to focus on : IOC injury & illness surveillance methodology and establishing PHE of participating Development of overuse injury methodology and research on tendinopathy and other overuse injuries Genetics and injury risk/medical conditions Targeting International Federations to translate knowledge from research and elite to recreational /kids/health related issues 10 IOC Journal Injury Prevention and Health The IOC joined BJSM and created the Injury Prevention and Health This IPHP Journal is unique. It publishes the very best work on prevention of injury and diseases and protection of the athlete in the sports world. At the moment there are no other journals dealing specifically with and prevention

3 September 2011 Dec 2012 BJSM ranked 4 th among 84 journals in sports sciences 13 The IOC Biennial Congress Tromsø 2008 Oslo Svolvær June 21-24: Advanced Team Physician Course Tromsø June taede@stanford.ed u 3

4 IOC Advanced Team Physician Course Corsica April 3-5, 2011 Geared towards the practical issues of working with high-level in a team setting! Addressing controversial topics, presenting new evidence, challenging existing dogma. Case-based discussions, plenary lectures and panel discussions Maximum capacity: 125 participants from 49 countries Welcome to a great experience! Latest IOC Medical Com. encyclopaedia Genetic and Molecular Aspects of Sports Performance (Bouchard & Hoffman, 2011) Neuromuscular Aspects of Sports Performance (Komi, 2011) Latest IOC Medical Com. handbooks The Paralympic Athlete (Vanlandewijck & Thompson, 2011) Sports Injury Prevention (Bahr & Engebretsen, 2009) Sport Psychology (Brewer, 2009) 23 4

Consensus statements Sports Nutrition (2003) Sex Reassignment in Sports (2003) Sudden Cardiovascular Death in Sports (2004) Training the Elite Child Athlete (2005) Female Athlete Triad (2005) Sexual

Elite Athletes (2008) Fasting in Sports (2009) Periodic Health Evaluation of Elite Athletes (2009) Age Determination in High-Level Young Athletes (2009) Sports Nutrition (2010) Functional

altitude challenges in the high-level athlete (2011) 25 IOC Consensus Meetings Consensus statements Example September 2012 : IOC Consensus Statement on Thermoregulation and altitude challenges for

5 Consensus statements Sports Nutrition (2003) Sex Reassignment in Sports (2003) Sudden Cardiovascular Death in Sports (2004) Training the Elite Child Athlete (2005) Female Athlete Triad (2005) Sexual Harassment & Abuse in Sport (2006) Molecular Basis of Connective Tissue and Muscle Injuries in Sport (2007) Non-contact ACL Injury in the Female Athlete (2008) Concussion in Sport (2008) Asthma in Elite Athletes (2008) Fasting in Sports (2009) Periodic Health Evaluation of Elite Athletes (2009) Age Determination in High-Level Young Athletes (2009) Sports Nutrition (2010) Functional Hyper-Androgenism and Sport (2010) The Use of Platelet-Rich Plasma in Sports Medicine (2010) Fitness and Health in Young People through Physical Activity and Sport (2011) Thermoregulatory and altitude challenges in the high-level athlete (2011) 25 IOC Consensus Meetings Consensus statements Example September 2012 : IOC Consensus Statement on Thermoregulation and altitude challenges for the elite athlete Guest Editor: Michael F Bergeron The IOC Periodic Health Exam project To be available for all participating in the Olympic Games To include muscusloskeletal, cardiac, pulmonary, gender issues Working group appointed July 08 Consensus meeting March 09 Consensus paper published in 7 journals in September/October

SCD in : Global Debate, or Common Ground?

elite is a catastrophic event (for family, team and country) Prevention of

teaching course, with the aim to provide the examining physician with the

London 2012 Two educational courses for NOC physicians regarding the

Scientific program included lectures on the most common abnormalities in

ECGs. Target of the Course were the NOC and IFs physicians.

6 SCD in : Global Debate, or Common Ground? The ESC/IOC Consensus Statements Athletes are at increased CV risk SCD in elite is a catastrophic event (for family, team and country) Prevention of SCD is possible ECG screening is efficient to detect most occult CV diseases 1 st IOC Course on PHE. Lausanne, September 9th, 2011 The IOC medical commission organized a teaching course, with the aim to provide the examining physician with the means for learning the appropriate interpretation of athlete s ECG. London 2012 Two educational courses for NOC physicians regarding the interpretation of ECGs in were held during the 2012 Olympic Games The Scientific program included lectures on the most common abnormalities in and practical sessions, guided by experts, of reading and interpreting ECGs. Target of the Course were the NOC and IFs physicians. A certification of proficiency was released. IOC Consensus meetings IOC NOC and If medical conference IOC Beijing, Vancouver and London injury and disease surveillance and prevention study

London Games Compliance study based on 74 NOCs NOC size 30-100 101-200 >200 Results: 89% 88% 97% Based on data by Aug

(%) Severe injuries (n, %) Injuries & Illnesses per Oct 13 10 748 participants (44% females) 205 NOCs 36 sports 1361

1 per 100 High-risk sports injuries (per 100) Taekwondo 39 7 (14) Football 36 11 (6) BMX 31 2 (13) Handball 23 17

7 London Games Compliance study based on 74 NOCs NOC size >200 Results: 89% 88% 97% Based on data by Aug 8 (13 days) We used to have a back log of 1-3 days (Compliance by Aug 7 is 95%) Olympic Sport Injuries per 100 (%) Severe injuries (n, %) Injuries & Illnesses per Oct participants (44% females) 205 NOCs 36 sports 1361 injuries incidence: 12.7 per illnesses incidence: 7.1 per 100 High-risk sports injuries (per 100) Taekwondo 39 7 (14) Football (6) BMX 31 2 (13) Handball (22) MTB 20 2 (13) Hockey (15) Weightlifting (25) Athletics (16) Badminton 15 4 (15) Triathlon 15 3 (19) XX 6/11/201 X 3 41 Sailing 15 1 (2) Synchronized 14 0 (0) 7

$33%) (mostly in Athletics) 43 fractures + 6 stress fractures (0.46%) (mostly in Team Sports, all locations, Running) 27 knee sprains and dislocations, incl. 6 ACL, 1 PCL (0.$ 25%) (Fencing, Handball, Judo, Wrestling, Badminton, Badminton, Table Tennis, Tennis, Football) 6 concussions (0.

25%) (Fencing, Handball, Judo, Wrestling, Badminton, Badminton, Table Tennis, Tennis, Football) 6 concussions (0.

WEIGHT-SENSITIVE SPORTS. Preventing illness and injury in sport is a pre-condition to enable optimal performances.

IOC Concerned about Body Composition, Health and Performance of Athletes,18 October 2010, http://www.olympic.

8 Severe injuries (>1 week absence) TKD 39 inj reported, no concussion 14% serious 14 shoulder, elbow, and knee dislocation (0.13%) (Hockey, Football, Judo, BMX, Weightlifting) 36 thigh strains (0.33%) (mostly in Athletics) 43 fractures + 6 stress fractures (0.46%) (mostly in Team Sports, all locations, Running) 27 knee sprains and dislocations, incl. 6 ACL, 1 PCL (0.25%) (Fencing, Handball, Judo, Wrestling, Badminton, Badminton, Table Tennis, Tennis, Football) 6 concussions (0.06%) 43 6/11/2013 XXX 44 TheIOCMedicalCommissionhassetupan adhocworkinggroupforresearchon 45 Body Composition, Health and Performance (BCHP) to address issues related to these topics in WEIGHT-SENSITIVE SPORTS. Preventing illness and injury in sport is a pre-condition to enable optimal performances. However, the health of the can be severelythreatened by current weight loss practices with serious consequences. IOC Concerned about Body Composition, Health and Performance of Athletes,18 October 2010, Kishimoto 47 IOC Diploma in Sports Medicine Nutrition by Distance Learning Program Directors: Thinking of Post-Graduate training in Sports Medicine? Lars Engebretsen, Ron Maughan Academic Advisory Board: Dr Elisabeth Arendt, USA Professor Roald Bahr, Norway Study for a part-time Diploma in Sports Professor Michael Bergeron, USA Medicine awarded by the International Dr Toru Fukubayashi, Japan Olympic Committee Dr Joao Grangeiro, Brazil Dr Manikavasagam Jegathesan, Malaysia Professor Jon Karlsson, Sweden Dr Hubert Krysztofiak, Poland The 2-year program includes web-based Dr Guoping Li, China lectures by international Professor Michael Kjäer, Denmark Professor Paul McCrory, Australia experts, various online resources, and an Professor Willem Meeuwisse, Canada annual residential meeting Dr Margo Mountjoy, Canada Information on the Program is available at: Professor Antonio Pellucida, Italy Professor Per Renström, Sweden Professor Martin Schwellnus, South Africa Entry requirements: degree or or equivalent admin@sportsoracletoo.com medicine or a related subject IOC Liaison: Torbjorn Soligard 8

9 The IOC Diploma in Sports Nutrition 49 9

The work to protect the health of Olympic athletes. Prof. Lars Engebretsen, Head of Scientific Activities

The work to protect the health of Olympic athletes Prof. Lars Engebretsen, Head of Scientific Activities Organisational Chart IOC Medical and Scientific Commission IOC Medical & Scientific Department IF