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

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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 Medical Chairpersons Group Continental Group Games Group Medical & Scientific Group OCOG & YOGOC 12/ 2

Projects IOC Research Centres IOC Journal Injury Prevention and Health Protection IOC Injury Prevention Conference IOC Advanced Team Physician Courses IOC Sports Med Publications IOC Consensus conference IOC IF meeting yearly IOC/IF joint meeting on injury prevention IOC Periodic Health Exam (PHE) + EHR IOC Sports Med Courses (Olympic Solidarity) IOC Vancouver, London and Sochi injury and disease surveillance and prevention study IOC SHA and Body composition group IOC Advanced Sports Medicine Diploma IOC Olympic Games Sports Med Academy 3

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 mechanisms and intervention). Consequences of sports injuries and sports-related illnesses Pathophysiology, risk factors and injury mechanisms Methods for sports injury and disease prevention Fostering collaborative relationships with individuals, institutions and organisations to improve athletes health Implementing (and collaborating with) applied, ongoing and novel research and development within the framework and long-term strategy of the 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 athletes. 4

IOC Research Centers from 2015 through 2018: Australian Centre for Research into Injury in Sport and its Prevention, Federation University Australia, Australia Sport Injury Prevention Research Centre, University of Calgary, Canada Institute of Sports Medicine, Copenhagen University Hospital, Denmark Yonsei University, Republic of Korea (South-Korea) Amsterdam Collaboration on Health & Safety in Sports, VU University and Academic Medical Center, Netherlands Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Norway Clinical Sport and Exercise Medicine Research Group, University of Pretoria, South Africa London s Institute for Sports, Exercise and Health (ISEH) and National Centre for Sports Exercise and Medicine (NCSEM), United Kingdom Aspetar Research & Education Department, Orthopaedic and Sports Medicine Hospital, Qatar US Coalition for the Prevention of ILLNESS AND INJURY in Sports (US Olympic Center, University of Utah, Steadman-Philippon Clinic in Vail)

IOC is perfectly placed

Projects IOC Research Centres IOC Journal Injury Prevention and Health Protection IOC Injury Prevention Conference IOC Advanced Team Physician Courses IOC Sports Med Publications IOC Consensus conference IOC IF meeting IOC Periodic Health Exam (PHE) + EHR IOC Sports Med Courses (Olympic Solidarity) IOC Vancouver, London and Sochi injury and disease surveillance and prevention study IOC SHA and Body composition group IOC Advanced Sports Medicine Diploma 9

In 2009, the IOC joined BJSM and created special issues on Injury Prevention and Health Protection Through these initiatives, the IOC will increasingly emphasise protection of the athletes health and the prevention of injuries

#40

British Journal of Sports Medicine Injury Prevention & Health Protection

BJSM s IF in 2018 = 7.9 #1 sports med journals BJSM IPHP papers cite as high as BJSM papers

Projects IOC Research Centres IOC Journal Injury Prevention and Health Protection IOC Injury Prevention Conference IOC Advanced Team Physician Courses IOC Sports Med Publications IOC Consensus conference IOC IF meeting IOC Periodic Health Exam (PHE) + EHR IOC Sports Med Courses (Olympic Solidarity) IOC Vancouver and London injury and disease surveillance and prevention study IOC SHA and Body composition group IOC Advanced Sports Medicine Diploma 15

IOC Advanced Team Physician Courses 2008: Svinøya, Norway 2009: Stanford, USA 2011: Calvi, Corsica 2012: Soria Moria, Norway 2013: Saltsjøbaden, Sweden 2014: Mandelieu, France 2015: Doha, Qatar 2016: Stellenbosch, South Africa 2017: Antalya, Turkey 2018: Marakesh, Marocco 2019: Tokyo, Japan

IOC World Congress in Injury and Illness Prevention in Sport, March 12-14 2020: Call for Keynote Speakers and Symposia November 2018 82 workshops 318 abstracts

Projects IOC Research Centres IOC Journal Injury Prevention and Health Protection IOC Injury Prevention Conference IOC Advanced Team Physician Courses IOC Sports Med Publications IOC Consensus conference IOC IF meeting IOC Periodic Health Exam (PHE) + EHR IOC Sports Med Courses (Olympic Solidarity) IOC Vancouver and London injury and disease surveillance and prevention study IOC SHA and Body composition group IOC Advanced Sports Medicine Diploma 19

All book will be in the e-books format and all previous issues will be available on the net 20

Projects IOC Research Centres IOC Journal Injury Prevention and Health Protection IOC Injury Prevention Conference IOC Advanced Team Physician Courses IOC Sports Med Publications IOC Consensus conferences IOC IF meeting IOC Periodic Health Exam (PHE) + EHR IOC Sports Med Courses (Olympic Solidarity) IOC Vancouver and London injury and disease surveillance and prevention study IOC SHA and Body composition group IOC Advanced Sports Medicine Diploma 22

IOC Consensus Meetings 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 Hyperandrogenism and Sport (2010,2013, 2016) 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 highlevel athlete (2011) Body Composition, Health and Performance in Sport (2012) NCDs and prevention 2013 Triad update 2013 Youth Athlete Development Nov 2014 Health consequences of a saturated sports calendar 2015-16 Pregnancy and the elite athlete 2015-16 Pain and medications in sports 2016 Concussion 2016 Nutritional suplements 2017 Knee injuries in children 2017 Mental health in elite athletes 2018 Sports injury epidemiology methods 2019 Concussion 2020

The IOC ACL in children consensus group 2017

Pediatric ACL injuries - Setting the stage IOC Consensus meeting Lausanne 2017 Guri Ekås (MD) Clare Ardern (PT/PhD) Hege Grindem (PT/PhD) Prof. Lars Engebretsen (MD/PhD)

Projects IOC Research Centres IOC Journal Injury Prevention and Health Protection IOC Injury Prevention Conference IOC Advanced Team Physician Courses IOC Sports Med Publications IOC Consensus conference IOC IF meeting IOC Periodic Health Exam (PHE) + EHR IOC Sports Med Courses (Olympic Solidarity) IOC Beijing, Vancouver, London, Sochi, Rio and Pyeongchang injury and ilness surveillance study IOC SHA and Body composition group IOC Advanced Sports Medicine Diploma 27

Surveillance: IOC Injury & illnesses surveillance during Olympic Summer and Winter Games: 2008 Beijing 2010 Vancouver 2012 London 2014 Sochi 2016 Rio 2018 Pyongchang During Youth Olympic Winter Games 2012 Innsbruck 2016 Lillehammer

Definition of injury and illness New or recurring musculoskeletal complaints or concussions (injuries) or illnesses Occurring in the period of the Olympic Games Medical attention, regardless of the consequences with respect to absence from competition or training

IOC Medical Research Group Lars Engebretsen Torbjorn Soligard Deborah Palmer Natalia Salmina Marie-Elaine Grant Alexandre Lopes Kathrin Steffen

Pyeongchang 2016 Injury & Illness Surveillance 3340 athletes (40%females) 15 sports athletes distributed to 18% Hockey 11% Alpine 10% Cross country skiing 9 % Freestyle skiing 8% Snowboard.

2 sources to collect surveillance data from NOC medical staff through EMR 90-95% yet (better than in previous Games at this time) 56 countries with 4 athletes included (equals 94% of all athletes) Clinic/venue EMRs We want to daily export data from the EMR system and crosschecked data entries for duplicates with the NOC encounters XXX 10/12/201 8 32

Injured athletes (%) per sport (all) Vancouver 2010, Sochi 2014 & PyeongChang 2018 Injured athletes (%) 60% 50% 40% 30% 20% 10% 0% Snowboard cross Ski cross Vancouver 2010 Sochi 2014 PyeongChang 2018 All =>1 day >7 days All =>1 day >7 days All =>1day >7 days Snowboard slopestyle Ski halfpipe Snowboard big air Alpine skiing Ski slopestyle Snowboard halfpipe Luge Moguls Short track Ice hockey Speed skating Aerials Bobsleigh Figure skating Curling Skeleton Ski jumping Cross-country skiing Snowboard slalom Biathlon Nordic combined 60% 50% 40% 30% 20% 10% 0% For internal use until scientific report published fall 2018

Ill athletes (%) per sport (all) Vancouver 2010, Sochi 2014 & PyeongChang 2018 Ill athletes (%) 30% 20% 10% 0% Vancouver 2010 Sochi 2014 PyeongChang 2018 All illnesses All illnesses All illnesses =>1 day =>1 day =>1 day Biathlon Curling Bobsleigh Snowboard slalom Short track Ski halfpipe Cross-country skiing Ski slopestyle Luge Nordic combined Alpine skiing Speed skating Snowboard big air Skeleton Snowboard halfpipe Snowboard cross Ski jumping Figure skating Snowboard slopestyle Aerials Ice hockey Moguls Ski cross 30% 20% 10% 0% For internal use until scientific report published fall 2018

Injuries and illnesses in 6 consecutive Olympic Games 16% 16% 14% 12.9 14.0 12.6 14% 12% 11.2 12% Injured/ill athletes (%) 10% 9.6 8.9 9.8 9.4 10% Injured Ill 8% 7.2 7.2 8% 6% 5.4 6% 4% Beijing 2008 Vancouver 2010 London 2012 Sochi 2014 Rio 2016 PyeongChang 2018 4% For internal use until scientific report published fall 2018

Take-home message 10-14% of athletes injured and 7-9% ill during Games Injuries and illnesses vary substantially between sports, winter/summer, and gender Respiratory track infections are the most common illness Little valid knowledge on burden of overuse injury risk

Implications Development of preventive measures need to be tailored for each sport Continued focus among sport bodies/ifs to institute and further develop injury and illness surveillance systems Not just during the Game, but also up to the Games

Projects IOC Research Centres IOC Journal Injury Prevention and Health Protection IOC Injury Prevention Conference IOC Advanced Team Physician Courses IOC Sports Med Publications IOC Consensus conference IOC IF meeting IOC Periodic Health Exam (PHE) + EHR IOC Sports Med Courses (Olympic Solidarity) IOC Vancouver, Beijing and London injury and disease surveillance and prevention study IOC SHA and Body composition group IOC Advanced Sports Medicine Diploma NEW!!!!! IOC Get set ap 38 NEW!!!!! IOC program of postgraduate study in Sports Physical Therapy

Projects IOC Research Centres IOC Journal Injury Prevention and Health Protection IOC Injury Prevention Conference IOC Advanced Team Physician Courses IOC Sports Med Publications IOC Consensus conference IOC IF meeting IOC Periodic Health Exam (PHE) + EHR IOC Sports Med Courses (Olympic Solidarity) IOC Vancouver, Beijing and London injury and disease surveillance and prevention study IOC SHA and Body composition group IOC Advanced Sports Medicine Diploma IOC Diploma program of postgraduate study in Sports Physical 40 Therapy NEW!!!!! IOC Sports Medicine Research Fund

IOC Certificate in Drugs in Sport NEW Started in 2018

24 Lectures 6 Month Program Topics include Pharmacology in sports medicine Providing healthcare within anti-doping regulations and procedures Clinical use of medications and supplements Doping prevention strategies for healthcare providers Healthcare providers at major sporting events

Mission: Protecting the health of the athlete

Although acute sports injuries are a significant concern for the injured athlete, for sports organizations, and society, we have ways to prevent them!

Heard about the app Get Set Train Smarter? - A free app on injury prevention training

Exercise programs for 51 Olympic summer + winter sports

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