Football Traumatology Current Concepts: from Prevention to Treatment

Piero Volpi (Ed.)

Football Traumatology Current Concepts: from Prevention to Treatment

Foreword by: Neil P. Thomas Franco Carraro Sergio Campana Giacinto Facchetti

Springer -

PIERO VOLPI Center for Sports Rehabilitation Galeazzi Orthopaedics Institute Milan, Italy

Library of Congress Control Number: 2005937087

ISBN 10 88-470-0418-7 Springer Milan Berlin Heidelberg New York ISBN 13 978-88-470-0418-4 Springer Milan Berlin Heidelberg New York

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Foreword

This anthology of Football Traumatology edited by Dr. Piero Volpi comprises the collective experience of many of the leading surgeons in Europe whose practice includes footballers at all levels. By pooling this experience and clearly defining common problems and areas of current interest Professor Volpi has produced a very useful reference source for orthopaedic surgeons, sports physicians and physiotherapists. Future editions may expand on emerging areas in non-surgical fields such as dietary supplements and the effects of psychological factors on both injury itself as well as recovery. Topics in this first edition such as Epidemiology, Training Methods, Prevention, and Future Treatment are welcome adjuncts to the usual subjects and reflect recent areas of research.

Neil P. Thomas President ESSKA 2000

Winchester UK

With football becoming ever more relentless and intense, the role of the sports doctor has become in the last few years increasingly important in protecting footballers' health and their physical integrity. It is in this context that Dr. Volpi's in depth and wide ranging work must be viewed. His attention has focused specifically on two important aspects: the fight against doping and the preven- tion of sports traumas. Together with his scientific experience as a sports clini- cian and traumatologist, Dr. Volpi can also draw on his direct field experience as a football player, which adds considerable value to the editing of the current vol- ume, intended as a service to football. With the Football World Cup just round the corner, this book produced in collaboration with both Italian and foreign experts is particularly topical: I am convinced that the spread of medical-scien- tific knowledge and innovations is the most efficient way to safeguard the health of athletes and encourage the growth of a "better" football.

Franco Carraro President of the Italian Football Federation

VI Foreword

This wide editorial initiative, conceived and realized by Dr. Piero Volpi, a pre- cious and not replaceable AIC consultant, brings an important scientific contri- bution to medical questions connected to football.

It is noticeable in the work the importance of the Author's direct experiences, first as players and as sport and traumatic doctor then.

AIC has always been strongly engaged in safeguarding the players' health, real protagonists of the sport event, and has, between his leading aims, the fight against doping and the traumas prevention.

The information, the knowledge and the education are fundamental for play- ers who want to successfidly face the fight to defend their physical integrity and professional dignity.

This praiseworthy editorial effort goes exactly in the direction wished by AIC and will be useful for all the football component to enrich their cultural heritage but especially to know how important is the work done by who acts in order to improve sport anyhow.

Sergio Campana President AIC

Italian Footballers Association

As an F.C. Internazionale executive, and through dealing with the topic in UEFA and FIFA Commision meetings, I have been able to closely follow Piero Volpi's work in these past ten years. I have come to appreciate the preparation and ethics of a person who was "born" on the pitch and has since been through many experiences, first as footballer and later as a sports doctor. This interesting book is the result of an analysis of these two lives that run parallel, but which are not always necessarily linked in the professional world: theory is verified by practice, research addresses the demands and problems faced at the highest com- petitive levels.

The knowledge and possibilities offered by sports medicine today are far superior to those in my generation of footballers. Piero Volpi's book is the most recent and vivid example that today's athlete has the moral and professional duty to consider his own health as one of the most important and decisive aspects of his career - at the very level and on each occasion, starting from the basis, from the decisive transition between playing for fun and playing competitively.

Giacinto Facchetti President, EC. Internazionale Milano

Preface

Every child has a dream: to play football and become a famous footballer. When I was 10 years old, my father was used to bring me to San Siro stadium

on sunday afternoons to watch the Inter team playing. The great Inter was grow- ing up. Sarti, Burnich, Facchetti.. . it was an absolute and sudden love.

Twenty years later I was climbing that prestigious stadium through the stairs from the locker rooms wearing the shirt of Como team to play a football match of the first league Italian championship against Inter.

Fifteen years later, I was sitting as a chief physician on the bench of the Moratti's Inter team, Ronaldo, Baggio, etc.

Sometimes dreams come true. With the present book I accomplish today another wish. To enrich the won-

derful world of football with scientific and specialistic contributions on football traumatology, a branch that has undergone important hits and progresses.

Football has constant need of medical, diagnostic, clinical, therapeutic knowl- edge to counteract the increased number of traumas occurring during sport per- formance in order to defend the integrity of its players, beeing them profession- als, amateurs, young or women.

Thanks to my father, to him my dearest memory, thanks for bringing me to the stadium when I was a child.

Thanks to everybody that I met in the football world: players, team compan- ions and competitors, trainers, managers, physicians, physiotherapists, press reporters, fans; I learned from everyone as in a real "gym of lifeyy.

Thanks to the Authors of this book, for their participation and for the high scientific level reached in their chapters.

Thanks to Springer who has been recipient of this idea and was able with great skill to make it real.

Piero Volpi

Contents

Section I General concepts

Epidemiology and Risk Factor P. VOLPI ..........................................................

Aspects of Biomechanics G. CERULLI, A. CARAFFA, G. ZAMARRA, F. FANTASIA, M. LORENZINI, D. CHECCARELLI ........................................ 1 1

Training Methods C.BORDON ....................................................... 23

Evaluation of Whole Physical Condition F. PIGOZZI,A. GUIMBINI, F. FAGNANI,~. DI SALVO .......................... 33

Biochemical and Haematological Parameters in Football Players G.BANFI.. ........................................................ 43

Prevention of Football Injuries I. BERKES,A. KYNSBURG, G. PANICS ..................................... 53

Organisation of a Professional Team's Medical Staff and the Physician's Role P.VOLPI .......................................................... 67

Injuries in Women's Football L. ENGEBRETSEN, K. STEFFEN .......................................... 75

Referee Lesions J. ESPREIGUERA-MENDES, C. ARCE ...................................... 89

X Contents

Future treatmentsfor Football lnjuries M.FERRETTI,B.A.ZELLE,F.H.FU ..................................... 101

Section II: Specific lnjuries

Maxillo-Facial Traumatology R. BRUSATI, F. BIGLIOLI ........................................ 1 13

Upper Extremity lnjuries P.VOLPI, R. POZZONI, M. GALLI, C. BAIT ................................. 123

Shoulder Dislocation R.ZINI ........................................................... 127

Back Problems E. ROLLAND, G. SAILLANT ............................................ 143

Muscle lnjuries D. TORNESE, G. MELEGATI, P.VOLPI ..................................... 153

Tendon lnjuries M.K. SAYANA, N. MAFFULLI ........................................ 165

Groin Pain A. FERRETTI, A. DE CARLI, E. MONACO .................................. 183

Meniscal Lesions M.DENTI,D.LOVETERE ............................................. 197

Anterior Cruciate Ligament lnjuries P. AGLIETTI, F. GIRON, P. CUOMO ....................................... 205

Anteromedial Knee Instability M. MARCACCI, S. ZAFFAGNINI ......................................... 2 17

Medial Side Injury of the Knee P. ADRAVANTI, A. AMPOLLINI .......................................... 231

Posterior Cruciate Ligament lnjuries P.P. MARIANI, F. MARGHERITINI ........................................ 245

Contents XI

Articular Cartilage Lesions in Football Players L. PETERSON, C. ERNEST .............................................. 255

Patellofemoral Problems A. SCHIAVONE PANNI, M. TARTARONE,A. PATRICOLA, D. SANTAITI ............. 263

Footballer's Arthritic Knee S. LUSTIG, T. AIT SI SELMI, E. SERVIEN, G. TROTTA, P. NEYRET ................ 275

Leg Fractures KARLP.BENEDETTO ................................................. 287

Malleolar Fractures F. CASTOLDI, R. ROSSI, A. MARMOTTI, R. DEL DIN, P. ROSSI .................. 297

Ankle Ligament Injuries A.VENTURA,A.LANZETTA ............................................ 307

Osteochondral Ankle Defects M.ZENGERINK,N.VANDUK ........................................... 319

Chronic Footballer's Ankle E. GIZA, B. MANDELBAUM ............................................ 333

Foot Problems S. GIANNINI,A. FERRUZZI, M. MOSCA, C. BIAGINI .......................... 353

Stress Fractures F. BENAZZO, M. MOSCONI, G. ZANON .................................... 365

Rehabilitation after Football Injuries S.WERNER ........................................................ 375

Return to Play A. CACCHIO, G. MELEGATI, P.VOLPI ..................................... 389

Protective Equipment D.T. KIRKENDALL ................................................... 401

Subject Index ....................................................... 417

Contributors

ADRAVANTI PAOLO Casa di Cura "Citti di Parma" Parma, Italy

AGLIETTI PAOLO First Orthopaedic Clinic University of Florence Florence, Italy

AIT SI SELMI TARIK Centre Livet Service Professeur Philippe Neyret Caluire, France

AMPOLLINI ALDO Casa di Cura "Citti di Parma" Parma, Italy

ARCE CARLOS Orthopaedics and Sports Trauma Department Pedro Hispano Hospital Matosinhos, Portugal

ARCHILLETTI ANTONIO Laboratory of Clinical Biomechanics "Let People Move" Perugia, Italy

BAIT CORRADO Center for Sports Rehabilitation

Galeazzi Orthopaedics Institute Milan, Italy

BANFI GIUSEPPE Facolti di Scienze Motorie Universitl di Milano Istituto Ortopedico Galeazzi Milano, Italy

BENAZZO FRANCESCO Orthopaedics and Trauma Department, University of Pavia Policlinico San Matteo Pavia, Italy

BENEDETTO KARL P. Trauma Surgery and Sports Medicine Academic Hospital Feldkirch Austria

BERKES ISTVAN Department of Sports Orthopaedic Medicine and Rehabilitation Faculty of Physical Education and Sports Science, Semmelweis University Budapest, Hungary

BIAGINI CHIARA Orthopaedics Department University of Bologna Rizzoli Orthopaedic Institute Bologna, Italy

XIV Contributors

BIGLIOLI FEDERICO Maxillo-Facial Surgery Unit Ospedale San Paolo Milan, Italy

BORDON CLAUDIO U.S. Citth di Palermo Palermo, Italy

BRUSATI ROBERTO Maxillo-Facial Surgery, University of Milan, Italy Maxillo-Facial Surgical Unit Ospedale San Paolo Milan, Italy

CARAFFA AURO University of Perugia Orthopaedics and Traumatology Department R. Silvestrini Hospital Laboratory of Clinical Biomechanics "Let People Move" Perugia, Italy

CACCHIO ANGELO Dipartimento di Neuroscienze Unith Operativa di Medicina Fisica e Riabilitazione Ospedale San Salvatore L'Aquila, Italy

CASTOLDI FILIPPO University of Turin Medical School "Umberto I" Hospital Turin, Italy

CERULLI GIULIANO University of Perugia Orthopaedics and Traumatology

Department R. Silvestrini Hospital Laboratory of Clinical Biomechanics "Let People Move" Perugia, Italy

CHECCARELLI DANIELE University of Perugia Orthopaedics and Traumatology Department R. Silvestrini Hospital Perugia, Italy

C u o ~ o PIERLUIGI First Orthopaedic Clinic University of Florence Florence, Italy

DE CARLI ANGELO Orthopaedic Unit and Kirk Kilgour Sports Injury Center San Andrea Hospital University "La Sapienza" Rome, Italy

DEL DIN RAINERO Third Department of Orthopaedics and Traumatology University of Turin Medical School "Umberto I" Hospital, Turin, Italy

DENTI MATTEO Sports Traumatology and Arthroscopic Surgery Unit Galeazzi Orthopaedics Institute Milan, Italy

DI SALVO VALTER University Institute of Movement Sciences Rome, Italy

Contributors XV

ENGEBRETSEN LARS Orthopaedic Center Ulleval University Hospital Oslo, Norway

ERNEST CHRISTIAN Gothenburg Medical Center Wstra Frolunda, Sweden

ESPREGUEIRA-MENDES JOAO

Orthopaedic and Sports Trauma Department Minho University and Porto University Porto, Portugal

FAGNANI FEDERICA University Institute of Movement Sciences Rome, Italy

FANTASIA FABIANO University of Perugia Orthopaedics and Traumatology Department R. Silvestrini Hospital Perugia, Italy

FERRETTI ANDREA Orthopaedic Unit and Kirk Kilgour Sports Injury Center San Andrea Hospital University "La Sapienza" Rome, Italy

FERRETTI MARIO University of Pittsburgh School of Medicine Department of Orthopaedic Surgery Kaufmann Building Pittsburgh, USA

Fu FREDDIE H. University of Pittsburgh School of Medicine Department of Orthopaedic Surgery Kaufmann Building Pittsburgh, USA

GALLI MARCO Sports Traumatology and Arthroscopic Surgery Unit Galeazzi Orthopaedics Institute Milan, Italy

GIANNINI SANDRO Orthopaedics Department University of Bologna Rizzoli Orthopaedic Institute Bologna, Italy

GIOMBINI ARRIGO University Institute of Movement Sciences Rome, Italy

GIRON FRANCESCO First Orthopaedic Clinic University of Florence Florence, Italy

GIZA ERIC Santa Monica Orthopaedic Sports Medicine and Research Foundation Santa Monica, USA

KIRKENDALL DONALD T. Department of Exercise and Sport Sciences University of North Carolina Chapel Hill, USA

XVI Contributors

KRISHNA SAYANA, MURALI Department of Trauma and Orthopaedics University Hospital of North Staffordshire Post Graduate Medicine Keele Medical School Stoke-on-Trent, United Kingdom

KYNSBURG AKOS Department of Sports Orthopaedic Medicine and Rehabilitation Faculty of Physical Education and Sports Science, Semmelweis University Budapest, Hungary

LANZETTA ALBINO 1st Division, Traumatology Sport Centre Orthopaedic Institute Gaetano Pini Milan, Italy

Lo VETERE DARIO Sports Traumatology and Arthroscopic Surgery Unit Galeazzi Orthopaedics Institute Milan, Italy

L~RENZINI MICHELA University of Perugia Orthopaedics and Traumatology Department R. Silvestrini Hospital Perugia, Italy

LUSTIG SBBASTIEN Centre Livet Service Professeur Philippe Neyret Caluire, France

MAFFULLI NICOLA Department of Trauma and Orthopaedics University Hospital of North Staffordshire Post Graduate Medicine Keele Medical School Stoke-on-Trent United Kingdom

MANDELBAUM BERT Santa Monica Orthopaedic Sports Medicine and Research Foundation Santa Monica, USA

MARCACCI MAURIZIO Rizzoli Orthopaedic Institute Sports Traumatology and Orthopaedics Division Biomechanics Laboratory Bologna, Italy

MARGHERITINI FABRIZIO University of Motor Sciences Unit of Sports Traumatology Rome, Italy

MARIANI PIER PAOLO University of Motor Sciences Unit of Sports Traumatology Rome, Italy

MARMOTTI ANTONGIULIO Third Department of Orthopaedics and Traumatology University of Turin Medical School Mauriziano "Umberto I" Hospital Turin, Italy

Contributors XVII

MELEGATI GIANLUCA Center for Sports Rehabilitation Galeazzi Orthopaedics Institute Milan, Italy

MONACO EDOARDO Orthopaedic Unit and Kirk Kilgour Sports Injury Center St. Andrea Hospital University "La Sapienzayy Rome, Italy

Mosc~ MASSIMILIANO Orthopaedics Department University of Bologna Rizzoli Orthopaedic Institute Bologna, Italy

MOSCONI MARIO Clinica Ortopedica e Traumatologia dell'universitl degli Studi di Pavia Centro Studi e Ricerche in Medicina e Traumatologia dello Sport Policlinico San Matteo Pavia, Italy

NEYRET PHILIPPE Centre Livet Service Professeur Phiippe Neyret Caluire, France

PANICS GERGELY Department of Sports Orthopaedic Medicine and Rehabilitation Faculty of Physical Education and Sports Science Semmelweis University Budapest, Hungary

PATRICOLA ALESSANDRO ANTONIO ISpeO Istituto Specialistico Ortopedico Casa di Cura "San Giuseppe" Rome, Italy

PETERSON LARS Gothenburg Medical Center Vastra Friilunda, Sweden

PIGOZZI FABIO University Institute of Movement Sciences Rome, Italy

P o z z o ~ ~ ROBERTO Sports Traumatology and Arthroscopic Surgery Unit Galeazzi Orthopaedics Institute Milan, Italy

ROLLAND ERIC

Orthopaedic Surgery Service PitiC SalpEtriCre Hospital Paris, France

ROSSI PAOLO 3rd Department of Orthopaedics and Traumatology University of Turin Medical School "Umberto I" Hospital Turin, Italy

Ross1 ROBERTO Orthopaedics and Traumatology University of Turin Medical School "Umberto I" Hospital Turin, Italy

XVIII Conttibutors

SAILLANT G~RARD Orthopaedic Surgery Service Piti6 Salp&tri&re Hospital Paris, France

SANTAITI DANIELE ISpeO Istituto Specialistico Ortopedico Casa di Cura "San Giuseppe" Rome, Italy

SCHIAVONE PANNI ALFREDO ISpeO Istituto Specialistico Ortopedico Casa di Cura "San Giuseppe" Rome, Italy

SERVIEN ELVIRE Centre Livet Service Professeur Philippe Neyret Caluire, France

STEFFEN KATHRIN Oslo Sports Trauma Research Center Norwegian School of Sport Sciences Oslo, Norway

TARTARONE MARIO ISpeO Istituto Specialistico Ortopedico Casa di Cura "San Giuseppe" Rome, Italy

TORNESE DAVIDE Center for Sports Rehabilitation Galeazzi Orthopaedics Institute Milan, Italy

TROTTA GIUSEPPE Centre Livet Service Professeur Philippe Neyret Caluire, France

VAN DIJK C. NIEK Department of Orthopaedic Surgery Academic Medical Centre University of Amsterdam Amsterdam, The Netherlands

VENTURA ALBERTO 1st Division, Traumatology Sport Centre Orthopaedic Institute Gaetano Pini Milan, Italy

VERCILLO FABIO University of Perugia Orthopaedics and Traumatology Department R. Silvestrini Hospital Perugia, Italy

VOLPI PIERO Center for Sports Rehabilitation Galeazzi Orthopaedics Institute Milan, Italy

WERNER SUZANNE Section of Sports Medicine Division of Molecular Medicine and Surgery Karolinska Institutet Stockholm, Sweden

ZAFFAGNINI STEFANO Rizzoli Orthopaedic Institute Sports Traumatology and

Conttibutoa XIX

Orthopaedics Division Biomechanics Laboratory Bologna, Italy

ZAMARRA GIOVANNI University of Perugia Orthopaedics and Traumatology Department of Perugia R. Silvestrini Hospital Perugia, Italy

ZANON GIACOMO Clinica Ortopedica e Traumatologia dell'Universit8 degli Studi di Pavia Centro Studi e Ricerche in Medicina e Traumatologia dello Sport Policlinico San Matteo Pavia, Italy

ZELLE BORIS A. University of Pittsburgh School of Medicine Department of Orthopaedic Surgery Pittsburgh, USA

ZENGERINK MAARTJE Department of Orthopaedic Surgery Academic Medical Centre University of Amsterdam Amsterdam The Netherlands

ZINI RAUL U.O. Ortopedia Azienda Ospedaliera San Salvatore Pesaro, Italy