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FootballTraumatology
Current Concepts:fromPrevention
to
Treatment
Piero Volpi
(Ed.)
Football
Traumatology
Current Concepts:
from PreventiontoTreatment
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
This work is subject to copyright. All rights are reserved, whether the whole or part of the
material is concerned, specifically the rights of translation, reprinting, reuse of illustra-
tions, recitation, broadcasting, reproduction on microfilm or in any other way, and storage
in data banks. Duplication of this publication or parts thereof is permitted only under the
provisions of the Italian Copyright Law in its current version, and permission for use must
always be obtained from Springer. Violations are liable to prosecution under the Italian
Copyright Law.
Springer is a part of Springer Science+Business Media
springer.com
63
Springer-Verlag Italia 2006
-
2nd printing 2006
Printed in Italy
The use of general descriptive names, registered names, trademarks,etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt
from the relevant protective laws and regulations and therefore free for general use.
Product liability: The publishers cannot guarantee the accuracy of any information about
dosage and application contained in this book. In every individual case the user must
check such information by consulting the relevant literature.
Cover design: Simona Colombo, Milan, Italy
Typesetting: Graphostudio, Milan, Italy
Printing: Grafiche Porpora, Cernusco SIN (MI), Italy
Foreword
This anthology of FootballTraumatology 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
[...]... Division, Traumatology Sport Centre Orthopaedic Institute Gaetano Pini Milan, Italy MARCACCI MAURIZIO Rizzoli Orthopaedic Institute Sports Traumatology and Orthopaedics Division Biomechanics Laboratory Bologna, Italy DARIO Lo VETERE Sports Traumatology and Arthroscopic Surgery Unit Galeazzi Orthopaedics Institute Milan, Italy MARGHERITINI FABRIZIO University of Motor Sciences Unit of Sports Traumatology. .. and Traumatology Department R Silvestrini Hospital Perugia, Italy LUSTIG SBBASTIEN Centre Livet Service Professeur Philippe Neyret Caluire, France MARIANI PAOLO PIER 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 XVII Contributors... 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 SAILLANT G~RARD Orthopaedic Surgery Service Piti6 Salp&tri&re Hospital Paris, France SANTAITI DANIELE ISpeO Istituto Specialistico Ortopedico Casa di Cura "San Giuseppe"... Medicine and Surgery Karolinska Institutet Stockholm, Sweden TORNESE DAVIDE Center for Sports Rehabilitation Galeazzi Orthopaedics Institute Milan, Italy STEFANO ZAFFAGNINI Rizzoli Orthopaedic Institute Sports Traumatology and XIX Conttibutoa Orthopaedics Division Biomechanics Laboratory Bologna, Italy ZAMARRA GIOVANNI University of Perugia Orthopaedics and Traumatology Department of Perugia R Silvestrini... friendlies) (Table 2), giving a training -to- match ratio of 3.6:1 This ratio itself shows how little time is devoted to preparation as opposed to playing, especially since sessions prior to a match are devoted to the tactics to be adopted rather than to training while those conducted after it are mainly concerned with unwinding It is also defective insofar as it takes into no account the matches in which... such as kicking, jumping, running, cutting, stopping, headers, and the like Biomechanical Analysis of Soccer Biomechanical analysis applied to soccer allows the implementation of studies from basic science to practical application with clear repercussions on performance, prevention, and aetiologic treatment Thanks to biomechanical analysis, it is possible to obtain objective and reproducible data on... Amsterdam The Netherlands RAUL ZINI U.O Ortopedia Azienda Ospedaliera San Salvatore Pesaro, Italy Section I GENERAL CONCEPTS Epidemiology and Risk Factor PIERO VOLPI Introduction Football is the world’s most popular sport According to the International Football Federation (FIFA), there are more than 200 club members in its 203 affiliated nations The Union of European Football Associations (UEFA) has 23 members... publications Many footballers have had to stop playing and undergo medical treatment and surgery followed by rehabilitation periods before being able to resume playing Those who have been able and lucky enough to take part in professional soccer know that a second, or even a tenth of a second, is time enough for the occurrence of an accident that may require days, weeks, or months to put right and which... Netherlands VAN 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 TARTARONE MARIO ISpeO Istituto Specialistico Ortopedico Casa di Cura "San Giuseppe"... injuries in football players Influencing factors Am J Sports Med 28[Suppl 5]:58–68 Hawkins RD, Fuller CW (1999) A prospective epidemiological study of injuries in four English professional football clubs Br J Sports Med 33:196–203 Nielsen AB, Yde G (1989) Epidemiology and traumatology of injuries in soccer Am J Sports Med 17:803–807 Luthje P, Nurmi I, Kataja M et al (1996) Epidemiology and traumatology . Football Traumatology
Current Concepts: from Prevention
to
Treatment
Piero Volpi
(Ed.)
Football
Traumatology
Current Concepts:
from Prevention. accomplish today another wish. To enrich the won-
derful world of football with scientific and specialistic contributions on football
traumatology, a