Soccer Shoulder - Lennard Funk

AMSTERDAM / THE NETHERLANDS

www.esska-congress.org

Lennard Funk

1



INCIDENCE

• 2-4% of all injuries !

• BUT: – Longest period of time away from

play

3



EKSTRAND ET AL. BR J SPORTS MED 2009

4

Original article

Ekstrand J , Hägglund M , Waldén M . Br J Sports Med (2009). doi:10.1136/bjsm.2009.0605824 of 6

elite team with 25 players in the squad can expect about 50 injuries each season, half of them minor and causing absences of less than a week, but as many as eight or nine severe and causing absences of >4 weeks. Hamstring strain was the most common diagnosis, which is in accordance

with fi ndings in other studies carried out at elite level using the consensus study design. A typical 25-player squad can thus expect about seven hamstring strains each season. It can be speculated that the high risk of hamstring strain refl ects the high intensity of modern professional football.

Figure 1 Distribution of traumatic injuries during a match (data from the 2006/07 and 2007/08 seasons).

Figure 2 Distribution of traumatic and overuse injuries over the football season.

Table 3 Injury pattern by severity of injuries Total 1–3 Days 4–7 Days 8–28 Days >28 days

Injury location Head and neck 77 (2) 19 (2) 23 (2) 29 (2) 6 Neck/cervical spine 23 11 (1) 8 3 1 Shoulder/clavicula 80 (2) 12 (1) 16 (1) 30 (2) 22 (3) Upper arm 3 1 2 0 0 Elbow 24 3 10 8 3 Forearm 5 1 0 2 2 Wrist 8 1 1 4 2 Hand/fi nger/thumb 38 8 6 16 8 Sternum/ribs/upper back 47 (1) 9 16 (1) 19 (1) 3 Abdomen 31 3 7 17 (1) 4 Lower back/pelvis 237 (5) 74 (8) 78 (7) 66 (4) 19 (3) Hip/groin 616 (14) 119 (12) 169 (15) 256 (16) 72 (10) Thigh 1064 (23) 184 (19) 272 (23) 469 (28) 139 (20) Knee 818 (18) 183 (19) 155 (13) 268 (16) 212 (30) Lower leg/Achilles tendon 511 (11) 116 (12) 132 (11) 178 (11) 85 (12) Ankle 625 (14) 150 (15) 185 (16) 220 (13) 70 (10) Foot/toe 268 (6) 75 (8) 81 (7) 63 (4) 49 (7) Unknown 8 2 3 3 0Injury type Fracture 160 (4) 7 9 59 (4) 85 (12) Other bone injury 26 5 1 6 14 (2) Dislocation/subluxation 50 (1) 5 4 24 (1) 17 (2) Sprain/ligament injury 828 (18) 123 (13) 197 (17) 334 (20) 174 (25) Meniscus/cartilage 124 (3) 3 7 41 (2) 73 (10) Muscle injury/strain 1581 (35) 212 (22) 397 (34) 765 (46) 207 (30) Tendon injury 327 (7) 95 (10) 71 (6) 101 (6) 60 (9) Haematoma/contusion 744 (17) 306 (32) 282 (24) 141 (9) 15 (2) Abrasion 7 3 3 1 0 Laceration 31 10 (1) 11 10 0 Concussion 34 5 14 (1) 14 1 Nerve injury 29 7 3 14 5 Synovitis/effusion 158 (4) 55 (6) 36 (3) 55 (3) 12 (2) Overuse complaints 285 (6) 110 (11) 99 (9) 59 (4) 17 (2) Other type 91 (2) 23 (2) 27 (2) 24 (1) 17 (2)Total injuries 4483 971 1164 1651 697

Values within brackets show percentage of total (values below 1% not shown).

bjsports60582.indd 4bjsports60582.indd 4 5/26/2010 11:48:03 AM5/26/2010 11:48:03 AM

group.bmj.com on June 21, 2010 - Published by bjsm.bmj.comDownloaded from



PREMIERSHIP SHOULDER INJURIES

• Data courtesy of Health Partners Europe

• Anonymous !!

• Jan 2007 - Jan 2010 • 35,000 claimed injuries • 3.3% Shoulders

5

Mills, Pritchard, Funk, Batty. BJSM. 2011



INCIDENCE

6

0

10

20

30

40

50

60

70

80

90

100

2006-2007 2007-2008 2008-2009 2009-2010

Right Left




SURGERY

7

!




TYPES OF SURGERY

8

!




• 25 Professional Footballers – 15 Field players – 10 Goalkeepers

9

GOALKEEPERS VS. OUTFIELD PLAYERS Hart & Funk, KSSTA. 2013



INJURY PATTERNS

10

Hart & Funk, KSSTA. 2013



FIELD

11

Goalie



FINDINGS IN GOALKEEPERS SHOULDERS

• Poor postural control and position

• Abdominal

• Pelvis

• Scapula thoracic

• Poor recruitment of posterior cuff

• Problems with thoracic and

costo-vertebral joints

12

Tatlow & Funk, 2008



Common Injuries

13

6%

81%

16%

12% (outfield) 50% (goalies)

12%

18%

Mills, Pritchard, FunkISSM, 2011



CLASSIFICATION OF LESIONS

14

Major ‘Minor’

• Bony Bankart!

• ALPSA!

• Rotator Cuff Tear!

• HAGL!

• Undisplaced Labral Tear!

• Partial Cuff Tear!



TIMING OF SURGERY

• Early Surgery:

– ‘Major’ lesions

– Late in Season

– Unable to Return

• Rehab & Return:

– ‘Minor’ lesions

– Early season

15



RETURN TO PLAY

• Unrestricted play = 11.4 weeks (3.7 SD) – Outfield = 11.6 wks (4.1 SD) – Goalies = 11.1 wks (3.2 SD)

16

Hart & Funk, KSSTA. 2013



ROTATOR CUFF TREATMENT

17

Impingement & Bursitis Rehab & Subacromial Injection

Partial Cuff Tears Platelet Rich Plasma Injection / Arthroscopic debridement or repair

Full Thickness Tear Arthroscopic Repair



SUMMARY

• Not common, but serious

• Outfield players = Labral injuries

• Goalkeepers = cuff pathology

• MR Arthrogram investigation of choice

• Arthroscopic surgery

• Sports specific rehabilitation

18


www.esska-congress.org19


www.esska-congress.org20

Soccer Shoulder - Lennard Funk

Health & Medicine

Transcript of Soccer Shoulder - Lennard Funk