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  1. Youth Soccer Injury Prevention Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD

  2. Youth Soccer Injury Prevention Anthony Beutler, MD Major, USAF, MC Department of Family Medicine, USU

  3. Overview Objective The Spectrum of Soccer Injuries Are Soccer Injuries a Problem? What We “Know” About Injury Prevention What’s Next in Injury Prevention Encourage You to Stay-Tuned & Stay Involved

  4. Your Chance to be Sports Doc

  5. How About This One?

  6. Overview The Spectrum of Soccer Injuries Are Soccer Injuries a Problem? What We “Know” About Injury Prevention What’s Next in Injury Prevention

  7. Fast Facts About:Youth Sports Injuries • Account for 42% of medically attended injuries in children • More than transportation-related accidents • 3.7 million ER visits • 7 million doctor visits • 20% of children miss at least 1 school day per year due to sports related injury Lower Extremity Injuries=70%

  8. Common & Severe:ACL (Anterior Cruciate Ligament) Tear • Greatest risk in High School and College • Higher % risk in girls • Higher # of injuries in boys

  9. Bad News Gets Worse:Long-term Effects of ACL Tear • Surgery • 6 to 36 month rehabilitation • 77% sports disability within 5 years • 44% disability with daily living in 5 years

  10. Prevention is Key!! Bad News Gets Worse:Long-term Effects of ACL Tear • Surgery • 6 to 36 month rehabilitation • 77% sports disability within 5 years • 44% disability with daily living in 5 years • Arthritis Risk: • No Surgery: >90% in 20 years • “Good” Surgery: >90% in 20 years

  11. Overview The Spectrum of Soccer Injuries Are Soccer Injuries a Problem? What We “Know” About Injury Prevention What’s Next in Injury Prevention

  12. Looking at the Man in the Mirror:What to Change? • Rules? • Braces? • Fields/Cleats? • Changing You!

  13. Human Movement Change:What we “Know” about Injury Prevention • Mandelbaum - 2005 • 80% decrease in ACL Injury • 14-18 yo female soccer players • 30 minute exercise program before pract/game • Non-randomized

  14. Human Movement Change:What we “Know” about Injury Prevention • Mandelbaum - 2005 • 80% decrease in ACL Injury • Myklebust - 2003 • Decreased ACL injury in “elite” handball athletes

  15. Human Movement Change:What we “Know” about Injury Prevention • Mandelbaum - 2005 • 80% decrease in ACL Injury • Myklebust - 2003 • Decreased ACL injury in “elite” handball athletes • Olsen - 2005 • 50% decrease leg injuries (?ACL) • 14-18 yo male & female handball players • 20 minute program before practice & game

  16. Human Movement Change:What we “Know” about Injury Prevention • Mandelbaum - 2005 • 80% decrease in ACL Injury • Myklebust - 2003 • Decreased ACL injury in “elite” handball athletes • Olsen - 2005 • 50% decrease leg injuries (?ACL) • 14-18 yo male & female handball players • 20 minute program before practice & game • Pfieffer - 2006 • No Change in Injury • Female High School Soccer, Basketball, and Volleyball Athletes

  17. Landing/moving “stiff” Decreased trunk, hip, and knee flexion Large ground reaction forces Excessive frontal plane motion Knee valgus Tibial rotation Multifactorial Human Movement Change:Risk Factors for ACL Injury

  18. Overview The Spectrum of Soccer Injuries Are Soccer Injuries a Problem? What We “Know” About Injury Prevention What’s Next in Injury Prevention

  19. Future of Injury Prevention:What’s Going on Now? • 20 Teams from North Carolina - TUSA • Triangle United Soccer, Chapel Hill • 20 Teams from Maryland - MSI & NCSL

  20. Preseason • Movement Assessment • Jump Landing • Two Legged Squats • One Legged Squats

  21. In-season • Exercise “Warm-Up” Program • Tailored Program • Generalized Program • Placebo (Mouthguard) Program Injury Monitoring

  22. Postseason • Post-Season Assessment • Improvement overall score • Improvement individual deficits • Not just injury prevention - but injury screening

  23. Future of Injury Prevention:Why Injury Screening? • Post-Season • Pre-Season

  24. Future of Injury Prevention:What Have We Learned? • Post-Season scores are better than Pre-Season scores • Gains mostly retained between Spring & Fall seasons

  25. Future of Injury Prevention:What Have We Learned? • Post-Season scores are better than Pre-Season scores • Gains mostly retained between Spring & Fall seasons What Would We Still Like to Know? • Does tailored program prevent more injuries? • What biomechanics are associated with fewer ACL injuries? • How often, how long, how long between?

  26. Can We Prevent All Injuries?

  27. Overview Objective The Spectrum of Soccer Injuries Are Soccer Injuries a Problem? What We “Know” About Injury Prevention What’s Next in Injury Prevention Encourage You to Stay-Tuned & Stay Involved

  28. Questions? Youth SoccerInjury Prevention Anthony Beutler, MD abeutler@usuhs.mil Chief, Injury Prevention Research Lab Uniformed Services University Lindsay DiStefano, MA, ATC Doctoral Student Sports Medicine Research Laboratory Michelle Boling, MS, ATC Doctoral Student Sports Medicine Research Laboratory In collaboration with: Darin Padua, Ph.D, ATC Associate Director Sports Medicine Research Laboratory Steve Marshall, Ph.D Associate Professor Injury Prevention Research Center University of North Carolina, Chapel Hill