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How to Manage Sports Injuries?

Adriano Vretaros
Strength and Conditioning Coach
2018
So Paulo BRAZIL
avretaros@gmail.com
How to Manage Sports Injuries?
What are Sports Injuries?

A sports injury can be dened as an injury


that occurs during sporting activi-ties or
exercise.
(Rolf, 2007)
How to Manage Sports Injuries?
Types of Sports Injuries - I

Adapted from Marujo, 2014

- Contact and Non-Contact

- Acute and Chronic

- Fatigue, muscle
- Intrinsic
imbalances, etc.

- Equipment, playing field,


- Extrinsic environment, etc.
How to Manage Sports Injuries?
Types of Sports Injuries - II

IMPORTANT ASPECTS:

- Athlete Level
- Type of Sport
- Location
- Biomechanical Mechanism
- Symptoms
- Clinical Tests and Exams
- Diagnosis
- Relevant Research
- Treatment
- Evaluation of Treatment
- Return to Training
- Return to Play
How to Manage Sports Injuries?
Professionals Involved in Management

Sports Physician
- Assessment
- Indication of
Treatment Strength and
Conditioning
Sports Coach
Physiotherapist - Specific Training
- Rehabilitation - Prevention of
Injuries
Health - End Stage of
Professionals Rehabilitation
- Physiologist - Return to Play
- Masseur
- Chiropractic
- Podiatrist
- Nutritionist
- And Other
How to Manage Sports Injuries?
The Scientific Staff Work

Multidisciplinary
Team

Interdisciplinary
Team

Transdisciplinary
Team
How to Manage Sports Injuries?
Injury Management Platforms

CORRECTIVE
Plataform

PREVENTIVE
Platform

PREDICTIVE
Platform
How to Manage Sports Injuries?
Corrective Platform - I

** CYCLE INJURY-CORRECTION **
How to Manage Sports Injuries?
Corrective Platform - II

1) URGENT When the severity of the


injury involves the athlete
CORRECTIVE IMMEDIATE clearance to
PLATFORM: reach a DEFINITIVE
SOLUTION.

When the injury to the


athlete undergoes
2) PROGRAMMED PERIODIC treatment and/or
CORRECTIVE a surgical intervention is
PLATFORM: decided in the MEDIUM or
LONG TERM.
How to Manage Sports Injuries?
Preventive Platform - I

SMART
TRAINING
(Boyle, 2015)

SPORTS PREVENT
PERFORMANCE INJURIES
How to Manage Sports Injuries?
Preventive Platform - II

EVALUATION TOOLS for Injury


Prevention:

- Functional Movement Screen


- Y-Balance Test
- Star Excursion Balance Test
- Isokinetic Evaluation
- Global Postural Assessment
- Unilateral Vertical Jump Test
- Unilateral Horizontal Jump Test
- And Other
How to Manage Sports Injuries?
Preventive Platform - III

Training Loads
(internal and external)
(Adapted from Gabbett, 2016)

Dose-response of loads

Weekly load
Loading Thresholds increases
(up to 10%)

Relationship Between ~ 0,6-1,3


Acute-Chronic Load
High Risk Area would be
above or equal to 1.5
How to Manage Sports Injuries?
Preventive Platform - IV

Training Loads
(internal and external)
(Adapted from Gabbett, 2016)

Train "strong" INJURIES


inappropriately

EFFECT
Train "strong" NATURAL
appropriate PROTECTIVE
How to Manage Sports Injuries?
Preventive Platform - V

ACTION PLAN
(Adapted from Parkkari, Kujala & Kannus, 2001)

VARIABLES:
- Number SET UP:
- Incidence a) Etiology
- Temporal Tendency b) Risk factors
- Consequences c) Injury Mechanisms
(deficiencies, disabilities and
costs)

Evaluate EFFECTIVENESS and Preventive


COST of Preventive Action Program
How to Manage Sports Injuries?
Preventive Platform - VI

RECOVERY RESOURCES:
(Bompa & Haff, 2012)

- Cryotherapy
- Compressive Clothing
- Massage
- Hydrotherapy
- Hydration
- Nutrition
- Sleep
- Etc
How to Manage Sports Injuries?
Predictive Platform - I

*** What is
PREDICTION? ***

Affirm With CONVICTION What


May Happen in the FUTURE "
How to Manage Sports Injuries?
Predictive Platform - II

Empiricists

Rationalists
How to Manage Sports Injuries?
Predictive Platform - III

EXPLICIT TACIT
Knowledge Knowledge

- Declarative Information
- Perceptual Skills
- Routines
- Pattern Matching
- Procedures
- Workarounds
- Protocols
- Judging (?)
- Mathematical Expressions
- Mental Models
-Others
- Insights
- And (???)
How to Manage Sports Injuries?
Predictive Platform - IV

MANIPULATE

GREAT RANDOMNESS
UNCERTAINTY
How to Manage Sports Injuries?
Predictive Platform - V

HOW TO ACT?

UNFORGETTABLE
CONTINGENCIES

THINK
DIFFERENT

MENTALITY OUTSIDE THE


CURVE
How to Manage Sports Injuries?
Predictive Platform - IV
VI

THREE THEORIES:

3) Logarithmic
1) Heuristic
Engineering
Methodology
2) Black Swan
Logic
How to Manage Sports Injuries?
Predictive Platform - VII
HEURISTIC METHODOLOGY
(Gingerenzer & Gaissmaier, 2011)

"Serve to Discover"

FASTER You IGNORE Some of


Decision Making the Information

There Are NO RIGID


RULES of Direction to
Discoveries WITHOUT
Seek Solutions Statistical Calculations of
a Higher Level of
Complexity
INTUITIVE FILTER
for Analysis ECOLOGICAL
RATIONALITY
How to Manage Sports Injuries?
Predictive Platform - VIII

HEURISTIC Focused on the


Sporting Environment
(Adapted from Jovanovic, 2017)

ASSURANCE RISK
Predictable
Knowledge
Results

UNCERTAINTY
Unpredictable
Results
How to Manage Sports Injuries?
Predictive Platform - IX

BLACK SWAN LOGIC


(Adapted from Taleb, 2015)

CAUSAL
ANTI- CHAINS
KNOWLEDGE

Forecast
ERRORS of RANDOM
Magnitude Often EVENTS
NOT SCALED
How to Manage Sports Injuries?
Predictive Platform - X
BLACK SWAN LOGIC
(Adapted from Taleb, 2015)

DECREASE the
Probability of Surprises:

1) Illusion of the 3) Overvaluation


Understanding of Factual
Information
2) Retrospective
Distortion
How to Manage Sports Injuries?
Predictive Platform - XI

THOUGHT:
(Taleb, 2015)

Non-linear ILLOGICAL
SPECULATIONS Real-life
Problems
How to Manage Sports Injuries?
Predictive Platform - XII

LOGARITHMIC ENGINEERING:

PREDICTION ARTIFICIAL
MODEL INTELLIGENCE
(Douetteau, 2017) (Cruz, 2010)

Decision Tree Neural Networks


Linear Regression
Random Forest
Logistic Regression
Gradient Boosting
How to Manage Sports Injuries?
Predictive Platform - XIII
LOGARITHMIC ENGINEERING:

POLYNOMIAL CURVES
TABLE (R = 0.53)
(Blanch & Gabbett, 2016)

Create a SPECIFIC logarithmic


BY SPORT

RECURRENCE of the same injury

NEW INJURY UNKNOWN RISK


How to Manage Sports Injuries?
Predictive Platform - XIV

JUNCTION OF THREE THEORIES

Heuristic
Methodology
+ Logarithmic
Engineering + Black Swan
Logic

Complexity
MULTIFACTORIAL
How to Manage Sports Injuries?
Predictive Platform - XV

1) Heuristic 2) Logarithmic
Methodology Engineering

3) Black Swan
Logic

FORMULATE
Hypotheses
and
Probabilities

PREDICT Sports
Injuries
How to Manage Sports Injuries?
Sports Injury Management

CORRECTIVE PREVENTIVE PREDITIVE


Platform Plataform Platform

Secondary PRIMARY Primary Resource


and/or Tertiary Resource COMPLEMENTARY
Resource to the preventive
platform

Only employed in Try to solve possible Speculate through


typical emergency variables in a way conventional and
situations or specific that prevents the unconventional
cases such as onset and information and to
congenital injuries, recurrence of the anticipate situations
etc. injury. randomly.