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
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 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