Table Of ContentJoão Espregueira-Mendes
Editor-in-Chief
C. Niek van Dijk · Philippe Neyret
Moises Cohen · Stefano Della Villa
Helder Pereira · J. Miguel Oliveira
Editors
Injuries and
Health Problems
in Football
What Everyone Should Know
Injuries and Health Problems in Football
Editor-in-Chief
João Espregueira-Mendes
Editors
C. Niek van Dijk • Philippe Neyret
Moises Cohen • Stefano Della Villa
Helder Pereira • J. Miguel Oliveira
Injuries and Health
Problems in Football
What Everyone Should Know
Editor-in-Chief Moises Cohen
João Espregueira-Mendes Department of Orthopedics & Traumatology
Clínica do Dragão, Espregueira-Mendes Federal University of São Paulo
Sports Centre - FIFA Medical Centre of Vila Clementino - São Paulo
Excellence Brazil
Porto
Portugal Stefano Della Villa
Isokinetic Medical Group
Dom Henrique Research Centre
FIFA Medical Centre of Excellence
Porto
Bologna
Portugal
Italy
3B’s Research Group–Biomaterials,
Biodegradables and Biomimetics, Helder Pereira
University of Minho, Headquarters of the 3B’s Research Group–Biomaterials,
European Institute of Excellence on Biodegradables and Biomimetics,
Tissue Engineering and Regenerative University of Minho, Headquarters of the
Medicine, AvePark, Parque de Ciência European Institute of Excellence on Tissue
e Tecnologia, Zona Industrial da Gandra Engineering and Regenerative Medicine,
Barco, Guimarães AvePark, Parque de Ciência e Tecnologia,
Portugal Zona Industrial da Gandra
Barco, Guimarães
ICVS/3B’s–PT Government Associate
Portugal
Laboratory
Braga/Guimarães ICVS/3B’s–PT Government Associate
Portugal Laboratory
Braga/Guimarães
Orthopaedics Department of Minho
Portugal
University
Minho
J. Miguel Oliveira
Portugal
3B’s Research Group–Biomaterials,
Biodegradables and Biomimetics,
Editors
University of Minho, Headquarters of the
C. Niek van Dijk
European Institute of Excellence on Tissue
Department of Orthopaedic Surgery
Engineering and Regenerative Medicine,
Academic Medical Centre
AvePark, Parque de Ciência e Tecnologia,
Amsterdam Zuidoost
Zona Industrial da Gandra
Noord-Holland
Barco, Guimarães
The Netherlands
Portugal
Philippe Neyret ICVS/3B’s–PT Government Associate
Hopital de la Croix-Rousse Laboratory
University of Lyon 1 Hopital de la Braga/Guimarães
Croix-Rousse Portugal
Lyon
France
ISBN 978-3-662-53923-1 ISBN 978-3-662-53924-8 (eBook)
DOI 10.1007/978-3-662-53924-8
Library of Congress Control Number: 2017938163
© ISAKOS 2017
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Foreword
Not so long ago, the medical world was not interested in the world of sport,
although there were some exceptions, like the well-known Galenus, who was
also, besides his other duties, the doctor of the Roman gladiators.
Sport medicine, related to football, was limited to one single question:
“Can he play next Sunday?”
Indeed, the relation between medicine and sport only concerned the treat-
ment of lesions.
Times changed: progressively, sports medicine received more attention,
essentially due to the worldwide development of sport itself, becoming one of
the most important social surroundings for young people.
This resulted in general principles, valuable for the global world of sport.
There was, however, no differentiation: the medical approach concerned,
without specification, all sports disciplines.
Later, times changed again: the specificity of each sport discipline resulted
in sports-medical challenges, completely different from one discipline to
another.
Even in the same discipline, differences became evident and led to impor-
tant medical repercussions.
One of the most important specific approaches concerned football medi-
cine: indeed, football, today, is played in every country of the world, and
brings together, under the worldwide umbrella of FIFA, some 300 million
football players.
This gives us, football doctors, an important place in the contemporary
society. It also gives us, however, an important responsibility.
That is why I enthusiastically support the edition of this ISAKOS – book
about injuries and health problems in football.
This book is, naturally, essentially focused on locomotoric problems, but
it also concerns other aspects of football medicine, essentially cardiologic,
nutritional and respiratory aspects.
It follows the different steps in the medical guidance of football medicine,
from prevention to diagnosis, conservative and surgical therapy, rehabilita-
tion and, finally, “return to play”.
This is not the end of the story. Like so many other aspects in our human
society, the medicine of football will be influenced, and directed tomorrow,
by the “BINC” revolution: Biophysiology, Biotechnology, Informatics and
artificial Intelligence, Nanotechnology and Cognitive sciences.
v
vi Foreword
The techniques of diagnosis and therapy will change. What must remain is
our constant care for the health and the physical condition of the young foot-
ball players.
Football doctors must never forget
that football is a game before being a product,
that football is a sport before being a market,
that football is a spectacle before being a business.
Baron Dr Michel D’Hooghe
Chairman of the Medical Commission of FIFA and UEFA
Preface
Medical education is a noble mission, where basic sciences together with
medical skills, innovations, and applied technology compete to improve the
quality of life and performance of sports practitioners.
Football is the world’s number one sport, played by 300 million men and
women, including referees and officials. It is interesting that 69.6% of regis-
tered female and 54.7% of registered male players are young, which shows
that FIFA and its member associations are on track toward enhancing the
popularity of this sport further in the future.
This new publication on football medicine is dedicated to all those who
love football and presents insights into the most frequent problems in the
sport and some of the hot topics in a friendly, clear, and practical way. In
injuries and health problems in football – what everyone should know,
we sought to provide an update on the state of the art. To achieve this goal, we
gathered valuable contributions from some of renowned experts in the field,
selected from FIFA, UEFA, ISAKOS, and ESSKA.
We used our experience to put together a team that could contribute to the
leverage of education in this field, providing knowledge of high- performance
skills, offering guidance on the current rules for best practice, and ensuring
high standards in football medicine with regard to prevention, diagnosis, con-
servative and surgical treatment, complications, time and criteria for return to
sports, and prognosis. We are now entering the era of biologics, tissue engi-
neering, and a molecular understanding of healing, and starting to leave the
gray area of experimental therapies behind in favor of evidence-b ased
treatments.
In the subsequent pages of this book, the reader will become acquainted
with a generous amount of cognitive knowledge, conveying a comprehensive
resource for understanding the most frequent problems in football medicine.
Talented and passionate authors in sports medicine bring science to you. We
hope you will join us on this priceless mission.
“I hear and I forget. I see and I remember. I do and I understand” Confucius,
551–479 BC.
Thank you so much to all the contributors. It is an honor, a privilege, and
a great pleasure to share with you this exciting challenge.
João Espregueira-Mendes
vii
Contents
Part I The Athlete in the Field
1 The Relevance of Medicine in Football . . . . . . . . . . . . . . . . . . . . . . 3
José Ferraz, José Pereira, Jacques Menetrey, and Paulo Lobo
2 Epidemiology: The Most Frequent Lesions . . . . . . . . . . . . . . . . . . 5
Henrique Jones, Pedro Cantista, and Matteo Denti
3 Teamwork in Football/Bringing Science to the Pitch . . . . . . . . . 13
José Neto
4 The Field Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Rodolfo Moura
5 How to Examine an Athlete on the Field:
What You Should Not Miss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Frederico Varandas, Nuno Oliveira, João Pedro Araújo,
Paulo Beckert, and Paco Biosca
6 Principles of Rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
João Pedro Araújo, Isabel Lopes, Filipe Guimarães,
and Vítor Moreira
Part II Anatomy, Biomechanics and Imaging
7 Basics on Knee (dys)Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Rogério Pereira, Ricardo Vidal, Ana Leal,
and Maria Amélia Ferreira
8 Biomechanics of Lower Limb Injuries . . . . . . . . . . . . . . . . . . . . . 53
Manuel Vieira da Silva and Bruno Pereira
9 Imaging in Football Lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Sérgio Rodrigues-Gomes, José Carlos Vasconcelos,
Pedro Portugal, Rui Aguiar, Abdalla Skaf, and Nuno Sousa
Part III Ankle and Foot Injuries
10 Injury of Ankle Ligaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Renato Andrade, Hélder Pereira, João Paulo Vilas- Boas,
João Espregueira-Mendes, and C. Niek van Dijk
ix
x Contents
11 Osteochondral Ankle Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Ricardo Telles Freitas, Hélder Pereira, John Kennedy,
and C. Niek Van Dijk
12 Ankle and Foot Fractures and Dislocations . . . . . . . . . . . . . . . . 113
Marta Massada, Gino Kerkoffs, and Paulo Amado
13 Football Ankle Fractures and Return to Sport:
A Review on the Arthroscopic Approach . . . . . . . . . . . . . . . . . . 129
Pieter d’Hooghe, Hélder Pereira, and Stefano Zaffagnini
Part IV Knee Injuries
14 Meniscal Lesions: From Basic Science to Clinical
Management in Footballers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Ibrahim Fatih Cengiz, Hélder Pereira, Joana Silva- Correia,
Pedro L. Ripoll, João Espregueira- Mendes,
Rodrigo Kaz, J. Miguel Oliveira,
and Rui Luís Reis
15 Injury of Knee Ligaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Frantzeska Zampeli, Anastasios Georgoulis,
Freddie Fu, Romain Seil, Jim-Dimitris Georgoulis,
and João Espregueira-Mendes
16 Patellofemoral Pain and Instability . . . . . . . . . . . . . . . . . . . . . . . 177
Ana Leal, Paulo Flores, Filipe Silva, Elizabeth
Arendt, Philippe Neyret, and João Espregueira-Mendes
17 Osteochondritis Dissecans of the Knee
in Football Players . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Alberto Gobbi, João Espregueira-Mendes,
Mustafa Karahan, Moisés Cohen, and Graeme P. Whyte
18 Knee and Tibial Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Luís Silva, Ricardo Varatojo, Camila Cohen,
and Philippe Neyret
Part V Hip, Groin and Tigh Injuries
19 Groin Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217
Nuno Loureiro, João Pedro Araújo, Luís Simões,
and Marco Fonseca
20 Femoroacetabular Impingement . . . . . . . . . . . . . . . . . . . . . . . . . 227
André Sarmento, J. Cruz de Melo, Alberto Monteiro,
and Pieter D’Hooghe
21 Femur Fractures � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 243
Eurico Bandeira-Rodrigues, Sebastiano Vasta,
José Carlos Leitão, and Joan Carles Monllau
Contents xi
Part VI Spine and Head Conditions
22 First Aid and Cares in Spine Trauma . . . . . . . . . . . . . . . . . . . . . 259
Luís Silva, J.M. Pinto de Freitas, and Jorge Mineiro
23 Low Back Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Rui Rocha, Ana Margarida Fernandes,
and António Oliveira
24 Brain Concussion in Football . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
Basil Ribeiro and Bruno Carvalho
25 Face Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295
Rui Pratas and Victor Hugo
26 Ophthalmic Lesions in Football . . . . . . . . . . . . . . . . . . . . . . . . . . 299
Luís Torrão
27 ColorADD: Color Identification System
for Color-Blind People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
Miguel Neiva
Part VII Upper Limb Injuries
28 Acute Fractures of the Upper Limb . . . . . . . . . . . . . . . . . . . . . . 317
Carina Cohen, Horácio Sousa, Nuno Sevivas,
and Guillermo Arce
29 Traumatic Lesions of the Elbow and Wrist . . . . . . . . . . . . . . . . 329
Ricardo Bastos, Miguel Trigueiros, Nuno Sevivas,
and Luigi Pederzini
30 Shoulder Instability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335
Nuno Gomes, Nuno Sevivas, Pietro Randelli,
and Marc Safran
31 Overuse Injuries of the Goalkeeper . . . . . . . . . . . . . . . . . . . . . . 353
Nuno Sevivas, Mustafa Karahan, Carlos Vilela,
and António Cartucho
Part VIII Muscle Injuries in the Lower Limb
32 Epidemiology, Risk Factors, and Prevention . . . . . . . . . . . . . . . 365
Paulo Barreira, João Pedro Araújo, Ruben Ferreira,
and Nuno Loureiro
33 Muscle Injury Classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . 375
Xavier Valle, Johannes L. Tol, Bruce Hamilton,
and Ricard Pruna
34 Diagnosis and Management of Muscle Injuries . . . . . . . . . . . . . 381
Ricard Pruna and Matilda Lundblad
