AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
Lennard Funk
1
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
INCIDENCE
• 2-4% of all injuries
!
• BUT:
– Longest period of time away...
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
EKSTRAND ET AL. BR J SPORTS MED 2009
4
Original article
Table 3 Injury ...
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
PREMIERSHIP SHOULDER INJURIES
• Data courtesy of Health Partners
Europe...
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
INCIDENCE
6
0
10
20
30
40
50
60
70
80
90
100
2006-2007 2007-2008 2008-2...
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
SURGERY
7
!
Mills, Pritchard, Funk, Batty. BJSM. 2011
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
TYPES OF SURGERY
8
!
Mills, Pritchard, Funk, Batty. BJSM. 2011
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
• 25 Professional Footballers
– 15 Field players
– 10 Goalkeepers
9
GOA...
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
INJURY PATTERNS
10
Hart & Funk, KSSTA. 2013
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
FIELD
11
Goalie
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
FINDINGS IN GOALKEEPERS
SHOULDERS
• Poor postural control and position
...
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
Common Injuries
13
6%
81%
16%
12% (outfield)
50% (goalies)
12%
18%
Mill...
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
CLASSIFICATION OF LESIONS
14
Major ‘Minor’
• Bony Bankart!
• ALPSA!
• R...
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
TIMING OF SURGERY
• Early Surgery:
– ‘Major’ lesions
– Late in Season
–...
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
RETURN TO PLAY
• Unrestricted play = 11.4 weeks (3.7 SD)
– Outfield = 1...
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
ROTATOR CUFF TREATMENT
17
Impingement & Bursitis Rehab & Subacromial In...
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
SUMMARY
• Not common, but serious
• Outfield players = Labral injuries
...
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
19
AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
20
Soccer Shoulder - Lennard Funk
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Soccer Shoulder - Lennard Funk

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Shoulder injuries in Soccer - our experience and research.

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Soccer Shoulder - Lennard Funk

  1. 1. AMSTERDAM / THE NETHERLANDS www.esska-congress.org Lennard Funk 1
  2. 2. AMSTERDAM / THE NETHERLANDS www.esska-congress.org INCIDENCE • 2-4% of all injuries ! • BUT: – Longest period of time away from play 3
  3. 3. AMSTERDAM / THE NETHERLANDS www.esska-congress.org EKSTRAND ET AL. BR J SPORTS MED 2009 4 Original article 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/finger/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 0 Injury 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) group.bmj.comon June 21, 2010 - Published bybjsm.bmj.comDownloaded from
  4. 4. AMSTERDAM / THE NETHERLANDS www.esska-congress.org 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
  5. 5. AMSTERDAM / THE NETHERLANDS www.esska-congress.org INCIDENCE 6 0 10 20 30 40 50 60 70 80 90 100 2006-2007 2007-2008 2008-2009 2009-2010 Right Left Mills, Pritchard, Funk, Batty. BJSM. 2011
  6. 6. AMSTERDAM / THE NETHERLANDS www.esska-congress.org SURGERY 7 ! Mills, Pritchard, Funk, Batty. BJSM. 2011
  7. 7. AMSTERDAM / THE NETHERLANDS www.esska-congress.org TYPES OF SURGERY 8 ! Mills, Pritchard, Funk, Batty. BJSM. 2011
  8. 8. AMSTERDAM / THE NETHERLANDS www.esska-congress.org • 25 Professional Footballers – 15 Field players – 10 Goalkeepers 9 GOALKEEPERS 
 VS. OUTFIELD PLAYERS Hart & Funk, KSSTA. 2013
  9. 9. AMSTERDAM / THE NETHERLANDS www.esska-congress.org INJURY PATTERNS 10 Hart & Funk, KSSTA. 2013
  10. 10. AMSTERDAM / THE NETHERLANDS www.esska-congress.org FIELD 11 Goalie
  11. 11. AMSTERDAM / THE NETHERLANDS www.esska-congress.org 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
  12. 12. AMSTERDAM / THE NETHERLANDS www.esska-congress.org Common Injuries 13 6% 81% 16% 12% (outfield) 50% (goalies) 12% 18% Mills, Pritchard, Funk
 ISSM, 2011
  13. 13. AMSTERDAM / THE NETHERLANDS www.esska-congress.org CLASSIFICATION OF LESIONS 14 Major ‘Minor’ • Bony Bankart! • ALPSA! • Rotator Cuff Tear! • HAGL! • Undisplaced Labral Tear! • Partial Cuff Tear!
  14. 14. AMSTERDAM / THE NETHERLANDS www.esska-congress.org TIMING OF SURGERY • Early Surgery: – ‘Major’ lesions – Late in Season – Unable to Return • Rehab & Return: – ‘Minor’ lesions – Early season 15
  15. 15. AMSTERDAM / THE NETHERLANDS www.esska-congress.org 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
  16. 16. AMSTERDAM / THE NETHERLANDS www.esska-congress.org 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
  17. 17. AMSTERDAM / THE NETHERLANDS www.esska-congress.org SUMMARY • Not common, but serious • Outfield players = Labral injuries • Goalkeepers = cuff pathology • MR Arthrogram investigation of choice • Arthroscopic surgery • Sports specific rehabilitation 18
  18. 18. AMSTERDAM / THE NETHERLANDS www.esska-congress.org 19
  19. 19. AMSTERDAM / THE NETHERLANDS www.esska-congress.org 20

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