Shoulder injuries in Soccer - our experience and research.

1. AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
Lennard Funk
1

3. AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
INCIDENCE
• 2-4% of all injuries
!
• BUT:
– Longest period of time away from
play
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4. 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

5. 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

6. 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

7. AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
SURGERY
7
!
Mills, Pritchard, Funk, Batty. BJSM. 2011

8. AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
TYPES OF SURGERY
8
!
Mills, Pritchard, Funk, Batty. BJSM. 2011

9. AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
• 25 Professional Footballers
– 15 Field players
– 10 Goalkeepers
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GOALKEEPERS
VS. OUTFIELD PLAYERS Hart & Funk, KSSTA. 2013

10. AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
INJURY PATTERNS
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Hart & Funk, KSSTA. 2013

11. AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
FIELD
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Goalie

12. 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
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Tatlow & Funk, 2008

13. AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
Common Injuries
13
6%
81%
16%
12% (outfield)
50% (goalies)
12%
18%
Mills, Pritchard, Funk
ISSM, 2011

14. AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
CLASSIFICATION OF LESIONS
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Major ‘Minor’
• Bony Bankart!
• ALPSA!
• Rotator Cuff Tear!
• HAGL!
• Undisplaced Labral Tear!
• Partial Cuff Tear!

15. 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

16. 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)
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Hart & Funk, KSSTA. 2013

17. AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
ROTATOR CUFF TREATMENT
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Impingement & Bursitis Rehab & Subacromial Injection
Partial Cuff Tears Platelet Rich Plasma Injection /
Arthroscopic debridement or
repair
Full Thickness Tear Arthroscopic Repair

18. 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
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19. AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
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20. AMSTERDAM / THE NETHERLANDS
www.esska-congress.org
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