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4th IOC Advanced Team Physician CourseOslo, Norway • May 30–June 1, 2012
Organized by the Oslo Sports Trauma Research Center and Olympiatoppen, the Norwegian Olympic Training Center
WELCOME
The Organising Committee for 2012 IOC Advanced Team Physician Course (ATPC) is very pleased to welcome our experienced faculty and delegates to the 4th Course in Soria Moria, Oslo.
This is the second time we have hosted this event in Norway. The first Advanced TeamPhysician Course took place in Svolvær in 2008, organised by the Oslo Sports TraumaResearch Centre. Last year’s IOC ATPC, held in Calvi, Corsica, was a great success andgave us the inspiration to continue developing the ATPC concept for it to become evenmore valuable for experienced team physicians and a select group of physical therapists.
This year, we have sharpened the programme with pre-prepared cases to be presentedand discussed. The aim is to foster good discussions and interaction among allparticipants.
We will have some time for informal social interaction, and we hope that each one of youwill take the opportunity to build a true international network with experienced colleagues.There are many situations in which the benefit of consulting a colleague with perspectivesand practical experiences other than your own could be very valuable. Do take advantageof this opportunity during the IOC ATPC.
A warm welcome to Soria Moria, Oslo.
Fredrik S. Bendiksen, MDChairman - Organizing Committee
Roald Bahr, MD,PhDChairman - Program Committee
Fredrik S.Bendiksen, MD
Roald Bahr,MD, PhD
IOC ATPC 2012 PROGRAM � 3
UEMS
European accreditation for the
4th IOC Advanced Team Physician Course(Oslo, Norway, 30.05.-1.06.2012)Event code: 7499
has been granted with 15 European CME credits (ECMEC) by the Eu-ropean Accreditation Council for Continuing Medical Education(EACCME).
4 � IOC ATPC 2012 PROGRAM
Program-at-a-glanceTUESDAY MAY 29th WEDNESDAY MAY 30th
08.00
08.30 Welcome
09.00 Session 1: Working as a team physician – challenges & strategies
09.45
10.00 Arrival & Registration
10.15
10.30 Coffee break
11.00 Session 2: Working as a team physician – pearls and pitfalls
11.45
12.00
12.30 LUNCH
13.00
13.30 Session 3: Managing concussions in a team setting
14.30
15.00 Coffee break
15.30 Session 4: The groin/hip enigma in sports
17.00 Session 5: Managing the overhead throwing athlete
19.00 DINNER (Soria Moria hotel & Holmenkollen ski jump)
20.00 WELCOME DINNER Soria Moria hotel
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This will be a team physician course geared towards the practical issues of work-ing with high-level athletes in a team sports setting! We will learn from the best!We will address controversial topics where agreement may not exist and newevidence on diagnosis and treatment. We will challenge existing dogma. Uponarrival in Oslo, participants will receive cases illustrating specific scenarios, whichwe will address through small-group discussions, plenary lectures and panel discussions.
Course vision
IOC ATPC 2012 PROGRAM � 5
THURSDAY MAY 31st FRIDAY JUNE 1st
Session 10: Pharmacological treatment 08.00of common sports injuries
Session 6: The underperforming athlete: 08.30causes and management
09.00
Coffee break 09.45
Coffee break 10.00
Session 11: The hamstring problem in sports 10.15
Session 7: Managing the overhead 10.30throwing athlete: elbow
11.00
Coffee break 11.45
LUNCH Session 12: Return to sport: 12.00How do we make the best medical decisions?
12.30
Session 8: Protecting health and preventing 13.00illness in athletes
LUNCH – Departure from hotel 13.30
Coffee break – Transfer to Oslo airport 14.30
Session 9: Novel approaches to the treatment 15.00of tendinopathy – the case of the patellar tendon
15.30
Departure for Oslo Harbor 17.00– Boat trip on Oslo Fjord
19.00
20.00
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Location: Soria Moria Hotel, Oslo – situated above the famous Holmen-kollen ski jump, Norway's most visited tourist attraction and one of one of theworld's most famous sporting arenas. Welcome to Soria Moria, the conferencehotel on the roof of Oslo. The hotel's location at the gateway to Nordmarka offerseasy access to Oslo’s vast national park area, yet is just 20 minutes by tram tothe center of Oslo. Soria Moria provides an ideal framework for the meeting, withexcellent conference facilities in inspiring surroundings.
Course informationFaculty:
20 speakers
Maximum capacity: 80 participants
(first come, first served!)
6 � IOC ATPC 2012 PROGRAM
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IOC ATPC 2012 PROGRAM � 7
Tuesday May 29th
Individual arrivals throughout the day; transfer by shuttle from Oslo airport to Soria Moria hotel (apx. 60 min)
20.00 Welcome dinner at the Soria Moria hotel
Wednesday May 30th
08.45 – 09.00 WelcomeVice Mayor for Environment and Transport Ola Elvestuen
09.00 – 10.30 Session 1Working as a team physician – challenges and strategies
Chairs: Lars Engebretsen & Roald Bahr • Norway
Patrick Schamasch • SwitzerlandRichard Budgett • UKGordon Matheson • USA
Introduction Roald Bahr • Norway
The role of the IOC Medical Commission Patrick Schamasch • Switzerland
Preparing for the Olympic Games – lessons learned from London 2012 Richard Budgett • UK
Where are your loyalties: coach, team or athlete? Gordon Matheson • USA
10.30 – 11.00 Coffee break
11.00 – 12.30 Session 2Working as a team physician – pearls & pitfalls
Chair: Roald Bahr • Norway
Richard Budgett • UKÉanna Falvey • Irelandars Engebretsen • NorwayJón Karlsson • SwedenPatrick Schamasch • SwitzerlandBabette Pluim • NetherlandsLuis Serratosa • Spain
The smartest and the dumbest thing I have done as a team physician:Working with the British Olympic and Paralympic Teams Richard Budgett • UK
Working with a professional rugby team Éanna Falvey • Ireland
Working with the Norwegian Olympic Team Lars Engebretsen • Norway
Working with a semi-professional soccer team Jón Karlsson • Sweden
Working within the IOC Patrick Schamasch • Switzerland
Working with a Davis Cup tennis team Babette Pluim • Netherlands
Working with a professional soccer team Luis Serratosa • Spain
Panel discussion
12.30 – 13.30 Lunch break
PROGRAM
8 � IOC ATPC 2012 PROGRAM
13.30 – 15.00 Session 3Managing concussions in a team setting
Chair: Markus Waldén • Sweden
Paul McCrory • AustraliaÉanna Falvey • IrelandGordon Matheson • USA
Introduction of learning objectives and two cases illustrating key issues• explain the rapid changes that have taken place in clinical managementandregulatory policy related to concussion management
• use the SCAT2 and Pocket SCAT2 tools appropriately• interpret the clinical management of patients with concussion within the context of multiple outside influences
Small-group discussions
The Zurich Concussion Consensus Guidelines Paul McCrory • Australia
Acute sideline assessment and the role of the SCAT2 Éanna Falvey • Ireland
Management of concussion in the US; how the science, media, legislation and lawyersaffect management strategies Gordon Matheson • USA
Guidelines for safe return to play; controversies and long term risks Paul McCrory • Australia
Open Forum: Review of cases and learning objectives
15.00 – 15.30 Coffee break
15.30 – 17.00 Session 4The groin/hip enigma in sports
Chair: Karim Khan • Canada
Per Hölmich • DenmarkÉanna Falvey • IrelandMarc Philippon • USA
Introduction of learning objectives and two cases illustrating key issues• Summarize the evidence for the biomechanical stressors which predispose the athlete to groin pain
Soria Moria hotell
IOC ATPC 2012 PROGRAM � 9
• Discuss a standardized and evidence-based approach to diagnose groin pain• Accurately diagnose femoroacetabular impingement and list the indications for surgical treatment
Small-group discussions
The biomechanics of groin pain – the evidence base for current practice and the myth of osteitis pubis! Éanna Falvey • Ireland
Soft tissue problems of the groin - well established diagnoses or entities? Per Hölmich • Denmark
The approach to differential diagnosis and treatment of hip pain Marc Philippon • USA
Open Forum: Review of cases and learning objectives
17.00 - 18.30 Session 5Managing the overhead throwing athlete: Shoulder
Chair: Bruce Hamilton • Qatar
Babette Pluim • NetherlandsAnn Cools • BelgiumArne Kristian Aune • Norway
Introduction of learning objectives and two cases illustrating key issues• Discuss sports-related risk factors for shoulder pain in the overhead athlete and the structures ultimately affected• Work through a clinical examination algorithm• List the pros and cons associated with surgical treatment• Prescribe evidence-based prevention and rehabilitation programs
Small-group discussions
Shoulder injuries in elite sport Babette Pluim • Netherlands
Physical examination of the shoulder Ann Cools • Belgium
Surgical management of shoulder injuries Arne Kristian Aune • Norway
Injury prevention, conservative management and rehabilitation Ann Cools • Belgium
Open Forum: Review of cases and learning objectives
19.00 Dinner at Soria Moria hotell & Holmenkollen Ski Jump Tower/Museum
Holmenkollen Ski JumpTower/Museum
10 � IOC ATPC 2012 PROGRAM
Thursday May 31st
08.30 - 10.00 Session 6The underperforming athlete: causes and management
Chair: Michael Kjær • Denmark
Richard Budgett • UKOla Rønsen • NorwayLuis Serratosa • Spain
Introduction of learning objectives and two cases illustrating key issues• Discuss the variety of conditions, medical and non-medical, that may be related to underperformance
• Confidently manage athletes with prolonged fatigue and underperformance using a multidisciplinary approach
• Learn from the practical experiences obtained over years at a high-level, high-performance, intense training volume team
Small-group discussions
What is overtraining? Richard Budgett • UK
How to assess the underperforming athlete Ola Rønsen • Norway
How we manage training and competition load in elite team sports athletes – the case of Real Madrid Luis Serratosa • Spain
Open Forum: Review of cases and learning objectives
10.00 - 10.30 Coffee break
10.30 - 12.00 Session 7Managing the overhead throwing athlete: Elbow
Chair: Per Hölmich • Denmark
Babette Pluim • NetherlandsAnn Cools • BelgiumDenise Eygendaal • Netherlands
Introduction of learning objectives and two cases illustrating key issues• Highlight 6 key conditions affecting the athlete with elbow pain• Execute adroit physical examination to detect the recently described pathology in the athlete’s elbow
• Prescribe evidence-based prevention and rehabilitation• Discuss recent development in minimally invasive surgery with realistic windows for post-op rehabilitation
Small-group discussions
Elbow injuries in athletes Babette Pluim • Netherlands
Physical examination of the elbow Denise Eygendaal • Netherlands
Injury prevention and conservative management of common injuries Ann Cools • Belgium
Surgical management and rehabilitation Denise Eygendaal • Netherlands
Open Forum: Review of cases and learning objectives
12.00 - 13.00 Lunch break
Session: Heiko Van Vliet, DJO GlobalElectro stimulation goes «Wireless».A new era in functional rehabilitation and re-athletisation
IOC ATPC 2012 PROGRAM � 11
13.00 - 14.30 Session 8Protecting health and preventing illness in athletes
Chair: Babette Pluim • Netherlands
Roald Bahr • NorwayBen Clarsen • NorwayGordon Matheson • USALuis Serratosa • SpainOla Rønsen • Norway
Introduction of learning objectives• Articulate the key elements of the Periodic Health Evaluation• Use Periodic Health Evaluations and Team Injury Surveillance in a team setting• Quantify the injury risk in the preparation phase and list ways to mitigate it• Discuss lessons learned about these instruments shared by experienced clinicians working in the elite athlete setting
Injury and illness patterns in elite athletes – What can I expect when working with an Olympic team? Ben Clarsen • Norway
Screening in athletes: What are the take home messages of the IOC consensus on Periodic Health Evaluation? Gordon Matheson • USA
From postseason injury analysis through pre-season screening – risk management in the team setting Roald Bahr • Norway
Periodic Health Evaluations in practice – the Real Madrid experience Luis Serratosa • Spain
Stay healthy! How it is done in the Norwegian Olympic team Ola Rønsen • Norway
Open Forum: Review learning objectives
14.30 - 15.00 Coffee break
15.00 – 16.45 Session 9Novel approaches to the treatment of tendinopathy – the case of the patellar tendon
Chair: Paul McCrory • Australia
Roald Bahr • NorwayMichael Kjær • DenmarkKarim Khan • CanadaAasne Hoksrud • NorwayLars Engebretsen • NorwayJón Karlsson • Sweden
Introduction and two cases illustrating key issues• Define tendinopathy, its pathogenesis and mechanotherapy• Discuss the relative merit of eccentric exercise prescription, Doppler-guided sclerosis,platelet-rich plasma injections, shock-wave therapy and contemporary surgery
Small-group discussions
What is tendinopathy and why does it happen? Michael Kjær • Denmark
What is mechanotransduction? Karim Khan • Canada
Does eccentric training work? Roald Bahr • Norway
Does ultrasound-& Doppler-guided sclerosis work? Aasne Hoksrud • Norway
Do platelet-rich plasma injections work? Lars Engebretsen • Norway
Does shock-wave therapy work? Michael Kjær • Denmark
Does surgery work? Jón Karlsson • Sweden
Open Forum: Case discussions: which is the first option, and which the last line of defense? Review of learning objectives
17.00 Departure for Oslo Harbor – boat trip on the Oslo Fjord
12 � IOC ATPC 2012 PROGRAM
Friday June 1st
08.00 - 09.45 Session 10Pharmacological treatment of common sports injuries
Chair: Michael Kjær • Denmark
Gordon Matheson • USAJens Ivar Brox • NorwayKarim Khan • CanadaLars Nordsletten • NorwayLars Engebretsen • Norway
Introduction of learning objectives and two cases illustrating key issues• In relation to MSK injuries, recite the pharmacology, contraindications, side effects and risks associated with the injection of local anesthetics/glucocorticoids/PRP, and prescription of NSAIDs (for muscle or fracture)
Small-group discussions
Is there a place for local anesthetics in the treatment of acute sports injuries? Gordon Matheson • USA
Is there a place for cortisone injections in the treatment of musculoskeletal injuries? Jens Ivar Brox • Norway
Is there a place for NSAIDs or Cox-2 inhibitors in the treatment of acute muscle tears? Karim Khan • Canada
Is there a place for NSAIDs or Cox-2 inhibitors in the treatment of fractures?Lars Nordsletten • Norway
Platelet-rich plasma injections for acute sports injuries: do they work? Lars Engebretsen • Norway
Open Forum: Review of cases and learning objectives
09.45 - 10.15 Coffee break
IOC ATPC 2012 PROGRAM � 13
10.15 - 11.45 Session 11The hamstring problem in sports
Chair: Jón Karlsson • Sweden
Markus Waldén • SwedenCarl Askling • SwedenBruce Hamilton • QatarRoald Bahr • Norway
Introduction of learning objectives and two cases illustrating key issues• Use the evidence-base for intervention in hamstring injury to prescribe preventive and treatment programs for specific categories of patients
• Integrate novel clinical tests with imaging results to guide the clinical element of the return to sport decision
• Differentiate primary prevention from prevention of recurrent hamstring strain
Small-group discussions
Hamstring injury – still a growing problem in elite sports? Markus Waldén • Sweden
The role of 'intervention' in hamstring injury, an examination of the evidence base and rationale behind some common interventions Bruce Hamilton • Quatar
Different types of hamstring strains require different rehabilitation protocols Specific exercises and a specific test before return to sport Carl Askling • Sweden
This is how you can prevent hamstring strains in your team Roald Bahr • Norway
Open Forum: Review of cases and learning objectives
11.45 - 12.00 Coffee break
12.00 - 13.30 Session 12Return to sport: How do we make the best medical decisions?
Chair: Karim Khan • Canada
Paul McCrory • AustraliaLars Engebretsen • NorwayOla Rønsen • NorwayBabette Pluim • NetherlandsJón Karlsson • SwedenGordon Matheson • USA
Introduction of learning objectives and five cases:• Design an approach for return-to-play decisions that optimizes the medical decision making process
• Cite the non-medical factors that are part of decision making for return to play
Concussion in a soccer player Paul McCrory • Australia
Hamstring strain in an elite hurdler Lars Engebretsen • Norway
Upper respiratory infection in an elite cross-country skier Ola Rønsen • Norway
Female athlete with disordered eating Babette Pluim • Netherlands
Achilles tendon pain in professional soccer player Jón Karlsson • USA
Which are the medical factors that go into return to play decisions? Lars Engebretsen • Norway
Which are the non-medical factors that go into return to play decisions? Gordon Matheson • USA
Open Forum: Review of cases and learning objectives
13.30 Lunch & Departure from hotel 14.30 Transfer to Oslo airport
14 � IOC ATPC 2012 PROGRAM
Organizing Committee
• Roald Bahr, MD PhD (Chair, Program Committee)• Fredrik S. Bendiksen, MD (Chair, Organizing Committee)• Lars Engebretsen, MD PhD• Cherine Fahmy, IOC• Bruce Hamilton, MD• Karim Khan, MD PhD • Anne Guri Sklet, Gyro Conference AS
Speakers
Carl Askling, PT PhD Assistant professorThe Swedish School of Sport and HealthSciences, Stockholm, Sweden
Arne Kristian Aune, MD PhD OrthopaedicSurgeon Dept. of Orthopedics and SportsMedicine, Drammen Private Hospital,Drammen, Norway
Roald Bahr, MD PhD ProfessorOslo Sports Trauma Research Center &Norwegian Olympic Training Center, Oslo, Norway
Jens Ivar Brox, MD PhD ProfessorOslo University Hospital-Rikshospitalet,Oslo, Norway
Richard Budgett, MD Chief Medical Officer2012 Summer Olympic Games, London,United Kingdom
Ben Clarsen, PT MSc PhD-studentOslo Sports Trauma Research Center &Norwegian Olympic Training Center, Oslo, Norway
Ann Cools, PT PhD Associate ProfessorDepartment of Rehabilitation Sciences andPhysiotherapy, Faculty of Medicine andHealth Sciences. Ghent University, Ghent, Belgium
Denise Eygendaal, MD PhD OrthopaedicSurgeon Department of OrthopedicSurgery, Amphia Hospital, Breda, the Netherlands
Lars Engebretsen, MD PhD ProfessorOslo Sports Trauma Research Center, OsloUniversity Hospital & Norwegian OlympicTraining Center, Oslo, Norway
Éanna Falvey, MB BCh, MRCPI, FFSEM,MMedSci (Sports & Exercise Med) Directorof Sports MedicineSports Surgery Clinic, Dublin, Ireland
Bruce Hamilton, MD, Chief of SportsMedicine Aspetar, Doha, Qatar
Aasne Hoksrud, MD PhDOslo Sports Trauma Research Center,Oslo, Norway
Per Hölmich, MD Associate ResearchProfessor Amager Hospital, Copenhagen,Denmark
Jón Karlsson, MD PhD ProfessorDepartment of Orthopaedics, SahlgrenskaUniversity Hospital, Mölndal, Sweden
Karim Khan, MD PhD ProfessorUniversity of British Columbia, Vancouver,BC, Canada & Oslo Sports TraumaResearch Center, Oslo, Norway
Michael Kjaer, Dr.Med. MD ProfessorInstitute of Sports Medicine Copenhagen,Copenhagen, Denmark
Gordon O. Matheson, MD PhD ProfessorStanford University, Stanford, California,USA
Paul McCrory, MBBS PhD AssociateProfessor. The University of Melbourne,Melbourne, Victoria, Australia
Lars Nordsletten, MD PhD ProfessorOslo Sports Trauma Research Center, OsloUniversity Hospital & Norwegian OlympicTraining Center, Oslo, Norway
Marc Philippon, MD Orthopaedic SurgeonThe Steadman Clinic, Vail, Colorado, USA
Babette Pluim MD PhD Chief Medical Adviser Royal Netherlands Lawn Tennis Association, Amersfoort, the Netherlands
Ola Rønsen MD PhDNorwegian Olympic Training Center, Oslo,Norway
Patrick Schamasch MD Medical DirectorInternational Olympic Committee,Lausanne, Switzerland
Luis Serratosa, MD PhD Real Madrid FC1st Team DoctorSanitas Real Madrid FC Sports MedicineDepartment. Madrid, Spain
Markus Waldén MD PhD OrthopaedicSurgeon & Senior ResearcherDepartment of Orthopaedics, Hässleholm-Kristianstad-Ystad Hospitals, Hässleholm& Division of Community Medicine,Department of Medical and HealthSciences, Linköping University, Linköping, Sweden
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Welcome to Oslo, NorwayMay 30–June 1, 2012
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