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Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD

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Page 1: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Youth Soccer

Anthony Beutler, MDMajor, USAF, MC

Chief, Injury Prevention Research LaboratoryUniformed Services University, Bethesda MD

Page 2: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Youth Soccer

Anthony Beutler, MDMajor, USAF, MC

Department of Family Medicine, USU

Page 3: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Overview

The Spectrum of Soccer Injuries Are Soccer Injuries a Problem? What We “Know” About Injury Prevention What’s Next in Injury Prevention

Encourage You to Stay-Tuned

& Stay Involved

Page 4: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Your Chance to be Sports Doc

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Page 5: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

How About This One?

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Page 6: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Overview

The Spectrum of Soccer Injuries Are Soccer Injuries a Problem? What We “Know” About Injury

Prevention What’s Next in Injury Prevention

Page 7: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Fast Facts About: Youth Sports Injuries

Account for 42% of medically attended injuries in children More than transportation-related accidents

3.7 million ER visits 7 million doctor visits

20% of children miss at least 1 school day per year due to sports related injury

Page 8: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Greatest risk in High School and College Higher % risk in girls Higher # of injuries in boys

Common & Severe: ACL (Anterior Cruciate Ligament) Tear

Page 9: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Surgery 6 to 36 month

rehabilitation 77% sports disability

within 5 years 44% disability with

daily living in 5 years

Bad News Gets Worse: Long-term Effects of ACL Tear

Page 10: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Surgery 6 to 36 month

rehabilitation 77% sports disability

within 5 years 44% disability with

daily living in 5 years

Bad News Gets Worse: Long-term Effects of ACL Tear

Arthritis Risk: No Surgery: >90% in 20 years “Good” Surgery: >90% in 20 years

Arthritis Risk: No Surgery: >90% in 20 years “Good” Surgery: >90% in 20 years

Page 11: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Overview

The Spectrum of Soccer Injuries Are Soccer Injuries a Problem? What We “Know” About Injury

Prevention What’s Next in Injury Prevention

Page 12: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Rules?

Braces?

Fields/Cleats?

Changing You!

Looking at the Man in the Mirror: What to Change?

Page 13: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Human Movement Change: What we “Know” about Injury Prevention

Mandelbaum - 2005 80% decrease in ACL Injury 14-18 yo female soccer players 30 minute exercise program before pract/game Non-randomized

Page 14: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Human Movement Change: What we “Know” about Injury Prevention

Mandelbaum - 2005 80% decrease in ACL Injury

Myklebust - 2003 Decreased ACL injury in “elite” handball athletes

Page 15: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Human Movement Change: What we “Know” about Injury Prevention

Mandelbaum - 2005 80% decrease in ACL Injury

Myklebust - 2003 Decreased ACL injury in “elite” handball athletes

Olsen - 2005 50% decrease leg injuries (?ACL) 14-18 yo male & female handball players 20 minute program before practice & game

Page 16: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Human Movement Change: What we “Know” about Injury Prevention

Mandelbaum - 2005 80% decrease in ACL Injury

Myklebust - 2003 Decreased ACL injury in “elite” handball athletes

Olsen - 2005 50% decrease leg injuries (?ACL) 14-18 yo male & female handball players 20 minute program before practice & game

• Pfieffer - 2006 • No Change in Injury• Female High School Soccer, Basketball, and Volleyball Athletes

• Pfieffer - 2006 • No Change in Injury• Female High School Soccer, Basketball, and Volleyball Athletes

Page 17: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Landing/moving “stiff” Decreased trunk, hip, and knee flexion Large ground reaction forces

Excessive frontal plane motion Knee valgus Tibial rotation

Multifactorial

Human Movement Change: Risk Factors for ACL Injury

Page 18: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Overview

The Spectrum of Soccer Injuries Are Soccer Injuries a Problem? What We “Know” About Injury

Prevention What’s Next in Injury Prevention

Page 19: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Future of Injury Prevention: What’s Going on Now?

• 20 Teams from North Carolina - TUSA• Triangle United Soccer, Chapel Hill

• 20 Teams from Maryland - MSI & NCSL

• 20 Teams from North Carolina - TUSA• Triangle United Soccer, Chapel Hill

• 20 Teams from Maryland - MSI & NCSL

Page 20: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Movement Assessment Jump Landing Two Legged Squats One Legged Squats

PreseasonPreseason

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Page 21: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Exercise “Warm-Up” Program Tailored Program Generalized Program Placebo (Mouthguard) Program

In-seasonIn-season

Injury Monitoring Injury Monitoring

Page 22: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Post-Season Assessment Improvement overall score Improvement individual deficits Not just injury prevention - but injury

screening

PostseasonPostseason

Page 23: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Pre-Season

Future of Injury Prevention: Why Injury Screening?

Post-Season

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Page 24: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Post-Season scores are better than Pre-Season scores

Gains mostly retained between Spring & Fall seasons

Future of Injury Prevention: What Have We Learned?

Page 25: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Post-Season scores are better than Pre-Season scores

Gains mostly retained between Spring & Fall seasons

What Would We Still Like to Know? Does tailored program prevent more

injuries? What biomechanics are associated with

fewer ACL injuries? How often, how long, how long between?

Future of Injury Prevention: What Have We Learned?

Page 26: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Can We Prevent All Injuries?

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Page 27: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Overview

The Spectrum of Soccer Injuries Are Soccer Injuries a Problem? What We “Know” About Injury Prevention What’s Next in Injury Prevention

Encourage You to Stay-Tuned

& Stay Involved

Page 28: Youth Soccer Anthony Beutler, MD Major, USAF, MC Chief, Injury Prevention Research Laboratory Uniformed Services University, Bethesda MD *

Questions?Questions?Youth SoccerYouth Soccer

Injury PreventionInjury PreventionAnthony Beutler, MDAnthony Beutler, MD

[email protected] Chief, Injury Prevention Research LabChief, Injury Prevention Research Lab

Uniformed Services UniversityUniformed Services University

In collaboration with:Darin Padua, Ph.D, ATCAssociate DirectorSports Medicine Research Laboratory

Steve Marshall, Ph.DAssociate ProfessorInjury Prevention Research Center

In collaboration with:Darin Padua, Ph.D, ATCAssociate DirectorSports Medicine Research Laboratory

Steve Marshall, Ph.DAssociate ProfessorInjury Prevention Research Center

Lindsay DiStefano, MA, ATCDoctoral StudentSports Medicine Research Laboratory

Michelle Boling, MS, ATCDoctoral StudentSports Medicine Research Laboratory

Lindsay DiStefano, MA, ATCDoctoral StudentSports Medicine Research Laboratory

Michelle Boling, MS, ATCDoctoral StudentSports Medicine Research Laboratory

University of North Carolina, Chapel HillUniversity of North Carolina, Chapel Hill


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