Football	
  Club	
  Barcelona	
  Injury	
  Study	
  
Lluís	
  Til	
  	
  

Sports	
  Medicine	
  &	
  Orthopedics	
  FCBarcelona	
  

Olympic	
  Training	
  Center	
  (CAR)	
  Consorci	
  Sanitari	
  de	
  Terrassa	
  (CST)	
  
1.  IntroducFon	
   	
  

	
  why	
  

2.  ObjecFve 	
  

	
  

	
  what	
  

3.  Method	
  

	
  

	
  how	
  

	
  

4.  Results	
  
5.  Conclusions	
  
6.  Messages	
  
1. IntroducFon	
   	
  	
  
•  To	
   know	
   what	
   are	
   the	
   most	
   common	
   and	
   the	
   most	
   serious	
  
injuries	
  that	
  our	
  athletes	
  suffer	
  is	
  the	
  first	
  step	
  to	
  improve	
  our	
  
medical	
  resources	
  to	
  treat	
  and	
  prevent	
  them	
  
•  In	
  view	
  of	
  the	
  frequency	
  of	
  injury,	
  the	
  resulFng	
  costs	
  and	
  not	
  
least	
  the	
  personal	
  suffering	
  of	
  the	
  injured	
  players,	
  we	
  are	
  
focused	
  in	
  sports	
  injury	
  study	
  
•  FCBarcelona	
  wants	
  to	
  share	
  its	
  experience	
  to	
  improve	
  the	
  
athletes	
  health	
  	
  
2012-2013 CENSUS SUMMARY
Sports Sections

Athletes

Staff

TOTAL people

CATEGORIES

TEAMS

	
  ATHLETICS	
  

210	
  

7	
  

217	
  

18	
  

18	
  

	
  BASKETBALL	
  
	
  WHEELCHAIR	
  BASKETBALL	
  
	
  BASEBALL	
  
	
  FOOTBALL	
  
	
  Female	
  FOOTBALL	
  
	
  FUTSAL	
  
	
  HANDBALL	
  
	
  ICE	
  HOCKEY	
  
	
  FIELD	
  HOCKEY	
  
	
  ROLLER	
  HOCKEY	
  
	
  FIGURE	
  SKATING	
  &	
  ICE	
  DANCE	
  
	
  RUGBY	
  
VOLLEYBALL	
  
Female	
  VOLLEYBALL	
  
	
  

170	
  
13	
  
107	
  
283	
  
75	
  
146	
  
80	
  
130	
  
95	
  
36	
  
79	
  
206	
  
59	
  
24	
  

37	
  
4	
  
16	
  
42	
  
17	
  
36	
  
27	
  
7	
  
10	
  
15	
  
7	
  
20	
  
9	
  
-­‐	
  

207	
  
17	
  
123	
  
325	
  
92	
  
182	
  
107	
  
137	
  
105	
  
51	
  
86	
  
226	
  
68	
  
24	
  

14	
  
1	
  
6	
  
12	
  
4	
  
6	
  
3	
  
6	
  
6	
  
4	
  
8	
  
7	
  
4	
  
2	
  

16	
  
1	
  
7	
  
17	
  
4	
  
12	
  
5	
  
6	
  
6	
  
5	
  
7	
  
8	
  
4	
  
2	
  

1713	
  

254	
  

1967	
  

101	
  

118	
  

14	
  	
  

	
  

More	
  than	
  4,000	
  matches	
  a	
  year.	
  
FINANCIAL	
  DATA:	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  
	
  2012/2013	
  BUDGET
	
  

	
  

	
  6,8200,000	
  Euros	
   	
  1.5%	
  total	
  	
  

90%	
  Expenditures	
  for	
  services	
  and	
  salaries	
  

	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  
HUMAN	
  RESOURCES	
  

	
  	
  Structural	
  
	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  20	
  	
  Physicians	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  Sports	
  medicine,	
  Orthopedics,	
  Cardiology,	
  	
  
	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  26	
  Physiotherapists	
  -­‐	
  Qualified	
  nurses

	
  Physiotherapy,	
  Nursing,	
  Osteopathy,	
  RecuperaFon	
  

	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  Chiropodist	
  1	
  
	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  Youth	
  football	
  physiotherapists	
  (matches)	
  16/20	
  
	
  
	
  	
  SERVICES	
  

	
  

	
  	
  	
  	
  	
  HR	
  –	
  Match	
  days	
  at	
  Camp	
  Nou	
   	
  
	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  HR	
  –	
  Weekend	
  coverage

	
  

	
  17/30	
  	
  

	
  20/25	
  matches	
  

	
  
As	
  we	
  work	
  in	
  an	
  internal	
  and	
  external	
  network:	
  	
  	
  	
  	
  trainers,	
  coaches,	
  external	
  health	
  providers…
2.	
  ObjecFves 	
  	
  

•  To	
  quanFfy	
  workload	
  
•  To	
  compare	
  the	
  injury	
  incidence	
  with	
  others	
  databases	
  
•  To	
  know	
  wich	
  are	
  the	
  most	
  common	
  and	
  most	
  severe	
  
injuries	
  for	
  each	
  sport	
  and	
  age	
  
•  Quality	
  control	
  	
  
It	
  will	
  allow	
  us	
  to	
  develop	
  appropiate	
  
prevenFon	
  programs	
  
• 1713	
  athletes	
  we	
  take	
  care.	
  	
  
• 20	
  Physicians	
  ad	
  26	
  physiotherapist	
  who	
  work	
  as	
  a	
  Service,	
  
sharing	
  experiences,	
  protocols	
  ,…	
  
• Working	
  in	
  a	
  network	
  is	
  the	
  easier	
  way	
  	
  for	
  us	
  
• In	
  each	
  team	
  
• In	
  the	
  sports	
  medicine	
  group	
  
• With	
  external	
  colleagues,	
  friends	
  and	
  insFtuFons	
  from	
  
everywhere	
  

• The	
  FCB	
  interest	
  in	
  sports	
  medicine	
  	
  
• Excellent	
  sport	
  Fme	
  

	
  

	
  

To	
  improve	
  the	
  knowledge	
  in	
  
sports	
  medicine	
  is	
  the	
  only	
  
opFon	
  
3.	
  Methods 	
  	
  
Shared	
  external	
  databases	
  
–  Standarized	
  collecFon	
  data	
  method	
  
–  The	
  UCL	
  study	
  allows	
  to	
  compare	
  the	
  injury	
  epidemiology	
  between	
  similar	
  elite	
  teams	
  and	
  it	
  
shows	
  how	
  has	
  been	
  the	
  evoluFon	
  along	
  the	
  seasons	
  at	
  each	
  team	
  
–  Different	
  medical	
  staffs	
  maybe	
  record	
  the	
  data	
  with	
  some	
  differences	
  between	
  them	
  
3.	
  Methods 	
  	
  
Shared	
  external	
  databases	
  
–  The	
  less	
  injuries	
  the	
  team	
  has	
  got,	
  more	
  opFons	
  it	
  has	
  to	
  get	
  a	
  good	
  
ressult	
  
	
  

0	
  

1	
  

Liga	
  

2	
  

Liga	
  

0	
  

0	
  

6	
  

1	
  

Liga	
  
Cup	
  

Liga	
  

3	
  

Liga	
  

1	
  

Cup	
  
3.	
  Methods 	
  	
  
Interal	
  database	
  (GEM)	
  
	
  
	
  

–  5	
  seasons	
  2008/09	
  to	
  2012/13	
  
–  Less	
   homogenous	
   in	
   sports,	
   	
   more	
  
consistent	
  in	
  collecFon	
  data	
  
–  Players:	
  4260:	
  
•  682	
  (16.0	
  %)	
  	
   	
  football	
  
•  3578	
  (84.0	
  %)	
  	
  

	
  no	
  football	
  

–  Age:	
  17	
  y.o	
  

•  OSICS	
  	
  1st	
  &	
  2nd	
  leler	
  
•  Same	
  injury	
  definiFon	
  (Fme	
  loss)	
  
	
  
	
  
	
  
4.	
  Medical	
  assistance	
  per	
  athlete	
  per	
  year	
  
	
  
	
  
4.	
  Results	
  by	
  month	
  	
  
	
  
	
  
4.	
  Medical	
  assistance	
  per	
  athlete	
  per	
  year	
  
Anual	
  rate	
  of	
  medical	
  assistance	
  0.79	
  /	
  player	
  *	
  year	
  (0-­‐16)	
  
	
  
	
  
Anual	
  rate	
  of	
  sport	
  injury	
  (Fme	
  loss)0.39	
  /	
  player	
  *	
  year	
  (0-­‐8)	
  

Medical	
  assistance	
  per	
  athlete*year	
  
38.4	
  %	
  (3711/9670)	
  

Sports	
  injury	
  per	
  athlete*year	
  	
  
26.6	
  %	
  (2569/9670)	
  
4.	
  Medical	
  assistance	
  per	
  
athlete	
  per	
  year	
  
	
  
	
  

4.	
  Sports	
  injury	
  per	
  
athlete	
  per	
  year	
  
4.	
  Sports	
  injury	
  per	
  athlete	
  per	
  year	
  
	
  
	
  
4.	
  Sports	
  injury	
  per	
  athlete	
  per	
  year	
  
	
  
	
  
4.	
  Sport	
  injury	
  per	
  athlete	
  per	
  year	
  
	
  
	
  
4.	
  Sports	
  injury	
  per	
  athlete	
  per	
  year	
  (sports)	
  
	
  
	
  
4.	
  Medical	
  assistance	
  and	
  Sports	
  injury	
  per	
  
athlete	
  per	
  year	
  
	
  
	
  
4.	
  Medical	
  assistance	
  and	
  Sports	
  injury	
  per	
  
athlete	
  per	
  year	
  in	
  some	
  sports	
  
	
  
	
  
4.	
  Severity	
  of	
  injury	
  and	
  age	
  	
  
	
  
	
  
4.	
  Severity	
  of	
  injury	
  and	
  month	
  
	
  
	
  
4.	
  Severity	
  of	
  injury	
  and	
  sport	
  
B	
  

F	
  

	
  
	
  

H	
  

F	
  
FF	
  

F	
  

	
  
R	
   H	
  
4.	
  Severity	
  of	
  injury	
  and	
  sport	
  
B	
  

F	
  

	
  
	
  

H	
  

F	
  
FF	
  

F	
  

	
  
R	
   H	
  
4.	
  Site	
  of	
  sports	
  injury	
  	
  
4.	
  Site	
  of	
  sports	
  injury	
  &	
  age	
  	
  
4.	
  Site	
  of	
  sports	
  injury	
  &	
  age	
  	
  
4.	
  Site	
  of	
  sports	
  injury	
  &	
  season	
  
4.	
  Site	
  of	
  sports	
  injury	
  &	
  sport	
  
4.	
  Site	
  of	
  sports	
  injury	
  &	
  sport	
  
4.	
  Site	
  of	
  sports	
  injury	
  &	
  severity	
  
4.	
  Type	
  of	
  sports	
  injury	
  	
  
4.	
  Type	
  of	
  sports	
  injury	
  &	
  age	
  	
  
4.	
  Type	
  of	
  sports	
  injury	
  &	
  season	
  
4.	
  Site	
  of	
  sports	
  injury	
  &	
  sport	
  
4.	
  Type	
  of	
  sports	
  injury	
  &	
  severity	
  
5.	
  Conclusions 	
  	
  
•  Our	
  athletes	
  are	
  so	
  young	
  17	
  y.o	
  (	
  8-­‐42)	
  
•  Every	
   athlete	
   in	
   FCB	
   has	
   a	
   rate	
   of	
   Medical	
   assistance	
   0,79	
   /
season	
  and	
  a	
  rate	
  of	
  sports	
  injury	
  with	
  Fme	
  loss	
  0,39	
  /season	
  
•  The	
   injury	
   are	
   distributed	
   during	
   the	
   year	
   with	
   a	
   bimodal	
  
distribuFon	
  (like	
  many	
  illness)	
  
•  The	
  data	
  are	
  so	
  constant	
  and	
  consistent	
  last	
  5	
  seasons	
  
•  The	
  rates	
  are	
  diferents	
  between	
  ages	
  and	
  sports	
  
5.	
  Conclusions 	
  	
  
•  The	
  older	
  athletes	
  have	
  more	
  Fme	
  loss	
  injuries	
  
•  Basket	
   &	
   handball	
   have	
   less	
   severe	
   injuries	
   (>28d)	
   than	
  
football,	
  it	
  could	
  be	
  due	
  than	
  the	
  players	
  can	
  return	
  faster	
  to	
  
play	
  because	
  the	
  changes	
  in	
  compeFFon	
  are	
  unlimited	
  
•  The	
  most	
  frequent	
  sites	
  are	
  Thigh,	
  knee	
  and	
  ankle	
  
•  The	
  most	
  frequent	
  types	
  are	
  muscles,	
  joint	
  and	
  tendon	
  
•  The	
  apophysiFs	
  appear	
  in	
  young	
  football	
  players	
  
•  The	
  types	
  and	
  the	
  sites	
  of	
  the	
  injury	
  show	
  different	
  
tendencies	
  in	
  each	
  sport	
  
5.	
  Message 	
  	
  
•  The	
  injury	
  incidence	
  is	
  constant	
  in	
  FCBarcelona	
  
•  Our	
   interest	
   areas	
   are	
   Thigh	
   muscles,	
   knee,	
   ankle,	
   patellar	
   and	
   Achilles	
  
tendon	
  
•  To	
   improve	
   our	
   data	
   we	
   need	
   to	
   collect	
   the	
   exposure	
   to	
   train	
   and	
  
compeFFon	
  
•  We	
   must	
   conFnue	
   analyzing	
   data	
   to	
   understand	
   some	
   links	
   between	
  
injuries	
  
•  More	
  deeper	
  analysis	
  of	
  risk	
  factors	
  are	
  been	
  done	
  in	
  some	
  teams	
  (	
  u-­‐19	
  
and	
  Female	
  football	
  teams)	
  
Football	
  Club	
  Barcelona	
  Injury	
  Study	
  
Lluis	
  Til	
  	
  
Mauricio	
  Monaco	
  
Ramon	
  Canal	
  
Bruno	
  Montoro	
  

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Lluis Til. Sports Medicine & Orthopedics FCBarcelona Olympic Training Center (CAR) Consorci Sanitari de Terrassa (CST)

  • 1. Football  Club  Barcelona  Injury  Study   Lluís  Til     Sports  Medicine  &  Orthopedics  FCBarcelona   Olympic  Training  Center  (CAR)  Consorci  Sanitari  de  Terrassa  (CST)  
  • 2. 1.  IntroducFon      why   2.  ObjecFve      what   3.  Method      how     4.  Results   5.  Conclusions   6.  Messages  
  • 3. 1. IntroducFon       •  To   know   what   are   the   most   common   and   the   most   serious   injuries  that  our  athletes  suffer  is  the  first  step  to  improve  our   medical  resources  to  treat  and  prevent  them   •  In  view  of  the  frequency  of  injury,  the  resulFng  costs  and  not   least  the  personal  suffering  of  the  injured  players,  we  are   focused  in  sports  injury  study   •  FCBarcelona  wants  to  share  its  experience  to  improve  the   athletes  health    
  • 4. 2012-2013 CENSUS SUMMARY Sports Sections Athletes Staff TOTAL people CATEGORIES TEAMS  ATHLETICS   210   7   217   18   18    BASKETBALL    WHEELCHAIR  BASKETBALL    BASEBALL    FOOTBALL    Female  FOOTBALL    FUTSAL    HANDBALL    ICE  HOCKEY    FIELD  HOCKEY    ROLLER  HOCKEY    FIGURE  SKATING  &  ICE  DANCE    RUGBY   VOLLEYBALL   Female  VOLLEYBALL     170   13   107   283   75   146   80   130   95   36   79   206   59   24   37   4   16   42   17   36   27   7   10   15   7   20   9   -­‐   207   17   123   325   92   182   107   137   105   51   86   226   68   24   14   1   6   12   4   6   3   6   6   4   8   7   4   2   16   1   7   17   4   12   5   6   6   5   7   8   4   2   1713   254   1967   101   118   14       More  than  4,000  matches  a  year.  
  • 5. FINANCIAL  DATA:                                              2012/2013  BUDGET      6,8200,000  Euros    1.5%  total     90%  Expenditures  for  services  and  salaries                         HUMAN  RESOURCES      Structural                                20    Physicians                            Sports  medicine,  Orthopedics,  Cardiology,                                  26  Physiotherapists  -­‐  Qualified  nurses  Physiotherapy,  Nursing,  Osteopathy,  RecuperaFon                                Chiropodist  1                                Youth  football  physiotherapists  (matches)  16/20        SERVICES              HR  –  Match  days  at  Camp  Nou                                    HR  –  Weekend  coverage    17/30      20/25  matches     As  we  work  in  an  internal  and  external  network:          trainers,  coaches,  external  health  providers…
  • 6. 2.  ObjecFves     •  To  quanFfy  workload   •  To  compare  the  injury  incidence  with  others  databases   •  To  know  wich  are  the  most  common  and  most  severe   injuries  for  each  sport  and  age   •  Quality  control     It  will  allow  us  to  develop  appropiate   prevenFon  programs  
  • 7. • 1713  athletes  we  take  care.     • 20  Physicians  ad  26  physiotherapist  who  work  as  a  Service,   sharing  experiences,  protocols  ,…   • Working  in  a  network  is  the  easier  way    for  us   • In  each  team   • In  the  sports  medicine  group   • With  external  colleagues,  friends  and  insFtuFons  from   everywhere   • The  FCB  interest  in  sports  medicine     • Excellent  sport  Fme       To  improve  the  knowledge  in   sports  medicine  is  the  only   opFon  
  • 8. 3.  Methods     Shared  external  databases   –  Standarized  collecFon  data  method   –  The  UCL  study  allows  to  compare  the  injury  epidemiology  between  similar  elite  teams  and  it   shows  how  has  been  the  evoluFon  along  the  seasons  at  each  team   –  Different  medical  staffs  maybe  record  the  data  with  some  differences  between  them  
  • 9. 3.  Methods     Shared  external  databases   –  The  less  injuries  the  team  has  got,  more  opFons  it  has  to  get  a  good   ressult     0   1   Liga   2   Liga   0   0   6   1   Liga   Cup   Liga   3   Liga   1   Cup  
  • 10. 3.  Methods     Interal  database  (GEM)       –  5  seasons  2008/09  to  2012/13   –  Less   homogenous   in   sports,     more   consistent  in  collecFon  data   –  Players:  4260:   •  682  (16.0  %)      football   •  3578  (84.0  %)      no  football   –  Age:  17  y.o   •  OSICS    1st  &  2nd  leler   •  Same  injury  definiFon  (Fme  loss)        
  • 11. 4.  Medical  assistance  per  athlete  per  year      
  • 12. 4.  Results  by  month        
  • 13. 4.  Medical  assistance  per  athlete  per  year   Anual  rate  of  medical  assistance  0.79  /  player  *  year  (0-­‐16)       Anual  rate  of  sport  injury  (Fme  loss)0.39  /  player  *  year  (0-­‐8)   Medical  assistance  per  athlete*year   38.4  %  (3711/9670)   Sports  injury  per  athlete*year     26.6  %  (2569/9670)  
  • 14. 4.  Medical  assistance  per   athlete  per  year       4.  Sports  injury  per   athlete  per  year  
  • 15. 4.  Sports  injury  per  athlete  per  year      
  • 16. 4.  Sports  injury  per  athlete  per  year      
  • 17. 4.  Sport  injury  per  athlete  per  year      
  • 18. 4.  Sports  injury  per  athlete  per  year  (sports)      
  • 19. 4.  Medical  assistance  and  Sports  injury  per   athlete  per  year      
  • 20. 4.  Medical  assistance  and  Sports  injury  per   athlete  per  year  in  some  sports      
  • 21. 4.  Severity  of  injury  and  age        
  • 22. 4.  Severity  of  injury  and  month      
  • 23. 4.  Severity  of  injury  and  sport   B   F       H   F   FF   F     R   H  
  • 24. 4.  Severity  of  injury  and  sport   B   F       H   F   FF   F     R   H  
  • 25. 4.  Site  of  sports  injury    
  • 26. 4.  Site  of  sports  injury  &  age    
  • 27. 4.  Site  of  sports  injury  &  age    
  • 28. 4.  Site  of  sports  injury  &  season  
  • 29. 4.  Site  of  sports  injury  &  sport  
  • 30. 4.  Site  of  sports  injury  &  sport  
  • 31. 4.  Site  of  sports  injury  &  severity  
  • 32. 4.  Type  of  sports  injury    
  • 33. 4.  Type  of  sports  injury  &  age    
  • 34. 4.  Type  of  sports  injury  &  season  
  • 35. 4.  Site  of  sports  injury  &  sport  
  • 36. 4.  Type  of  sports  injury  &  severity  
  • 37. 5.  Conclusions     •  Our  athletes  are  so  young  17  y.o  (  8-­‐42)   •  Every   athlete   in   FCB   has   a   rate   of   Medical   assistance   0,79   / season  and  a  rate  of  sports  injury  with  Fme  loss  0,39  /season   •  The   injury   are   distributed   during   the   year   with   a   bimodal   distribuFon  (like  many  illness)   •  The  data  are  so  constant  and  consistent  last  5  seasons   •  The  rates  are  diferents  between  ages  and  sports  
  • 38. 5.  Conclusions     •  The  older  athletes  have  more  Fme  loss  injuries   •  Basket   &   handball   have   less   severe   injuries   (>28d)   than   football,  it  could  be  due  than  the  players  can  return  faster  to   play  because  the  changes  in  compeFFon  are  unlimited   •  The  most  frequent  sites  are  Thigh,  knee  and  ankle   •  The  most  frequent  types  are  muscles,  joint  and  tendon   •  The  apophysiFs  appear  in  young  football  players   •  The  types  and  the  sites  of  the  injury  show  different   tendencies  in  each  sport  
  • 39. 5.  Message     •  The  injury  incidence  is  constant  in  FCBarcelona   •  Our   interest   areas   are   Thigh   muscles,   knee,   ankle,   patellar   and   Achilles   tendon   •  To   improve   our   data   we   need   to   collect   the   exposure   to   train   and   compeFFon   •  We   must   conFnue   analyzing   data   to   understand   some   links   between   injuries   •  More  deeper  analysis  of  risk  factors  are  been  done  in  some  teams  (  u-­‐19   and  Female  football  teams)  
  • 40. Football  Club  Barcelona  Injury  Study   Lluis  Til     Mauricio  Monaco   Ramon  Canal   Bruno  Montoro