Monday 28 September 2020
08.40-10.30
Session 1: WORKING AS A TEAM PHYSICIAN – CHALLENGES AND STRATEGIES
Chairs: Roald BAHR, Norway/Qatar & Fredrik S. BENDIKSEN, Norway
Format: Lecture series
Speakers:
Uğur Erdener, Turkey
Krisztián Kulcsár, Hungary
Lars Engebretsen, Norway/Switzerland
Richard Budgett, Switzerland
Alan Vernec, Canada
Phatho Zondi, South Africa
Jane Thornton, Canada
Karim Khan, Canada
Programme:
08.40-08.50 Welcome from the IOC Medical & Scientific Commission Chair
Uğur Erdener, Turkey
08.50-08.55 Welcome
Krisztián Kulcsár, Hungary
08.55-09.10 The scientific activities of the IOC Medical Commission
Lars Engebretsen, Switzerland/Norway
09.10-09.25 The Olympic Movement Medical Code – How does it apply to you as team physician?
Richard Budgett, Switzerland
09.25-09.45 Understanding the Prohibited List and dietary supplements – keeping you and your athletes out of trouble
Alan Vernec, Canada
09.45-10.00 Working as a team physician – what they don’t teach you in medical school
Phatho Zondi, South Africa
10.00-10.15 Slower, calmer, wiser – achieving excellence as a team doctor
Jane Thornton, Canada
10.15-10.30 The team clinician as a leader, mentor AND and mentee – what’s the evidence?
Karim Khan, Canada
10.30-11.00 Coffee break
11.00-12.45
Session 2: HAMSTRING INJURIES: OPTIMAL TREATMENT – MINIMAL RISK OF REINJURY
Chair: Adam WEIR, The Netherlands/Qatar
Format: Case-based discussions
Speakers:
Haydar A. Demirel, Turkey
Johannes Tol, The Netherlands/Qatar
Rod Whiteley, Qatar
Gino Kerkhoffs, The Netherlands
Learning objectives:
Participants will be able to:
- Understand the natural repair process of hamstring injuries
- Discuss the prognostic value of muscle injury classification systems
- Describe an evidence-based rehabilitation programme
- Discuss possible prevention strategies
- Describe when surgical treatment is indicated for hamstring injuries
Programme:
11.00-11.05 Introduction of two cases illustrating key issues
11.05-11.15 Small-group discussions
11.15-11.30 Muscle regeneration after injury
Haydar A. Demirel, Turkey
11.30-11.45 Classifying muscle injuries: useless or useful?
Johannes Tol, The Netherlands/Qatar
11.45-12.00 What are the keys to rehabilitation success?
Rod Whiteley, Qatar
12.00-12.15 Predicting prognosis–accurate classification or flawed fortunetelling?
Johannes Tol, The Netherlands/Qatar
12.15-12.30 When everything fails – what is the role of surgery in hamstring injuries?
Gino Kerkhoffs, The Netherlands
12.30-12.45 Panel: Review of cases and learning objectives
12.45-14.00 Lunch
14.00-15.30
Session 3: ACUTE INFECTIVE ILLNESS IN ATHLETES
Chair: Roald BAHR, Norway/Qatar
Format: Interactive (Kahoot/Mentimeter)
Speakers:
Olaf Schumacher, Qatar
Nick Webborn, United Kingdom
Martin Schwellnus, South Africa
Wayne Derman, South Africa
Learning objectives:
Participants will be able to:
- Identify risk factors for infection in athletes
- Develop a working plan to decrease the risk of infections in individual athletes and a team
- Be aware and screen for possible medical complications in athletes with an infection
- Know how antibiotic choices may be modified in athletes
Programme:
14.00-14.05 Introduction of the session (poll)
Roald Bahr, Norway/Qatar
14.05-14.20 Acute infections in athletes – Who is at risk? (intrinsic and extrinsic risk factors)
Olaf Schumacher, Qatar
14.20-14.40 Strategies for preventing of acute infective illness in your team
Nick Webborn, United Kingdom
14.40-14.55 Possible medical complications in athletes who exercise during an acute infective illness
Martin Schwellnus, South Africa
14.55-15.15 Antibiotic and other prescription medication for acute infections in athletes – which ones to use or not to use?
Wayne Derman, South Africa
15.15-15.30 Questions & Post-test (Quiz)
15.30-16.00 Coffee break
16.00-17.30
Session 4: MENTAL HEALTH SYMPTOMS AND DISORDERS: A CLINICAL APPROACH FOR THE TEAM PHYSICIAN
Chair: Simon KEMP, United Kingdom
Format: Case-based discussion
Speakers:
Margo Mountjoy, Canada
Vincent Gouttebarge, The Netherlands
Claudia Reardon, USA
Margot Putukian, USA
Learning objectives:
Participants will be able to:
- Understand the magnitude and aetiology of mental health symptoms and disorders based on the available scientific knowledge
- Be familiar with the IOC Sport Mental Health Assessment and Recognition Tools (SMHAT / SMHRT)
- Develop competency in the clinical approach to athlete mental symptoms and disorders:
- Treatment principles for the sport medicine physician
- The return to play following time away for mental health symptoms and disorders
- Develop a prevention program specifically targeted at high-risk sport situations for mental health symptoms and disorders
Programme:
16.00-16.05 Introduction of two cases illustrating key issues
16.05-16.15 Small-group discussions
16.15-16.30 Mental health symptoms and disorders in elite sport: Science base
Margo Mountjoy, Canada
16.30-16.45 Screening for mental health symptoms and disorders in elite sport
Vincent Gouttebarge, The Netherlands
16.45-17.00 Treatment principles for mental health symptoms and disorders in elite athletes
Claudia Reardon, USA
17.00-17.15 Prevention of mental health symptoms and disorders in elite athletes
Margot Putukian, USA
17.15-17.30 Panel: Panel discussion & Review of cases
Tuesday 29 September 2020
09.00-10.30
Session 5: MEDICAL ISSUES RELATED TO TRAVELLING WITH ATHLETES
Chair: Jiří DVOŘÁK, Switzerland
Format: Interactive (Kahoot/Mentimeter)
Speakers:
Christa Janse van Rensburg, South Africa
Martin Schwellnus, South Africa
Olaf Schumacher, Qatar
Wayne Derman, South Africa
Emin Ergen, Turkey/Qatar
Learning objectives:
Participants will be able to:
- Recognise and plan for possible medical issues related to travelling with athletes
- Recognise and plan for environmental issues related to travel
- Design a plan to reduce the negative effects of travel to foreign destinations
- Formulate a clinical approach to common illnesses related to travel
- Evaluate evidence that team illness prevention strategies are effective
Programme:
09.00-09.05 Introduction of session (poll)
Jiří Dvořák, Switzerland
09.05-09.20 Medical challenges – effects of travel fatigue and “jet lag”
Christa Janse van Rensburg, South Africa
09.20-09.30 Medical challenges – risk of illness/infections and injuries
Martin Schwellnus, South Africa
09.30-09.45 Medical challenges – environmental issues (seasons, altitude, temperature and humidity, pollution)
Olaf Schumacher, Qatar
09.45-10.00 Pre-travel preparation and approach to medical issues during travel: What the team physician should do?
Wayne Derman, South Africa
10.00-10.15 What to bring when you travel: The team physician’s medical bag
Emin Ergen, Turkey/Qatar
10.15-10.20 Are Team Illness Prevention Strategies (TIPS) effective?
Martin Schwellnus, South Africa
10.20-10.30 Questions & post-test (Quiz)
10.30-11.00 Coffee break
11.00-12.35
Session 6: NOVEL APPROACHES TO THE TREATMENT OF TENDINOPATHY – THE CASE OF THE PATELLAR TENDON
Chair: Margo MOUNTJOY, Canada
Format: Case-based discussions
Speakers:
Michael Kjær, Denmark
Rod Whiteley, Qatar
Ben Clarsen, Norway
Johannes Tol, The Netherlands/Qatar
Jón Karlsson, Sweden
Learning objectives:
Participants will be able to:
- Understand the pathogenesis of tendinopathy
- Become familiar with the effects of tendon loading
- Develop a clinical reasoning process that identifies those who should undertake conservative treatment, those who need further intervention and those who require surgical treatment
- Identify patients where further interventions such as Doppler-guided sclerosis, platelet-rich plasma injections, shock-wave therapy may be appropriate
Programme:
11.00-11.05 Introduction of two cases illustrating key issues
11.05-11.15 Small-group discussions
11.15-11.30 What is tendinopathy and why does it happen?
Michael Kjær, Denmark
11.30-11.45 The clinical assessment: history, physical examination, load assessment, demand
Rod Whiteley, Qatar
11.45-12.00 Physiotherapy management: First line
Ben Clarsen, Norway
12.00-12.10 Shock wave therapy, platelet-rich plasma or pharmaceutical treatments?
Johannes Tol, The Netherlands/Qatar
12.10-12.20 Does surgery work?
Jón Karlsson, Sweden
12.20-12.35 Panel: Case discussions: which is the first treatment option, and which the last line of defense?
12.35-13.30 Lunch
13.30-15.00
Session 7: ANKLE INJURIES – WHEN YOU HEAR HOOF BEATS, THINK HORSE, BUT DON’T FORGET THE ZEBRA
Chair: Simon KEMP, United Kingdom
Format: Interactive (Kahoot/Mentimeter)
Speakers:
Roald Bahr, Norway/Qatar
Gino Kerkhoffs, The Netherlands
Rod Whiteley, Qatar
Learning objectives:
Participants will be able to:
- Describe the differential diagnoses after an ankle sprain – and their typical history and likelihood
- Perform a quick but precise sideline management of an acute ankle injury
- Distinguish a lateral ligament injury from a syndesmotic injury
- Diagnose a peroneal tendon problem
- Recognize a serious midfoot injury mechanism
- Organize an accurate RTP program after an ankle injury
Programme:
13.30-13.35 Introduction of the session (poll)
Simon Kemp, United Kingdom
13.35-13.55 Sideline management of ankle sprains – assessment and initial treatment
Roald Bahr, Norway/Qatar
13.55-14.15 High ankle sprains – assessment and treatment
Gino Kerkhoffs, The Netherlands
14.15-14.30 How to return the elite athlete to play after an ankle sprain
Rod Whiteley, Qatar
14.30-14.50 Midfoot sprains – assessment and treatment
Gino Kerkhoffs, The Netherlands
14.50-15.00 Questions & post-test (Quiz)
15.00-15.30 Coffee break
15.30-17.00
Session 8: MANAGING CONCUSSIONS IN THE TEAM SETTING
Chair: Johannes TOL, The Netherlands/Qatar
Format: Case-based discussions
Speakers:
Jiří Dvořák, Switzerland
Simon Kemp, United Kingdom
Margo Mountjoy, Canada
Learning objectives:
Participants will be able to:
- Understand the 2016 Berlin Concussion Consensus statement and the key changes that have taken place in the clinical management of sports concussion
- Be able to use the CRT and SCAT5 tools appropriately in the sideline/pitch side assessment of concussion
- Understand the need to individualise and be able to prescribe safe RTP programs following concussion
- Understand the critical issues (e.g. long-term problems) and modifying factors that influence the clinical management of concussed athletes
Programme:
15.30-15.35 Introduction of two cases illustrating key issues
15.35-15.45 Small-group discussions
15.45-15.55 The 2016 Berlin Concussion Consensus Guidelines – what is new?
Jiří Dvořák, Switzerland
15.55-16.10 Acute sideline assessment and the role of the SCAT5
Simon Kemp, United Kingdom
16.10-16.25 The role of active rehabilitation – taking a targeted approach to therapy
Margo Mountjoy, Canada
16.25-16.55 Hands on with the SCAT5 – workshop participation
Simon Kemp, United Kingdom / Jiří Dvořák, Switzerland
16.55-17.00 Panel: review of cases Simon Kemp, United Kingdom
Wednesday 30 September 2020
09.00-10.30
Session 9: RELATIVE ENERGY DEFICIENCY IN SPORT (RED-S): CLINICAL APPROACH FOR THE TEAM PHYSICIAN
Chair: Karim KHAN, Canada
Format: Case-based discussions
Speakers:
Margo Mountjoy, Canada
Naama Constantini, Israel
Kathryn Ackerman, USA
Jane Moran, Canada
Learning objectives:
Participants will be able to:
- Describe the pathophysiology of RED-S
- Understand the health and performance presentations of Low Energy Availability
- Identify and work up patients with RED-S appropriately
- Manage patients with RED-S clinically
- Develop a prevention program specifically for an at-risk population
Programme:
09.00-09.05 Introduction of two cases illustrating key issues
09.05-09.15 Small-group discussions
09.15-09.30 What is RED-S?
Margo Mountjoy, Canada
09.30-09.45 Making the diagnosis of RED-S
Naama Constantini, Israel
09.45-10.00 Treatment protocols for RED-S
Kathryn Ackerman, USA
10.00-10.15 Prevention of RED-S
Jane Moran, Canada
10.15-10.30 Review of cases and learning objectives
10.30-11.00 Coffee break
11.00-12.30
Session 10: RETURN TO SPORT: HOW DO WE MAKE THE BEST RETURN TO PLAY DECISIONS FOLLOWING INJURY AND ILLNESS?
Chair: Robbart VAN LINSCHOTEN, The Netherlands
Format: Case-based discussions
Speakers:
Roald Bahr, Norway/Qatar
Martin Schwellnus, South Africa
Adam Weir, The Netherlands/Qatar
Rod Whiteley, Qatar
Learning objectives:
Participants will be able to:
- Design and implement a 3-step model for return-to-play that optimizes the medical decision making process
- Cite the non-medical factors that are part of decision making for return to play
Programme:
11.00-11.05 Introduction of two cases illustrating key issues
11.05-11.15 Small-group discussions
11.15-11.30 A decision-based model for return to play in sport
Roald Bahr, Norway/Qatar
11.30-11.50 What is the best practice for medical decision making in return to play following acute illness?
Martin Schwellnus, South Africa
11.50-12.00 Can imaging help make return to play decisions?
Adam Weir, The Netherlands/Qatar
12.00-12.15 How can functional testing help make return to play decisions?
Rod Whiteley, Qatar
12.15-12.30 Panel: Panel discussion – Clearance for sports: Ethical dilemmas illustrated by cases
12.30-13.30 Lunch
13.30-15.00
Session 11: PHARMACOLOGICAL TREATMENT OF ACUTE SPORTS INJURIES
Chair: Karim KHAN, Canada
Format: Case-based discussions
Speakers:
Robbart van Linschoten, The Netherlands
Lars Engebretsen, Norway/Switzerland
Michael Kjær, Denmark
Johannes Tol, The Netherlands/Qatar
Wayne Derman, South Africa
Learning objectives:
Participants will be able to:
- In relation to acute musculoskeletal injuries (muscle injuries or fractures), recite the pharmacology, contraindications, side effects and risks associated with the injection of local anesthetics/glucocorticoids/PRP, and prescription of NSAIDs
Programme:
13.30-13.35 Introduction of two cases illustrating key issues
13.35-13.45 Small-group discussions
13.45-13.55 Is there a place for NSAIDs or Cox-2 inhibitors in the treatment of acute muscle or ligament tears?
Robbart van Linschoten, The Netherlands
13.55-14.05 Is there a risk with NSAIDs or Cox-2 inhibitors in the treatment of fractures?
Lars Engebretsen, Norway/Switzerland
14.05-14.15 Is there a place for cortisone injections in the treatment of acute musculoskeletal injuries?
Michael Kjær, Denmark
14.15-14.25 Platelet-rich plasma injections for acute musculoskeletal injuries: do they work?
Johannes Tol, The Netherlands/Qatar
14.25-14.45 Treatment of pain in the athlete – The 2017 IOC consensus statement
Wayne Derman, South Africa
14.45-15.00 Panel: Review of cases and learning objectives
12.30-13.30 Coffee break
15.30-17.00
Session 12: THE GROIN/HIP ENIGMA IN SPORTS
Chair: Lars ENGEBRETSEN, Norway/Switzerland
Speakers:
Adam Weir, The Netherlands/Qatar
Üstün Aydıngöz, Turkey
Per Hölmich, Denmark
Jón Karlsson, Sweden
Learning objectives:
Participants will be able to:
- Understand the complexity of the various interconnections between structures in the groin
- Be aware of the complexity of diagnostic terminology used in groin injuries
- Understand the clinical entities approach to groin pain
- Understand the possibilities for imaging in athletic groin pain
- Show potential and limitations/common misunderstandings of imaging
- Know the evidence for the conservative treatment of athletic groin injuries
- Appreciate the timeframes for the various treatment modalities in groin injuries
- Have a framework to base the decision to refer for surgery on
- Describe the prevalence of hip injuries in athletes presenting with athletic groin pain
- Describe a system to make a diagnosis for athletes presenting with hip pain
- Know the options and evidence behaving conservative and surgical treatment for athletes with hip pain
Programme:
15.30-15.35 Introduction of two cases illustrating key issues
15.35-15.45 Small-group discussions
15.45-16.00 Groin pain: anatomy and diagnosis– what do I need to know as a team physician?
Adam Weir, The Netherlands/Qatar
16.00-16.15 Imaging in groin pain – what do I need to know as a team physician?
Üstün Aydıngöz, Turkey
16.15-16.30 Treatment of groin injuries
Per Hölmich, Denmark
16.30-16.45 The hip in athletic groin pain
Jón Karlsson, Sweden
16.45-17.00 Panel: Review of cases and learning objectives