2. Goals Tonight Confirm common vision: – Promote and improve educational based athletics for all WCPSS students – Focus on minimizing risks and maximizing athletic performance through education – Provide overview of WakeMed SportFit opportunities – Explore your educational needs and how we can maximize this partnership Introduce a simple injury prevention program proven to reduce up to 50% of injuries and keep your players on the field

3. General Overview: – We recognize WCAA is new and our desire to evolve this relationship to meet your needs – We want to help coaches and athletes succeed

4. What we offer: resources, education and expertise – Concussion – Nutrition/hydration – CPR and cardiac related care – Injury Prevention Programs – Treatment, rehab and SAFE return to sport

5. Why do we play sports? Sports are generally safe Benefits Exercise Social Development Team Work Bone and muscle health Decreased obesity and diabetes

6. The “GOOD AND BAD” Problem 45 million youth participate in organized sports Young athletes are specializing in sports (and positions) at an earlier age, with one sport, year round participation. Increased injuries due to: increasing body mass supported by immature bones suboptimal training, conditioning and equipment failure to recognize early injuries insufficient REST after injuries Source: Centers for Disease Control and Safe Kids USA OVERUSE INJURIES - account for half of all sports injuries

7. Sports Injuries are Very Common Up to 19% of the ER visits are sports related Middle & High School athletics account for >2 million injuries annually 3-8 Xs more common in women

8. Sport Organized Activities Unorganized Activities Football61,139117,057 Basketball55,869165,355 Baseball53,112115,948 Soccer28,16540,978 Hockey21,311 combined Gymnastics13,58821,183 Volleyball7,53014,688 775,000 Children Under 15 Treated in Emergency Rooms for Sports Injuries Source: The National Electronic Injury Surveillance System

9. Knee injuries are INCREASING Each Year: Knee ligament injuries account for more than 30% of time lost 3 45,000 female athletes <19 yo experience an Anterior Cruciate Ligament (ACL) injury

10. Young, active people typically need surgery Allows stable knee and return to sport (at 6 – 12 months) Many athletes never return to pre-injury functional status Prevents further injury: cartilage (70%) & meniscal tears (98%) 10 Bach, AJSM 1995

11. How do ACL Injuries Occur? In most cases (70%) Non-Contact Injury (no collision) Knee collapses into a “knock-knee” position (valgus) Hip rotates inward (internal rotation) Muscular imbalance

13. How can we prevent ACL injuries? Knee collapse into a “knock-knee” position (valgus) Hip rotating inward Muscular imbalance Jump and land differently We can train our muscles to resist:

14. Research: ACL Prevention Project* PEP Program Prevent Injury and Enhance Performance http://smsmf.org/smsf-programs/pep-program The Santa Monica Sports Medicine Research foundation 1.Avoidance 2.Flexibility 3.Strengthening 4.Plyometrics 5.Agilities *Mandelbaum Am J Sports Med. 2005

15. Results From PEP Program Enrolled: 1041 athletes 2 ACL tears Control: 1901 athletes 32 ACL’s Mandelbaum Am J Sports Med. 2005 Overall 88% reduction in ACL tears

16. CDC/NCAA Randomized Controlled Trial* The PEP Program NCAA Division I Women’s soccer 61 teams enrolled – Control: 833 athletes (no intervention) – Enrolled: 561 athletes (performed intervention program) *Gilchrist, J. Am J Sports Med. 2008

17. Results of NCAA Study 1,394 AthletesControl 833 Intervention 561 % Decrease Total (training & games) ACL Tears102 72% Training ACL Tears30 100% Gilchrist, J. Am J Sports Med. 2008

18. Results of NCAA Study (cont’d) 1,394 AthletesControl 833 Intervention 561 % Decrease Late in Season (weeks 6-11 ) ACL Tears30 100% History of ACL surgery New ACL Tear40100% Prevent Re-injury! Gilchrist, J. Am J Sports Med. 2008

19. INJURY PREVENTION IS POSSIBLE!! So why isn’t everyone already doing it??

20. Challenges with Prevention Programs Not enough time Not enough money Low Motivation Athletes adherence Lack of coaching role (education and time)

21. INJURY PREVENTION MADE SIMPLE 11+ = comprehensive 20 minute injury prevention warm-up program Initial running exercises (8 minutes) Strength, plyometric, balance, & coordination (10 minutes) Final- speed running (2 minutes)

22. Injury Prevention Program Designed to reduce the most frequent athletic injuries: Ligament injuries (ACL, MCL) Muscles injuries of thigh (Quad and hamstring strains) Ankle sprains Overuse injuries

23. GOAL: Core-hip-Knee Control Poor leg control increases risk for injuries. Master in a controlled environment, translates to the field of play. DEFENSE MECHANISM Improves agility, power and performance

24. Research Confirms Success 93 Youth teams 1,892 female players Randomized- Intervention or Control (no intervention) Average age 15.4y Minimum 2x per week training 8 months intervention (2 seasons) Soligard T, et al., Brit Med Journal Dec, 2008

25. Proven Results - Injury Reductions InterventionControlReduction All13.0%19.8%34.3% Match Injuries9.1%13.6%33.1% Training Injuries4.7%7.5%37.3% Acute Injuries10.6%15.5%31.6% Overuse Injuries2.6%5.7% 54.4% Severe Injuries4.3%8.6% 47.7% Soligard T, et al., Brit Med Journal Dec, 2008

26. Downloadable Handouts and Videos

28. 11+ PROGRAM VIDEO EXAMPLE

29. Key points to remember Not all sports injuries can be prevented, but most can be significantly reduced FIFA 11+ – A clinically proven simple 20-minute warm-up program that prevents up to 50% of injuries – No expensive equipment or gym membership required – 11+ can be done anywhere, anytime, by anyone – The IDEAL time: practice/training Goal: the “routine”

30. NEXT STEPS Confirm common goal – Collaborate to minimize risks, maximize performance through education For success, we need to hear form you – Bobby emailing a survey for greatest needs What works best? – Large group sessions (coaches and staff) – Individual team and/or parent sessions

31. THANK YOU FOR YOUR ATTENTION! “Success is not an accident. It is hard work, perseverance, learning, studying, sacrifice, and most of all, love of what you are doing or learning to do” - Pelé

32. References: 1. Mandelbaum BR, et al. Cartilage Issues in Football (Soccer): An Executive Summary of the Federation International de Football Association (FIFA) / International Cartilage Repair Society (ICRS) Initiative. Cartilage. 2012;3(Suppl. 1). 2. Bekkers JEJ, et al. Cartilage Repair in Football (Soccer) Athletes: What Evidence Leads to Which Treatment? A Critical Review of the Literature. Cartilage. 2012;3(Suppl. 1). 3. Hambly K, et al. Cartilage Issues in Football (Soccer): An Executive Summary of the Federation International de Football Association (FIFA) / International Cartilage Repair Society (ICRS) Initiative. Cartilage. 2012;3(Suppl. 1). 4. Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report. September 29, 2006 / Vol. 55 / No. 38. 5. Renstrom P. et al. Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement. Br. J Sports Med 2008; 426 394-412 6. Mandelbaum BR, et al. Cartilage Issues in Football (Soccer): An Executive Summary of the Federation International de Football Association (FIFA) / International Cartilage Repair Society (ICRS) Initiative. Cartilage. 2012;3(Suppl. 1). Sports Med 2008. 7. Soligard T, et al. A comprehensive warm-up programme to prevent injuries in female youth football : a cluster randomized controlled trial. BMJ Dec9, 2008. 8.,9. Lee HH, et al. Clinical and Basic Science of Cartilage Injury and Arthritis in the Football (Soccer) Athlete. Cartilage. 2012;3(Suppl. 1). 10,.11. Bekkers JEJ, et al. Cartilage Repair in Football (Soccer) Athletes: What Evidence Leads to Which Treatment? A Critical Review of the Literature. Cartilage. 2012;3(Suppl. 1). 12. http://www.medicinenet.com/dehydration/article.htmhttp://www.medicinenet.com/dehydration/article.htm