Injury and Illness Prevention Monte Carlo style

17 May 2017
Dr Lisa Elkington

In March, the IOC held its Injury and Illness Prevention Conference in Monte Carlo. Australia was well represented at the conference with around 15 ACSEP Fellows, sports physiotherapists, exercise physiologists and sports science researchers. ACSEP Fellows Michael Makdissi, Mark Fulcher, Chris Milne and Steve Targett, gave excellent presentations in the symposium program, as did Geoff Verrall and Martin Raftery in the workshops.

The main take home message for me was that whilst injury prevention programs can be very effective, the challenge now is to increase compliance in the implementation phase for target populations. This seems to be the key to translating research findings into real world results outside the lab. As an example, Kristian Thorborg presented the results of a survey of Nordic medical staff working in the highest level football clubs in Scandinavian countries, where there was only 11% compliance in implementation of Nordic programs for hamstring injury prevention.

One of the highlights was the final keynote from Professor Jon Drezner, who led the latest International Criteria for ECG Interpretation in Athletes Consensus Statement. Jon discussed the challenges of interpreting the sports cardiology literature to date - including the pitfalls of misinformation and confirmation bias and the importance of critical reasoning in clinical decision making; the ethics of cardiac screening; and encouraged the scientific community to collaborate to form evidence based, clinically focused consensus statements.

A few other key messages for me were:

Sports cardiology:

  • 75% of all fatalities that occur during sports are cardiovascular related
  • New International criteria for ECG interpretation in athletes (published JACC Feb 2017) is an updated guideline to reflect the latest evidence and aims to provide clear advice for clinicians on appropriate evaluation of ECG abnormalities in athletes
  • The new criteria classifies ECG changes as normal, abnormal or borderline. One borderline feature in asymptomatic individuals is allowed without the need for further evaluation


  • Effective for detection of current injuries or issues
  • Important for reviewing medications, TUE requirements, and supplement use and building rapport with the athletes
  • Low predictive power for injury
  • Sport and nation specific, but in many cases, although risk factors are identified, there is no individualized follow up on these, to translate this in to prevent injury. Better to implement injury prevention strategy on entire target population


  • Source of tendon pain is still not clear
  • The pain involves a balance between excitatory and inhibitory influences of brain and spinal cord
  • Imaging doesn’t have much role if any, and monitoring imaging does not relate to symptoms
  • Appropriate load management is best way to keep athletes with tendon pain going

The IOC Conference was a fantastic opportunity to hear the latest SEM from our clinical and research colleagues around the globe. Being able to meet and chat (often over a glass of wine) with individuals who are absolute leaders in the field was an extraordinary opportunity and another highlight. I look forward to seeing more Aussie colleagues at the 2020 conference.