HOW DOES A MEDICAL

SERVICE WORK IN A
PROFESSIONAL TEAM?
FCO. JAVIER LINDE COT

ORADEA 31 MAY 1 JUNE 2014

THE CLUB- STRUCTURE
Presidence

Vice-presidence (5)

Administration Council (8)

Council Delegate

Secretari of the council Sport Manager / Sports Director

Financial Director Medical Area*

Marketing director

Stadium Director

...
 THE CLUB - MEDICAL AREA
Medical Area

Professional Area Non- professional Area

Antonio Turmo (Head of Services Narciso Amigo (Responsible of non-

RCDE professional) professional health area)

Womens teams All U-18

First Team Second Team Youth Team Youth B team all categories categories

4 2
2 doctors physiotherapists 1 doctor physiotherapists Doctor, physio Doctor, physio, Match physios
(2 RT) (1 RT)
THE CLUB- OTHERS IN 1ST TEAM

Delegate
Physical Trainers
Physical Conditioning Assistants
Mass Media Responsible
Material Chargeds
Responsible of relationship players-club.
Technical stament (1st, 2nd, goalkeepers)

Each one has a very

important TASK to do
PLANNING
Previously to the end of the current season, planning of next one must be performed

It will be very important to determine working system. How many people will be
available? How many people in staff? Anything to take into account?

About Medical Service, the first thing to take into account is to preset medical checking,
as well as medical testing proceeds.
I.e. We do in the first 3 days of the preseason, medical checking and then isokinetic,
teniomyography, DJ test and other assessments.

It may be necessary to help in de development of conditioning tests.

It WILL be necessary to discuss and have dialogue with other departments in orther to
do everything on time (PC Technichal staff)

Alfredo Tena: Hemos funcionado como un grupo, porque no nos ha importado a

ninguno arremangarnos los brazos para ayudar a un compaero con su tarea
PLANNING
Why do we do medical checking and medical tests?

-Detecting underlying pathology

-Detecting risk factors
PLANNING
What do we get with medical checking?

- General medical checking

- Electrocardiograma
- Ecocardiograma
- MRI, US,...

Is there any heart disease?

It must be prevented sudden death
Cases: Dani Jarque (SD) /// Victor lvarez (surgeoned)
PLANNING
What do we get with medical tests?

- Global view of the player

- Detect injury risk factors
- With
- Isokinetic
- Tensiomyography
- 3D DJ test
- Medx*
- Others can be included
PLANNING
Injury prevention strategies:
-How do we test? What do we test? When do we test?

Preseason testing
At the end of each macrocycle (difficult!)
In determinate moments to determinate patients
PLANNING
Injury prevention strategies:
-Analyzing screening results and developing specific work.

Individual strategies
INFORMACIN GENERAL
Sinovitis cadera
RAUL%RODRGUEZ%
EJERCICIOS

How do that strategies work? Elevacin del culo y rotacin externa

Rodillas en flexin
Ombligo dentro
Elevaciones laterales cadera en flexin
Rodilla en extensin
Pie mira adelante, ombligo dentro
Ejercico perrito
Ombligo dentro
2x8 rep con cada pierna
2x6 repeticiones 2x8 rep con cada pierna

Ombligo dentro y aguantar "pi-p" Elevar una rodilla y bajar Extensin atrs de la pierna
Rodillas dobladas Velocidad lenta! No ha de bascular la pelvis
5 ventilaciones hasta apnea Ombligo dentro y aguantar "pi-p" Ombligo dentro
8 repeticiones con cada pierna 2x8 rep con cada pierna

Elevar un brazo y bajar, alternando Contraccin isomtrica adductores

Velocidad lenta! Piernas elevadas i ombligo dentro
Ombligo dentro y aguantar "pi-p" Mantener una activacin submxima
8 repeticiones con cada brazo 20 segundos
PLANNING
INFORMACIN GENERAL
TRABAJO NIVEL 1
MANU%LANZAROTE%
EJERCICIOS

Individual strategies

INFORMACIN GENERAL
Trabajo refuerzo isquiotibiales Rutina 2
CRISTIAN(STUANI(
( Squat a 1 pierna Elevar una rodilla y bajar Curl isquiotibiales
EJERCICIOS
Contrarrestar tensin goma Velocidad lenta! Bajar rapido subir lento a una pierna
Mantener rodilla neutra Ombligo dentro y tensin hacia arriba Carga 60-70% peso
6 repeticiones cada pierna 4 repeticiones con cada pierna 10-12 repeticiones por pierna

Curl isomtrico
Flexin mnima de rodilla y
mantener 15"
3 repeticiones por pierna
Extensin de cadera
Rodilla en extensin
8 repeticiones
PESO MUERTO
Squat a dos piernas Elevacin rodilla y flexin brazo opuesto Ejercico perrito
Usar la TRX para control rodilla Velocidad lenta Ombligo dentro
Mantener espalda recta Ombligo dentro y aguantar "pi-p" 8 rep con cada pierna
Peso muerto disco 20 kg 10 repeticiones 4 repeticiones de cada lado
Espalda recta
Rodillas semiflexionadas
8 repeticiones

Skipping variado 4 ejercicios

Peso muerto disco 10 kg Elevaciones laterales cadera en flexin Skipping variado 4 ejercicios
Elevacin glteo Espalda recta Rodilla en extensin
Disco 15 kg sobre cintura Rodillas semiflexionadas Pie mira adelante, ombligo dentro
Subir rpido bajar lento 5 repeticiones 6 rep con cada pierna
8 repeticiones
El
PLANNING
Injury prevention strategies:
-Analyzing screening results and developing specific work.

Full group strategies

CORE
FUNCTIONAL STRENGTH

How do we control them? Assistance list? Obligation? Our

job is to teach them this is important...
PLANNING
Injury prevention strategies:
Full group strategies
CORE

How do we proceed?
PLANNING
Injury prevention strategies:
Full group strategies
FUNCTIONAL STRENGTH

How do we proceed?
PLANNING
Injury prevention strategies:
-Analyzing screening results and developing specific work.

Little group strategies

-Depending on Q strength asymmetries

-Depending on H strength asymmetries
-Depending on Ratio
-Depending on technique
PLANNING
Injury prevention strategies:
LITTLE GROUP STRATEGIES

Ratio? Assymmetries?
PLANNING
It must be counted how many sessions have been performed

Assistance will be difficult to be 100% if is not obligation

Different roles of players must be tackled

Use the Van Mechelen basis to determine its utility.

PLANNING
PRE-SEASON
- Material. Prepared with time to be out about 15 days.
- Physiotherapy materials
- Nutrition and supplies
- Cold pool
- Others...
- Register activity
- Organize schedule for treatments in funtion of training and
number of sessions/day.
PLANNING
HOTEL STAGE (home or away)
When do we go to hotel? Distribution?
- Checklist
- Physiotherapy material
- Medical bag
- CPR
- Team clothing*
- Organize patients to be treated
- What kind of treatments?
PLANNING

COBERTURA SERVICIO FISIOTERAPIA

DURANTE LA SEMANA

MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY

Physio 1 Physio 2 Physio 3 Physio 4 Physio?
RTP ? RTP ? RTP ? RTP ? RTP ?
TASKS DISTRIBUTION
Which role has each of the professionals of medical service?

Head Doctor of professional area

1st Team Doctor
2 Physiotherapists
2 Physiotherapists + RTP
PATIENTS DISTRIBUTION
Is there a norm to distribute players to the physios?
There are many factors that will have effect on it...

-Individual preference of the player

-Personal interest of the player*
-Distribution per kind of pathology
-Distrubution per number of players being treated
-Distribution per availability

When a player starts a process with a professional, it should be

finished by the same. Different process can get different
professional
INJURY PROCESS
When it happens an injury episode...

First aid in the field?

If is not necessary, lead the player to the doctor to be examinded.

If the patient comes first to the physio because is not grave, analyze and talk to the
doctor to determine if he gest visit or not. Not always needed.

Information exchange ALWAYS between doctors and physiotherapists is REALLY

important. How do we use information can be as much important as the treatment
indeed.
INJURY PROCESS
After the first evaluation, process is discussed between doctor
and physiotherapist.

When must it be controled? Ultrasound? Does it need other

imagine techniques?

Caution with the message given to the player!

In normal processes, visited each 48 hours aprox; in particular

cases each day and sometimes before and after training.

Treatment and visits will be registered

INJURY PROCESS
Daily treatment should be recordered in a database
If the treatment does not requiere field or gym work, player
wont stop training normally
RETURN TO PLAY
If the process is important enough to make stop the player, it
will be necessary a process to bring him back to normal
training.
MASS MEDIA
Department of Mass Media and Marketing

Responsible and assistance of 1st Team Communication

Manages interviews, reports, radios, tvs and their

relationship with players and coaches.

Everyday press speach

Give information to mass media about injured players

according to diagnosis and discussion with the doctors.
HOW TO USE INFORMATION
All professionals have to give the same information to the
player
- Diagnosis
- Treatment purposal
- Timing...

If there are doubts, must be resolved before talking to the

player.

Only one message to him and environment.

DAILY ORGANISATION
Each individual has a responsibility.
- Preparing training drinks
- Preparing suplementation for after training

Meeting before training at the beginning of the morning

Treatment of patients
Help in training?
Treatment of patients
Meeting?
ABOUT THE GAME
PEOPLE AVAILABE IN
THE GAME
Who is in the bank?
Technichal Staff
Medical Staff (Team Doctor & 1 physio)
Delegate
Physical Conditiones

Others outside:
2nd physio when away, 4 when homely
2nd Doctor when homely
Mass media
Assistants, physical conditioners
Goalkeeper coach
...
WHERE DO WE PLAY THE
GAME?
Home
Look at cheklist
?

Away
Prepare material? What do we need?
Adapt to trip timing
STAGE IN HOTEL?
If there is no doctor, check menus.
Organizing schedule of breakfast, lunch and dinner with PC if
there is no doctor
Treatments
Wear always CPR, basic pills under medical prescription...
PREPARING MATERIAL...
Check medical kit
Check physiotherapy bag (taping, cream, cold spray...)
Check supplementation (bars, gels, fruit, energy drinks...)
Check CPR
Cold water pool (bring it if travelling. Check if homely)
Ice
Other materials (towels, colibrs...)

Check list!!!!
PRE - GAME
Check medical kit (AGAIN)
Prepare drinks (Pre / During / Post)
Prepare supplementation (gels, bars, cookies, fruits...)
Game activators (caffeine, taurine, others...)
Taping. What kind of?
Manual therapy
Active warm up / Manual activation. How??

What cant be done in pre-game?

DURING THE GAME
Medical kit always closer
Wearing always latex globes
Always look at the game
Ice pack ready
When can we get inside the field? Respect referee
Always respect medical criteria.
...
POST GAME
Recommend recovering measures
Cold baths
Hidration
Supplementation drinks
Chek for injuries? Ice application?
Stretching
...
MEDICAL KIT
Globes
Guedel cannula
Nasal packing
Adrenaline
Ventoln
Steri-strip
Blastoestimulina (scars)
Oral aids (ibuprofen, diclofenaco...)
Scissors
Epistaxol
MEDICAL KIT
Afterbite, relec
Stapler
Suture
Cold Spray
Vaseline
Iodine povidone
Adhesive spray
Taping (pretape, tape, CPK...)
Vicks vapo rub
Radiosalil
Omnifix
MEDICAL KIT
Second skin
Hot cream
Cold cream
Tuff Skin
Cap or closest to hold head taping
Gauze
...

Everything that might be necessary depending on sport

speciality. I.e. In waterpolo can be used a mesh to hold a
taping
Multumesc pentru atentie