Gesellschaft für Orthopädisch-Traumatologische Sportmedizin

GOTS-Kongress 2013 | Fechten | Verbandsärzte

GOTS – Pressenewsletter 21.11.2012

Sehr geehrte Damen und Herren,

nach einem eindrucksvollen GOTS-Kongress 2012 in Salzburg ist Heidelberg/Mannheim im Juni 2013 erstmals Tagungsort der 28. Jahrestagung der deutschsprachigen Sportorthopäden und Sporttraumatologen. In wenigen Tagen endet die Abstract-Frist für diesen Kongress. In diesem Newsletter finden Sie außerdem weitere Veranstaltungshinweise der GOTS sowie eine Zusammenfassung der sportmedizinischen Herausforderungen im Fechtsport. Außerdem berichten wir von den Verbandsärtzen Deutschlands, die mit einem neuen Vorsitzenden in die Wintersaison gehen.

Mit freundlichen Grüßen,
Frank Wechsel und Dr. Wolfgang Schillings, GOTS-Pressesprecher

GOTS-Kongress 2013: Abstract-Frist endet am 1. Dezember

Die 28. Jahrestagung der Gesellschaft für Orthopädisch-Traumatologische Sportmedizin (GOTS) findet am 14. und 15. Juni 2013 erstmals in Mannheim statt. Kongresspräsident ist Prof. Dr. Holger Schmitt (Heidelberg), die wissenschaftliche Organisation liegt bei Prof. Dr. Matthias Buchner (Karlsruhe), PD Dr. Martin Engelhardt (Osnabrück), Dr. Michael Krüger-Franke (München), Dr. med. univ. Gerhard Oberthaler (Salzburg) und GOTS-Präsident Prof. Dr. Dr. Victor Valderrabano (Basel).

Auf der Kongress-Homepage finden Sie bereits jetzt alle wichtigen Informationen zur Jahrestagung 2013. Unter www.gots-kongress.org können Sie auch die Abstracts für Ihre Kongressbeiträge einreichen. Wichtig: Die Abstractfrist endet am 1. Dezember 2012.

GOTS-Kongress 2013
www.gots-kongress.org

GOTS-Kongress 2012
Die Bildergalerie aus Salzburg

Veranstaltungshinweise der GOTS

Am 1. und 2. Februar 2013 findet die 23. Jahrestagung des Berufsverbandes für Arthroskopie in Düsseldorf statt. Berufspolitische Themen gewinnen vor dem Hintergrund des allgemeinen Kostendrucks in Praxis und Klinik eine zunehmende Bedeutung. Schwerpunktmäßig möchten die Organisatoren der Jahrestagung, die unter dem Patronat der GOTS stattfindet, diskutieren, wie durch Möglichkeiten eines optimierten Prozessmanagements diesen Herausforderungen begegnet werden kann. Klinisch-operative Themen zu aktuellen Fragestellungen aus der Arthroskopie werden im Wechsel mit berufspolitischen Themen präsentiert. Den Kongressflyer finden Sie im hier, GOTS-Mitglieder erhalten einen Rabatt von 10 Prozent auf den Tagungsbeitrag.

Für Kurzentschlossene weisen wir auch auf das 11. Sporttraumatologische Symposium der Sportklinik Stuttgart am 1. Dezember 2012 hin. Den Flyer zum Symposium finden Sie ebenfalls im Anhang.

Verbandsärzte: Christian Schneider übernimmt Staffelstab von Hubert Hörterer

Auf der diesjährigen Mitgliederversammlung der Verbandsärzte Deutschland kam es zu einer Verjüngung an der Spitze. Der langjährige Vorsitzender der Verbandsärzte und noch immer als Leiter der medizinischen Kommission der FIS tätige Hubert Hörterer übergab die Präsidentschaft in geordneten Verhältnissen an Christian Schneider, den leitenden Verbandsarzt des Bob- und Schlittenverbandes.

In ihren Ämtern bestätigt wurden die stellvertretenden Vorsitzenden Bernd Wolfarth und Hans-Peter Boschert, Schriftführer Martin Engelhardt und Beiratsmitglied Casper Grim. Als Nachfolger des bisherigen Schatzmeisters wurde Matthias Ritsch gewählt.

Neben der Wissensvermittlung und der Förderung junger Kollegen im sportärztlichen Einsatz verstehen sich die Verbandsärzte als Interessenvertretung zur Verbesserung der Stellung der Ärzte in den Verbänden und im DOSB. Diesbezüglich wurde auf der Versammlung auch ein Antrag an den DOSB verabschiedet.

Traditionelles Anti-Doping-Seminar
Neben den Update-Informationen der NADA für den praktisch tätigen Sportarzt durch Martina Klein und einem Vortrag zum Andidopingmanagement aus verbandlicher Sicht durch Bernd Wolfarth gab es zwei wichtige Fachvorträge: Toni Graf-Baumann gab einen fundierten Überblick über den Einsatz von erlaubten Schmerzmitteln, insbesondere von Diclofenac. Wilfried Kindermann bot eine Übersicht zum legalen Einsatz von Cortison als Therapie in Abgrenzung zum illegalen Einsatz zum Zwecke der Leistungsmanipulation.

Schwere Verletzungen auch mit Todesfolge in neuen Wintersportdisziplinen
Hubert Hörterer präsentierte fundierte FIS-Studien über die tatsächlichen Verletzungen und Gefahren im Ski-Hochleistungssport. Er forderte die konsequente Umsetzung der Forderungen und Empfehlungen der medizinischen Kommission. Leider könnten die Ärzte jedoch nur Empfehlungen geben. Entscheidungen würden häufig aus wirtschaftlichen und medialen Gründen gegen ärztlichen Rat getroffen.

Peter Brucker präsentierte beeindruckende Präventionsmaßnahmen der FIS, um Knieverletzungen im alpinen Ski-Rennsport zu minimieren.

Bestürzend waren die Ausführungen von Heinz Kusche zu den schweren Verletzungen in den neuen Snowboard-Freestyle-Wettbewerben. Etliche Todesfälle unterstreichen, dass die Forderung der Verbandsärzte konsequenter umgesetzt werden müssen. Die Hauptforderung der Verbandsärzte waren:

Das wissenschaftliche Symposium wurde durch Vorträge zur Überlastungssymptomatik von Bernd Wolfarth und Aspekten der Ernährung am Wettkampftag durch Claudia Osterkamp-Baehrens abgerundet.

Fechten aus sportmedizinischer Sicht

Seit Beginn der Olympischen Spiele im Jahr 1896 ist Fechten eine der ausgewählten Sportarten. Im 17. Jahrhundert gehörte die Fechtkunsterziehung in Militärschulen und Universitäten. Während dieser Zeit entwickelte sich das Akademische Fechten, das nach streng definierten Regeln in fester Mensur (definierter Abstand der Sportler) durchgeführt wurde. Davon unabhängig entwickelte sich der moderne Fechtsport.

Beim modernen Sportfechten unterscheidet man drei verschiedene Waffen: Das Florett und der Degen sind Stichwaffen, der Säbel eine Hieb- und Stichwaffe. Je nach Waffe gibt es eine unterschiedlich definierte gültige Trefffläche und ein verschiedenes Regelwerk. Im Florett- und Säbelfechten erfolgt der Kampf nach den Regeln „Treffen, ohne getroffen zu werden“. Beim Florettfechten gilt nur der Rumpf (Torso) als gültige Trefffläche. Beim Säbelfechten wird nur ein Treffer gezählt, der oberhalb der Gürtellinie gesetzt wird. Nur im Degenfechten gilt der gesamte Körper als gültige Trefffläche. Außerdem gibt es Doppeltreffer, wenn beide Degenfechter innerhalb einer bestimmten Zeitspanne treffen. Dies führt zu einem anderen taktischen Vorgehen als beim Säbel- oder Florettfechten. In den letzten 30 Jahren hat sich neben dem Fußfechten das Rollstuhlfechten etabliert.

Trainingsmerkmale im modernen Fechtsport
Ein besonderes Augenmerk wird neben dem fechtsportspezifischen Training auf das Grundlagenausdauer-, Athletik- und Schnellkrafttraining gelegt. Entscheidend für den Erfolg sind die jeweilige Tagesform sowie die psychische Stabilität des Athleten.

Akute Verletzungen
Im Fechtsport kommt es selten zu akuten Verletzungen. Dabei muss unterschieden werden, ob die Verletzung während des Fechtens oder im Rahmen des Begleittrainings auftritt. Ausgelöst durch mangelndes Training, Überlastung, nicht adäquate Fechtkleidung oder situationsbedingt werden verschiedene akute Verletzungen festgestellt. Dabei sind am häufigsten Fuß- und Sprunggelenke (26 %), die Wirbelsäule (21 %) und das Handgelenk der waffenführenden Hand (21 %) betroffen.

Häufige Überlastungsschäden
Überlastungsschäden werden durch fechtsportspezifische Bewegungen begünstigt und treten insbesondere bei Übertraining, unregelmäßigem Training sowie bei strukturellen Veränderungen auf. An erster Stelle stehen bei Überlastungsschäden die Kniegelenke (34 %). Im Einzelnen handelt es sich dabei um einen nicht weiter differenzierbaren vorderen Kniegelenkschmerz bei gleichzeitig bestehender Einschränkung der Hüftbeuger und Abschwächung der Hüftstreckmuskulatur des vorderen Beines. Es folgen das Kniescheibenspitzensyndrom, die Ansatzentzündung des Kniescheibenbandes sowie die Schleimbeutelentzündung unterhalb des Kniescheibenbandes. An zweiter Stelle folgen Überlastungen an Fuß- und Sprunggelenken (24 %) mit Tendinosen und Peritendinosen im Bereich der Achillessehne und der Ferse sowie Mittelfußschmerzen. Bei langer Fechtkarriere finden sich nicht selten Gelenkkörper im oberen Sprunggelenk des vorderen Fußes. An dritter Stelle folgen Überlastungen am Unterschenkel (11 %) mit innerem Schienbeinkantensyndrom beidseits, dem Fußheber- sowie dem Fußaußenrandhebersyndrom.

Prävention
Aufgrund des unterschiedlichen Verteilungsmusters bei akuten Verletzungen und Überlastungsschäden in den verschiedenen Altersgruppen müssen detaillierte Empfehlungen gegeben werden. Um die gehäuft auftretenden Verletzungen und Überlastungen an Fuß- und Sprunggelenken zu vermeiden, sollte zum einen auf eine exakte Durchführung der Beinarbeit geachtet werden. Zum anderen sollte eine konsequente Einlagenversorgung erfolgen, da es nachweislich am vorderen sowie hinteren Fuß zu erheblichen Druckbelastungen an unterschiedlichen Bereichen des Fußes kommt. Aufgrund der profilierten Fechtstellung sowie des Passganges sind typische muskuläre Dysbalancen an Rumpf und Extremitäten festzustellen. Um diese zu vermeiden, sind ein ständiges Ausgleichstraining sowie ein frühzeitiges Krafttraining ab dem Jugendalter notwendig.

Tabelle 1: Akute Sportverletzung (Wettkampfphase 1993-1996)

bis 16 Jahre älter als 16 Jahre Summe
Hand, Handgelenk 49 22,0% 32 13,7% 81 17,8%
Ellenbogen, Unterarm 5 2,2% 5 2,1% 10 2,1%
Schulter 4 1,8% 11 4,7% 15 3,2%
Wirbelsäule 35 15,7% 67 38,0% 102 22,4%
Oberschenkel/Hüftregion 39 17,5% 31 13,3% 70 15,3%
Kniegelenk 22 9,9% 13 5,5% 35 7,6%
Unterschenkel 3 1,3% 4 1,7% 7 1,5%
Fuß/Sprunggelenke 65 29,2% 70 30,0% 135 29,6%
Summe 222 100,0% 233 100,0% 455 100,0%

 

Tabelle 2: Überlastungsbedingte Beschwerden (Wettkampfphase 1993-1996)

bis 16 Jahre älter als 16 Jahre Summe
Hand, Handgelenk 6 3,8% 4 2,1% 10 2,9%
Ellenbogen, Unterarm 2 1,2% 6 3,8% 8 2,3%
Schulter 4 2,5% 26 16,6% 30 8,7%
Wirbelsäule 21 13,4% 8 5,1% 29 8,5%
Oberschenkel/Hüftregion 15 9,6% 18 11,5% 33 9,6%
Kniegelenk 70 44,8% 56 35,8% 126 36,9%
Unterschenkel 6 3,8% 11 7,0% 17 4,9%
Fuß/Sprunggelenke 32 20,5% 56 35,8% 88 25,8%
Summe 156 100,0% 185 100,0% 314 100,0%

Über den Autor: Dr. med. Axel. Jäger; Facharzt für Orthopädie, Praxisklinik in Tauberbischofsheim; Chirotherapie, Sportmedizin, Unfallarzt für Berufsgenossenschaften; Ambulante Operationen mit Tätigkeitsschwerpunkt arthroskopische Knie- und Fußchirurgie; betreuender Orthopäde des Olympiastützpunktes Fechten Tauberbischofsheim seit 1985; Verbandsarzt seit 1985; Olympiaarzt 2004 in Athen; ehemaliger Degen-Nationalfechter

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  38. {Tôi hạnh phúc hơn cả vui để tìm thấy trang web này. Tôi muốn cảm ơn bạn {vì đã|dành thời gian cho|chỉ vì điều này|vì điều này|cho bài đọc tuyệt vời này!! Tôi chắc chắn thực sự thích từng một chút nó và tôi cũng đã đã lưu vào mục ưa thích để xem điều mới trên trang web của bạn.|Tôi có thể chỉ nói rằng thật thoải mái để khám phá một người mà thực sự biết họ là gì thảo luận trên internet. Bạn chắc chắn biết cách đưa một rắc rối ra ánh sáng và làm cho nó trở nên quan trọng. Nhiều người hơn nữa thực sự cần kiểm tra điều này và hiểu khía cạnh này câu chuyện của bạn. Tôi đã ngạc nhiên bạn không nổi tiếng hơn vì bạn chắc chắn sở hữu món quà.|Rất tốt bài viết trên blog. Tôi chắc chắn yêu thích trang web này. Tiếp tục làm tốt!|Thật khó tìm những người có kinh nghiệm về điều này, nhưng bạn nghe có vẻ bạn biết mình đang nói gì! Cảm ơn|Bạn cần tham gia một cuộc thi dành cho một trang web trên mạng hữu ích nhất. Tôi sẽ khuyến nghị trang web này!|Một hấp dẫn đáng giá bình luận. Tôi tin rằng bạn cần xuất bản thêm về chủ đề này, nó có thể không là một điều cấm kỵ chủ đề nhưng thường xuyên mọi người không thảo luận những chủ đề như vậy. Đến phần tiếp theo! Chúc mừng!|Chào bạn! Tôi chỉ muốn cho bạn một rất to cho thông tin tuyệt vời bạn có ở đây trên bài đăng này. Tôi sẽ là trở lại trang web của bạn để biết thêm thông tin sớm nhất.|Sau khi tôi ban đầu để lại bình luận tôi có vẻ như đã nhấp vào hộp kiểm -Thông báo cho tôi khi có bình luận mới- và bây giờ mỗi lần được thêm vào tôi nhận được bốn email có cùng nội dung. Phải có một cách bạn có thể xóa tôi khỏi dịch vụ đó không? Cảm ơn.|Lần sau Tôi đọc một blog, Tôi hy vọng rằng nó sẽ không thất bại nhiều như bài này. Rốt cuộc, Tôi biết điều đó là sự lựa chọn của tôi để đọc, dù sao thì tôi thực sự nghĩ bạn sẽ có điều gì đó hữu ích để nói về. Tất cả những gì tôi nghe được là một loạt phàn nàn về điều gì đó mà bạn có thể sửa nếu bạn không quá bận tìm kiếm sự chú ý.|Đúng với bài viết này, tôi hoàn toàn tin trang web này cần nhiều hơn nữa sự chú ý.

  39. {Tôi rất vui khám phá trang này. Tôi muốn cảm ơn bạn {vì đã|dành thời gian cho|chỉ vì điều này|vì điều này|cho bài đọc tuyệt vời này!! Tôi chắc chắn thích từng của nó và tôi đã đánh dấu để xem những thứ mới trên trang web của bạn.|Tôi có thể chỉ nói rằng thật thoải mái để khám phá một người mà thực sự hiểu họ là gì thảo luận trên internet. Bạn thực sự biết cách đưa một rắc rối ra ánh sáng và làm cho nó trở nên quan trọng. Nhiều người hơn nữa phải đọc điều này và hiểu khía cạnh này câu chuyện của bạn. Tôi đã ngạc nhiên rằng bạn không nổi tiếng hơn cho rằng bạn chắc chắn có món quà.|Rất hay bài đăng. Tôi chắc chắn đánh giá cao trang web này. Tiếp tục làm tốt!|Thật khó đến những người có hiểu biết sâu rộng trong chủ đề cụ thể này, nhưng bạn có vẻ bạn biết mình đang nói gì! Cảm ơn|Bạn cần tham gia một cuộc thi dành cho một trang web trên mạng có chất lượng cao nhất. Tôi sẽ Rất khuyến nghị trang web này!|Một hấp dẫn chắc chắn đáng giá bình luận. Tôi nghĩ rằng bạn cần xuất bản thêm về chủ đề này, nó có thể không là một điều cấm kỵ chủ đề nhưng nói chung mọi người không nói về chủ đề như vậy. Đến phần tiếp theo! Cảm ơn rất nhiều!|Chào buổi sáng! Tôi chỉ muốn đề nghị rất cho thông tin xuất sắc bạn có ngay tại đây trên bài đăng này. Tôi sẽ là quay lại blog của bạn để biết thêm thông tin sớm nhất.|Sau khi tôi ban đầu để lại bình luận tôi có vẻ như đã nhấp hộp kiểm -Thông báo cho tôi khi có bình luận mới- và từ bây giờ mỗi lần được thêm vào tôi nhận được bốn email cùng chính xác một bình luận. Phải có một phương tiện bạn có thể xóa tôi khỏi dịch vụ đó không? Kudos.|Lần sau Tôi đọc một blog, Tôi hy vọng rằng nó sẽ không làm tôi thất vọng nhiều như bài này. Ý tôi là, Vâng, đó là sự lựa chọn của tôi để đọc hết, dù sao thì tôi thực sự nghĩ có lẽ có điều gì đó hữu ích để nói về. Tất cả những gì tôi nghe được là một loạt tiếng rên rỉ về điều gì đó mà bạn có thể sửa nếu bạn không quá bận tìm kiếm sự chú ý.|Đúng với bài viết này, tôi thực sự tin rằng trang web này cần nhiều hơn nữa sự chú ý.

  40. {Tôi khá hài lòng khám phá trang này. Tôi muốn cảm ơn bạn {vì đã|dành thời gian cho|chỉ vì điều này|vì điều này|cho bài đọc tuyệt vời này!! Tôi chắc chắn thực sự thích từng một chút nó và tôi đã đã lưu vào mục ưa thích để xem thông tin mới trong trang web của bạn.|Tôi có thể chỉ nói rằng thật thoải mái để khám phá một người mà thực sự hiểu họ là gì thảo luận trên web. Bạn thực sự nhận ra cách đưa một vấn đề ra ánh sáng và làm cho nó trở nên quan trọng. Nhiều người hơn nữa nên kiểm tra điều này và hiểu khía cạnh này câu chuyện của bạn. Tôi đã ngạc nhiên rằng bạn không nổi tiếng hơn vì bạn chắc chắn sở hữu món quà.|Rất hay bài viết. Tôi chắc chắn đánh giá cao trang web này. Tiếp tục làm tốt!|Thật khó tìm những người có hiểu biết sâu rộng trong chủ đề cụ thể này, tuy nhiên, bạn nghe có vẻ bạn biết mình đang nói gì! Cảm ơn|Bạn nên là một phần của một cuộc thi dành cho một blog trên mạng tốt nhất. Tôi sẽ khuyến nghị trang web này!|Một hấp dẫn đáng giá bình luận. Tôi tin rằng bạn nên xuất bản thêm về chủ đề này, nó có thể không là một điều cấm kỵ chủ đề nhưng thường xuyên mọi người không nói về chủ đề những điều này. Đến phần tiếp theo! Cảm ơn rất nhiều!|Chào bạn! Tôi chỉ muốn đề nghị rất to cho thông tin tuyệt vời bạn có ngay tại đây trên bài đăng này. Tôi đang quay lại trang web của bạn để biết thêm thông tin sớm nhất.|Sau khi tôi ban đầu bình luận tôi có vẻ như đã nhấp vào hộp kiểm -Thông báo cho tôi khi có bình luận mới- và từ bây giờ mỗi lần được thêm vào tôi nhận được bốn email có cùng nội dung. Có một phương pháp dễ dàng bạn có thể xóa tôi khỏi dịch vụ đó không? Cảm ơn rất nhiều.|Lần sau Tôi đọc một blog, Tôi hy vọng rằng nó không thất bại nhiều như bài này. Rốt cuộc, Tôi biết điều đó là sự lựa chọn của tôi để đọc, nhưng tôi thực sự nghĩ bạn sẽ có điều gì đó hữu ích để nói. Tất cả những gì tôi nghe được là một loạt khóc lóc về điều gì đó mà bạn có thể sửa nếu bạn không quá bận tìm kiếm sự chú ý.|Đúng với bài viết này, tôi thực sự cảm thấy trang web này cần nhiều hơn nữa sự chú ý.

  41. {Tôi đã rất hài lòng để tìm thấy trang web này. Tôi muốn cảm ơn bạn {vì đã|dành thời gian cho|chỉ vì điều này|vì điều này|cho bài đọc tuyệt vời này!! Tôi chắc chắn thích từng một phần nó và tôi cũng đã đã đánh dấu trang để xem thông tin mới trên trang web của bạn.|Tôi có thể chỉ nói rằng thật thoải mái để khám phá một người mà thực sự hiểu họ là gì đang nói về trên web. Bạn chắc chắn biết cách đưa một rắc rối ra ánh sáng và làm cho nó trở nên quan trọng. Nhiều người hơn cần xem điều này và hiểu khía cạnh này câu chuyện của bạn. Tôi không thể tin bạn không nổi tiếng hơn vì bạn chắc chắn có món quà.|Rất hay bài đăng. Tôi hoàn toàn yêu thích trang web này. Cảm ơn!|Thật khó tìm những người có học thức cho điều này, tuy nhiên, bạn có vẻ bạn biết mình đang nói gì! Cảm ơn|Bạn cần là một phần của một cuộc thi dành cho một trang web trên internet có chất lượng cao nhất. Tôi sẽ khuyến nghị blog này!|Một cuộc thảo luận thú vị đáng giá bình luận. Tôi nghĩ rằng bạn cần viết thêm về chủ đề này, nó có thể không là một điều cấm kỵ vấn đề nhưng điển hình mọi người không nói về những chủ đề những điều này. Đến phần tiếp theo! Trân trọng!|Xin chào! Tôi chỉ muốn đề nghị rất cho thông tin tuyệt vời bạn có ngay tại đây trên bài đăng này. Tôi sẽ là quay lại trang web của bạn để biết thêm thông tin sớm nhất.|Sau khi tôi ban đầu để lại bình luận tôi có vẻ như đã nhấp hộp kiểm -Thông báo cho tôi khi có bình luận mới- và từ bây giờ mỗi lần được thêm vào tôi nhận được 4 email cùng chính xác một bình luận. Phải có một cách bạn có thể xóa tôi khỏi dịch vụ đó không? Cảm ơn bạn.|Lần sau Tôi đọc một blog, Hy vọng rằng nó không thất bại nhiều như bài này. Rốt cuộc, Vâng, đó là sự lựa chọn của tôi để đọc hết, dù sao thì tôi thực sự tin bạn sẽ có điều gì đó thú vị để nói. Tất cả những gì tôi nghe được là một loạt khóc lóc về điều gì đó mà bạn có thể sửa nếu bạn không quá bận tìm kiếm sự chú ý.|Đúng với bài viết này, tôi thành thật tin trang web này cần nhiều hơn nữa sự chú ý.

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