GOTS – Newsletter vom 23.03.2010
Sehr geehrte Damen und Herren,
am heutigen Abend beginnt in Turin (Italien) die Weltmeisterschaft im Eiskunstlauf. Betrachtung aus der Sicht der Sportmedizin. Gerade in einer Saison mit zwei Höhepunten – den Olympischen Spielen und den Titelkämpfen – ist eine sportorthopädische und sporttraumatologische Begleitung der Athleten besonders wichtig. Mehr dazu finden Sie in diesem Newsletter.
Mit freundlichen Grüßen,
Frank Wechsel und Dr. Wolfgang Schillings, GOTS-Pressesprecher
Verletzungen und Überlastungsschäden im Eiskunstlauf
Die Eiskunstlauf-Weltmeisterschaft 2010 findet vom 22. bis 28. März in Turin/Italien im Torino Palavela statt, wo bereits vor vier Jahren die Olympischen Winterspiele ausgetragen wurden. Weltmeisterschaften im Anschluss an Olympische Spiele sind immer wieder eine besondere Herausforderung für Athleten und Betreuer, gilt es doch neben der Form auch die entsprechende Motivation zu erhalten beziehungsweise neu aufzubringen.
Eiskunstlauf ist eine Sportart, die Kunst und Ästhetik mit Kraft und Athletik in einzigartiger Weise vereint. Galt Eiskunstlauf früher als Wintersportart, so kann aufgrund der wachsenden Zahl an Eishallen vielerorts Eislaufen auch ganzjährig ausgeübt werden. Eiskunstlauf beinhaltet insgesamt vier Disziplinen: Einzel (Männer und Frauen), Paarlaufen sowie den Eistanz. Der Paarlauf kombiniert die klassischen Elemente wie Sprünge, Sprungkombinationen, Pirouetten und Drehungen mit Hebefiguren und Würfen, wohingegen beim Eistanz neben den rein sportlichen Anforderungen der tänzerische Aspekt mit Interpretation der Musik im Vordergrund steht.
Extreme technische Anforderungen
Wie kaum eine andere Sportart kombiniert das Eiskunstlaufen die sportmotorischen Eigenschaften Kraft (die Schnellkraft, Kraftausdauer und Maximalkraft umfasst), Beweglichkeit, Artistik, Musik- und Rhythmusgefühl und nicht zuletzt die Kombination der einzelnen Fähigkeiten zu einem „motorischen Ganzen“. Die steigenden technischen Anforderungen sind unter Berücksichtigung der genannten motorischen Größen nur mit einem im Kindesalter beginnenden und auf Langfristigkeit ausgelegten Training zu meistern. Elite-Eiskunstläufer trainieren im Schnitt bis zu acht Stunden pro Tag, sechsmal die Woche, zwischen zehn und elf Monate im Jahr. Bereits im Kindesalter sind 10 bis 14 Stunden Training pro Woche keine Seltenheit. Es gilt dabei, die verschiedenen motorischen Fähigkeiten zunächst zu erlernen und später durch Repetition im Training zu vertiefen.
Akute und chronische Verletzungen
Trotz großer Trainings- und Wettkampfbelastungen ist die Gesamtzahl der Verletzungen beim Eiskunstlaufen bezogen auf die Trainingsstunden als gering anzusehen. So kommt es durchschnittlich zu 1,4 Unfällen mit Verletzungsfolge pro 1.000 Trainingsstunden.
Grundsätzlich müssen akute von chronischen Verletzungen und Überlastungsschäden abgegrenzt werden. Dabei unterscheiden sich die einzelnen Disziplinen maßgeblich voneinander: Während im Einzellaufen die Überlastungsschäden wie chronische Sehnenbeschwerden und Ermüdungsbrüche im Vordergrund stehen, überwiegen sowohl im Paarlauf als auch im Eistanz die akuten Verletzungen durch Stürze und Kollisionen. Bei den chronischen Verletzungen und Überlastungsproblemen sind meist die unteren Extremitäten betroffen. Man findet Ermüdungsbrüche (bis 20%) ebenso wie Sehnenerkrankungen (Jumpers Knee 15%) und Schleimbeutelentzündungen über den Knöcheln und dem Fußrücken durch die chronische Druckbelastung. Das akute Verletzungsspektrum reicht von Hautabschürfungen über Sprunggelenksverstauchungen bis hin zu Frakturen und Schädelverletzungen.
Psychische Erkrankungen
Neben den akuten und chronischen Verletzungen mit Überlastungsphänomenen des Bewegungsapparates spielen auch psychophysische Erkrankungen wie Ess- und Ernährungsstörungen, die „Female Athlete Triad“ (Essstörung, Amenorrhö und Osteoporose), aber auch rein psychologische Problemkreise in der Wechselbeziehung und Einflussnahme zwischen Athlet, Trainer und Eltern eine wichtige, nicht zu vernachlässigende Rolle. Gerade bei diesen komplexen Störungen, die vielfach eine sehr variable und auch vielgestaltige Ursache haben, ist eine Zusammenarbeit der einzelnen Personengruppen im Sinne der Vorbeugung ein entscheidendes Maß für den Erfolg im medizinischen und letztlich im sportlichen Bereich.
Anforderungen an den Sportarzt
Die Anforderungen an den Sportarzt umfassen fast das gesamte Spektrum der Sportmedizin. Stehen während der Wettkämpfe vor allem akute Verletzungen im Vordergrund, so kommt es in den Trainingsphasen neben Verletzungen sehr häufig zu Überlastungsproblemen. Internistische und allgemeinmedizinische Fragestellungen wie beispielsweise chronischer Eisenmangel gehören ebenso dazu wie Infekte und „overstrain“ (=Überforderung).
Insgesamt gesehen ist Eiskunstlaufen eine Sportart, die trotz intensiver körperlicher Belastung und einem großen zeitlichen Aufwand verschiedene motorische Eigenschaften bereits im Kindes- und Jugendalter fördert und gemessen an anderen Sportarten trotzdem ein relativ geringes Verletzungsrisiko darstellt.
Tabelle: Akute Verletzungen bei Elite-Junior-Eiskunstläufern
(Dubravcic-Simunjak et al. 2003)
Damen n=236 | Herren n=233 | |||||
Einzel n=107 | Paarlauf n=61 | Eistanz n=68 | Einzel n=104 | Paarlauf n=61 | Eistanz n=68 | |
Sprunggelenksdistorsionen | 16,8% | 13,5% | 3,4% | 15,4% | 10,8% | 3,1% |
Bandverletzungen am Knie | 5,1% | 1,8% | – | 4,6% | 3,1% | 1,5% |
Schulterluxationen | – | 3,4% | – | – | 4,6% | – |
Weichteilverletzungen | – | 13,5% | 6,8% | – | 7,7% | 6,2% |
Kopfverletzungen | – | 13,5% | – | – | 7,7% | 1,5% |
Oberarmfrakturen | 3,4% | 6,8% | – | 6,2% | 3,1% | – |
Oberschenkelfrakturen | 5,1% | 3,4% | – | 6,2% | 3,1% | – |
Knieverletzungen | – | 3,4% | – | 4,6% | 1,5% | – |
Handgelenksfrakturen | – | – | – | – | 4,6% | 3,1% |
Fingerfrakturen | – | – | – | – | 1,5% | – |
Maßnahmen zur Vorbeugung von Verletzungen
- Tragen von Helm und Protektoren beim Training
- Vermeidung und Vorbeugung muskulärer Dysbalancen
- variable Trainingsgestaltung
- alternative Trainingsreize
- aktive Erholungsmaßnahmen
- gezieltes muskuläres Aufbautraining
- aktive Regenerationsmaßnahmen
- Beachtung einer guten Zusammenarbeit zwischen Athlet, Trainer, Arzt und Psychologen
Autor: Dr. Andreas Gösele-Koppenburg, Swiss Olympic Medical Center, crossklinik in Basel/Schweiz
In eigener Sache: Sind Ihre Kontaktdaten aktuell?
Liebe GOTS-Mitglieder,
sind wir auf dem aktuellen Stand? Bitte prüfen Sie Ihre persönlichen Daten, die in der GOTS-Datei auf der Website www.gots.org hinterlegt sind. Mit Ihrer E-Mail-Adresse haben Sie den Zugang.
Herzlichen Dank,
Ihre GOTS-Geschäftsstelle
Petra Enderlein
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