eNews
Q&A with Tonje Wåle Flørenes, Project Manager, FIS ISS
| February 2008
Tonje Wåle Flørenes, MD, (29) graduated from the University of Lund in southern Sweden in January 2004. She spent her internship in the ‘winter wonderland’ of Lillehammer, at the Lillehammer Central Hospital where she continued to work as a registrar in the Orthopaedic Department for nine months after she had finished her internship. Tonje is working full time as a PhD student at the Oslo Sports Trauma Research Centre (OSTRC) in Norway as Project Manager for the FIS Injury Surveillance System - the first surveillance project initiated by the International Ski Federation to analyse injuries among elite skiers. |  |
Questions:
What influenced your decision to study medicine and in what subject are you doing your PhD?
I think it was my uncle and his job as a surgeon that first inspired me to become interested in medicine and think of it as my future profession. In addition, I have always been very interested in sport and thought that the perfect job would be to combine medicine and personal interests. I wanted to work within the speciality of sports medicine and was always particularly interested in this area during medical school and later during my internship at Lillehammer Central Hospital. During my time at Lillehammer, skiing injuries were frequent and when I was offered the opportunity to be a part of a collaboration project between the International Ski Federation (FIS) and the Oslo Sports Trauma Research Center (OSTRC) to research skiing injuries I was really pleased and enthusiastic. So I’m now doing my PhD in skiing injuries.
When you were a medical student was it always your aim to specialise in sports research?
During my medical studies I was very pleased to have the opportunity to do the mandatory 10 week research project (towards the end of my studies) at OSTRC on a football project with Dr Thor Einar Andersen and Prof Roald Bahr looking at injury mechanisms for ankle injuries in football (soccer). This was my first encounter with research which I found very interesting, especially the clinical aspects and the methodology used to find ways to prevent injuries from happening in the first place. Being part of this project encouraged me to continue working in this kind of sports research.
I have always been interested in sport, and love being out training as well as skiing and hiking, but I have never competed in any sport. I’m also fortunate not to have sustained any injuries during my recreational skiing.
The Oslo Sports Trauma Research Center was established in May 2000 at the Norwegian School of Sports and is chaired by Professor Roald Bahr and Professor Lars Engebretsen. The main objective for the Center has been to develop a long-term research programme on sports injury prevention. This includes studies on basic epidemiology, risk factors, injury mechanisms and intervention studies. The Center concentrates its research on the largest Norwegian sports (in terms of injuries) i.e. soccer, team handball and skiing/snowboarding, and on the most common and serious injury types. The OSTRC currently has ten Ph.D. students and, as senior research staff, they have a multidisciplinary background (medical doctors, sports scientists, physiotherapists and biomechanists). The OSTRC organised the 1st World Congress on Sports Injury Prevention in Oslo in June 2005 where more than 550 leading researchers and other experts from 55 countries gathered in Oslo. The Congress provided a fantastic opportunity to share new research and experiences on how to best prevent sport injuries.
The 1st World Congress on Sports Injury Prevention was a great success and the OSTRC is delighted to invite everybody back to Norway for the 2nd World Congress on Sports Injury Prevention. The Congress will be held in Tromsø in the ‘Land of the Midnight Sun’ from June 26 to June 28. There is still time to register, but hurry! The first Congress was a sell out, and during the last few weeks we actually had to turn people away!
This year we will also have an Advanced Team Physician Course before the Congress. This is organised with ESSKA, the American Medical Society of Sports Medicine and the IOC and is geared towards the practical issues of working with high-level athletes in a team sports setting. The Advanced Team Physician Course will be in the picturesque Lofoten region, and we only have room for 100 participants. This will be a great opportunity to combine the wonders of the North with the best speakers in the World! More information and registration for both the Congress and the Advanced Team Physician Course is available on our website www.ostrc.no.
The FIS ISS is based on an existing reporting system within the FIS where Technical Delegates (TD’s) from FIS, who attend every FIS race, complete an injury form if an injury occurs during official training or competition. This means the FIS ISS can cover all FIS races and the athletes starting in these events, although at present the detailed reporting focuses on World Cup and World Championship levels. As this system has never been validated or analysed before, we also had to collect injury information from interviews with World Cup athletes at the end of last season. Through these interviews we collate information on all injuries, which gives us an insight into the overall injury frequency experienced by World Cup athletes, notably during the Winter season. We need to know what the injuries are before we can look further into the injury mechanisms and try to prevent them from happening. This is why an injury surveillance system like the FIS ISS is important because it can over time provides us with such information and hopefully helps us reduce injuries from occurring.
Research teams from the OSTRC were at events towards the end of the season in both Europe and the US and interviewed World Cup athletes from nine selected nations in all the different disciplines - alpine, freestyle, snowboard, ski jumping, nordic combined and cross-country - regarding injuries they had suffered during that season. A total of 902 athletes were interviewed and 296 injuries reported. The first results showed that injuries to the knee were the most common in all disciplines except for cross-country skiing where lower back problems were most common. Nearly half (47%) of all injuries reported from the interviews (139 of 296) took place in World Cup competitions/World Championships (WSC) or during official training for these events (as opposed to other competitions, other training activity on snow or basic training not on snow). So far results have shown that injuries forcing the athlete to miss at least one day in alpine, freestyle and snowboard were 15, 14 and 11 injuries respectively per 100 athletes during World Cup competitions/WSC and official training sessions. In comparison, Nordic combined, ski jumping and cross-country had 11, 6 and 3 injuries respectively per 100 athletes per season. Overall, we found that 22% to 43% of all injuries were more severe, resulting in the athlete missing more than one month’s participation except in cross-country skiing where no severe injuries were recorded. So, the injury rate is high, too high!
At the end of the current winter season we will interview the World Cup athletes again. Last year, our team was met with great interest by the athletes, the many coaches, event organisers and other support staff and were willing to contribute information to the survey. We therefore hope for the same participation this season to increase the amount of data on which to base the results.
Previous | All articles | NextIn which sports have you competed and have you ever personally experienced any injuries while participating in them?
I have always been interested in sport, and love being out training as well as skiing and hiking, but I have never competed in any sport. I’m also fortunate not to have sustained any injuries during my recreational skiing.
You now work for one of the World’s leading sports trauma research centres; tell us more about OSTRC and which sports it focuses on.
The Oslo Sports Trauma Research Center was established in May 2000 at the Norwegian School of Sports and is chaired by Professor Roald Bahr and Professor Lars Engebretsen. The main objective for the Center has been to develop a long-term research programme on sports injury prevention. This includes studies on basic epidemiology, risk factors, injury mechanisms and intervention studies. The Center concentrates its research on the largest Norwegian sports (in terms of injuries) i.e. soccer, team handball and skiing/snowboarding, and on the most common and serious injury types. The OSTRC currently has ten Ph.D. students and, as senior research staff, they have a multidisciplinary background (medical doctors, sports scientists, physiotherapists and biomechanists). The OSTRC organised the 1st World Congress on Sports Injury Prevention in Oslo in June 2005 where more than 550 leading researchers and other experts from 55 countries gathered in Oslo. The Congress provided a fantastic opportunity to share new research and experiences on how to best prevent sport injuries.
When is the 2nd Injury Prevention Congress and is there still time to register?
The 1st World Congress on Sports Injury Prevention was a great success and the OSTRC is delighted to invite everybody back to Norway for the 2nd World Congress on Sports Injury Prevention. The Congress will be held in Tromsø in the ‘Land of the Midnight Sun’ from June 26 to June 28. There is still time to register, but hurry! The first Congress was a sell out, and during the last few weeks we actually had to turn people away!
This year we will also have an Advanced Team Physician Course before the Congress. This is organised with ESSKA, the American Medical Society of Sports Medicine and the IOC and is geared towards the practical issues of working with high-level athletes in a team sports setting. The Advanced Team Physician Course will be in the picturesque Lofoten region, and we only have room for 100 participants. This will be a great opportunity to combine the wonders of the North with the best speakers in the World! More information and registration for both the Congress and the Advanced Team Physician Course is available on our website www.ostrc.no.
How did OSTRC get involved with the FIS Injury Surveillance System and why is it such an important project?
FIS had concerns regarding the injury risk for their athletes, and contacted us to help set up a research programme to record injuries at World Cup level. At the same time, Lieve Vanden Berghe from DJO also contacted us, expressing an interest in the activities at the OSTRC. So this was a perfect opportunity for us to match the research needs of FIS with DJO’s interest in supporting sports injury prevention research. With financial support from DJO, the FIS Injury Surveillance System (FIS ISS) could be established at the OSTRC with the long-term objective of reducing the number of injuries sustained by our elite skiers and snowboarders. The aim of the FIS ISS is to provide current and reliable data on injury trends in international skiing and snowboarding at elite level. We hope to use this information to reduce the injury rates either through suggested changes in rules and regulations, equipment or coaching techniques. |  |
Who is involved and how do you collate the information?
The FIS ISS is based on an existing reporting system within the FIS where Technical Delegates (TD’s) from FIS, who attend every FIS race, complete an injury form if an injury occurs during official training or competition. This means the FIS ISS can cover all FIS races and the athletes starting in these events, although at present the detailed reporting focuses on World Cup and World Championship levels. As this system has never been validated or analysed before, we also had to collect injury information from interviews with World Cup athletes at the end of last season. Through these interviews we collate information on all injuries, which gives us an insight into the overall injury frequency experienced by World Cup athletes, notably during the Winter season. We need to know what the injuries are before we can look further into the injury mechanisms and try to prevent them from happening. This is why an injury surveillance system like the FIS ISS is important because it can over time provides us with such information and hopefully helps us reduce injuries from occurring.
How many injuries have you documented since its inception and what are the results to date?
Research teams from the OSTRC were at events towards the end of the season in both Europe and the US and interviewed World Cup athletes from nine selected nations in all the different disciplines - alpine, freestyle, snowboard, ski jumping, nordic combined and cross-country - regarding injuries they had suffered during that season. A total of 902 athletes were interviewed and 296 injuries reported. The first results showed that injuries to the knee were the most common in all disciplines except for cross-country skiing where lower back problems were most common. Nearly half (47%) of all injuries reported from the interviews (139 of 296) took place in World Cup competitions/World Championships (WSC) or during official training for these events (as opposed to other competitions, other training activity on snow or basic training not on snow). So far results have shown that injuries forcing the athlete to miss at least one day in alpine, freestyle and snowboard were 15, 14 and 11 injuries respectively per 100 athletes during World Cup competitions/WSC and official training sessions. In comparison, Nordic combined, ski jumping and cross-country had 11, 6 and 3 injuries respectively per 100 athletes per season. Overall, we found that 22% to 43% of all injuries were more severe, resulting in the athlete missing more than one month’s participation except in cross-country skiing where no severe injuries were recorded. So, the injury rate is high, too high!
902 interviews in the first season (2006/2007) is a high number - are you hoping for more responses this season and when do you plan to publish the final results?
At the end of the current winter season we will interview the World Cup athletes again. Last year, our team was met with great interest by the athletes, the many coaches, event organisers and other support staff and were willing to contribute information to the survey. We therefore hope for the same participation this season to increase the amount of data on which to base the results.
If there was one innovation you would like to see in sports medicine, what would it be?
I very much hope that we will be able to identify the injury mechanisms that cause the more serious injuries to our top level skiers and snowboarders such as those to the knee and head in order to provide information on why these injuries occur and to suggest preventive measures to reduce them as much as possible. I think we all agree that we don’t like seeing our top level athletes being forced to end their careers due to injury.
