By Bertalan Mesko, The Medical Futurist | April 2018
Not only the experience of sporting activities and events, but also rehabilitation after sports injuries are changing due to cutting-edge technologies. In sports medicine, the future holds a shift towards prevention through genomics, nutrigenomics, countless trackers, and wearables, while there are many great technologies which aim to alleviate the pain and shorten the time of recovery – if, against all odds, a sports injury still happens.
Technology will change the experience of sports injuries and rehabilitation
When was the last time you went out for a run without Endomondo or had a bike tour without Strava? Have you thought about how different the commentaries for live football or basketball matches were only a couple of years ago? Where were those sixteen cameras that have been monitoring the field and performance of football players since 2007? Where was the hawk-eye technique to track the trajectory of balls in cricket or tennis before 2001? What about professional timer services? Who saw whether the ball was in or out if not the camera?
The experience of sports and following sports events radically changed in the last two decades due to technology. The assessment of performance, the training methods, the episode of cheering for your team – all activities connected to sports have been hijacked by technology.
The most painful event of them all, being a victim of a sports injury, is no exception either. There are many technologies which aim to improve the state of sportsmen and sportswomen going through the rough period of recovery, as well as technology-based methods to prevent those injuries. The appearance of the following tools falls neatly in line with the general trends, namely that there is a palpable shift from proactive to preventive medicine.
Here, we collected the most relevant and exciting examples, which could help professionals in sports medicine make sportsmen and sportswomen less prone to injuries and if an accident happens they can recover in less time.
Preventing sports injuries
Technology gathers data about every second of the performance of the players during training or the actual race. Data not only helps to analyze, create new strategies and thus boost players’ performance in the arena but can also monitor health state and warn about overstraining. Current scientific achievements also give the chance to sports fanatics to dig deeper and discover what health risks they carry in their genes or what diet they should follow to stay on top for a long, long time.
1) Preventive genomics
What if your genes could tell you how you should change your work-out or your overall training to prevent injury? Or what kind of nutritional demands do you have? Wouldn’t life be more comfortable if you could personalize your training regimen or your diet based on your genetic background?
It is already possible. The Nova Scotia-based performance company, Athletigen Technology Inc. works with several athletes aiming to use collected DNA information to improve performance, health, and safety. These genetic tests reveal additional insight about a possible heightened risk of injury or specific nutritional demands. Later, these results allow the helpers of an athlete to adjust his or her workout plan and nutrition accordingly.
With regards to the appropriate diet plan for athletes, the new field in dietetics, nutrigenomics could be the answer. In my case, the data of my entire DNA sequence at home in a digital file showed that I’m sensitive to caffeine and process alcohol more thoroughly than most people (I’m Hungarian after all). But you don’t have to figure out this information by yourself. There is a California-based start-up, Habit, which might help you with that. If you send back their required blood sample kit, they will analyze your DNA, and create a personalized meal plan that works best for your body. The spread of nutrigenomics could be of massive help for athletes to find the right diet boosting their performance to reach new records and make their immune systems stronger to fight off diseases and prevent injuries easily.
2) Monitoring health through sensors and wearables
There is a gazillion of healthcare wearables and sensors out there which aim to support training, keep sports professionals healthy while help them reach their very best. Most of the time, they offer constant health data management, real-time performance monitoring, and immediate feedback. We already know about Pebble Time and the Android Sleep App which follow your sleeping habits; Fitbit Surge or Fitbit Ionic tracking your fitness activities, while PIP giving you an overview of your stress levels.
However, there are many specialized tools for monitoring the stress load and performance of players to avoid fatigue-induced injuries. For example, athletes who do lots of jump roping during their training might want to try Vert. It helps them measure and improve their jumping capabilities; and know when they are nearing an unsafe level of fatigue that may lead to injury. Blast Motion does something similar. It tracks and analyses players’ swings during training to optimize performance and decrease the risk of injury.
Osman Hassan Ahmed, a physiotherapist to the Football Association in the UK, told The Medical Futurist that in the future, sportswear will be able to show the clinician standing at a playfield’s sidelines vital physiological data in real-time. That will enable them to gain an accurate picture of the individuals’ status; and combining this with GPS data may also help to make decisions as to when to substitute the player in a match or to remove him from the field of play when training, he added.
3) Prevention through sensory garments, helmets, mouth guards
The Australian company, Catapult Sports is considered one of the biggest suppliers of sports tracking devices. More than 1500 professional teams are using their trackers worldwide. Players wear their small, pocket-sized GPS trackers on the back of their training tops, and the device tracks over 100 metrics from speed through heart rate until acceleration. As a consequence, the coach can monitor players’ information on the sidelines in real time – just as Hassan Ahmed said. Players in the National Football League wear the chip of Zebra Technologies on their shoulders that send data to receivers placed around the stadium.
Maryland-based Zephyr Technology backed by Medtronic produces among others a bio-harness, which allows coaches to see the intensity of a specific training regarding biomarkers, such as heart rate, temperature or acceleration. The company’s trauma-monitoring patches that stick to the player’s body measure force and impact so that specialists could have more data about concussion risks for football or hockey players.
Beyond gadgets, imagine chips and clothing measuring vital signs and devices boosting performance actively! Many athletes in professional clubs now wear unique shirts that measure their vital signs during practice or even games. HexoSkin developed a shirt with sensors woven into it that measure heart rate, breathing, number of steps, pace, and calories burned. The London-based D30 introduced a smart material this year. It provides terrific shock absorption and impact protection capabilities, which are naturally an ideal fit for basically every sport.
In the future, many high-contact sports, where players have to use helmets for their safety will utilize high-tech hard-hats. These helmets utilize shock absorbers that release air when the head has suffered an impact. This air inflates the protective interior of the helmet and reduces the amount of quick movement the head sustains, thus reducing the chance of a concussion. Special mouth guards can now even alert athletes if they are at risk for a shock: sensors warn the player when an injury that could lead to a concussion has occurred.
Sports injury rehabilitation
As the Tao says, injuries happen. Technologies might decrease the occurrence rate, but accidents will still occur in the future. However, state-of-the-art diagnostics and appropriate rehabilitation tools could shorten the time of recovery and alleviate the pain along the way to feel well again.
Regarding diagnostics, portable medical devices and real-time visualization will make a difference in the future. Osman Hassan Ahmed says that musculoskeletal ultrasound is becoming more common in elite sport. He thinks that’s a forward-looking solution, but it would be great if the technology emerged to a level where a clinician could have an on-pitch scanner which could work through clothing and wouldn’t need conducting gel. Start-uppers – here’s an idea for success. Go for it!
1) Revolutionary rehabilitation technologies: anti-gravity treadmill, exoskeletons
After breaking a bone, injuring a knee or rupturing a ligament, it takes much time and a long rehabilitation process to be able to do sports again. The AlterG Anti-Gravity Treadmill allows patients to work-out without bearing their full body weight. The machine can take over between 20-100 percent of the original weight enabling to move muscles and bones without overstraining them. The treadmill could do wonders not only in sports rehabilitation but also in neurological, orthopedic, senior rehabilitation or with weight loss. Another product of the company, the Bionic Leg provides patient-initiated motor assistance during sit-to-stand exercises, overground walking, and stair climbing. It strengthens weak muscles, increases balance, and helps patients to learn faster how to walk again!
Going one step further, complex robotic structures called exoskeletons could also support rehabilitation in the future. They could help the recovery of stroke or spinal cord injury patients, and already let paralyzed people walk again. For example, a gait-training exoskeleton, suit helped Matt Ficarra, paralyzed from the chest down, walk down the aisle on his wedding day! How amazing is that?
2) HawkGrips, dynamometers and exercising machines
Sometimes the worst stories have the most hopeful endings. In 1997, Frank Osborne broke his neck, back, wrist, arm and both shoulders in a terrible ski accident. As a result, he struggled with debilitating pain for more than a decade. Thirty surgeries, extensive physical therapy, and alternative treatments offered little help. Until he met Instrument Assisted Soft Tissue Mobilization (IASTM) treatments, where a hard-edged instrument made of metal, plastic or ceramic is used to add shearing stress to soft tissue to enhance the body’s healing response. The method was so effective that he promised to make the best instruments for the technology. That’s how HawkGrips was born.
The Baltimore-based international company, BTE, offers complex rehabilitation systems in over 35 countries. It has various rehabilitation equipment, such as the Primus RS dynamometer or the Eccentron, resistance trainer. The former evaluates patients’ movements – how firm their grip is, whether they can lift a box – so the physician can assign the appropriate rehabilitation exercises for them. In case of the Eccentron, the exercising machine is an essential part of both rehabilitation and performance enhancement. It targets purely eccentric exercise for both assessment and then sets up an appropriate training program.
3) AR/VR in sports medicine
Although virtual reality and augmented reality is already used in several medical specialties, their application in sports medicine is limited, explained Osman Hassan Ahmed. However, given the unique demands of this discipline, he believes that blending existing evidence-based rehabilitation strategies with cutting-edge VR technologies which could replicate the players in their own stadium, the noise of the fans would be a valuable adjunct.
Fortunately, there are already some positive examples leading the way to the full-blown utilization of VR in sports medicine. Israeli start-up VRPhysio harnesses the power of gaming technology to help treat neck, spinal and other injuries through VR and rehabilitating games. It has created a platform that makes physiotherapy exercises easily accessible and enjoyable to patients, while also being easily monitored and analyzed by doctors and physiotherapists.
In the future, the appearance of VR/AR will be more frequent in sports medicine. Some visualize an augmented reality app which helps physicians check the collisions of players in real time sitting on the bench next to a trainer, assess the impact and make the decision whether or not a player should be taken off the field. It’s a wonderful idea, and just as AR could assist surgeons before complex operations or med students in their practice, this app might be used both for training or in real sports events. Here, another way to disrupt medicine and another idea for start-uppers. The future indeed seems to be exciting!
Just as every other specialty, sports medicine will change a lot due to AR/VR, trackers, wearables or exoskeletons. The challenge is to learn how to use those technologies to make sports medicine physicians better at their job without losing the human touch. Patients need interaction while they can enjoy the benefits of using digital health.