"Olympic athlete check in Wuppertal - until - health promotion for all"

Prof Dr Dr Thomas Hilberg and the Chair of Sports Medicine

When US singer Whitney Houston released the summer Olympic anthem "One moment in time" in 1988, she spoke from the soul of many top athletes; standing at the top of the podium once in a lifetime. Sports physician Prof Dr Dr Thomas Hilberg knows only too well that the road to this goal is hard, rocky and full of hardship.

"You are a top athlete if you don't just do sport as a hobby, but as a profession or if sport is your absolute focus. If athletes don't focus on sport the whole day, week, month or year, they can no longer compete at the top level. Life has to be centred on high-performance sport."

Born in Trier, he has headed the Chair of Sports Medicine at the University of Wuppertal since 2008, for which he was re-licensed as a sports medicine examination centre by the German Olympic Sports Confederation (DOSB) for four years in 2017. There are only around 30 of these examination centres in Germany, where top athletes are allowed to be examined once a year. Hilberg's centre, which he continues to expand, is one of them. Competitive athletes are put through their paces here in the truest sense of the word.

The comprehensive sports medical examinations include a detailed personal, family and sports anamnesis (recording of medical history), measurement and determination of relevant body parameters, resting and exercise ECG and echocardiography, blood pressure measurement, various laboratory tests and sport-specific performance tests in areas such as endurance, strength, coordination and speed.

Sport is an essential part of my life

The overall health of an athlete is the be-all and end-all of success, and in addition to health and physical performance, the right diet also plays an important role. This is why his team of around 15 people also includes an experienced nutritionist who develops individual nutrition programmes with the athletes. Other scientists take care of specific tests that the athletes undergo in the sports medicine department or in the training centre on site.

In addition to the national judo and badminton teams, Hilberg's clientele includes top athletes from various sports such as athletics, handball, ice hockey, roller hockey, football, canoeing, rowing, horse riding and dancing, as well as an increasing number of para-Olympic athletes from the field of disabled sports.

Professor Hilberg, who himself is actively involved in cycling, cross-country skiing, windsurfing and sophisticated fitness training, explains: "Sport is an essential part of my life". The fact that he is not just saying this out of the blue is also illustrated by his many years as a national team doctor for speed skaters and short track, as well as his current voluntary work as an anti-doping officer for the German Speed Skating Association. He is aware of the many cases of athletes under severe pressure who try to improve their performance level with medication; he can explain this, but never understand it. But doping is not only still a big problem in high-performance sport, where there is a clear set of rules, the anti-doping code, to which every athlete is subject and where every athlete must expect sanctions for doping. This is also problematic for ambitious amateur athletes, who do not have to confirm in writing that they comply with the anti-doping code and are not subject to anti-doping testing. In addition, there is also abuse of authorised drugs that are not on the doping list. In this area, too, there is a need for constant educational work.

Health is the top priority

Hilberg states: "Health must have the highest priority, doping must be consistently combated with appropriate measures, but also the application of compliant and therefore authorised medication and measures must be reduced to the absolutely necessary and sensible use through education. This is a central task for sports medicine in high-performance sport, but increasingly also in ambitious and performance-orientated popular sport. The Anti-Doping Code serves to avoid jeopardising health and to create "fair" competition conditions"

The hope for a sport that is as "clean" as possible is a piece of idealism that Hilberg is constantly fighting for.

Sports medicine outpatient clinic but not just for athletes

In the sports medicine outpatient clinic, both amateur athletes and rehabilitation athletes are comprehensively examined and advised on their state of health and possible improvements to their physical performance. However, the outpatient clinic and its services are open to all people, including non-athletes from young to old, who have health problems, including cardiovascular and/or joint or pain problems, and are unable to cope with other medical systems or would like to exercise in the future. It is particularly important to emphasise that people with no connection to sport also receive care and advice, as health promotion goes far beyond sport. Many patients have already taken advantage of this opportunity. Care is provided on a private medical basis.

Programmed sports therapy

In addition, Sports Medicine Wuppertal also develops targeted exercise therapy programmes for prevention and rehabilitation for patients with cardiovascular, haemostaseological (coagulation-specific) or joint diseases. Hilberg, who completed his doctorate at the Max Planck Institute for Coagulation Research in Giessen/Bad Nauheim, pays particular attention to the rare disease haemophilia (bleeding disorder). A major problem here is spontaneous haemorrhaging, which leads to inflammation of the mucous membrane and loss of cartilage. Patients referred by treatment centres throughout Germany are invited to Bad Blankenburg twice a year to attend sports therapy camps where they are trained in home self-treatment.

The central location in Thuringia offers every opportunity to provide patients with adequate training, examine their joints and create individual training plans through discussions with physiotherapists and sports therapists from the department. This combination of training camp and home training, which Hilberg calls "programmed sports therapy", is a sensible alternative to group therapy because it is individualised and is therefore particularly relevant for rare diseases. Scientific studies are also carried out as part of these sports therapy camps, so that there is a direct transition from sports medicine care to science and vice versa. In addition, this platform is also used for teaching students, particularly those studying for a Master's degree in sports science.

Three large research groups

Hilberg supervises three large research groups in Wuppertal: Cardiovascular, Haemostaseological and Molecular Sports Medicine (KaHäMo-Sportmed), which deals with the effects of sport on cardiovascular and coagulation diseases, physiotherapy and sports therapy with their possibilities in the treatment of, for example, arthrosis or haemostasis.The Pain and Motion (PAM) research group investigates the effects of pain on movement and movement on pain.

Nerves react sensitively

Pain in particular, which is often triggered by movement but can also be alleviated by movement, offers a broad field of research. It is perceived subjectively and is difficult to quantify. In addition to questionnaires with classic scale categorisation, in which the patient determines where they feel their pain between levels one and ten, many other parameters can be examined at the Sports Medicine Outpatient Clinic using so-called "Qualitative Sensory Testing", which enables a precise assessment. For example, stimuli in the form of pressure pain or vibrations are applied to nerves, which the patient then evaluates.

A particular prerequisite for these different research tasks is the excellent networking with clinics and practices in Wuppertal and the surrounding area, which enables a very good professional exchange.

International sports osteopaths come to Wuppertal

Hilberg is also organising the first sports osteopath seminar in Wuppertal in February 2018 in collaboration with the German-American Academy of Osteopathy (DAAO). The physician is delighted to have the opportunity to bring this seminar to Wuppertal for the first time, as he knows that this also strengthens the attractiveness of the location.

Health promotion has many facets

Hilberg sees his work as a combination of various disciplines and summarises: "It's like putting together ingredients from a large chemist's cabinet. You put together different knowledge and experience from different areas, map the illness precisely, bring this together with the appropriate elements of sports therapy, customise it to the patient and thus achieve an improvement in the general and health status in terms of health promotion."

Bringing these disciplines together in a kind of interdisciplinary collection centre certainly harbours a great treasure for holistic treatment.

Uwe Blass (interview from 29/08/2017)

Prof Dr Dr Thomas Hilberg

Specialist in general medicine - sports medicine - chirotherapy - osteopathy (DAAO) Chair of Sports Medicine, University of Wuppertal.

The Chair of Sports Medicine at the University of Wuppertal was established in 2008. At that time, Professor Thomas Hilberg was appointed to Wuppertal from Jena. The chair is located in Pauluskirchstr. on the Haspel campus.