A trip down memory lane

– Written by Stefano Della Villa, Italy

I have always loved the ocean, and after completing high school my dream was to study marine biology in San Diego, emulating the famous French oceanographer Jacques Cousteau. The year was 1978; I was 18 years old and medicine was not my priority at all. As John Lennon once said: “life is what happens to you while you’re busy making other plans” and during that summer, I fell in love with a pretty student of architecture at the University of Bologna, Anna, who would later become my wife. Due to this course of events, instead of taking a flight to San Diego to pursue my dream, I decided to ride my bike to downtown Bologna, the city where I was born, and enrol at medical school at the prestigious University of Bologna.

I had a great time throughout the 6 years I spent at medical school. My academic year would last 8 months, while I spent the remaining 4 months occupied as a sales representative for a fashion company. These were crucial formative years in which I had the great opportunity to profit from a dual education by combining on one hand the rich medical theory and culture of the oldest university in the Western world, and on the other the charming world of the Italian fashion business.

Though I was blissfully unaware of it, I was acquiring from university the scientific approach, the relevance of research and the importance of being fully committed to each action we perform; while simultaneously, from the fashion market I was receiving inspiring examples from many entrepreneurs, who were able to develop new companies and business opportunities. They taught me that if you have an idea and you are ready to take risks, as well as being consistent in what you are trying to pursue, you can achieve your dreams.

Looking back at my life, it is evident that I became a doctor and an entrepreneur at the same time. After finishing medical school and getting my degree I was determined and ready to create a start-up in the medical field. The real issue was that, at the time, I had no clue as to which field of medicine I wanted to dive into. I was doing my residency at the Rizzoli Institute, one of the most prestigious orthopaedic hospitals in the world, but I could not see myself working in an orthopaedic department. I was searching for something that could help me express my creativity – and sports medicine was the answer. I have always loved sports; I’m an avid Bologna Calcio fan and my favourite movie of all time is Chariots of Fire, the story of a group of Cambridge students who competed for Great Britain and won gold at the 1924 Olympic Games.

During the last year of my residency, everything changed when I was granted the opportunity to take a position in the United States with the San Francisco 49ers medical team, an opportunity I grasped and never looked back. Nine years after the initial idea of flying to the USA in order to chase my dream of studying oceanography, I finally boarded a plane to California, at the age of 27, to pursue a new dream. During my time in America I had the great privilege of working with the 49ers team physician Michael Dillingham, who was also the director of the Sports Medicine programme at Stanford University. Working with Michael Dillingham and physical therapist Rick Eagleston, I discovered that the famous saying: ‘one day with a great teacher is worth more than one thousand days of diligent study’ was indeed a fact and not a myth.

My time in the USA helped me understand how a professional club at the top level behaves; I had the opportunity to work alongside bright clinicians, observe the recovery of players like Joe Montana and learn the workings of a sports medicine centre. The late 1980s were the era of pioneering for the sports medicine field and it was a unique challenge. We were at the beginning of the age of arthroscopy and sports rehabilitation had just begun to emerge in the medical field. With the introduction of the isokinetic machine we could use computer technology to calculate and understand the power of the muscle. It was a paradise for a young physician full of curiosity and passion.

My experience abroad changed my life forever. When I returned to Bologna I quit the hospital and embarked on my adventure, as a doctor and entrepreneur, opening the first sports medicine clinic in Bologna.

Patient Zero was a professional footballer by the name of Claudio Ottoni. He had ruptured his ACL and came to us after receiving surgery. He was able to teach me the importance of the psychological approach when working with patients. Thereafter I understood that patients could be great teachers and I realised that inside a sports medicine facility a positive atmosphere could be more important than the latest technology.

It was quite easy to focus immediately on the key point surrounding the positive atmosphere in my clinic; this was in large part due to the nature my home city, Bologna. The positive atmosphere one feels while walking in downtown Bologna is pretty unique. This is due to the tradition of being a University city – students have wandered the streets of Bologna for more than 9 centuries – since 1088, when the University of Bologna was founded. It is the oldest university in the Western world, older than Oxford, Paris and Salamanca. We call it ‘Alma Mater Studiorum’ and it is really part of our medieval city.

In Bologna the hospitality is something that you can feel immediately, as you enjoy the local food or take a walk under the ‘portici’ – a system of arches built in ancient times that allows you to walk anywhere in the centre of the city while avoiding the rain in winter and the heat in summer. Bologna takes excellent care of its guests and we try to do the same with our patients during their stay at our clinic.

Our first clinic was a combination of pragmatic American organisation and warm Italian hospitality. Subsequently, over the next few years, we began developing our own style of working and, drawing on my various life experiences, I created a special ethos that all 200 people working in our group try to apply to everything they do. We call this ‘CIAO’, which in Italian is a greeting or an informal goodbye, but in this case it is an acronym:

• Culture (which is parallel to Knowledge)
• Image
• Atmosphere
• Organisation.

To summarise the acronym, I can say that I've learned Culture/Knowledge from my university, Image from the fashion industry, Atmosphere from my city and Organisation from my experience in the USA.

We think that using CIAO to implement your ideas gives you a better chance of success. It is a simple concept and easy to use; whatever you are doing, you can begin by asking yourself four simple questions:

• Do I have sufficient knowledge for what I am doing?
• Do I have the right image?
• Do I offer the right atmosphere to the people involved?
• Am I using the right organisation?

Efforts to answer first question led us to invest a lot of money and energy into establishing our Education and Research Department – the core of our medical group, set up to translate the global scientific culture of the sports medicine community into practical tools and advice for our people. This helped us to open new clinics and become an international organisation. The rest of the CIAO concept followed the C of culture embraced by the Education and Research Department and gave us the opportunity to be where we are today.

A perfect example of the implementation of the CIAO concept is our international Football Medicine Conference, an event we have organised every year since 1992. The last edition was held at the Camp Nou in Barcelona, home of the Blaugrana, and for 3 days more than 3000 attendees from 90 different countries discussed ‘The Future of Football Medicine’.

In the long preparation for the conference we tried to apply the CIAO principles: the Culture and the Knowledge come from a multidisciplinary international faculty, able to inspire the audience from different points of view. The Image was ensured by the iconic facility of the Camp Nou in Barcelona, an opportunity for everybody to play at their best in their respective fields in a stadium that is home to great champions. The Atmosphere was guaranteed by the hospitality of all the people from our clinics,   the Isokinetic team were hosts to the conference participants. The Organisation was correlated with the solid know-how of the conference office, a branch our Education and Research Department that, after 27 years of experience, attempts to take into consideration even the smallest details and prevent any difficulties.

Dealing with so many people, each bringing with them a different culture and background, inside a huge facility like the Camp Nou, was challenging for all of us. Mistakes happen all the time, but the correct interpretation and use of CIAO helps us to minimise issues and/or complications that could arise, and create the right conditions to allow the faculty and attendees to play a great game, all together. We created the hub, but they did the real job by presenting, contributing and discussing many topics about the future of sports medicine. This, for us, was the greatest satisfaction.

Football medicine could really have a global impact on our planet, because there are more than 300 million players worldwide. It is a huge family that shares a love for the sport, regardless of age, gender and ability. The most famous of them – Messi and Ronaldo – lead the system, but the strategies used to prevent, treat and rehabilitate their injuries could be shared to all in the big family of football. Progressing from football we may then be able to reach all active people around the world.

In 2018, we will once again bring the football medicine community together under one roof, inside the Camp Nou, this time with a slightly different theme that will be even more challenging for the sports medicine community: ‘Football Medicine Outcomes: Are We Winning?’

In the end our international community needs to project the results of our studies and of our passion towards the field of sports medicine.

The story of my life is but a mere pixel in the big picture of sports medicine. I know hundreds of colleagues who have similar experiences and I am glad that together we contributed to writing the first chapters of this young science. Sports medicine is set to have a great future because it could improve the quality of life of countless people around the world. The best is yet to come and considering my new position as grandfather to my son’s little boy, I want to divulge to the younger generation three key pieces of advice for their professional career: reach the top, work as a team and communicate with the world.

Stefano Della Villa M.D.

President, Isokinetic Medical Group

Bologna, Italy

Contact: s.dellavilla@isokinetic.com

Image by Yuri Virovets