Injuries In Australian Rules Football

10 Mar

Injuries will always be a part of sport and according to the statistics, Australian Rules Football or AFL tops the list nationwide. When looking at these statistics, the classification of an injury is where a minimum of one game is missed due to that specific injury. Sports injuries are something we treat daily at the clinic and work towards both reducing the prevalence through strength and conditioning/preparation programs, as well as recovering from the injury and returning to play.

If we break down the injuries in AFL the most prevalent are:

Hamstring Injuries (19.1 missed games/club/season in 2015)
ACL Injuries (16.7 missed games/club/season)
Shoulder Sprains and Dislocations (11.5 missed games/club/season)
Leg and Football Fractures (8.6 missed games/club/season)
Ankle Sprain/Joint Injuries (7.2 missed games/club/season).

Table 1 below compares the most prevalent injuries across all AFL, Union, Soccer and American Football codes:

  
    Table 1. Injury incidence and most prevalent injuries across football codes at the professional level
  
    Injury incidence
    Australian Football
    Rugby Union (English)
    Soccer (UEFA)
    American Football

    41.7 injuries per club per season
    54 match injuries, 27 training injuries per club per season*
    2 injuries per player per season**
    
    Most prevalent injuries
    Hamstring strain
    ACL
    Hamstring strain
    Knee ‘internal derangement’
  
    ACL
    Concussion
    MCL
    Ankle sprains
  
    Shoulder sprain / dislocation
    Hamstring strain
    Quadriceps strain
    Concussion
  
    Leg / foot stress fractures
    Ankle syndesmosis
    Adductor pain / strain
    Upper leg contusion
  
    Ankle sprains
    MCL
    
    Upper leg muscle-tendon injury

    Groin strains and osteitis pubis
    
    AC joint injury
  
    Knee cartilage injuries
    
    Shoulder ligament sprain

Top injuries:
AFL - 2015 season. Missed games¹
English Rugby Union - 2014-15 season, match injuries only. Days absent²¹
* includes injuries that do no result in missed matches, limiting comparison
Soccer - UEFA 2001-2008, time-loss injuries. List of most common injuries causing >28 days absent²⁰
** included players unavailable for either training or match. Half of these injuries were classified as 'minor' and resulted in absences of less than 1 week
American Football - most common match injuries were resulting in time-loss, ranked in order of frequency , not time lost¹⁴

The average number of matches lost per injury for the most common AFL injuries is outlined in Table 2 below. However, this data should be interpreted with caution, as the AFL Injury Survey only includes injuries that result in missed matches, in addition, if a significant injury (eg, shoulder dislocation requiring surgery) occurs late in the season, the player may miss fewer matches because they are able to recover during the off-season.

  
    Table 2. Insistence, prevalence and average missed matches from common injuries in the AFL
  

    
    Incidence
    Prevalence
    Average Missed Matches
  

    Hamstring strain
    5.2
    19.1
    3.7
  

    ACL rupture
    0.7
    16.7
    23.9
  

    Shoulder sprain / dislocation
    1.6
    11.5
    7.2
  

    Leg / foot stress fractures
    0.7
    8.5
    12.1
  

    Ankle sprains
    2.4
    7.2
    3.0
  

    Groin strains and osteitis pubis
    2.2
    7.1
    3.2
  

The mechanism of injury, or the position these tears occur in is knee abduction, lateral trunk motion with the body shifted over one leg and the plantar surface of the foot fixed flat on the playing surface, displaced away from the trunk and low kne… — The mechanism of injury, or the position these tears occur in is knee abduction, lateral trunk motion with the body shifted over one leg and the plantar surface of the foot fixed flat on the playing surface, displaced away from the trunk and low knee flexion.

How did I get this injury?

hamstring

In the swing phase, after you have pushed off and before you make contact with the same foot, the hamstrings are at their greatest length and at this moment, they generate maximum tension. In this phase, hamstrings contract to decelerate flexion of the hip and extension or straightening of the knee. During activities like running and kicking, your hamstring will lengthen with hip flexion and knee extension, this lengthening may reach the length limits of the muscle or lead to the accumulation of repetitive stress at a deep muscle level. Excessive anterior pelvic tilt will place the hamstring muscle group at longer lengths, whereby some studies proposes that this may increase the risk of strain injury.

ACL

These injuries are more commonly sustained in non contact situations, so why is this type of injury so common for this group of athletes? Due to the 360 degree’s of play in Football compared to other sports quick changes of direction are required to react to opponents, increasing the stress in directions the ligaments in the knee are not prepared to handle. The mechanism of injury or the position these tears occur in is knee abduction, lateral trunk motion with the body shifted over one leg and the plantar surface of the foot fixed flat on the playing surface, displaced away from the trunk and low knee flexion.

Shoulder

Anterior dislocation, where the ball portion of the ball and socket joint exits the front of the shoulder joint, is the most commonly seen type of dislocation: The mechanism of injury is usually a direct blow to the athletes arm while in a combination of out to the side, rotated backward and raised in the air. Such as going up for a marking contest and being spoiled. Alternatively it may also occur with a fall on an outstretched arm that causes the arm to go out to the side and behind the body.

The Table below shows the incidence, prevalence and average number of matches missed according to injury type:

  
    
    Incidence
    Prevalence
    Average Missed Matches
  

    Knee cartilage injuries
    1.1
    6.5
    5.9
  

    Calf strains
    2.9
    5.9
    2.0
  

    Concussion
    1.5
    4.2
    2.8
  

    PCL sprains
    0.5
    3.2
    6.4
  

    Quadriceps strains
    1.0
    2.2
    2.2
  

HOW LONG WILL I BE OUT FOR?

Hamstring

Timeframes for rehabilitation and return to sport vary depending on the nature and severity of the strain. As a general rule, Grade 1 hamstring strains should be rested from sporting activity for about three weeks and Grade 2 injuries for a minimum of four to eight weeks. In the case of a complete rupture (Grade 3), the muscle may have to be repaired surgically and the rehabilitation to follow will take a minimum of three months. Premature return to sport and inadequate rehabilitation will increase the risk of re-injury. Full range of motion, strength and control of the leg should be achieved to train in your chosen sport in full. Detailed sport specific assessment should be evaluated to clear the athlete to play, this should include weight bearing, twisting, jumping, reactive strength and speed related tasks.

ACL

Similarly, no clear and agreed upon timeframe for return to play is advised. Early return to play has been associated with increased risk of the repaired ligament to fail, with added risk to the opposing knee becoming injured. Recent trends adopt a more conservative rehabilitation protocol with considering returning to sport at 8-12 months.

Shoulder

For anterior dislocations the recovery time will vary depending on the associated structures damaged such as the ligaments supporting the joint or the labrum. Both of which you can find out more information on our Website Blog “Common Shoulder Complaints”. An artheroscopically repaired shoulder will generally take a minimum of 3 months rehabilitation to be able to return to sport. This timeframe can be severely affected by age, as the chance of reoccurrence is higher in our under 25 year old population

In Summary, if we look at the statistics for the game of Australian Rules Football, it is highly likely that you may sustain an injury of some sort through the season requiring you to miss one or more matches. The recovery time’s can vary but largely depends on hitting key goals and requirements to return safely to play. If you suspect you have sustained an injury or have a current injury that you would like to ensure you treat in the appropriate way, please contact one of our staff members.