Abstract
Prior injury is a commonly identified risk factor for subsequent injury. However, a binary approach to classifying prior injury (i.e., yes/no) is commonly implemented and may constrain scientific findings, as it is possible that variations in the amount of time lost due to an injury will impact subsequent injury risk to differing degrees. Accordingly, this study investigated whether session availability, a surrogate marker of prior injury, influenced the risk of subsequent non-contact lower limb injury in Australian footballers. Data were collected from 62 male elite Australian footballers throughout the 2015, 2016, and 2017 Australian Football League seasons. Each athlete’s participation status (i.e., full or missed/modified) and any injuries that occurred during training sessions/matches were recorded. As the focus of the current study was prior injury, any training sessions/matches that were missed due to reasons other than an injury (e.g., load management, illness and personal reasons) were removed from the data prior to all analyses. For every Monday during the in-season periods, session availability (%) in the prior 7, 14, 21, 28, 35, 42, 49, 56, 63, 70, 77, and 84 days was determined as the number of training sessions/matches fully completed (injury free) relative to the number of training sessions/matches possible in each window. Each variable was modeled using logistic regression to determine its impact on subsequent injury risk. Throughout the study period, 173 non-contact lower limb injuries that resulted in at least one missed/modified training session or match during the in-season periods occurred. Greater availability in the prior 7 days increased injury probabilities by up to 4.4%. The impact of session availability on subsequent injury risk diminished with expanding windows (i.e., availability in the prior 14 days through to the prior 84 days). Lesser availability in the prior 84 days increased injury probabilities by up to 14.1%, only when coupled with greater availability in the prior 7 days. Session availability may provide an informative marker of the impact of prior injury on subsequent injury risk and can be used by coaches and clinicians to guide the progression of training, particularly for athletes that are returning from long periods of injury.
Highlights
Since 1992, an average of 92.5 injuries per 100 athletes have occurred in the Australian Football League (AFL) (Australian Football League, 2017)
Given the impact that in-season injuries have compared to pre-season injuries in regards to missed matches (Orchard et al, 2013) and performance (Drew et al, 2017), the current study focused on identifying in-season injury risk
The effect, was small, with a 1% increase in session availability increasing the odds of injury by a factor of 1.0099
Summary
Since 1992, an average of 92.5 injuries per 100 athletes have occurred in the Australian Football League (AFL) (Australian Football League, 2017). Injuries can impose a significant Financial burden on individual players and their clubs (Hickey et al, 2014) and can negatively impact team and individual performances (Verrall et al, 2006; Drew et al, 2017), as well as physical and psychological wellness (Rozen and De L Horne, 2007) Given the toll these injuries can have, a large body of research has attempted to identify factors that increase or decrease the risk of injury (Orchard, 2001; Gabbe et al, 2004; Opar et al, 2012). Prior injuries of all types have been linked to an increased risk of subsequent injuries (Finch et al, 2017)
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