Australian Rules Research Articles

Sudden cardiac death related to physical exercise and sports in the young: a nationwide cohort study of Australia

Abstract Funding Acknowledgements Type of funding sources: None. Background Sudden cardiac death (SCD) during physical exercise is uncommon but devastating. Purpose We aimed to determine risk factors, causes and circumstances of sports and exercise-related SCD in the young in Australia. Methods We retrospectively reviewed the National Coronial Information System (NCIS) registry for deaths in Australia relating to cardiovascular disease (CVD) in cases aged 10 to 35 years between 2000-2016. Included cases had been undertaking sports or physical exercise at time of event. We collected baseline demographics and circumstances of death including location, type of physical exercise, whether the event was witnessed, and engagement of bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use prior to ambulance arrival. Results Over a 17-year period, 1,925 SCD cases were identified of which 110 cases (6%) related to sports/physical exercise were included in final analysis. Median age was 27 years (interquartile range [IQR] 21-32 years) with most being male (92%). Median BMI was 27 kg/m2 (IQR, 23-30) with 13 cases (12%) occurring in active athletes. Most common causes were coronary artery disease (CAD; 37%) and sudden arrhythmic death syndrome (SADS; 20%). Australian Rules Football (24%), running/jogging (14%) and soccer (14%) were the most frequently practiced at time of event. Prior symptoms were present in 39% (chest pain 37%, presyncope/syncope 26%). Most were witnessed (87%) with bystander CPR in 70%. AED use prior to ambulance arrival was 8%. Conclusions This study demonstrates the high occurrence of CAD and SADS in exercise-related SCD in the young. Although events were commonly witnessed, an AED was seldom used prior to ambulance arrival highlighting an important opportunity to improve outcomes in the post-arrest chain of survival.

Empowering Indigenous Networks: Collaborative Governance and the Development of a Racial Vilification Code in the Australian Football League

Few Indigenous Australians played Australian Rules football at the elite level before the 1980s. As the number of Indigenous players increased, a network of those who refused to accept on-field racial vilification developed. Opportunities for change were also seized by the Australian Football League, through a collaborative governance approach that empowered Indigenous players to inform strategies for reconciliation and education, and the development of anti-vilification rules. The case provides information about how governance structures may generate resources that improve socio-economic outcomes for indigenous and other disadvantaged people.

‘We need a whole range of different views’: exploring the lived experiences of women leaders in Australian rules football

Sport has traditionally been a male-dominated pastime, where the structures and practices within sport have most often favoured males. More recently, the dynamic of sport has changed and the capabilities of women as athletes and employees (including leaders) are being recognised. While there are ongoing explorations focussing on the barriers that women have faced as a minority group in a male-dominated setting, it is also imperative to acknowledge the positive experiences of women as they navigate such a setting. This paper explores the experiences of 26 women working in traditionally male-dominated leadership positions in the sport of Australian rules football. While these women have faced some challenges relating to gender within their roles, this paper, through a third wave feminist lens, will focus specifically on highlighting the positive experiences of, and changes that are evident for, women in traditionally male-dominated leadership positions in Australian rules football.

Relationship Between Movement Quality and Physical Performance in Elite Adolescent Australian Football Players.

Bennett, H, Fuller, J, Milanese, S, Jones, S, Moore, E, and Chalmers, S. The relationship between movement quality and physical performance in elite adolescent Australian football players. J Strength Cond Res 36(10): 2824-2829, 2022-The assessment of movement quality is commonplace in competitive sport to profile injury risk and guide exercise prescription. However, the relationship between movement quality scores and physical performance measures is unclear. Moreover, whether improvements in these measures are associated remain unknown. Over a 4-year period, 918 individual elite adolescent Australian Rules Footballers completed the Functional Movement Screen (FMS) and physical performance testing (5- and 20-m sprint, vertical jump, planned agility, and 20-m shuttle run test), allowing the analysis of relationships between FMS parameters and performance measures. In addition, 235 athletes completed testing over 2 consecutive years, allowing the analysis of relationships between changes in these outcomes. Small associations were observed between FMS composite score, hurdle step performance, in-line lunge performance, trunk stability push-up performance, rotary stability, and measures of speed, power, agility, and aerobic fitness (ρ = 0.071-0.238). Across consecutive seasons, significant improvements were observed in the deep squat subtest ( d = 0.21), FMS composite score ( d = 0.17), and 5- ( d = 0.16) and 20-m sprint times ( d = 0.39). A negative association between change in rotary stability and change in jump height (ρ = -0.236) from one season to the next was detected. Results suggest FMS scores have limited relationships with measures of performance in footballers. To optimize athletic performance, once acceptable movement capabilities have been established, training should not prioritize improving movement quality over improvements in strength, power, and change of direction ability.

Anterior Cruciate Ligament Injuries in Australian Rules Football: Incidence, Prevention and Return to Play Outcomes.

Australian Rules football is the most popular of the various codes of football played in Australia. During the game players perform frequent landing, cutting and pivoting manoeuvres that expose them to substantial risk for anterior cruciate ligament (ACL) injury. Recent years have seen the introduction of a professional women’s league that has resulted in an exponential growth in the participation of women and girls in this sport. Unfortunately, there is a corresponding growth in ACL injury rates in female players. This review summarizes the incidence of ACL injury in both men’s and women’s Australian Rules football and reviews potential causative factors and risk reduction strategies. The final section takes an in depth look at return to sport outcomes after ACL reconstruction surgery in these populations. Whilst an ACL injury does not mean the end of a player’s career in Australian football, it certainly presents a significant challenge in terms of return to preinjury levels of form and high rates of secondary and tertiary ACL injury are also a significant concern.

Regulating the post‐employment of public officials: Australian experience in an international context

AbstractThe potential abuse of power by public officials after they have left government employment became a major issue in Australia with the appointment of two recently retired senior federal ministers to lucrative positions with firms which had close dealings with their former departments. The cases raise important questions about the regulation of ‘the revolving door’ which is an increasing feature of governance as the public and private sectors move more closely together. Australian Commonwealth rules relating to both ministers and public servants are analysed in the context of international practice and as part of the wider issue of conflict of interest. Four types of conflict are relevant to post‐employment: ingratiation, profiteering, influence, and switching sides. The regulation of each type is discussed and Australian practice seen to be deficient in certain respects, particularly in relation to ministers. Regulation in this area faces two general challenges: definition of the offence and the comparative absence of oversight and sanctions. But international exemplars offer prospects for strengthening Australia's ethical regime.

Considerations in interpreting neuromuscular state in elite level Australian Rules football players

ObjectivesExamine the influence of test modality, season stage, match load and physical qualities on the interpretation of neuromuscular function (NF) post Australian Rules Football (ARF) matches. DesignRepeated measures design. MethodsThirty-two elite ARF players’ NF was assessed 72h following competitive matches (7±2) via the counter movement jump (CMJ) and isometric mid-thigh pull (IMTP). Influence of season stage, external load parameters (GPS; 10Hz) and moderating influences of lower body strength (LBS), lower body power (LBP) and intermittent exercise capacity upon NF recovery were assessed using linear mixed effects models. ResultsModerate negative seasonal trends were evident for both rate of force development (RFD) 0−100ms (d=−0.86, 95%, CI: ±0.57) and 0−200ms (d=−0.76, CI: ±0.64). Significant but trivial effects of match load were observed between one standardised unit increase in high speed running (HSR) versus CMJ: Force at zero velocity (d=0.12, CI: ±0.12), and sum of high intensity accelerations and CMJ: Eccentric deceleration RFD (d=−0.18, CI: ±0.14). Accounting for baseline LBS better explained (weight of evidence: W=87%) seasonal trends observed in IMTP: peak force, with lower LBS showing greater capacity for improvement. Positive moderating influences were observed with baseline LBS and LBP (W=91 & 75%) on CMJ: eccentric mean power responses to HSR, and CMJ: jump height responses to very-HSR, respectively. ConclusionsInterpretation of athlete NF responses is complicated by the inconsistent and interacting influence of contextual factors (assessment modality, stage of season, load), in-particular higher baseline LBS and LBP may improve acute load related responses of NF.

The Sleep of Elite Australian Rules Footballers During Preseason: A Comparison of Men and Women.

Australian football has elite men's (Australian Football League; AFL) and women's (Australian Football League Women's; AFLW) competitions. This study compared AFL and AFLW players' sleep and characterized players' sleep in the context of current sleep recommendations. A total of 70 players (36 AFL, 34 AFLW) had their sleep monitored via actigraphy over a 10-day preseason period. Sleep outcomes and their intraindividual variation, were compared between AFL and AFLW players using linear mixed models. Proportions of players sleeping ≥7 and ≥8hours per night, and achieving ≥85% sleep efficiency, were compared using chi-square analyses. Compared with AFL players, AFLW players slept less (7.9 [0.5] vs 7.1 [0.6]h, P = .000), had lower sleep efficiency (89.5% [2.8%] vs 84.0% [4.4%], P = .000), and greater intraindividual variation in sleep efficiency (3.1% [0.9%] vs 5.1% [2.1%], P = .000). A total of 47% of AFLW versus 3% of AFL players averaged <7 hours sleep (χ2 = 18.6, P = .000). A total of 88% of AFLW versus 50% of AFL players averaged <8 hours sleep (χ2 = 11.9, P = .001). A total of 53% of AFLW versus 14% of AFL players averaged <85% sleep efficiency (χ2 = 12.1, P = .001). AFLW players slept less and had poorer sleep quality than AFL players. Many AFLW players do not meet current sleep duration or sleep quality recommendations. Research should test strategies to improve sleep among Australian rules footballers, particularly among elite women.

Isolated Tear of the Distal Biceps Femoris Tendon in a Young Elite Australian Rules Football Player

Isolated tear of the distal biceps femoris tendon is rare in athletes. A recent systematic review identified only a total of 22 athletes with such injuries. More specifically, only one previously reported case in an athlete outlined a tear localised to the distal tendon, as opposed to the more commonly documented myotendinous junction. Most of these injuries were treated surgically (n = 20/22) with mean (± SD) overall time to return to sport of 4.9 +/- 3.3 months. This study presents a rare case of an isolated tear of the distal biceps femoris tendon in an elite athlete under the age of 18.

Prolonged elevation of serum neurofilament light after concussion in male Australian football players

BackgroundBiomarkers that can objectively guide the diagnosis of sports-related concussion, and consequent return-to-play decisions, are urgently needed. In this study, we aimed to determine the temporal profile and diagnostic ability of serum levels of neurofilament light (NfL), ubiquitin carboxy-terminal hydrolase L1 (UCHL1), glial fibrillary acidic protein (GFAP), and tau in concussed male and female Australian footballers.MethodsBlood was collected from 28 Australian rules footballers (20 males, 8 females) at 2-, 6-, and 13-days after a diagnosed concussion for comparison to their levels at baseline (i.e. pre-season), and with 27 control players (19 males, 8 females) without a diagnosis of concussion. Serum concentrations of protein markers associated with damage to neurons (UCHL1), axons (NfL, tau), and astrocytes (GFAP) were quantified using a Simoa HD-X Analyzer. Biomarker levels for concussed players were compared over time and between sex using generalised linear mixed effect models, and diagnostic performance was assessed using area under the receiver operating characteristic curve (AUROC) analysis.ResultsSerum NfL was increased from baseline in male footballers at 6- and 13-days post-concussion. GFAP and tau were increased in male footballers with concussion at 2- and 13-days respectively. NfL concentrations discriminated between concussed and non-concussed male footballers at all time-points (AUROC: 2d = 0.73, 6d = 0.85, 13d = 0.79), with tau also demonstrating utility at 13d (AUROC = 0.72). No biomarker differences were observed in female footballers after concussion.ConclusionsSerum NfL may be a useful biomarker for the acute and sub-acute diagnosis of concussion in males, and could inform neurobiological recovery and return-to-play decisions. Future adequately powered studies are still needed to investigate biomarker changes in concussed females.

Isolated Tibialis Posterior Muscle Strain: A rare sporting injury

We present the case of an isolated tibialis posterior muscle strain in an Australian Rules Football (AFL) player, an injury not previously described in the medical literature. The elite footballer presented with calf tightness following a game of AFL. The clinical history, examination findings and treatment regime followed a course similar to more typical “calf strains” involving the gastrocnemius and soleus muscles, however Magnetic Resonance Imaging (MRI) revealed a low grade isolated muscle strain of tibialis posterior. The only inciting factor was the use of new football boots. This novel case will alert radiologists and sports physicians to a new potential source of calf pain in athletes.

Classification of Australian football kick types in-situation via ankle-mounted inertial measurement units

ABSTRACT The utility of inertial measurement units (IMUs) for sporting skill and performance analysis during training and competition is advantageous for enhancing the objectivity of athlete monitoring. This study aimed to classify Australian Rules football (AF) kick types in an applied environment using ankle-mounted IMUs. IMUs and video capture of a controlled protocol, including four kick types at varying distances, were recorded during a single testing session with female AF athletes (n = 20). Processed IMU data were modelled using support vector machine classifier, random forest, and k-nearest neighbour algorithms under a 2-Kick, 4-Kick, and kick distance (10, 20, 30 m) conditions. The random forest model showed the highest results for overall classification accuracy (83% 2-Kick and 80% 4-Kick), test F1-score (0.76 2-Kick and 0.81 4-Kick), and AUC score (0.58 2-Kick and 0.60 4-Kick). Kick distance classification showed a model test and class weighted F1-score of 0.63 and overall accuracy of 64%, respectively. This study highlights the potential for an applied semi-automated AF training kick detection and type classification system using IMUs.

Coach Like a Woman: Learnings From a Pilot Coach Education Program

This best practice paper reflects on a pilot coach education program designed for women coaching Australian Rules football. Focused on enhancing self-regulation, and underpinned by a growth mindset framework, the “Coach like a Woman” program was delivered to a selected group of female coaches either working in or having been identified with the potential to coach at high-performance levels. This manuscript describes the program content and discusses the key insights identified by the delivery team. Creating a community of practice encouraged the transfer of knowledge and experience between the enrolled coaches, which increased competence and self-confidence. Providing an understanding of behavioral tendencies enhanced positive self-talk and aided self-regulation by the coaches. The delivery of the program and challenges experienced are also discussed. This reflection on the program is provided to assist future developments in coach education.

Sprinting and hamstring strain injury: Beliefs and practices of professional physical performance coaches in Australian football

ObjectivesThe purpose of this study was to establish beliefs and practices of physical performance coaches regarding sprinting and Hamstring Strain Injury (HSI) in Australian Rules football. DesignsDelphi-validated questionnaire. SettingOnline. ParticipantsEighteen high-performance managers of the Australian Football League. Main outcome measuresDescriptive statistics were collected to establish experience; central themes were established for the analyses of the beliefs and practices. ResultsNine (50%) physical performance coaches responded to an invitation to complete the questionnaire. Participants held an undergraduate degree and had 9.2 ± 4.3 years of experience. Accelerations (n = 9), maximum speed sprints (n = 9) and running with hip flexion (n = 7) were the most common activities associated with HSI. Coaches believed sprinting, eccentric strength training and proper periodisation were effective strategies to reduce HSI risk. There’s a disparity between beliefs and practices when using GPS to monitor sprinting, however, all coaches reported regular exposure to sprint training across both pre and in-season. Overstriding (n = 9) and pelvic instability (n = 6) were identified as key flaws in running mechanics. ConclusionsThis information can be used to improve training strategies, whilst these findings indicate further investigations into sprint training and running mechanics for HSI risk reduction.

Match High-Speed Running Distances Are Often Suppressed After Return From Hamstring Strain Injury in Professional Footballers.

Background:High-speed running is commonly implicated in the genesis of hamstring injury. The success of hamstring injury management is typically quantified by the duration of time loss or reinjury rate. These metrics do not consider any loss in performance after returning to play from hamstring injury. It is not known to what extent high-speed running is altered on return to play after such injury.Hypothesis:Match high-speed running distance will change after returning from hamstring injury.Study Design:Non-randomized cohort.Level of Evidence:Level 3.Methods:Match high-speed running distance in highest level professional football (soccer, Rugby League, Rugby Union, and Australian Rules) were examined for a minimum of 5 games prior and subsequent to hamstring strain injury for individual differences using a linear regression models approach. A total of 22 injuries in 15 players were available for analysis.Results:Preinjury cumulative high-speed running distances were strongly correlated for each individual (r2 = 0.92-1.0; P < 0.0001). Pre- and postinjury high-speed running data were available for a median of 15 matches (range, 6-15). Variance from the preinjury high-speed running distance was significantly less (P = 0.0005) than the post injury values suggesting a suppression of high-speed running distance after returning from injury. On return to play, 7 of the 15 players showed a sustained absolute reduction in preinjury high-speed running distance, 7 showed no change, and 1 player (only) showed an increase. Analysis of subsequent (second and third injury) return to play showed no differences to return from the index injury.Conclusion:Return to play was not associated with return to high-speed running performance for nearly half of the players examined, although the same number showed no difference. Persisting deficits in match high-speed running may exist for many players after hamstring strain injury.Clinical Relevance:Returning to play does not mean returning to (high-speed running) performance for nearly half of the high-level professional football players examined in this study. This suggests that successful return to play metrics should be expanded from simple time taken and recurrence to include performance.

Set distance time trials for predicting maximal aerobic speed in female Australian Rules Footballers

ObjectivesMaximal aerobic speed (MAS) may be predicted from 2.0km time trial (TT) running speed in male Australian Rules football (AF) players. Given the between-sex differences in physiological variables precursory to endurance performance, and the impact of this on MAS distance limit, this study determined running speed across various TT distances best approximating MAS in female AF players. Method33 female AF players completed assessments of MAS and TT performance separated by at least 48h. In a randomised order, half of the athletes completed TT distances of 1.2, 1.6 and 2.0km, and the other half completed distances of 1.4, 1.8 and 2.2km. Bias, limits of agreement (LOA) and linear mixed modelling determined agreement between TT-derived running speed and MAS. ResultsAverage speed for all TT distances were different to MAS (bias≥0.59±0.45km·h−1; p≤0.015) with the exception of the 1.4km TT (bias=−0.12±0.26km·h−1; p=0.34). LOA was narrowest for the 1.4km TT (±0.76km·h−1; ±6.1%) compared to other TT distances (±0.82–1.67km·h−1; ±6.7–12.9%). A significant linear association between bias and TT distance (r=−0.73; p<0.001) indicated TT speed would be equal to MAS when a 1.4–1.5km TT was completed, and that MAS may be predicted from any distance between 1.2 and 2.2km. ConclusionsMAS was best approximated by a 1.4–1.5km TT in female AF players, but may be predicted from TT speed for any distance between 1.2 and 2.2km. TT-derived MAS provides a time and resource efficient method for the quantification of aerobic fitness and prescription of future training intensities.

Utilising one minute and four minute recovery when employing the resistance training contrast method does not negatively affect subsequent jump performance in the presence of concurrent training.

BackgroundLittle is known about contrast training and post-activation performance enhancement (PAPE) in a same day concurrent training model. The aim of the current study was to examine the use of two short duration (1-min and 4-min) recovery periods on drop jump performance in same day concurrently trained athletes.MethodsTen professional Australian Rules footballers (age, 20.6 ± 1.9 yr; height, 184.8 ± 6.9 cm; body mass, 85.8 ± 8.4 kg) completed two resistance training sessions with different PAPE recovery durations; 1-min and 4-min, 1 h following a field-based endurance session. Baseline (pre) drop jumps were compared to post-test maximal drop jumps, performed after each set of three squats (where each participant was encouraged to lift as heavy as they could), to determine changes between 1-min and 4-min recovery periods. Data were analysed by fitting a mixed model (significance was set at P ≤ 0.05). Corrected Hedges’ g standardised effect sizes ±95% confidence limits were calculated using group means ± SDs.ResultsThere were no significant differences between baseline and experimental sets 1, 2 and 3 for reactive strength index (RSI), flight time, and total and relative impulse for either recovery duration. However, for contact time, 1-min baseline was significantly different from set 2 (mean difference; 95% CI [0.029; 0.000–0.057 s], P = 0.047, ES; 95% CI [−0.27; −1.20 to 0.66]). For RSI and flight time, 1-min was significantly higher than 4-min (RSI: 0.367; 0.091 to 0.642, P = 0.010, ES; 95% CI [0.52; −0.37 to 1.42]; flight time: 0.033; 0.003 to 0.063 s, P = 0.027, ES; 95% CI [0.86; −0.06 to 1.78]).DiscussionShort recovery periods of 1-min may be a time-efficient form of prescribing strength-power exercise in contrast loading schemes. Longer recovery periods do not appear to benefit immediate, subsequent performance.

Serum Protein Biomarker Findings Reflective of Oxidative Stress and Vascular Abnormalities in Male, but Not Female, Collision Sport Athletes.

Studies have indicated that concussive and sub-concussive brain injuries that are frequent during collision sports may lead to long-term neurological abnormalities, however there is a knowledge gap on how biological sex modifies outcomes. Blood-based biomarkers can help to identify the molecular pathology induced by brain injuries and to better understand how biological sex affects the molecular changes. We therefore analyzed serum protein biomarkers in male (n = 50) and female (n = 33) amateur Australian rules footballers (i.e., Australia's most participated collision sport), both with a history of concussion (HoC) and without a history of concussion (NoHoC). These profiles were compared to those of age-matched control male (n = 24) and female (n = 20) athletes with no history of neurotrauma or participation in collision sports. Serum levels of protein markers indicative of neuronal, axonal and glial injury (UCH-L1, NfL, tau, p-tau, GFAP, BLBP, PEA15), metabolic (4-HNE) and vascular changes (VEGF-A, vWF, CLDN5), and inflammation (HMGB1) were assessed using reverse phase protein microarrays. Male, but not female, footballers had increased serum levels of VEGF-A compared to controls regardless of concussion history. In addition, only male footballers who had HoC had increased serum levels of 4-HNE. These findings being restricted to males may be related to shorter collision sport career lengths for females compared to males. In summary, these findings show that male Australian rules footballers have elevated levels of serum biomarkers indicative of vascular abnormalities (VEGF-A) and oxidative stress (4-HNE) in comparison to non-collision control athletes. While future studies are required to determine how these findings relate to neurological function, serum levels of VEGF-A and 4-HNE may be useful to monitor subclinical neurological injury in males participating in collision sports.

Clinical utility of measuring the size of the lumbar multifidus and quadratus lumborum muscles in the Australian football league setting: A prospective cohort study

ObjectivesTest the odds of factors previously associated with lower limb injury (decreased size of the multifidus (MF) and increased size of the quadratus lumborum (QL) muscle) in an independent sample of Australian Rules Football (ARF) players. DesignProspective cohort study. SettingProfessional ARF. Participants: Forty-three male ARF players. Main outcome measuresCross-sectional areas (CSAs) of MF and QL muscles measured from pre-season ultrasound images. Playing season injuries were recorded by club personnel. A multivariable logistic regression model was used to evaluate the usefulness of MF and QL muscle size for predicting playing season lower limb injuries. ResultsFifteen players (35%) sustained a playing season lower limb injury. The multivariable model indicated that the odds of sustaining a lower limb injury during the season was 2.38 (95% CI: 1.18, 5.00; P = 0.017) times less likely for a one cm2 increase from the mean value in MF muscle CSA at the L5 vertebral level after adjusting for CSA of the QL, age and BMI. The main effect and interaction models positively predicted 75% of players that sustained a lower limb injury during the season (sensitivity 80%, specificity 85%). ConclusionFuture studies could examine the efficacy, feasibility and adherence of ‘at risk’ players to a pre-season training program aimed at increasing MF muscle size and monitor playing season injuries.

Examining territorialization in competitive sport markets

Drawing on both sociological and consumer behaviour literature, this study explores the influence of territorial geographic boundaries on shaping localized football preferences. Survey responses of 16,515 Australian metropolitan residents were demarcated to perform analysis across 43 territories, with four football codes analyzed (Australian rules, rugby union, rugby league and soccer). Preferences were evaluated utilizing chi-square tests, with football interest in Sydney found to vary significantly across territorial boundaries. Territories associated with a highly localized team typically exhibited higher interest toward their respective sport, with the inverse found in deterritorialized regions. Although most sport teams have a city based identity, consumer interest can vary widely within such cities. Given that teams typically retain one venue, they must therefore be conscious of maximising their physical availability across a desired population catchment. The findings support the theorized positive relationship between physical product availability and product popularity in a sport setting. Supplemental data for this article is available online at https://doi.org/10.1080/17430437.2020.1807953.