Injuries In Australian Football Research Articles

Changes in injury and illness incidence and burden in elite junior male Australian footballers over a 6–year period

ObjectivesThe study aimed to determine a contemporary multi-year junior Australian football (AF) injury and illness profile and secondly, explore changes in incidence and burden over the six-year period. DesignProspective cohort study. MethodsThis study involved an elite male junior Under-18 competition and included six seasons of injury data between 2015 and 2021. A total of 1559 eligible players were included in the analysis. An injury was defined as ‘any physical or medical condition that resulted in a player missing one or more regular competition season matches.’ A Poisson regression model determined injury and illness incidence and burden across the league over a 6-year period and explored changes in injury incidence and burden over time. ResultsThe frequency of injuries was 1023 over the six seasons. The most frequently reported injuries were ankle sprain or joint injuries (26.5 injuries/season), hamstring strains (15.8 injuries/season), and concussion (15.1 injuries/season). The most burdensome injuries were ankle sprain or joint injuries with 82.5 missed matches/season, followed by anterior cruciate ligament injuries with 53.7 missed matches/season and hamstring strains with 46.9 missed matches/season. Injury incidence did not change for the most common injury types over time (all p > 0.05). Injury burden significantly increased for concussions, ACL injuries, MCL injuries, and ankle sprain or joint injuries (all p < 0.05). ConclusionsThe multi-year injury surveillance methodology identified injuries with the highest consistent incidence and those that caused the most burden to elite male junior AF players. The results can be used to reliably guide future injury prevention methodologies to reduce the impact on players and clubs.

Relationships between physical fitness characteristics, technical skill attributes, and sports injury in female Australian football players.

To explore the relationships between physical fitness and i) technical skills and ii) time-loss from Australian football injury in female players across the talent and participation pathways. This study uses a subset of data from two cross-sectional and one prospective cohort studies. A total of 223 female Australian football players across five competition levels (elite/non-elite senior, high-level junior, and non-elite junior (14-17 years)/(10-13 years)) were included in this study. Comprehensive physical fitness assessments and modified Australian football kicking and handballing tests were conducted in the 2018/19 pre-seasons. During the respective competitive in-season, time-loss injuries were recorded by team personnel. Stepwise multiple linear regressions were performed to determine the relationship between physical fitness and kicking and handballing scores. Cox proportional regressions were conducted to identify physical fitness factors associated with injury. Increased running vertical jump height, greater hip abduction strength, and faster timed 6 m hop speed demonstrated a relationship with kicking accuracy when adjusted for years of Australian football playing experience (adjusted R2 = 0.522, p < 0.001). Faster agility time and increased lean mass were associated with better handballing accuracy (adjusted R2 = 0.221, p < 0.001). Multivariate Cox regression revealed an increased risk for sustaining a time-loss injury in less agile players (adjusted HR 2.41, 95% CI 1.23, 4.73, p = 0.010). However, this relationship no longer remained when adjusted for age and years of Australian football experience (adjusted HR 1.68, 95% CI 0.81, 3.50, p = 0.166). Physical fitness may be a significant factor contributing to development of Australian football technical skills in female players. However, its role is unclear in protecting against injury risk in this athlete population. Further research is needed to explore the multifactorial and complex phenomenon of talent development and injury risk reduction in female Australian football players.

Genetic Variants within NOGGIN, COL1A1, COL5A1, and IGF2 are Associated with Musculoskeletal Injuries in Elite Male Australian Football League Players: A Preliminary Study

IntroductionAustralian Football is a dynamic team sport that requires many athletic traits to succeed. Due to this combination of traits, as well as technical skill and physicality, there are many types of injuries that could occur. Injuries are not only a hindrance to the individual player, but to the team as a whole. Many strength and conditioning personnel strive to minimise injuries to players to accomplish team success.PurposeTo investigate whether selected polymorphisms have an association with injury occurrence in elite male Australian Football players.MethodsUsing DNA obtained from 46 elite male players, we investigated the associations of injury-related polymorphisms across multiple genes (ACTN3, CCL2, COL1A1, COL5A1, COL12A1, EMILIN1, IGF2, NOGGIN, SMAD6) with injury incidence, severity, type (contact and non-contact), and tissue (muscle, bone, tendon, ligament) over 7 years in one Australian Football League team.ResultsA significant association was observed between the rs1372857 variant in NOGGIN (p = 0.023) and the number of total muscle injuries, with carriers of the GG genotype having a higher estimated number of injuries, and moderate, or combined moderate and high severity rated total muscle injuries. The COL5A1 rs12722TT genotype also had a significant association (p = 0.028) with the number of total muscle injuries. The COL5A1 variant also had a significant association with contact bone injuries (p = 0.030), with a significant association being found with moderate rated injuries. The IGF2 rs3213221-CC variant was significantly associated with a higher estimated number of contact tendon injuries per game (p = 0.028), while a higher estimated number of total ligament (p = 0.019) and non-contact ligament (p = 0.002) injuries per game were significantly associated with carriage of the COL1A1 rs1800012-TT genotype.ConclusionsOur preliminary study is the first to examine associations between genetic variants and injury in Australian Football. NOGGIN rs1372857-GG, COL5A1 rs12722-TT, IGF2 rs3213221-CC, and COL1A1 rs1800012-TT genotypes held various associations with muscle-, bone-, tendon- and ligament-related injuries of differing severities. To further increase our understanding of these, and other, genetic variant associations with injury, competition-wide AFL studies that use more players and a larger array of gene candidates is essential.

Impact of Sudden Rule Changes on Player Injuries and Performance: Insights from Australian Football.

This study investigated the effects of reduced quarter time due to COVID-19 pandemic rule changes, on running performance and injuries in Australian Football. Microsensor data for eight matches performed by the same 17 players were compared between the 2019 (standard) and 2020 (COVID-19) seasons using linear and generalised mixed models. Injury rates were assessed in 34 players across the full 2019 season, and 32 players across the full 2020 season. The total distance (ES = 1.28 [0.55 to 2.02]), high-speed (>18 km/h) (ES = 0.44 [-0.24 to 1.12]) and very highspeed (>24 km/h) (ES = 0.27 [-0.41 to 0.94]) distances, PlayerLoad™ (ES = 0.96 [0.25 to 1.67]), high-intensity efforts (ES = 0.48 [-0.20 to 1.16]), and accelerations (ES = 0.33 [-0.34 to 1.01]) were smaller (p ≤ 0.01) for the 2020 than the 2019 season. Expressed relative to playing time, distance (ES=-0.38 [-1.06 to 0.30]), PlayerLoad™ (ES = -0.27 [-0.94 to 0.41]), and acceleration efforts (ES = -0.50 [-1.18 to 0.18]) were greater (p < 0.05) for the 2020 than the 2019 season. No significant differences in maximum ball-in-play periods nor the difference between the 1st and 4th quarters were evident. Injury rates remained similar between 2019 (3.36 per game) and 2020 (3.55 per game). However, the proportion of injuries that led to lost time (missed games) was greater for the 2020 (38%) than 2019 season (24%). The changes in the rules had a profound impact on player performance and increased the likelihood of time loss injuries.

Hospital-treated Australian Football injury in women and girls, Victoria, 2010/11-2019/20

Introduction: Rates of participation for women and girls playing Australian Football at the school, club and professional level in recent years has increased significantly, from 95,000 participants nationally in 2011 to 586,422 in 2019. In 2010, there were 58 female club teams in Victoria, increasing almost 20-fold to 1092 teams in 2019. The dramatic increase in participation has also seen a sharp rise in serious injuries such as concussion, ruptured ACLs and fractured wrists. The study aims to describe the incidence of hospital-treated Australian Football injuries among women and girls aged 5 years and above in Victoria, Australia. Methods: Routinely collected Victorian emergency department and hospital admissions data from 2010/11 to 2019/20 will be extracted and analysed. Trends over a ten-year period will be examined, while in-depth analysis will focus on the three most recent years of available data. Records will be restricted to females aged 5 plus years with an ICD-10-AM external cause activity code indicating Australian Football (admissions data), while narrative texts and Australian Football sports code will be used for selection of ED presentation data. Results: Outcome measures include frequencies and rates per 100,000 participants for hospital-treated Australian Football injury. Preliminary results: 2509 hospitalisations for women and girls injured while playing Australian Football from 2010/11 to 2019/20; hospitalisations were 94 in 2010/11, increased to 584 in 2018/19 and dropped to 311 in 2019/20 (reflecting limited activity during COVID-19 lockdown). Thirty-four percent (n=859) recorded for females aged 15 to 19 years, followed by 10 to 14 year olds (19%, n=473). Most injuries were to the head (29%, n=727), wrist/hand (24%, n=610) and knee/lower leg (21%, n=521). Discussion: It’s anticipated that both the frequency and participation-adjusted rate of hospital-treated female Australian Football injury will have increased over the past 10 years, with the highest increases occurring in more recent years of data. This research pushes the boundaries through the capture of state-wide population-based hospital treated injury cases. The inclusion of descriptive text regarding the circumstances of injury events in the VEMD is a unique feature that can provide valuable information not adequately described by standard health coding systems. The demographic profile and injury description might also provide a basis for injury prevention to curb the injury trend. Conflict of interest statement: I acknowledge that I have no conflict of interest of relevance to the submission of this abstract.

Prediction of Hamstring Injuries in Australian Football Using Biceps Femoris Architectural Risk Factors Derived From Soccer

Background: Hamstring strain injuries are the most common injuries in team sports. Biceps femoris long head architecture is associated with the risk of hamstring injury in soccer. To assess the overall predictive ability of architectural variables, risk factors need to be applied to and validated across different cohorts. Purpose: To assess the generalizability of previously established risk factors for a hamstring strain injury (HSI), including demographics, injury history, and biceps femoris long head (BFlh) architecture to predict HSIs in a cohort of elite Australian football players. Study Design: Cohort study; Level of evidence, 3. Methods: Demographic, injury history, and BFlh architectural data were collected from elite soccer (n = 152) and Australian football (n = 169) players at the beginning of the preseason for their respective competitions. Any prospectively occurring HSIs were reported to the research team. Optimal cut points for continuous variables used to determine an association with the HSI risk were established from previously published data in soccer and subsequently applied to the Australian football cohort to derive the relative risk (RR) for these variables. Logistic regression models were built using data from the soccer cohort and utilized to estimate the probability of an injury in the Australian football cohort. The area under the curve (AUC) and Brier score were the primary outcome measures to assess the performance of the logistic regression models. Results: A total of 27 and 30 prospective HSIs occurred in the soccer and Australian football cohorts, respectively. When using cut points derived from the soccer cohort and applying these to the Australian football cohort, only older athletes (aged ≥25.4 years; RR, 2.7 [95% CI, 1.4-5.2]) and those with a prior HSI (RR, 2.5 [95% CI, 1.3-4.8]) were at an increased risk of HSIs. Using the same approach, height, weight, fascicle length, muscle thickness, pennation angle, and relative fascicle length were not significantly associated with an increased risk of HSIs in Australian football players. The logistic regression model constructed using age and prior HSIs performed the best (AUC = 0.67; Brier score = 0.14), with the worst performing model being the one that was constructed using pennation angle (AUC = 0.53; Brier score = 0.18). Conclusion: Applying cut points derived from previously published data in soccer to a dataset from Australian football identified older age and prior HSIs, but none of the modifiable HSI risk factors, to be associated with an injury. The transference of HSI risk factor data between soccer and Australian football appears limited and suggests that cohort-specific cut points must be established.

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.

Gender differences in female and male Australian Football injuries — A prospective observational study of emergency department presentations

ObjectivesTo compare injury-profiles of females and males presenting to Emergency Departments (EDs) with an Australian Football injury. DesignProspective observational study. MethodsAll patients presenting to one of 10 EDs in Victoria, Australia, with an Australian Football injury were included in the study. Data were prospectively collected over a 10 month period, coinciding with a complete Australian Football season, including pre-season training and practice matches. Relevant information was extracted from patient medical records regarding injury-type, body part injured, investigations and treatments required. Female and male data were compared with chi-squared and Fisher’s exact tests. Results1635 patients were included, of whom 242 (14.8%) were female. Females had a higher proportion of hand/finger injuries (34.3% v 23.4%), neck injuries (6.6% v 2.5%) and patella dislocations (2.9% v 0.6%). Males had a higher proportion of shoulder injuries (11.5% v 5.8%), skin lacerations (8.0% v 1.7%), and thorax/abdominal/pelvic injuries (5.7% v 2.1%). Concussion rates were similar between the genders, occurring in 14.1% of all patients. Anterior cruciate ligament injuries were infrequent (1.0%) and not significantly different between genders. Females received more imaging investigations (83.1% v 74.7%) and analgesia (62.4% v 48.5%). A higher proportion of males required admission to hospital (5.0% v 2.1%), usually for surgery. ConclusionAustralian Football injury profiles differed between females and males. Gender-specific injury prevention and management programs would be indicated based on the study findings.

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.

Player Wellness (Soreness and Stress) and Injury in Elite Junior Australian Football Players Over 1 Season

Purpose: To investigate the association between player wellness and injury in elite junior Australian football players over 1 competitive season. Methods: Prospective cohort study. Elite junior Australian football players (N = 196, average age = 17.7 y, range = 16–18 y) were recruited in the under-18 state league competition in Victoria, Australia. They recorded their wellness (sleep, fatigue, soreness, stress, and mood) according to a 5-point Likert scale 3 times weekly, with injuries (missed match/training session) entered into an online sport-injury surveillance system. A logistic generalized estimating equation was used to examine the association (expressed as odds ratio [OR]) between wellness and injury (yes/no). Results: Soreness was associated with injury at each time point across the week, with the strongest association evident for soreness reported 6 d postmatch (OR = 1.30; 95% confidence interval [CI], 1.17–1.44; P &lt; .001). Stress and injury were associated with injury for average stress values across the week, as well as specifically on day 1 postmatch (OR = 1.10; 95% CI, 1.01–1.21; P = .038). Mood reported in the middle of the week (3 d postmatch) was associated with injury (OR = 0.87; 95% CI, 0.78–0.97; P = .014), as was fatigue (OR = 1.10; 95% CI, 1.00–1.22; P = .044). Conclusions: This study demonstrates key associations between wellness and injury in elite junior Australian football, specifically soreness, stress, fatigue, and mood. Monitoring strategies help identify injury-risk profiles, which can help decision makers (coaches or medical staff) intervene when relevant to reduce injury risk.

An evaluation of the presentation and severity of Australian football injury in children

Introduction Child participation in sport is important for physical, cognitive and psychosocial wellbeing. Australian rules football has high participation, but also carries a high risk of injury due to the contact nature of the sport. This study aimed to evaluate changes in the presentation and hospital admission of paediatric Australian rules football-related injuries, and to compare the severity of these injuries with those from other team ball sports. Materials and methods At an Australian paediatric major trauma service, ED and hospital trauma registry data relating to Australian rules football injury between 2009 and 2015 were obtained. Data from other common team ball sports with a shared field of play were also identified. Results During the study period, there were 10,003 ED presentations, and 1110 admissions resulting from team ball sports. With 4751 ED presentations and 616 admissions, Australian rules football accounted for almost one-third of all sports-related presentations and admissions, and around half of the team ball sports cohort. Compared to other team ball sports patients, Australian rules football-related patients were 40% more likely to be admitted, and nearly twice as likely to be classified as severe injury. Australian rules football players presented with different injury patterns were compared to other team ball sports players; admitted players were significantly more likely to have sustained head or neck injuries, and were more than twice as likely to sustain truncal injury. Conclusions Australian rules football is a common cause of ED presentations and results in substantial morbidity, both overall and when compared with other team ball sports. Australian rules football should remain a focus for ongoing and active research into strategies which reduce injury risk.

Which factors are predictive of return to play and re-injury following calf muscle strain injury?

Background: Calf muscle strain injuries (CMSI) are one of the most prevalent soft tissue injuries in elite Australian Football. Outcomes are highly variable (return to play: 0-102 days, re-injury: 4% to 16%) and little is known about factors that impact prognosis. The aim of this study was to determine whether clinical and radiological factors are predictive of (i) return to play, and (ii) re-injury.

Relationship between vertical stiffness and soft-tissue injuries in professional Australian football

ABSTRACT Soft-tissue injuries are common in Australian football. Recently, literature has identified non-modifiable and modifiable risk factors, including vertical stiffness (Kvert). However, limitations regarding measurement frequency and duration exist; thus, further information is required about the role of Kvert as a modifiable risk factor for injury. This study examined the seasonal variation in Kvert and its relationship to soft-tissue injuries in professional Australian football. The mean Kvert and bilateral asymmetry were assessed and compared between injured and non-injured players. For the seasonal analysis, 56 players were tested across two seasons with no variation in bilateral asymmetry evident (p= 0.33). While there were generally no changes in Kvert, the value from the end of the second pre-season revealed 5% lower values than the mean of two seasons (p= 0.02). Considering the injury analysis, 21 lower-body soft-tissue injuries were recorded from 18 participants. No differences were recorded for mean Kvert between the injured and non-injured groups (p= 0.16–0.76). When assessing Kvert asymmetry, the injured group displayed a 4.5% higher value than the non-injured group at the end of the pre-season test (p= 0.03) but not at other time-points (p= 0.16–0.99). Higher Kvert bilateral asymmetry measures after the pre-season appear to be related to lower-body soft-tissue injury in professional Australian footballers. Medical and conditioning staff should consider this measure when trying to mitigate the onset of injury or identify at-risk players.

Improvement of Prediction of Noncontact Injury in Elite Australian Footballers With Repeated Exposure to Established High-Risk Workload Scenarios.

To assess the effect of multiple high-risk-scenario (HRS) exposures on noncontact injury prediction in elite Australian footballers. Retrospective cohort study. Sessional workload data (session rating of perceived exertion, global positioning system-derived distance, sprint distance, and maximum velocity) from 1 club (N = 60 players) over 3 seasons were collated; several established HRSs were also defined. Accumulated HRS sessional exposures were calculated retrospectively (previous 1-8wk). Noncontact injury data were documented. Univariate and multivariate Poisson regression models determined injury incidence rate ratios (IRRs) while accounting for moderating effects (preseason workload volume and playing experience). Model performance was evaluated using receiver operating characteristics (area under curve). Very low (0-8 sessions: IRR = 5.76; 95% confidence interval [CI],1.69-19.66) and very high (>15 sessions: IRR = 4.70; 95% CI,1.49-14.87) exposures to >85% of an individual's maximal velocity over the previous 8 wk were associated with greater injury risk compared with moderate exposures (11-12 sessions) and displayed the best model performance (area under curve = 0.64). A single session corresponding to a very low chronic load condition over the previous week for all workload variables was associated with increased injury risk, with sprint distance (IRR = 3.25; 95% CI,1.95-5.40) providing the most accurate prediction model (area under curve = 0.63). Minimal exposure to high-velocity efforts (maximum speed exposure and sprint volume) was associated with the greatest injury risk. Being underloaded may be a mediator for noncontact injury in elite Australian football. Preseason workload and playing experience were not moderators of this effect.

Full training but not full function: Isometric hamstring strength deficits identified up to three years following injury in Australian Football athletes

Introduction: Reduced pre-season measures of concentric and eccentric hamstring strength have been identified as risk factors for future hamstring injury in soccer and Australian Football. The subsequent implementation of eccentric strength interventions has been shown to modulate this risk. However, the use of standalone pre-season assessments to predict future injury have been questioned with screening now advocated for the identification of existing and persisting deficits which may limit current sports participation. This concept is defined as tertiary prevention – assessments and interventions aimed at identification of persisting deficits following injury which may result in future complications such as recurrence or subsequent injury. The aim of this study was to use a simple and inexpensive method to evaluate unilateral isometric hamstring strength in Australian Football athletes with and without a past-history of hamstring muscle injury sustained within the previous three seasons. This information may inform the implementation of tertiary prevention strategies.

Risk factors for 3700 muscle strains occurring in 270,000 player matches of Australian football

Introduction: Muscle strains are common injuries in Australian football and other sports.

Strength, not flexibility is responsive to match-play in Australian Football athletes

Introduction: Hamstring strain injury remains the most common injury in Australian Football (AF) despite a large body of research dedicated to understanding the associated risk factors. Modifiable risk factors such as hamstring strength deficits and lower limb flexibility measures have previously been identified with respect to increased risk of hamstring strain injury. The aim of this study was to evaluate the variability of clinically feasible lower limb strength and flexibility tests pre- and post-AF match-play to determine their usefulness as injury prevention measures within a secondary prevention program (with the goal of early detection and intervention).

Calf strain injuries in elite Australian rules football: Epidemiological features, muscles injured and return to play

Calf strain injuries in elite Australian rules football: Epidemiological features, muscles injured and return to play

A video analysis of mechanisms of shoulder injuries in elite Australian Rules football

A video analysis of mechanisms of shoulder injuries in elite Australian Rules football

Predictive Modelling of Training Loads and Injury in Australian Football

Abstract To investigate whether training load monitoring data could be used to predict injuries in elite Australian football players, data were collected from athletes over 3 seasons at an Australian football club. Loads were quantified using GPS devices, accelerometers and player perceived exertion ratings. Absolute and relative training load metrics were calculated for each player each day. Injury prediction models (regularised logistic regression, generalised estimating equations, random forests and support vector machines) were built for non-contact, non-contact time-loss and hamstring specific injuries using the first two seasons of data. Injury predictions were then generated for the third season and evaluated using the area under the receiver operator characteristic (AUC). Predictive performance was only marginally better than chance for models of non-contact and non-contact time-loss injuries (AUC&lt;0.65). The best performing model was a multivariate logistic regression for hamstring injuries (best AUC=0.76). Injury prediction models built using training load data from a single club showed poor ability to predict injuries when tested on previously unseen data, suggesting limited application as a daily decision tool for practitioners. Focusing the modelling approach on specific injury types and increasing the amount of training observations may improve predictive models for injury prevention