Priorities for injury prevention in women's Australian football: a compilation of national data from different sources

Gender differences in female and male Australian football concussion injury: A prospective observational study of emergency department presentations

OBJECTIVE

To examine gender differences in Australian football (AF)-related concussion presentations to EDs in regional Australia.

METHODS

A prospective observational study of patients presenting to 1 of the 10 EDs in Western Victoria, Australia, with an AF-related concussion was conducted. Patients were part of a larger study investigating AF injuries over a complete AF season, including pre-season training and practice matches. Information regarding concussion injuries was extracted from patient medical records, including clinical features, concurrent injuries, mechanism and context of injury. Female and male data were compared with chi-squared and Fisher's exact tests. P < 0.05 was considered significant.

RESULTS

From the original cohort of 1635 patients with AF-related injuries (242 female and 1393 male), 231 (14.1%) patients were diagnosed with concussion. Thirty-eight (15.7%) females had concussions versus 193 (13.9%) males (P > 0.05). Females over the age of 16 were more likely to be concussed than males in the same age range (females n = 26, 68.4% vs males n = 94, 48.7%; P = 0.026). Neurosurgically significant head injury was rare (one case). Similar rates of concurrent injury were found between females 15 (39.5%) and males 64 (33.2%), with neck injury the single most common in 24 (10.3%) concussions. Sixty-nine patients (29%) were admitted for observation or to await the results of scans. The majority of concussions occurred in match play (87.9%). Females were more likely injured in contested ball situations (63.2% vs 37.3%; P < 0.05).

CONCLUSION

Concussion rates for community-level AF presentations to regional EDs were similar between genders. Serious head injury was rare, although hospital admission for observation was common. Concurrent injuries were common, with associated neck injury most often identified. Match play accounted for the majority of head injuries.

Injury prevention for women and girls playing Australian Football: programme cocreation, dissemination and early adopter coach feedback

Background

Adherence to injury prevention programmes may improve with greater end-user involvement and application of implementation frameworks during development. We describe the cocreation, initial dissemination and feedback from programme early adopters (coaches), to develop the first evidence-informed injury prevention programme for women playing community Australian Football (Prep-to-Play).

Methods

We used a pragmatic seven-step process for developing sports injury prevention programmes to (1) gain organisational support, (2) compile research evidence, (3) consult experts, (4) engage end-users, (5) test programme acceptability, (6) evaluate against theory and (7) gain early adopter feedback. All Australian Football-registered coaches of women's/girls' teams were sent a postseason survey to determine initial awareness, adoption and implementation (steps 5 and 6). Purposively selected coaches were invited to interviews/focus groups (step 7) to identify competency, organisational and leadership implementation drivers with a deductive thematic analysis applied.

Results

Prep-to-Play was cocreated using previous efficacious programmes and expert input (steps 1-4), and disseminated via the national sporting organisation in preseason 2019 to all registered coaches (step 5). 343 coaches (90 women) completed the postseason survey and 22 coaches (5 women) participated in an interview (n=9) or focus group (n=13) (steps 6 and 7). 268 coaches (78%) were aware of Prep-to-Play. Of those aware, 218 (81%) had used (at least one element) Prep-to-Play, and 143 (53%) used it at least twice per week. Competency drivers included local expert-delivered face-to-face workshops complimented by online content and ongoing support. Organisational drivers included coach education integrated into existing league/club. Leadership drivers included compulsory injury prevention education integrated into coach reaccreditation processes or incentivisation via recognition (eg, professional development points).

Conclusions

Cocreation and organisational support resulted in high programme awareness and adoption. However, high fidelity implementation and maintenance may need to be facilitated by competency, organisational and leadership drivers. Responsibility should be shared among all stakeholders.

Concussion in Ladies Gaelic Football: Self-reported History, Clinical Profiles, and Management Behavior

OBJECTIVE

To describe the prevalence, characteristics, and management behavior of self-reported sport-related concussion (SRC) in Ladies Gaelic Football (LGF) players.

DESIGN

Cross-sectional study.

SETTING

Online survey distributed to LGF clubs throughout Ireland.

PARTICIPANTS

Elite and nonelite adult LGF players (n = 657).

INTERVENTIONS

Participants were recruited by convenience sampling and answered an online survey. Questions on demographic characteristics, SRC history, symptoms, injury characteristics, and management behavior after SRCs that occurred while playing LGF during the previous season were included.

MAIN OUTCOME MEASURES

Overall concussion history, occurrence of an SRC during the previous LGF season, clinical profile scores, characteristics (eg mechanism and setting), and management behavior (eg following a graded RTP program) after SRCs that occurred during the previous season.

RESULTS

Approximately one-fifth (17.5%) of participants sustained a suspected or diagnosed SRC during the previous season, which was higher among elite (26.1%) than nonelite (15.3%) players ( P < 0.01). The highest scoring clinical profiles were the ocular and migraine profiles. Only 3.5% of respondents adhered to all SRC management recommendations. Although players who reported a medically diagnosed versus a suspected SRC more often followed these guidelines, SRC management beyond the initial phase of injury remained inadequate.

CONCLUSION

SRC is common in LGF; however, adherence to recommended management guidelines is poor, even among players who receive medical assistance. In particular, few LGF athletes receive clinical concussion care beyond the initial diagnosis and acute management phase. Further research is needed to examine the underlying reasons for poor SRC management in LGF, which will guide the development of future sport-specific interventions.

Wrist, hand and finger injuries in Australian football: A prospective observational study of emergency department presentations

OBJECTIVES

Investigate the characteristics of wrist, hand and finger (WHF) injuries in Australian footballers presenting to EDs and determine if injury profiles differed between females and males, and between children and adults.

METHODS

In this prospective observational study that took place during an entire football season, patients attended 1 of 10 EDs in Victoria, Australia with a WHF injury sustained while playing Australian football. Data were extracted from patient medical records by trained researchers. Data included injury type (e.g. fracture), body part (e.g. metacarpal) and mechanism of injury. Males versus females, and children versus adults were compared using chi-squared tests or Fisher's exact tests.

RESULTS

In total, 528 patients had a WHF injury, of which 105 (19.9%) were female and 308 (59.2%) were children. Fractures and sprains were the most common injury types (45.3% and 38.6%, respectively). Fingers were more often injured than wrists or hands (62.5%, 23.5% and 15.0%, respectively). Ball contact was the most common mechanism of injury (38.1% of injuries). Females were more likely than males to (i) have a sprain/strain injury, (ii) injure a finger (rather than wrist or hand) and (iii) injure themselves through ball contact. Children were more likely to injure their wrists, have a sprain/strain injury, or be injured falling to the ground. Adults were more likely to dislocate a joint or injure their hands.

CONCLUSIONS

Differences in injury type, location and mechanism between females and males, and children and adults, suggest an opportunity for customised injury prevention and management strategies by sex and age.

Economic consequences of injury in female Australian footballers: A prospective observational study of emergency department presentations

OBJECTIVE

Investigate the economic consequences of injuries to female Australian footballers from a health sector and societal perspective.

METHODS

This prospective observational study invited 242 females to complete an online questionnaire 3-6 months following an Australian football injury which involved presentation to an ED in Victoria, Australia. The questionnaire inquired regarding healthcare use, time off work, return to playing football and extent of recovery following injury. Relevant information was also extracted from respondents' medical records regarding injury-type, body part injured, investigations and treatments. Healthcare costs were determined for each respondent's ED presentation, hospital admission/s (when relevant), and subsequent healthcare use. Societal costs were determined as lost income to the respondent and/or carer.

RESULTS

A total of 108 people responded to the questionnaire. Sprains/strains and fractures accounted for 84.2% of respondents' injuries. Sixteen respondents (14.8%) required admission to hospital at the time of injury and 81 (75.0%) required subsequent healthcare appointments following discharge from the ED or hospital. Time off work or school following the injury was common (64.8% of respondents) and 27.8% of respondents had a carer take time off work. More than 80% of respondents missed training and matches following the injury. The median healthcare cost per respondent was AUD$753 and the median cost due to work absence was AUD$1393. One-quarter of respondents reported a full recovery.

CONCLUSIONS

Injuries to female Australian footballers can produce substantial healthcare and societal costs, which has important implications for healthcare provision and prioritising and implementing injury prevention programmes and post-injury rehabilitation.

Evaluation of an injury prevention programme (Prep-to-Play) in women and girls playing Australian Football: design of a pragmatic, type III, hybrid implementation-effectiveness, stepped-wedge, cluster randomised controlled trial

INTRODUCTION

Due to the increase in participation and risk of anterior cruciate ligament (ACL) injuries and concussion in women's Australian Football, an injury prevention programme (Prep-to-Play) was codesigned with consumers (eg, coaches, players) and stakeholders (eg, the Australian Football League). The impact of supported and unsupported interventions on the use of Prep-to-Play (primary aim) and injury rates (secondary aim) will be evaluated in women and girls playing community Australian Football.

METHODS AND ANALYSIS

This stepped-wedge, cluster randomised controlled trial will include ≥140 teams from U16, U18 or senior women's competitions. All 10 geographically separated clusters (each containing ≥14 teams) will start in the control (unsupported) phase and be randomised to one of five dates (or 'wedges') during the 2021 or 2022 season to sequentially transition to the intervention (supported Prep-to-Play), until all teams receive the intervention. Prep-to-Play includes four elements: a neuromuscular training warm-up, contact-focussed football skills (eg, tackling), strength exercises and education (eg, technique cues). When transitioning to supported interventions, study physiotherapists will deliver a workshop to coaches and player leaders on how to use Prep-to-Play, attend team training at least two times and provide ongoing support. In the unsupported phase, team will continue usual routines and may freely access available Prep-to-Play resources online (eg, posters and videos about the four elements), but without additional face-to-face support. Outcomes will be evaluated throughout the 2021 and 2022 seasons (~14 weeks per season).

PRIMARY OUTCOME

use of Prep-to-Play will be reported via a team designate (weekly) and an independent observer (five visits over the two seasons) and defined as the team completing 75% of the programme, two-thirds (67%) of the time.

SECONDARY OUTCOMES

injuries will be reported by the team sports trainer and/or players. Injury definition: any injury occurring during a football match or training that results in: (1) being unable to return to the field of play for that match or (2) missing ≥ one match. Outcomes in the supported and unsupported phases will be compared using a generalised linear mixed model adjusting for clustering and time. Due to the type III hybrid implementation-effectiveness design, the study is powered to detect a improvement in use of Prep-to-Play and a reduction in ACL injuries.

ETHICS AND DISSEMINATION

La Trobe University Ethics Committee (HREC 20488) approved. Coaches provided informed consent to receive the supported intervention and players provided consent to be contacted if they sustained a head or knee injury. Results will be disseminated through partner organisations, peer-reviewed publications and scientific conferences.

TRIAL REGISTRATION NUMBER

NCT04856241.

Injury profiles of Australian football players across five, women's and girls' competition levels

OBJECTIVES

To describe injury profiles of Australian football players and explore trends across five, women's and girls' competition levels.

DESIGN

Prospective cohort study.

METHODS

Injuries were prospectively recorded by team personnel across one or two seasons of Australian football (2017-18 and/or 2018-19) including five, women's and girls' competition levels (elite senior, non-elite senior, high-level junior, non-elite junior (14-17 years), and non-elite junior (10-13 years)). Injury incidence rates were calculated per 1000 h and injury prevalence calculated for pre-season, early-season, mid-season, and late-season. Descriptive statistics present injury profiles according to activity, body region, pathology, mechanism, and severity.

RESULTS

From the 392 included players, 760 injuries were recorded. Overall injury incidence was 20.9 injuries per 1000 h. Injury prevalence was highest during pre-season (64.1%). Most injuries were to the lower extremity (n = 440; 58.0%). Ligament/joint sprain injuries were common (n = 147, 19.3%). Several injuries resulted from contact mechanisms (n = 314, 61.4%), with many due to contact with another player (n = 131, 52.8%). Injuries resulting in time lost from participation were common (n = 444, 58.9%). Competition level injury trends were observed, with elite senior (125.1 injuries per 1000 h) and high-level junior (116.9 injuries per 1000 h) players having greater match injury incidence compared to their non-elite counterparts (15.5-41.4 injuries per 1000 h).

CONCLUSIONS

This study provides preliminary insight into injury profiles of Australian football players in women's and girls' competitions. These findings can drive future injury risk reduction research specific to this population across the developmental pathway.

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

OBJECTIVES

To compare injury-profiles of females and males presenting to Emergency Departments (EDs) with an Australian Football injury.

DESIGN

Prospective observational study.

METHODS

All 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.

RESULTS

1635 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.

CONCLUSION

Australian Football injury profiles differed between females and males. Gender-specific injury prevention and management programs would be indicated based on the study findings.

Test Re-test Reliability of Single and Multijoint Strength Properties in Female Australian Footballers

Purpose

To examine the test re-test reliability of isometric maximal voluntary contractions (MVC) of hip adduction (ADD_ISO), hip abduction (ABD_ISO), and multijoint leg extension (SQUAT_ISO) in sub-elite female Australian footballers.

Methods

Data were collected from 24 sub-elite female Australian footballers (age 22.6 ± 4.5 years; height 169.4 ± 5.5 cm; body mass 66.6 ± 8.0 kg; 4.5 ± 4.4 years sport-specific training; 2.5 ± 2.0 years unstructured resistance training) from the same club on two non-consecutive days. Participants performed three isometric MVCs of ADD_ISO, ABD_ISO, and SQUAT_ISO. The SQUAT_ISO was performed at 140° knee flexion with a vertical trunk position and ADD_ISO and ABD_ISO measures were performed in a supine position at 60° of knee flexion and 60° hip flexion. Reliability was assessed using paired t tests and the intraclass correlation coefficient (ICC) with 95% confidence intervals (CI), typical error (TE), and coefficient of variation (CV%) with 95% CI.

Results

SQUAT_ISO peak force (ICC .95; CV% 4.1), ABD_ISO for left, right, and sum (ICC .90–.92; CV% 5.0–5.7), and ADD_ISO for left, right, and sum (ICC .86–.91; CV% 6.2–6.9) were deemed acceptably reliable based on predetermined criteria (ICC ≥ .8 and CV% ≤ 10).

Conclusion

SQUAT_ISO, ABD_ISO, and ADD_ISO tests demonstrated acceptable reliability for the assessment of peak force in sub-elite female Australian footballers, suggesting these assessments are suitable for muscle strength testing and monitoring adaptations to training.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-020-00292-5.

Prevalence and Treatment Outcomes of Hand and Wrist Injuries in Professional Athletes: A Systematic Review

BACKGROUND

Injuries to the hand and wrist constitute up to 25% of all athletic injuries, yet not much information is available on the effects of such injuries on the careers of professional athletes. Understanding whether elite athletes can return to sport and at what level has value for athletes, coaches, managers, and others, including athletes at other levels of play.

QUESTIONS/PURPOSES

The purpose of this study was to systematically review the literature on injuries of the hand and wrist in professional athletes to determine the prevalence and types of injuries sustained in professional sports, the management and clinical outcomes of such injuries, and the statistics regarding return to play.

METHODS

A systematic review was conducted of PubMed/MEDLINE and the Cochrane Central Register of Controlled Trials to identify all studies reporting on hand and wrist injuries in professional athletes that were published between January 1970 and April 2019. Inclusion criteria were injuries of the upper extremity distal to the elbow that occurred in professional athletes during athletic competition, English language, and a study cohort consisting of four or more subjects. Details of injury sustained, sport, treatment, clinical outcome, and return to sport were extracted.

RESULTS

We identified 32 nonoverlapping studies involving a total of 4299 hand and wrist injuries. The most common sport studied was baseball (eight studies), followed by football (seven), boxing (six), and basketball (five). Specific injury type was included in 29 of 32 studies and totaled 792 injuries. Metacarpal fractures were the most common injuries (n = 273; 34.5%), followed by thumb collateral ligament injuries (n = 110; 13.9%), phalangeal fractures (n = 87; 11.0%), and scaphoid fractures (n = 56; 7.1%). The overall operative rate was 18.3% (n = 708 of 3867). One-half of the studies reported the return to play (average, 2.8 months; range, 0.5 to 9 months). Seven studies reported sport-specific objective performance measures, with six describing consistent return to preinjury levels of performance among athletes.

CONCLUSIONS

Based on the available evidence, a large majority of hand and wrist injuries in professional athletes are treated conservatively. Athletes frequently return to preinjury levels of performance after surgery. Additionally, return to play after a hand injury appears to be faster than that after other bony injuries. Further research is needed into the impact of these injuries on athletic performance, as well as how surgical intervention affects validated patient-reported outcome measures in professional athletes.

Making football safer for women: a systematic review and meta-analysis of injury prevention programmes in 11 773 female football (soccer) players

Objective

To evaluate the effects of injury prevention programmes on injury incidence in any women’s football code; explore relationships between training components and injury risk; and report injury incidence for women’s football.

Design

Systematic review and meta-analysis.

Data sources

Nine databases searched in August 2019.

Eligibility criteria

Randomised controlled trials evaluating any injury prevention programme (eg, exercise, education, braces) were included. Study inclusion criteria were: ≥20 female football players in each study arm (any age, football code or participation level) and injury incidence reporting.

Results

Twelve studies, all in soccer, met inclusion criteria, with nine involving adolescent teams (aged <18 years). All studies (except one) had a high risk of bias. Eleven studies examined exercise-based programmes, with most (9/11) including multiple (≥2) training components (eg, strength, plyometric, balance exercises). Multicomponent exercise programmes reduced overall (any reported) injuries (incidence rate ratio (IRR) 0.73, 95% CI 0.59 to 0.91) and ACL injuries (IRR 0.55, 95% CI 0.32 to 0.92). For exercise-based strategies (single-component and multicomponent), hamstring injuries were also reduced (IRR 0.40, 95% CI 0.17 to 0.95). While exercise-based strategies resulted in less knee, ankle and hip/groin injuries, and the use of multiple training components was associated with greater reductions in overall and knee injuries, further studies would be required to increase the precision of these results. The incidence of overall injuries in women’s football was 3.4 per 1000 exposure hours; with ankle injuries most common.

Conclusion

In women’s football, there is low-level evidence that multicomponent, exercise-based programmes reduce overall and ACL injuries by 27% and 45%, respectively.

PROSPERO registration number

CRD42018093527.

Lower limb musculoskeletal screening in elite female Australian football players

OBJECTIVE

To report physical characteristics of lower-limb strength, endurance, range of motion, balance, and pain during adductor squeeze in elite female Australian Football (AF) players, and to examine the effect of limb dominance, previous AF experience, age, and previous level of sports participation on these characteristics.

DESIGN

Cross-sectional study.

SETTING

Three elite AF clubs.

PARTICIPANTS

Eighty-five female players. All were aged ≥18, contracted for the 2018 season, and participated in pre-season training.

MAIN OUTCOME MEASURES

The physical characteristic assessments included; pain on adductor squeeze, weight-bearing lunge, side bridge, isometric hip abduction and adduction strength, and the modified star excursion balance test.

RESULTS

The adductor squeeze had low pain scores, with 93% of players scoring ≤2 on the numerical rating scale. Other assessment results were (mean ± SD): 10.8 ± 2.7 cm for weight-bearing lunge, 95 ± 39s for side bridge, 1.85 ± 0.23 and 1.85 ± 0.36Nm/kg for hip abduction and adduction strength respectively, and 92 ± 8% for the modified star excursion balance test. There was no clinically relevant effect of limb dominance, previous AF experience, age, or previous level of sports on physical characteristics.

CONCLUSIONS

Physical characteristics for five assessments are reported. These data can be used for comparison purposes in the screening and clinical management of elite female AF players.

A 2-Year Prospective Study of Injury Epidemiology in Elite Australian Rugby Sevens: Exploration of Incidence Rates, Severity, Injury Type, and Subsequent Injury in Men and Women

BACKGROUND

Injuries are common in rugby sevens, but studies to date have been limited to short, noncontinuous periods and reporting of match injuries only.

PURPOSE

To report the injury incidence rate (IIR), severity, and burden of injuries sustained by men and women in the Australian rugby sevens program and to provide the first longitudinal investigation of subsequent injury occurrence in rugby sevens looking beyond tournament injuries only.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

Ninety international rugby sevens players (55 men and 35 women) were prospectively followed over 2 consecutive seasons (2015-2016 and 2016-2017). All medical attention injuries were reported irrespective of time loss. Individual exposure in terms of minutes, distance, and high-speed distance was captured for each player for matches and on-field training, with the use of global positioning system devices. The IIR and injury burden (IIR × days lost to injury) were calculated per 1000 player-hours, and descriptive analyses were performed.

RESULTS

Seventy-three players (81.1%) sustained 365 injuries at an IIR of 43.2 per 1000 player-hours (95% CI, 43.0-43.3). As compared with male players, female players experienced a lower IIR (incidence rate ratio, 0.91; 95% CI, 0.90-0.91). Female players also sustained a higher proportion of injuries to the trunk region (relative risk, 1.75; 95% CI, 1.28-2.40) but a lower number to the head/neck region (relative risk, 0.58; 95% CI, 0.37-0.93; P = .011). The majority (80.7%) of subsequent injuries were of a different site and nature than previous injuries. A trend toward a reduced number of days, participation time, distance, and high-speed distance completed before the next injury was observed after successive injury occurrence.

CONCLUSION

Female players have a lower IIR than male players, with variation of injury profiles observed between sexes. With a surveillance period of 2 years, subsequent injuries account for the majority of injuries sustained in rugby sevens, and they are typically different from previous types of sustained injuries. After each successive injury, the risk profile for future injury occurrence appears to be altered, which warrants further investigation to inform injury prevention strategies in rugby sevens.

Working towards More Effective Implementation, Dissemination and Scale-Up of Lower-Limb Injury-Prevention Programs: Insights from Community Australian Football Coaches

Disseminating lower-limb injury-prevention exercise programs (LL-IPEPs) with strategies that effectively reach coaches across sporting environments is a way of preventing lower-limb injuries (LLIs) and ensuring safe and sustainable sport participation. The aim of this study was to explore community-Australian Football (community-AF) coaches' perspectives on the strategies they believed would enhance the dissemination and scale-up of LL-IPEPs. Using a qualitative multiple case study design, semi-structured interviews with community-AF coaches in Victoria, Australia, were conducted. Overall, coaches believed a range of strategies were important including: coach education, policy drivers, overcoming potential problem areas, a 'try before you buy approach', presenting empirical evidence and guidelines for injury-prevention exercise programs (IPEPs), forming strategic collaboration and working in partnership, communication and social marketing, public meetings, development of a coach hotline, and targeted multi-focused approaches. A shift to a culture whereby evidence-based IPEP practices in community-AF will take time, and persistent commitment by all involved in the sport is important. This will support the creation of strategies that will enhance the dissemination and scale-up of LL-IPEPs across community sport environments. The focus of research needs to continue to identify effective, holistic and multi-level interventions to support coaches in preventing LLIs. This could lead to the determination of successful strategies such as behavioural regulation strategies and emotional coping resources to implement LL-IPEPs into didactic curricula and practice. Producing changes in practice will require attention to which strategies are a priority and the most effective.

Injuries in Australian Rules Football: An Overview of Injury Rates, Patterns, and Mechanisms Across All Levels of Play

CONTEXT

The nature of Australian rules football (Australian football) predisposes both unique and common injuries compared with those sustained in other football codes. The game involves a combination of tackling, kicking, high-speed running (more than other football codes), and jumping. Two decades of injury surveillance has identified common injuries at the professional level (Australian Football League [AFL]).

OBJECTIVE

To provide an overview of injuries in Australian rules football, including injury rates, patterns, and mechanisms across all levels of play.

STUDY DESIGN

A narrative review of AFL injuries, football injury epidemiology, and biomechanical and physiological attributes of relevant injuries.

RESULTS

The overall injury incidence in the 2015 season was 41.7 injuries per club per season, with a prevalence of 156.2 missed games per club per season. Lower limb injuries are most prevalent, with hamstring strains accounting for 19.1 missed games per club per season. Hamstring strains relate to the volume of high-speed running required in addition to at times having to collect the ball while running in a position of hip flexion and knee extension. Anterior cruciate ligament injuries are also prevalent and can result from contact and noncontact incidents. In the upper limb, shoulder sprains and dislocations account for 11.5 missed games per club per season and largely resulted from tackling and contact. Concussion is less common in AFL than other tackling sports but remains an important injury, which has notably become more prevalent in recent years, theorized to be due to a more conservative approach to management. Although there are less injury surveillance data for non-AFL players (women, community-level, children), many of these injuries appear to also be common across all levels of play.

CLINICAL RELEVANCE

An understanding of injury profiles and mechanisms in Australian football is crucial in identifying methods to reduce injury risk and prepare players for the demands of the game.