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RAD BLOG

Injury Prevention in Australian Rules Football

Common Injuries and Injury Prevention for AFL Athletes

Author: Billy Jones

Introduction

Australian Rules Football (ARF) is an intermittent sport that requires great amounts of high-speed running, multidirectional agility and aerobic endurance. In the elite male competition (AFL), players can cover between 12-15km depending on the player’s position during the 120 minutes of match play (3). Due to the reduced match duration in the female competition, the players in the AFLW can cover between 3.5-7.0km per game depending on their positional requirements (1). The joints of the lower limbs, hip, knee and ankle, are most commonly injured with the shoulder being the most injured area of the upper limb (6). These will be explored further throughout the blog with preventative exercises provided for each. 

Hamstring Strains

The muscles of the hamstring group (semimembranosus, semitendinosus, biceps femoris) are two-joint muscles spanning from the hip to the knee. When the leg is fully extended during running the muscle is maximally stretched at both ends across the hip and knee which increases the risk of hamstring strain injury (2). As ARF is a running dominant sport this situation occurs constantly (2). To cope with the high-speed running demands of the game and reduce the risk of muscle strain it is important for players to strengthen their hamstrings eccentrically (contraction as the muscle lengthens). Furthermore, football coaches should ensure that sprinting is programmed into their training to better prepare their players for game demands. Listed below are hamstring focussed exercises that will improve hamstring strength and help to prevent injury during training and games. 

  • Single Leg Romanian Deadlift

  • Double Leg Hamstring Bridge
  • Eccentric Hamstring Slides
  • Hamstring Nordic Lowers

Knee Injuries

The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) have been found to be the most commonly injured ligaments of the knee during football (6). They can be fully ruptured which in most cases requires surgery to reconstruct, or partially torn. Conservative management is also an option other than surgery for some athletes however, with the high contact nature of ARF and high forces that go through the knee, surgery is highly recommended. Other common injuries that can occur are medial and lateral collateral ligament tears and meniscal injuries. Many of the mentioned injuries can even occur simultaneously making knee injuries quite formidable. Injury to the knee can cost the athlete months away from playing their sport therefore, prevention through conditioning is key. Poor change of direction technique, knee instability, angle of landing and direct impact to the knee joint are risk factors for ACL and PCL injury. Training should be focussed around strengthening the muscles around the knee joint and improving change of direction and landing technique. Exercises listed below are some that can be done at home with minimal equipment that will help in reducing the risk of knee injury. 

  • Single Leg Squat
  • Split Squat
  • Single Leg Skater Hops
  • Drop Jump with Lateral Cut
  • Two Foot Change of Direction

Ankle Injuries 

Ankle ligament sprains are common in football in all levels of competition. There are various mechanisms that can cause these injuries with the most common being landing in a compromised position following a marking contest and the foot becoming trapped under another player during a tackle (6). Previous injury to the ankle is the main risk factor for sprains to occur. Evidence has suggested that risk is doubled for up to 1 year post injury which highlights ongoing dysfunction and the need for preventative exercises to be completed (4). Following initial ankle sprain the joints protective mechanisms that make corrections to joint position (proprioception) to maintain stability can be damaged, leaving the joint at higher risk of reinjury (7). Without intervention athletes may begin to experience chronic ankle instability which is painful and leads to consistent time away from the field (5). Implementing proprioceptive training such as balancing exercises has been proven to be effective in reducing ankle sprain injuries (7). Completing ankle focussed plyometric and resistance exercises is also beneficial in improving mobility and strength of the joint. Included below are exercises that can be done at home to ensure the ankle is ready for training and competition. 

  • Single Leg Balance – 4 Point Star
  • Single Leg Hop with Spin
  • Pogo Jumps
  • Ankle Hops
  • Ankle Inversion/Eversion

Shoulder Injuries

Due to the contact nature of the sport shoulder injuries occur frequently during training and competition. Injuries to the shoulder joint have accounted for 11.5 games missed per club per season (6). It is important that footballers strengthen the muscles around the shoulder to ensure contact does not result in injury (6). Contact during overhead marking, impacts to the posterior aspect of the shoulder during contested ground balls and direct contact to the anterior portion of the joint are all patterns that can lead to glenohumeral instability or dislocation (6). Increasing the strength and size of the muscles surrounding the glenohumeral joint and focussed rotator cuff strengthening are both ways to ensure stability of the shoulder. In turn this will lead to a more robust joint capsule which can deal with the rigours of ARF. Below are some exercises that can be completed to improve shoulder stability that can be done with minimal equipment. 

  • Banded No Moneys
  • Prone Shoulder External Rotation @90 Degrees
  • Push Up with Shoulder Tap
  • Banded Pull Aparts

Conclusion

Australian rules football is a physically demanding sport that requires multiple fitness qualities. As with all sports, injuries are always a concern as they can result in valuable time lost away from the playing field, so it is within everyone’s interest, both athletes and coaches, to work to avoid them. Identifying what areas of the body are commonly injured and the mechanisms that cause them is crucial for effective exercise prescription. Performing exercises such as those above will help mitigate injury and keep the athlete on the ground and away from the rehabilitation group. 

References

  1. Clarke, AC, Ryan, S, Couvalias, G, Dascombe, BJ, Coutts, AJ, Kempton, T. Physical demands and technical performance in Australian Football League Women’s (AFLW) competition match-play. Journal of science and medicine in sport21(7): 748-752, 2018.
  2. Foreman, Addy, Baker, Burns, Hill, Madden. (2006). Prospective studies into the causation of hamstring injuries in sport: A systematic review. Physical Therapy in Sport, 7(2): 101–109, 2006. 
  3. Harrison, P, Johnston, R. Relationship Between Training Load, Fitness, and Injury Over an Australian Rules Football Preseason. Journal of Strength & Conditioning Research, 31: 2686-2693, 2017. 
  4. Owoeye, OB, Palacios-Derflingher, LM, Emery, CA. Prevention of ankle sprain injuries in youth soccer and basketball: effectiveness of a neuromuscular training program and examining risk factors. Clinical journal of sport medicine28(4): 325-331, 2018.
  5. Powden, CJ, Hoch, JM., Hoch, MC. Rehabilitation and improvement of health-related quality-of-life detriments in individuals with chronic ankle instability: a meta-analysis. Journal of athletic training52(8):753-765, 2017.
  6. Saw, R, Finch, CF, Samra, D, Baquie, P, Cardoso, T, Hope, D, Orchard, JW. Injuries in Australian Rules Football: An Overview of Injury Rates, Patterns, and Mechanisms Across All Levels of Play. Sports Health, 10(3), 208–216, 2018. 
  7. Schiftan GS, Ross LA, Hahne AJ. The effectiveness of proprioceptive training in preventing ankle sprains in sporting populations: a systematic review and meta-analysis. Journal of Science and Medicine in Sport: 18(3), 238–244, 2015.

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