Australian Rules Football

As Winter is rapidly approaching, Footy season is well underway. The purpose of this blog is to provide an overview and summary of the common injuries (there are more!) that can occur during the course of a season.

Traumatic Injuries

Muscle Strains / Tears

The most common injury that occurs in the AFL is the hamstring strain / tear. Muscles can strain or tear when they are overloaded, this may be due to fatigue, weakness or overuse. They are characterised by a sudden pain and weakness and you can pin point when the incident occurred. The acute injury management principles of rest, ice, compression and elevation (RICE) should be followed. Review with a Physiotherapist within the first 24 hours is ideal as we are able to provide the best guidance to manage your injury.

Treatment generally consists of massage and soft tissue techniques directed at improving the muscle length and promoting healing. Depending on the severity of each injury we may use ultrasound as a way of fast tracking the inflammatory process. Once able, your Physiotherapist will commence a gradual strengthening and return to sport program.

Ankle Injuries

Ankle injuries are another common traumatic injury that occurs in Australian Football. Most commonly a sprain of the lateral ligaments can occur when the foot rolls. These can occur from uneven surfaces, landing or if a player falls onto another player’s leg. The first focus in the acute stage is to determine if there is a fracture or not. Physiotherapists are well trained in picking up fractures as there are key indicators that we look out for.

Once clear of a bony injury, the RICE principles are then followed. Physiotherapy management in this stage is to reduce inflammation and improve joint range of motion. When pain has settled and we are sure that there is nothing that requires an extended period of rest, a rehabilitation program will be prescribed specific to your ankle injury. This program will include exercises to improve mobility, strength and control of the ankle. We may recommend taping upon return to training and games however, acknowledge the importance of regular compliance to your rehabilitation program in reducing the risk of re injury.

Knee Injuries

Unfortunately, due to the high speed nature of Football, traumatic knee injuries are extremely common. The most common of the traumatic knee injuries is an Anterior Cruciate Ligament tear. They are commonly a non-contact pivot injury. Establishing the mechanism of injury is critical in helping your Physiotherapist determine the ligament in question. Other common knee ligament injuries are to the collateral (medial or lateral) ligament or the Posterior Cruciate Ligament. Meniscal (cartilage) injuries are also common in football due to the forceful high speed landing and twisting that can occur.

Initial treatment for all these injuries is to follow the RICE principles. Presentation to your Physiotherapist within the first 24 hours is also recommended. It is also likely that an MRI may be required, sometimes this best helps us to determine the appropriate management (surgical or conservative) for each different knee injury.

If surgery is required there is a growing amount of evidence that a period of pre surgical rehab is recommended to ensure that the knee and surrounding musculature are ready to cope with the demands of surgery. It is likely that this will also result in a quicker recovery post op. Our team of Physiotherapists are experts in the management of traumatic knee injuries and have access to gym facilities which are essential in the rehab of these injuries.

Shoulder Injuries

As Football is quite a physical sport, the shoulder is susceptible to contact injuries. The two major traumatic shoulder injuries in Football are instability to the glenohumeral joint (ball and socket joint of the shoulder) or an injury to the acromioclavicular joint.

Shoulder instability is the term we use to describe an unstable shoulder joint, this is likely as result of repeat subluxations or dislocations. The most common instability we see in Football, is an anterior instability (the shoulder comes out forwards). If the Physiotherapist suspects there is an instability, it is likely some medical imaging is required. This will dictate to us exactly the level of instability and whether or not there is an injury to the joint surface. Based on your level of instability and functional capacity we will begin a structured strengthening program of your shoulder. Your Physiotherapist will spend time building up the muscles around the shoulder and gradually returning you back to training and then finally Football matches.

An AC joint sprain will likely occur when the shoulder makes contact with another shoulder or the shoulder is driven into the ground when being tackled, sometimes they can be damaged when falling onto an outstretched arm. An AC joint sprain is characterised by pin point swelling, bruising and pain on top of the shoulder. Physiotherapists have some specific tests that they can do to determine whether or not the AC joint is injured. In some cases, severe AC joint injuries will need medical imaging to ensure there is not an accompanying fracture.

Based on your level of injury and functional capacity we will begin treatment to relieve pain and improve joint range of motion. Your Physiotherapist will spend time building up the muscles around the shoulder and gradually returning you back to training and then finally Football matches. We may also recommend you have your shoulder taped in the early stages of returning to sport.

Concussion

Unfortunately, Concussion is a very common football injury. The Australian Institute of Sport put together a position on Concussion paper early this year. They defined Concussion as a traumatic brain injury, induced by biomechanical forces to the head or body which transmits an impulsive force to the head. Symptoms of concussion include but are not limited to headache, dizziness, not feeling right, neck pain, confusion, sensitivity to light/noise, feeling foggy, drowsiness, visual disturbances and difficulty concentrating.

Concussion is a serious injury and it is essential that you make contact with your GP or a sports doctor to ensure you are managed correctly. Physiotherapists are able to liaise with your GP / Sports Doctor and establish a return to sport plan. As per the AIS guidelines, if in doubt, sit them out – This is not an injury that is to be mucked around with.

Stay tuned for our next blog on the common Non Traumatic football injuries. If you have any questions then please do not hesitate to ask.

Article written by Matt Beavis (WA Football State Academy Physiotherapist)