March 2013 Newsletter – AFL Injuries

The sport of Australian rules football is known for its high level of physical stress and body contact compared to other sports such as soccer and basketball, and the fact that unlike gridiron, no padding is worn.

Players who experience large number of injuries during their career are more susceptible to ongoing and new injuries after they retire.

4 Common AFL Injuries

Hamstring Strain

Hamstring injuries are the most common injury in Australian Rules football. This is due to several reasons:

  • Requirements of rapid acceleration, endurance and agility running, kicking and bending to pick up the ball.
  • The dual role of the Hamstring muscle group as a stabilsing muscle and a prime mover
  • Hamstrings have several muscles in its group requiring greater biomechanical co ordination
  • Influence of pelvic and lumbar stability
  • Influence of sciatic and lower back neural inputs
  • Ratios of lower limb muscle group strengths
  • Biomechanical faults from the lower back, pelvic, hips, knee, ankle and the foot.

What is a muscle strain? 

This is a small or large muscle tear.   This can be within the muscle tissue itself or where the muscle attaches to the tendon.   This can occur because the muscle was too weak, inflexible or poorly co-ordinated.   Muscle strains can be classified broadly into 3 grades 1,2 &3.  Where 1 is the smallest and 3 a complete tear.

Prevention

  • Get a pre-season Physical from your Physiotherapist.   This will assess all of the potential causes for not only Hamstring injuries but most football injuries.  
  • Do a solid pre-season training routine to ensure you have the strength, flexibility, speed and skills to perform safely.  
  • Ensure you are hydrated when training and playing.
  • Have a well balanced diet to ensure your body recovers from Physical stresses of training and playing.
  • Make sure all of your previous injuries have been fully rehabilitated.   Your Physio or Sports Physio will be able to field test this.
  • A warm up prior to matches and training, especially in cold weather.   Muscles can increase their flexibility up to 25% with proper warm up.

What should you do if you suffer a Hamstring Strain injury?

The immediate treatment of any muscle injury consists of the RICER protocol – rest, ice and compression, elevation and referral (never apply ice directly to the skin). All injuries should be reviewed by a doctor or your physiotherapist. Depending upon the severity of the Hamstring injury, the leg might have to be rested from sporting activity for between a couple of weeks and 3 months. Make sure that you fully rehabilitate the injury which will include strengthening, stabilisation, neural stretching, sports training drills, running program and other treatment modalities.

Osteitis Pubis

Osteitis Pubis is a painful overuse injury that affects the pubic symphsis of the pelvis and commonly occurs during running, kicking and multi-directional activities. The Pubic Symphysis is a cartilaginous (made from fibrocartilage) joint, that is tightly bound by very strong ligaments. This means that only a very limited amount of movement takes place at this joint.

Osteitis PubisThe exact mechanism of injury is believed to be excessive shearing forces on the Pubic Symphysis caused by powerful kicking, overactive tummy muscles, repeated movements or instability of the Sacro Iliac joint. Excessive forces strain the Pubic Symphysis and cause an inflammatory response. This may involve erosion of the joint and is followed by a slow healing process.

SIGNS AND SYMPTOMS

Osteitis Pubis causes pain during and after exertion.  Typically this pain radiates to the lower abdomen or the groin region. In many cases the patient is unable to localise the pain, which may move around the pelvic region.

It is important that all cases of persistent groin pain are accurately assessed and  referred to a doctor who can carry out a full assessment and make a differential diagnosis by excluding other conditions that may be potentially more serious.

Medical imaging is able to see widening or erosion at the Pubic Symphysis which is indicative of Osteitis Pubis. An MRI can clearly depict bone stress reactions and inflammatory changes in the tendons that attach to the pelvis. In the case of those who undertaking a high level of sporting activity MRI findings may show bruising of the pubic bone even in those who have no symptoms.

TREATMENT

Strengthening of the structures around the joint is important to stabilise it.   A biomechanical assessment to determine the cause of the increased shearing forces and alter these causes.  Increase the strength of all of the lower limb muscles to encourage shock absorption and thus shock/ shearing forces.   Osteitis Pubis may be resistant to treatment and can last between 6 months and two years before symptoms resolve.