Distal Musculotendinous T Junction Injuries of the Biceps Femoris: Time to Return to Play in Professional Australian Football League Players

Background: Anterior cruciate ligament (ACL) injury has been a major cause of missed game time among Australian Football League (AFL) players. Return to play after ACL reconstruction is not always achieved, even among elite athletes. The rate of subsequent ACL injury in the AFL from 1990 to 2000 was high as compared with that of other elite sports. Purpose: To determine the rates of return to play and subsequent ACL injury after ACL reconstruction among AFL players from 1999 to 2013 and to explore factors associated with differing rates of return to play and subsequent ACL injury. Study Design: Case series; Level of evidence, 4. Methods: A total of 158 AFL players who underwent ACL reconstruction were identified from a prospectively maintained registry of AFL player injuries. Further data were gathered from official playing statistics, surgical records, and structured phone interviews. Results: The rate of return to play after an initial ACL injury was 77% (121 of 158 players). Greater preinjury playing experience and earlier selection in the AFL draft were associated with higher rates of return to play. The rate of subsequent ACL injury to either knee was 30% (48 of 158 players) and was especially high among players aged <21 years (23 of 46 players, 50%). After subsequent ACL injury, 34 of 48 players (71%) returned to play. In primary ACL reconstruction, the use of Ligament Augmentation and Reconstruction System grafts resulted in a faster return to play ( P = .001) but had a higher risk of subsequent revision reconstruction (risk ratio = 2.8, P = .048). Family history of ACL injury was associated with an increased risk of subsequent contralateral ACL injury (risk ratio = 3.8, P = .002). Conclusion: Most AFL players who underwent ACL reconstruction returned to play at least 1 AFL match. The high rate of subsequent ACL injury among AFL players demonstrates the highly demanding nature of Australian football, particularly at the elite level. The risk factors for subsequent ACL injury should be considered carefully when treatment and rehabilitation decisions are made for these high-demand athletes.

Download Full-text

Playing Performance After Anterior Cruciate Ligament Reconstruction Among Australian Football League Players From 1999 to 2013

The American Journal of Sports Medicine ◽

10.1177/0363546519843908 ◽

2019 ◽

Vol 47 (7) ◽

pp. 1550-1556

Author(s):

Courtney C.H. Lai ◽

Julian A. Feller ◽

Kate E. Webster

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Odds Ratio ◽

Cruciate Ligament ◽

Acl Injury ◽

Return To Play ◽

Average Level ◽

Australian Football League ◽

Australian Football ◽

Anterior Cruciate

Background: Achieving preinjury levels of athletic performance has been challenging for elite athletes after anterior cruciate ligament (ACL) reconstruction. Although a recent study found that 77% of Australian Football League (AFL) players who underwent ACL reconstruction from 1999 to 2013 returned to play at the highest level, the study did not indicate how consistently or well they were able to play. Purpose: To identify the number of AFL players who returned to play consistently over 2 seasons after ACL reconstruction, compare their playing performance in these seasons with preinjury performance, and evaluate factors associated with returning to preinjury levels of performance. Study Design: Case series; Level of evidence, 4. Methods: Analysis included 104 AFL players who underwent ACL reconstruction between 1999 and 2013. All had played at least 10 AFL matches in 1 season before ACL injury. Ranking points, as devised by AFL statisticians, were used to measure individual playing performance. Results: Of the 104 players who played at least 10 matches in 1 season before ACL injury, 53 (51%) returned to play at least 10 matches in 2 seasons after surgery. Of these 53 players, 36 (68%) returned to their preinjury levels of performance. The 17 remaining players who did not return to their preinjury performance still performed comparably to the AFL average level after surgery. Players <25 years old (odds ratio = 2.9, P = .01) or <90 kg (odds ratio = 2.7, P = .03) had greater odds of returning to their preinjury levels of performance. Conclusion: Returning to play on a consistent basis was a substantial challenge for AFL players after ACL reconstruction. However, among players who did return to play consistently over 2 seasons, their postsurgery average performance was comparable with the AFL average level of performance, and two-thirds returned to their preinjury levels of performance. Younger and lighter players were more likely to return to their preinjury levels of performance, possibly given the nature of AFL club playing list management decisions.

Download Full-text

Effect of Prior Injury on Changes to Biceps Femoris Architecture across an Australian Football League Season

Medicine & Science in Sports & Exercise ◽

10.1249/mss.0000000000001333 ◽

2017 ◽

Vol 49 (10) ◽

pp. 2102-2109 ◽

Cited By ~ 5

Author(s):

RYAN G. TIMMINS ◽

MATTHEW N. BOURNE ◽

JACK T. HICKEY ◽

NIRAV MANIAR ◽

PAUL J. TOFARI ◽

...

Keyword(s):

Biceps Femoris ◽

Australian Football League ◽

Australian Football ◽

Prior Injury

Download Full-text

Effects of stricter management guidelines on return-to-play timeframes following concussion in professional Australian Rules football

10.1101/2021.01.25.21250431 ◽

2021 ◽

Author(s):

Alan J Pearce ◽

Doug A King ◽

Adam J White ◽

Catherine M Suter

Keyword(s):

Policy Change ◽

Subjective Assessment ◽

Return To Play ◽

Primary Concern ◽

Concussion Management ◽

Australian Football League ◽

Australian Rules Football ◽

Australian Football ◽

Policy Objectives ◽

The Impact

AbstractBackgroundManagement of concussion remains a serious issue for professional sports, particularly with the growing knowledge on the consequences of repetitive concussion. One primary concern is the subjective assessment of recovery that dictates the time until a concussed athlete is returned to competition. In response to this concern, the Australian Football League (AFL) changed its policy in 2020 such that clearance for return-to-play was extended from one day, to a minimum of five days, prior to the next scheduled match.ObjectiveWe sought to examine the impact of the AFL policy change by asking whether the time to return-to-play after concussion was increased in the 2020 season relative to previous years.MethodsRetrospective data on injury and return-to-play were sourced from publicly available tables published on the AFL website. We compared the number of matches missed and the number of days missed in concussed players across 2017 to 2020 inclusive.ResultsAnalysis of data from 166 concussed players revealed no increase in the number of matches missed in 2020 relative to previous years as would have been expected from an extend recovery protocol. Considering the number of days missed in 2020 relative to 2017-19 we found, paradoxically, that there was an overall reduction in the average time to return-to-play in 2020 (11.2 vs 16.2 days).ConclusionThis study demonstrates that any policy change around concussion management requires ongoing auditing to ensure clearance meets policy objectives and highlights the need for objective measures for return-to-play after concussion.

Download Full-text

Return to Professional Australian Rules Football After Surgery for Traumatic Anterior Shoulder Instability

The American Journal of Sports Medicine ◽

10.1177/03635465211029022 ◽

2021 ◽

pp. 036354652110290

Author(s):

Michael Perret ◽

Sarah Warby ◽

Godefroy Brais ◽

Stephanie Hinse ◽

Sophie Hoy ◽

...

Keyword(s):

Shoulder Instability ◽

Return To Sport ◽

Field Performance ◽

Return To Play ◽

Anterior Shoulder Instability ◽

Level Of Evidence ◽

Australian Football League ◽

Early Return ◽

Significant Difference ◽

Australian Football

Background: The treatment of traumatic anterior shoulder instability in professional Australian Football League (AFL) players is challenging, with an emphasis on early return to play and avoidance of instability recurrence. Purpose: To investigate return-to-sport (RTS) outcomes and complications after 2 different procedures for traumatic anterior shoulder instability in professional AFL players. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively reviewed our surgical database for professional AFL players who underwent capsulolabral stabilization or open Latarjet procedure by a single surgeon between 2006 and 2017. Outcomes included RTS, on-field performance, and complications. Between-group analyses for RTS and complications were estimated using Kaplan-Meier survival analyses. Within-group analyses for on-field performance data were performed using paired t tests with significance set at .05. Results: A total of 58 capsulolabral stabilization procedures in 54 players and 32 Latarjet procedures in 29 players were included in the analysis; 93.1% of capsulolabral patients and 96.9% of Latarjet patients returned to professional AFL. The median RTS time was 6.8 months for the capsulolabral group and 7.3 months for the Latarjet group. There was no significant difference in RTS rates between the 2 groups ( P = .270). Of those undergoing surgery early in the season, 75% of the capsulolabral and 71% of Latarjet group were able to RTS within the same season, at a mean time of 16.9 weeks and 18.8 weeks, respectively. There was a significant difference in instability recurrence, with 19% for the capsulolabral group and no recurrence in the Latarjet group ( P = .017). There was no significant reduction in player on-field performance in either group ( P < .05). Conclusion: In this study, the median RTS in AFL players was approximately 7 months after capsulolabral and Latarjet surgery with no compromise to on-field performance. Instability-related complications occurred only in the capsulolabral group, and the incidence increased with time.

Download Full-text

MRI assessment of calf injuries in Australian Football League players: findings that influence return to play

Skeletal Radiology ◽

10.1007/s00256-016-2564-7 ◽

2017 ◽

Vol 46 (3) ◽

pp. 343-350 ◽

Cited By ~ 13

Author(s):

George Waterworth ◽

Sara Wein ◽

Alexandra Gorelik ◽

Andrew H. Rotstein

Keyword(s):

Return To Play ◽

Australian Football League ◽

Australian Football

Download Full-text

Concussion Guidelines in National and International Professional and Elite Sports

Neurosurgery ◽

10.1093/neuros/nyaa057 ◽

2020 ◽

Vol 87 (2) ◽

pp. 418-425 ◽

Cited By ~ 2

Author(s):

Gavin A Davis ◽

Michael Makdissi ◽

Paul Bloomfield ◽

Patrick Clifton ◽

Charlotte Cowie ◽

...

Keyword(s):

National Football League ◽

Rugby League ◽

Return To Play ◽

Long Term Effects ◽

Research Activities ◽

Australian Football League ◽

Essential Components ◽

Australian Football ◽

Level 3 ◽

Elite Sports

Abstract The Berlin statement on sport-related concussion was published in 2017 using evidence-based recommendations. We aimed to examine (1) the implementation of, distribution and education based on the Berlin recommendations, and the development of sport-specific protocols/guidelines among professional and elite sports, (2) the implementation of guidelines at the community level, (3) translation of guidelines into different languages, and (4) research activities. Senior medical advisers and chief medical officers from Australian Football League, All Japan Judo Federation, British Horseracing Authority, Cricket Australia, Fédération Equestre Internationale, Football Association, Gaelic Athletic Association, International Boxing Association, Irish Horseracing Regulatory Board, Major League Baseball, National Football League, National Hockey League, National Rugby League, and World Rugby completed a questionnaire. The results demonstrated that all 14 sporting organizations have published concussion protocols/guidelines based on the Berlin recommendations, including Recognize, Removal from play, Re-evaluation, Rest, Recovery, and Return to play. There is variable inclusion of Prolonged symptoms. Prevention and Risk reduction and Long-term effects are addressed in the guidelines, rules and regulations, and/or sport-specific research. There is variability in education programs, monitoring compliance with guidelines, and publication in other languages. All sporting bodies are actively involved in concussion research. We conclude that the Berlin recommendations have been included in concussion protocols/guidelines by all the sporting bodies, with consistency in the essential components of the recommendations, whilst also allowing for sport- and regional-specific variations. Education at the elite, community, and junior levels remains an ongoing challenge, and future iterations of guidelines may consider multiple language versions, and community- and junior-level guidelines.

Download Full-text

Preparing for an Australian Football League Women's League Season

Frontiers in Sports and Active Living ◽

10.3389/fspor.2020.608939 ◽

2020 ◽

Vol 2 ◽

Author(s):

Heidi Rose Thornton ◽

Cameron R. Armstrong ◽

Alex Rigby ◽

Clare L. Minahan ◽

Rich D. Johnston ◽

...

Keyword(s):

High Speed ◽

Descriptive Analysis ◽

Performance Outcomes ◽

Return To Play ◽

Range Of Movement ◽

Total Distance ◽

Australian Football League ◽

Positive Performance ◽

Standardized Effect Sizes ◽

Australian Football

The aims were to investigate the externally measured weekly loads, and the distribution intensity relative to the 1-min maximal mean (MM) intensity of matches. Athletes (n = 28) wore 10 Hz GNSS devices during training and matches. For the descriptive analysis, a range of movement variables were collected, including total distance, high-speed distance, very high-speed distance, acceleration, and acceleration load. Using raw GNSS files, 1-min moving averages were calculated for speed (m·min−1) and acceleration (m·s−2), and were multiplied by time, specifying total distance (m), and by body mass to quantify impulse (kN·s−1). The distribution of distance and impulse accumulated at varied intensities relative to MMs was calculated, with percentages ranging from zero to 110%. Drills were categorized as either; warm-ups, skill drills, games (i.e., small-sided games), conditioning and matches. Linear mixed models determined if the distribution of intensity within each threshold (>50%) varied between drill types and matches, and if the distribution within drill types varied across the season. Effects were described using standardized effect sizes (ES) and 90% confidence limits (CL). Compared to matches, a higher proportion of distance was accumulated at 50% of the MM within warm-ups and conditioning (ES range 0.86–1.14). During matches a higher proportion of distance was accumulated at 60% of MM when compared to warms ups, skill drills and conditioning (0.73–1.87). Similarly, greater proportion of distance was accumulated between 70 and 100% MM in matches compared to skill drills and warm-ups (1.05–3.93). For impulse, matches had a higher proportion between 60 and 80% of the MM compared to conditioning drills (0.91–3.23). There were no other substantial differences in the proportion of impulse between matches and drill types. When comparing phases, during competition there was a higher proportion of distance accumulated at 50% MM than general preparation (1.08). A higher proportion of distance was covered at higher intensities within matches compared to drills. The proportion of impulse was higher between 60 and 80% MM within matches compared to conditioning. Practitioners can therefore ensure athletes are not only exposed to the intensities common within competition, but also the volume accumulated is comparable, which may have positive performance outcomes, but is also extremely important in the return to play process.

Download Full-text

Classifying player positions in second-tier Australian football competitions using technical skill indicators

International Journal of Sports Science & Coaching ◽

10.1177/17479541211010281 ◽

2021 ◽

pp. 174795412110102

Author(s):

Adrian J Barake ◽

Heather Mitchell ◽

Constantino Stavros ◽

Mark F Stewart ◽

Preety Srivastava

Keyword(s):

Positional Information ◽

Multinomial Logistic Model ◽

Sports Science ◽

Lower Tier ◽

Australian Football League ◽

Australian Football ◽

Second Tier ◽

Performance Statistics ◽

Player Performance ◽

Player Positions

Efficient recruitment to Australia’s most popular professional sporting competition, the Australian Football League (AFL), requires evaluators to assess athlete performances in many lower tier leagues that serve as pathways. These competitions and their games are frequent, widespread, and challenging to track. Therefore, independent, and reliable player performance statistics from these leagues are paramount. This data, however, is only meaningful to recruiters from AFL teams if accurate player positions are known, which was not the case for the competitions from which most players were recruited. This paper explains how this problem was recently solved, demonstrating a process of knowledge translation from academia to industry, that bridged an important gap between sports science, coaching and recruiting. Positional information which is only available from the AFL competition was used to benchmark and develop scientific classification methods using only predictor variables that are also measured in lower tier competitions. Specifically, a Multinomial Logistic model was constructed to allocate players into four primary positions, followed by a Binary Logit model for further refinement. This novel technique of using more complete data from top tier competitions to help fill informational deficiencies in lower leagues could be extended to other sports that face similar issues.

Download Full-text