|
The sport of Australian rules football is known for its high level of physical body contact compared to other sports such as soccer and basketball, and the fact that unlike gridiron, no padding whatsoever is worn.
The high levels of injuries that take place during games of football are so much that not only during a players' career are they susceptible to injuries, but the effects afterwards are detrimental to their health.
4 COMMON AFL INJURIES
Hamstring Strain
Hamstring injuries are the most prevalent injury in Australian Rules football. This may be possibly due to the unique physical demands of the game requiring rapid acceleration, endurance and agility running, kicking and bending to pick up the ball. Hamstring injuries are not confined strictly to Australian Rules football but are also seen in soccer, athletics, hurling, cricket and touch football. This makes hamstring injuries the most prevalent muscle injury in sports consisting of rapid acceleration and maximum speed running. Such injuries can and do result in significant financial consequences to players and clubs alike.
It is agreed that hamstring injuries have a complicated multi-factorial etiology, including muscle weakness and balance, lack of warm up, decreased flexibility, previous injury history and fatigue. The only conclusive risk factors for future injury are a current hamstring injury or a previous history of hamstring injury. This makes prevention of the initial injury a primary focus in management efforts.
WHAT IS A HAMSTRING STRAIN?
During sprinting activities in football the Hamstring muscles can be forcibly stretched beyond their limits and the muscle tissue can be torn. A tear in a muscle is referred to as a strain and, depending on its severity, it is classified as a first, second or third  degree strain.
The Hamstring muscles work over both the hip and knee joint as well as the pelvis and lower back and can become susceptible to injury due to fatigue or if there is altered biomechanics in the pelvis and lower back. It is therefore very important to ask your physiotherapist what stretches and exercises you should be doing to prevent getting a back-related hamstring injury.
PREVENTION
A warm up, prior to matches and training, is thought to decrease muscle injuries because the muscle is more extensible when the tissue temperature has been increased by one or two degrees. A good warm up should last at least 20 minutes - starting gently and finishing at full pace activity. Practising sport specific activities helps tune coordination and prepare mentally for football.
What should you do if you suffer a Hamstring Strain injury?
The immediate treatment of any muscle injury consists of the RICE protocol - rest, ice and compression and elevation (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 must be rested from sporting activity for between a couple of weeks and 3 months.
Top of page
Osteitis Pubis
Osteitis Pubis is a painful overuse injury that affects the pelvis and most commonly occurs during kicking activities, ice skating and dance. It was first described by Legueue and Rochet in 1923. It affects an area at the front of the pelvis known as the 'Pubic Symphysis'. 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.
 The exact mechanism of the development of Osteitis Pubis remains unclear. Several theories have been proposed, including the overuse of the abdominal muscles that attach to the pelvis causing gradual micro trauma to the bone; excessive shearing forces on the Pubic Symphysis caused by powerful kicking or repeated movements; or even instability of the Sacro Iliac joint at the back of the pelvis resulting in abnormalities at the Pubic Symphysis.
Osteitis Pubis is most common in sports where a large shearing force goes across the Pubic Symphysis. This occurs during kicking activities, ice skating and dance. The excessive forces overstrain the Pubic Symphysis and cause an inflammatory response. This may involve erosion of the joint margins and is followed by a slow healing process.
SIGNS AND SYMPTOMS
Osteitis Pubis causes pain during and after exertion, which is often combined with tenderness to touch at the Pubic Symphysis area. Typically, this pain may radiate up to the lower abdomen or down to the groin region. In many cases the patient is unable to localise the pain, which may move around the pelvic region.
It is therefore important that all cases of persistent groin pain are 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 imagings in the form of x-rays are able to see widening or erosion at the Pubic Symphysis which is indicative of Osteitis Pubis. An MRI scan may also be helpful as they clearly depict bone stress reactions and inflammatory changes in the tendons that attach to the pelvis. However, in the case of athletes and those who undertake a high level of sporting activity MRI findings may show bruising of the Pubic bone even in those who have no symptoms.
TREATMENT
Frustratingly, Osteitis Pubis can be resistant to treatment and can last between 6 months and two years before symptoms resolve. For this reason a preventative approach is preferable. Over training should be avoided, particularly in those who participate in long or repetitive kicking sports.
Treatment options for those with acute symptoms are pretty limited. Rest is the most sensible approach - allowing the affected tissue to settle down and heal with a progressive rehabilitation in the form of pilates which needs to be an individualised program . Non Steroidal Anti Inflammatory Drugs (NSAIDs) are advocated by some but this may not help the healing process if the damage is to the bone.
If the pain does not resolve with prolonged rest (and often it doesn't) then Corticosteroid injections may be considered. If the injection is successful the patient can usually return to activity within two to three weeks, although some people require a second injection. Some authors have reported good results using progressive stretching of the muscles that attach to the pelvis and pilates. Improving hip range of movement is particularly important.
In cases where Osteitis Pubis does not respond to conservative treatment within 12 months, some surgeons advocate a surgical approach. This is particularly the case if there is mechanical instability at the Pubic Symphysis. The surgeon uses a plate and screws across the joint to restore stability. Crutches are required for around 3 weeks and a return to sports is not possible before three months. The mechanism of surgical treatment is poorly understood. It could be that the restoration of stability reduces abnormal stresses; alternatively pain may be resolved by cutting through local nerve tissue. Of course it could be that the extended rest period is helpful.
PREVENTION
Over training should be avoided, particularly by those who participate in long or repetitive kicking sports. Core Strength and Core Stability exercises which can be done in the form of pilates, can improve muscle function across the trunk and pelvis. Core strength exercises on a mat using a Swiss Ball and resistance bands are ideal, because the improved muscular strength and stability can help to counteract the large forces that are applied to the lower abdomen and pelvis. This can reduce the risk of developing Osteitis Pubis.
Top of page
|
