Context:The nature of Australian rules football (Australian football) predisposes both unique and common injuries compared with those sustained in other football codes. The game involves a combination of tackling, kicking, high-speed running (more than other football codes), and jumping. Two decades of injury surveillance has identified common injuries at the professional level (Australian Football League [AFL]).Objective:To provide an overview of injuries in Australian rules football, including injury rates, patterns, and mechanisms across all levels of play.Study Design:A narrative review of AFL injuries, football injury epidemiology, and biomechanical and physiological attributes of relevant injuries.Results:The overall injury incidence in the 2015 season was 41.7 injuries per club per season, with a prevalence of 156.2 missed games per club per season. Lower limb injuries are most prevalent, with hamstring strains accounting for 19.1 missed games per club per season. Hamstring strains relate to the volume of high-speed running required in addition to at times having to collect the ball while running in a position of hip flexion and knee extension. Anterior cruciate ligament injuries are also prevalent and can result from contact and noncontact incidents. In the upper limb, shoulder sprains and dislocations account for 11.5 missed games per club per season and largely resulted from tackling and contact. Concussion is less common in AFL than other tackling sports but remains an important injury, which has notably become more prevalent in recent years, theorized to be due to a more conservative approach to management. Although there are less injury surveillance data for non-AFL players (women, community-level, children), many of these injuries appear to also be common across all levels of play.Clinical Relevance:An understanding of injury profiles and mechanisms in Australian football is crucial in identifying methods to reduce injury risk and prepare players for the demands of the game.

AimsTo determine whether a single ultrasound-guided platelet-rich plasma (PRP) injection into the anterior inferior tibiofibular ligament (AITFL) reduces the time for rugby athletes to return to function and match play following MRI confirmed ankle syndesmosis injury.MethodsCohort controlled pilot study. 10 Rugby Union players were recruited during the 2014 season, and consented to receive a single autologous PRP injection into the AITFL within 14 days of MRI confirmed ankle syndesmosis injury. A historical control group included 11 comparable Rugby Union players between 2011 and 2013 who were treated conservatively with the same inclusion criteria and rehabilitation protocol as the intervention group. Participants followed a standardised rehabilitation protocol involving simple milestones for progression. Early functional tests were performed 2 weeks after the removal of the CAM (controlled ankle motion) boot. Time to return to play was recorded. Repeat functional testing occurred within 1 week of return to play.ResultsGroups were comparable in anthropometrics, playing position and MRI injury severity. Time to return to play was significantly less in the intervention group (p=0.048). Following return to play, athletes in the intervention group showed higher agility (p=0.002) and vertical jump (p=0.001). There was a lower level of fear avoidance associated with rugby in the intervention group (p=0.014).ConclusionsThis pilot study shows that, following ankle syndesmosis injury, a single autologous PRP injection may accelerate safe and successful return to Rugby Union, with improved functional capacity and reduced fear avoidance. It demonstrates the feasibility of a randomised controlled trial to further assess this therapy.Trial registration numberANZCTRN12614000055606.

BackgroundWe hypothesised that the application, production and administration of platelet-rich plasma (PRP) varies widely among sports physicians, bringing into question the validity and consistency of PRP described in research and clinical use. We also assessed congruence between the reported clinical indications for PRP, and the available research evidence for these indications.MethodsWe conducted an anonymous 23 question online survey of 153 current Fellows of the Australasian College of Sports Physicians (ACSP), using an emailed link. It was opened from April 2014 until August 2014.ResultsThe survey confirmed that there is wide variation in the application, production and administration of PRP. Over one-third (38%) of sports physicians performed PRP injections themselves. Almost half of clinicians (49%) did not provide the service themselves, and only referred for PRP injections. The remaining clinicians did not inject PRP or refer for PRP injections at all. Clinicians who provided PRP injections varied from an average of 0–500 injections per month, with a median of 12 times per month. Australian sports physicians were far more likely to use PRP than their New Zealand counterparts. For sports physicians who provided or referred for PRP injections, tendinopathy was overwhelmingly cited (n=63) as the condition for which clinicians thought PRP was most effective. 30 respondents cited effectiveness for osteoarthritis.ConclusionsThis study confirms that there is no clear consensus among sports physicians on the preparation, administration or best clinical indications for PRP.

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