Derby Tigers

Injury Prevention and recoveryDr Steven Peterson

Injury Prevention

• Sporting injuries are common, serious and preventable

• Common – majority of AFL players can nominate an injury received or aggrevated each year– It’s a tough game

• Serious– Prevent further sport or decrease performance– Lifelong disability

Preventable / treatable

• Prevent injuries from (re)occurring– Warm up / stretches– Strapping and protective gear– Warm down / recovery

• Minimize the initial damage of injuries– Acute post injury care

• Rehabilitate injuries that require it

Prevention

• Repair is not always possible so prevention key• Greatest risk of an injury is prior injury– Not always same injury either

• Prevention for AFL– Warm up– Stretching– Taping and bracing– Protective equipment

Warm Up• Prepares body for exercise– Increase blood flow to muscles– Helps mental preparation– Increase oxygen to muscles• Makes the fuel in the muscles work much, much better

– Makes muscles work smoothly• More effective and less risk of tear / overstretch

• Only works in last 30min before game– So not too early

Warm Up – Pre AFL• Personal – whatever helps you prepare• General activity– Jogging and general stretching

• Specific to your role– Practicing the movements and activities you will

do on the field– 50%-75% intensity max (sweat but not fatigued)– Reduce risk of injury from specific stretched

movements by 50%

Stretching

• To ensure smooth joint motion throughout full range of movement

• Especially useful for AFL (high intensity)• Safest after the warmup• Stretching is like weightlifting– Repeated regular stretching increases the muscles

strength, power and endurance– Decrease injury by 32%– Get in the habit

Stretching pre game

• Controversial how much it reduces injury• Probably does to targeted high risk areas– Risky if you overstretch

• Static stretch – slowly assume position– Hold muscle 30 seconds at least• This causes muscle fibers to relax

– After 30seconds push a little bit more– At no time discomfort• That means overstretching and possible injury

Strapping

• Point is to stop unwanted (over)movement– To protect from injury– To help an old one to fix

• Should be done prior to warm up• Best evidence is for prevention

Strapping

• Need rigid non-stretch tape• Ankle, wrist, shoulder most appropriate• Shave 8 hours prior (less skin irritation)• Injured ligaments should be in shortened

position prior to taping• Anchors (tape sticks better to tape than skin)• Overlap between strips• Redo if no longer firm, torn etc

Equipment

• Braces (knees etc) are good as can be fitted by patients but needs to be fitted correctly

• Ideal football boot– Rigid heel counter– Flexible forefoot– Wide sole– Slightly curved– Adequate foot depth

• Headgear not a lot of evidence

Recovery

• Goal is to recover from game quickly to maximize performance at training / next game– Remove lactic acid (waste product from muscle

metabolism (activity)) from muscles– Start damage minimization or healing of injuries– Change from breaking down muscle to building it– Replace carbohydrate stores

Recovery

• Stretching helps lactic acid clearance• Gentle walking and muscle use (5-10min)• Ice bath (1-3 min) body cooling and stop

swelling• Soft tissue massage• Benefit from light activity the next day• Recovery meal of carbs and protein

If that doesn’t work

• Injuries are individual and if concerned or unfamiliar should speak to doctor or physio

• Head and neck injuries need review• General principles and advice

Acute management of injury RICE

• First 24 hours most important– Damaged tissue and vessels cause blood pooling,

compression, hypoxia and further damage

• Rest - decrease bleeding and swelling• Ice - 20min every 2 hours for 6 hours• Compression - firm bandage over area• Elevation - reduce swelling

Avoid HARM

• Heat – causes further bleeding• Alcohol – mask injury, interfere with recovery• Running or other activity – further damage• Massage – further swelling

(I)Mobilisation

• Should discuss with doctor or physio as to specific injury management

• In general – short period of immobilization– Scar tissue strengthening, avoid re-injury

• Mobilization avoids stiffness and weakness– May need protection to stop unwanted

movement– May have passive or limited movement

Drugs

• Analgesia to control pain– This can help movement for rehabilitation

• Anti-inflammatories for inflammation– Stop the injury getting worse

• Steroid injections – bridge to buy time• Heat/cold, acupuncture, manipulation,

surgery, others – speak to doc.

Rehabiliation

• Something to consider during off season• Work out a plan with doctor or physio• An active process after acute phase of injury– Getting strength and flexibility in injured part– Acquiring skills of sport– Returning to prior activity

DAHS

• Walk in bulk billing clinic• Ask to see me (or male doctor) and I will try

see you quickly• Occasionally I am not there• If you want an appointment let me

(0439895573) or Matt know– we will work something out