AFL Shoulder Injuries

AFL is effectively an overhead sport. It seems though that most attention in regards to injury prevention tends to relate to lower limb injuries. There’s a significant focus on soft tissue injuries and rightly so, as they are the most common and prevalent in the game. But generally speaking they can be rehabbed in less than 6 weeks and don’t require surgery. Acute knee injuries also warrant attention primarily due to their severity rather than prevalence. Shoulder injuries in my opinion don’t get anywhere enough recognition or respect. Last season alone in the AFL there were 50 new incidents with almost half of them requiring surgery. I don’t have any numbers on total games missed I’d imagine they’d be significant.

Granted many of these injuries are unavoidable given the physical nature and speed of the game, but associated risk factors need to be addressed and prevention strategies employed.

It appears there’s variety of mechanisms but the following are 4 of the most common:

1. Tap or spoil with forced flexion or external rotation from an opponent.
2. Landing on the ground with force through the elbow
3. Outstretched arm with direct contact from opponent (hip and shoulder)
4. Tackling with forced horizontal extension (common mechanism for pec injuries).

After delving a little deeper into the individual incidents and mechanisms from last season it also becomes evident that these injuries aren’t being managed as well as perhaps they should be. There appears to be a rise in not only acute pec injuries but also secondary shoulder dislocations once the player returns to competition. It’s important to respect not only tissue healing time but also the subsequent adaptation and reconditioning process.

I personally believe responsibility for monitoring, prescription and implementation falls upon a few different parties. Injury prevention in general is often an area for which no one takes full accountability for and issues frequently slip through the cracks. Collaboration between S&C and medical staff is crucial to ensure players are assessed, tested and subsequent preventative exercises prescribed. They also need to encourage and empower the players to drive their own programs. Similarly it’s the responsibility of the player to seek out treatment on problem areas and not just lie face down on the table for 60mins because it makes it easier to read the paper or play angry birds. Triggering can also be a valuable self management tool.

Key prevention areas:

1. Thoracic and shoulder mobility
2. Strengthening of the whole shoulder complex.
3. Joint proprioception and coordination.
4. Identification and correction of other deficiencies further down the kinetic chain.
5. Improving landing mechanics and tackle technique.
    

As a side note, the majority of this information is my interpretation of work my wife Laura Schwab is completing as part of her PhD.