The AFL's Pre-Season Injury Crisis: Are We Missing the Bigger Picture?

The AFL's Pre-Season Injury Crisis: Are We Missing the Bigger Picture?

The Australian Football League (AFL) is no stranger to injuries, but the number sustained so far this pre-season has many fans and analysts scratching their heads.

Whether it be Kangaroo young gun George Wardlaw's high-grade hamstring tear, the trio of long-term injuries to important Saints, Nic Newman's nasty ruptured patella tendon, Todd Marshall's ruptured Achilles, or any number of other injuries sustained thus far in the men's competition, we're all looking for answers.

Are players training too hard or too often? Is the earlier start to the season having an impact? 

Polarising radio personality Kane Cornes even suggests that too much time off is the issue...

It's hard to comment on each player's specific situation from the outside because pain and injury are complicated phenomena. However, as a Physiotherapist who is passionate about uncovering the root, underlying cause of pain and injury - I find we might be lacking one hugely important perspective.

Consider this:

The majority of injuries aren’t caused by the thing you were doing at the time. Instead, the moment you hurt yourself was the last straw. The point at which a part of your body can no longer tolerate the mechanical environment it exists within. Especially when exposed to acute trauma, or enough repetition, intensity, ambiguity or time.

With this perspective in mind, let's see if we can make sense of the current AFL injury "crisis" and discuss why exercise and activity may just be the messenger and not the villain.


The AFL’s Pre-Season Injury Crisis: By the Numbers  

Overall Injury Rates

AFL injury rates have remained relatively stable over the past few years, with soft tissue injuries (hamstrings, calves, groins) being the most common. 

In 2022, the AFL reported an average of 1.5–2 injuries per club per round, with soft tissue injuries accounting for 40–50% of all injuries.

Concussions - which have been a growing focus due to increased awareness of long-term health risks have remained steady at 1–2 incidents per club per season.

The dreaded ACL injury accounts for only 2–3% of all injuries (8–12 per season) but still has a significant impact due to their year-long recovery time. Thankfully there have been no new incidents adding to these statistics so far this year. touches wood

The data isn't specific enough to highlight a split between pre-season and in-season injuries, but anecdotally, I think most would agree that it's common enough for AFL players to suffer "season-ending" or "season-impacting" injuries before the season starts.

At the time of writing three AFL players are likely to miss the entire season through injury.

And while these numbers aren't statistically any worse over the last few years, they certainly aren't getting better either.

So, what are we missing?

 

The Cause of Injury is Obvious, Right..?

Intuitively, it's easy to feel that what you were doing at the time of injury caused your injury. 

You weren't in pain or injured before you did the thing. You did the thing, and now you have pain and injury.

It makes sense.

However, taking a small step back often reveals a far more in-depth and ultimately beneficial conversation. One that is rich with ideas and hidden clues that not only explain why you may have hurt yourself, but what you may need to improve to optimise your chances of staying pain and injury-free in the future.

What you were doing clearly does play a role, and we'll get to what that might be in a second, but when you think about it - most people hurt themselves doing "normal" things.

How often have you seen an AFL player pull up short while sprinting because they've pinged a hammy or torn a calf?

 

We so easily accept this even though running and sprinting are normal expressions of human movement. Furthermore, these activities alone are not specific enough to explain why a player's right hamstring tears and not their left.

How many knee or ankle injuries result from jumping and landing without contact with the area?

Why does a player's shoulder disclocate when laying a tackle?

Why did a player's thigh muscle tear when kicking a football?

Once again, all of these are not only reasonable expressions of human movement, but something a player has likely practiced hundreds if not thousands of times before in the spirit of adapting and getting better.

So again, what are we missing?

At this point, it's important to acknowledge the things we intuitively blame for pain and injury:

  • Overuse
  • Going too hard
  • Overtraining
  • Poor recovery
  • Ageing
  • Moving the wrong way
  • Growing pains
  • Bad luck

And all of these make perfect sense - on the surface.

Player A was training too hard and his hamstring tore. Player B is getting on in years and left calf troubles were inevitable. Player C was training too much, overused his right Achilles and it became sore. Player D moved the wrong way and injured his back.

Player E's right knee got caught up in a tackle and wrenched his ACL - shocking luck.

We hear these explanations time and time again.

 

 

But from what I see day-to-day, they aren't good enough.

Yes, Player A trains hard, but why did his right hamstring tear and not his left?

Yes, Player B is getting older, but ageing is normal and both calves are the same age.

Yes, Player C has used his Achilles a lot over the years, but isn't that what it's for? Again, why did one Achilles fail and not the other?

Yes, Player D hurt his back performing a movement, but moving your back is also normal and a human spine shouldn't be fragile enough for one simple movement to bring the house of cards crumbling down - especially at AFL level.

Yes, Player E was unlucky with the tackle but there's nuance to this as well. We'll also circle back to this in a second.

So once again, what are we missing?

What makes strong, robust, well-conditioned AFL athletes vulnerable to normal things?

As mentioned above, the key here is perspective.

 

The Hidden Culprit: Normal Things Exposing Abnormal Things

In my 20 years as a Physiotherapist, one small shift in perspective has completely changed not only the way I view pain and injury but also my ability to generate genuine, lasting results.

"Pain and injury is rarely the start of something new, it's often the last straw." 

The overwhelming majority of acute pain and injury I've seen - that didn't come from direct blunt force trauma or a horrible accident, is just a consequence of something relatively normal exposing a hidden vulnerability somewhere. 

In short: normal things expose abnormal things.

To understand what these "abnormal things" might be, we just need to set some basic, boring standards for all humans to be measured against.

Basic Human Standards:

All humans should have the basic range of motion, muscle strength, and body control to perform any task one might need to perform on any given day.

Let's call this what it is - normal. Perhaps not as "common" as we'd all like to admit, but normal for a human nonetheless.

More specifically, do you have access to full range of motion at all your joints - including your spinal joints? Are all of your muscles working normally and not "tight" or "weak"? Can you use your native range of motion and strength to move in a way that is efficient, stable, and controlled? When you sit, can you express the same ideal body postures and positions required for optimal function when lifting and moving?

If not, why?

Further to this, we need to understand that the human body is a closed mechanical system. Nothing happens in isolation. 

Yes, we label your knee a "knee" for descriptive purposes, but it's impossible to define where it actually starts and finishes.

Because of this, we can't just look for knee-specific dysfunction to understand why a knee became sore or injured. We need more context.

Everything above and below your knee can play a role in how your knee feels and functions. It's all directly or indirectly connected by bones, muscles, ligaments, fascia, nerves, skin etc.

Furthermore, the function of your spine must also be explored because of its neural influence over our arms and legs. It's the switchboard whose wires pass through and control everything that happens in the leg and at the knee in this example.

And this is where the rubber hits the road.

AFL injuries - just like yours or mine, need to be looked at in the context of everything around it with consideration given to spinal function. Where are the hidden abnormalities often accrued in the non-athletic side of our daily lives that sport and activity can expose?

 

So, What Does it All Mean?

If we take this renewed perspective and apply it to our player examples from above, we may start to better understand what's gone wrong and why. At the very least it may give us the necessary clues to figure it out.

Player A still trained hard. But perhaps he didn't realise the right side of his lower back had become slightly weak and stiff. Perhaps he has no awareness that sitting and slouching in team meetings may be compromising the way his back functions, affecting his right hamstring function and leaving it vulnerable to forceful sprinting under fatigue.

Player B's left calf was getting older, but age didn't weary it. Perhaps the older he got, the longer a subtle left ankle joint restriction - leftover from a previous ankle sprain, had to alter his leg mechanics. His left calf could tolerate this altered environment over time... until it couldn't.

Player C's right Achilles was not overused. Repetition was just fantastic at exposing that same dual-sided ankle restriction Player B had, but this time it came from wearing heeled shoes or thongs his whole life. Or, perhaps Player C had also lost a little of his right hip rotation range - again from time spent sitting outside of the AFL environment. Could this have changed how he loaded his right Achilles - leaving it vulnerable to lots of use?

Player D certainly hurt his back bending down to pick up the footy. But if he spends his non-athletic moments sitting in team meetings, sitting on the couch playing Playstation, studying for his University degree, or just relaxing after a hard training session with his housemates - all in a slouched position, did he move the "wrong way" or was this a "death by a thousand cuts" type scenario exposed by something dynamic.

Player E's right knee definitely buckled under a tackle in an unfortunate set of circumstances. This is certainly more nuanced than the others, but important to discuss nonetheless.

Clearly, there is an amount of force that can exceed even the healthiest tissue's tolerance. A big hit, a fall from a great height, a brutal tackle.

But having said that, we can't just assume all trauma is testing out perfectly healthy, mechanically optimsed tissue just because nothing hurt beforehand.

Player E's ACL may have experienced enough awkward force to immediately breach its tolerance - so it ruptures. We can't do much about that. Or can we?

What if Player E had a sneaky hip restriction born from sitting on his couch at home? And when his body tried to absorb that tackle force, it had less slack in the system to do so?

What if his ankle or quads were restricted? Does this also compromise his ability to buffer that force?

My point here is that mobility, strength and normal function optimise our ability to bend and not break. Just assuming an injury was 100% bad luck robs a player of their ability to better protect themselves from the next awkward situation in the future.

 

Wrapping Things Up

At the end of the day, hidden dysfunctions at, or around the injured area help us understand why normal things affect us the way they do. They also help us understand how to improve our chances of buffering abnormal situations as well.

AFL is played at breakneck speeds, with hundreds of high-intensity efforts and high-impact collisions. The powers that be are always trying to make the game faster while at the same time trying to slow the players down.

But at the end of the day, it's not how hard we train or play. It's not how big the impacts are or how fatigued the players become. It's not how intense these guys and girls are. It's not too much time off, or too little time in between seasons. It's not that you're getting older, or that you're overusing things. In many instances, bad luck may not be as impactful as we intuitively think. 

These things still clearly hold value when trying to build reasonable, respectful and appropriate programs for our AFL athletes over pre-season. We want them to be as strong, fit and resilient as possible. But we also need to stop short of blaming these things as the cause in isolation.

Without this slightly different perspective, we may remain distracted from what's actually going on under the hood and behind the scenes - particularly when elite AFL athletes are not being elite AFL athletes.

But with all that being said, perhaps the most important question here is not "What is the cause of these pre-season injuries?"

Instead, perhaps we need to ask "What from their daily, non-athletic lives does an AFL pre-season expose?"

Maybe then we'll see the bigger picture and seriously reduce the number of pre-season injuries in the AFL.

What’s your take on the AFL’s injury crisis? Do you think the league is focusing too much on training loads and not enough on underlying issues? Share your thoughts in the comments below!  

 - Grant

Please note: this article is not designed to be a slight on any club's medical teams. They do an amazing job in so many ways. I hope this is taken in the spirit it's intended. 

Back to blog

Leave a comment

Please note, comments need to be approved before they are published.