Physiotherapy for AFL injuries

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29 July 2017


Australian football (AFL) is one of the most popular sports having the highest participation rate in Australia. Over the last four decades the sport has changed in many ways; the speed has doubled, the average number of collisions has doubled. Injuries occurred during both competition (78% of AFL injuries) and training (13%), has increased. This physical contact sport often results in injuries from tackling, kicking, running, handballing, marking and constant physical competition for the ball.

Pre-Season Preparation for AFL

Injuries occur more at the beginning of a season, suggesting a pre-season conditioning to reduce injuries. Pre-season conditioning programs gradually increase the intensity for players to prepare for the competition. Injury prevention strategies to reduce the severity of footy injuries could include coaching on defensive skills, correct tackling technique, correct falling technique and methods to minimize the absorption of impact forces in the sport.

Cause of injuries

Competition is the most common context in which footy players are injured. The major causes of injuries to players are, being struck by another player, tackled, collisions, hit by the ball, overuse and falls. Injuries to the thigh, knee, lower leg and ankle are the most common non-hospital-treated injuries. Striking is responsible for causing 28% of injuries, collision causes 21%, while overuse injuries cause 12% of all injuries. Sprains account for 30% of all AFL injuries and fractures 13%.

Common injuries while playing AFL

Injuries predominantly involve the lower limb. Hospital-admitted injuries (which make up 30% of all Australian Football hospital presentations) are usually fractures, sprains or strains affecting the wrists, hands, shoulders, head or face, lower leg and knee. The prevention of lower limb injuries, injuries caused by body contact and injuries caused by overuse should be a priority for injury prevention research in footy due to the predominance of these injury types in the pattern of injuries.
Preventing injury while playing AFL

Be prepared

Provide a safe environment
Wear the right protective gear.
Types of injuries in AFL

40% of injuries are muscular strains or contusions (bruising)
30% are sprains
Dislocations, fractures, lacerations, and overuse injuries.
Sprained ankles represent 10-15% of injuries.
Between 5-25% of rugby injuries are head injuries, including concussion.
In Detail..

Hamstring injuries

Hamstrings are the most common AFL injury each year occurring mainly due to over striding in high speed and trying to maintain speed. Other reasons of hamstring injury in AFL are leaning forward when trying to maintain or achieve extra speed, bending to pick up the ball whilst running or attempting to break out of a tackle. Hamstring injuries are more common with slippery grounds due to less traction.

Groin Strains and Pubic Stress Syndrome

Groin strains and pubic stress syndrome are the 2nd most frequent injury in AFL, behind hamstring strains. Overloading of the pelvic ring is common due to repetitive and frequent kicking and changing direction during running and sprinting. Groin strains often occur due to ground contact on to hard ground.

Quadriceps strains

Quadriceps strains are more frequent during training, when the practice environment is less varied than during a game. They occur more often during short kicks when the player is running at high speeds.

Hand injuries

Recreational AFL players are more likely to injure their upper limbs than competitive participants. This may be due to poor skill and coordination, poor tackling and falling techniques.

Knee injuries

Extrinsic factors such as ground hardness and increased traction can lead to increased knee injuries. Athletes with longer cleats have even greater boot to ground traction.

ACL – Anterior Cruciate Ligament

Anterior cruciate ligament, or ACL, injury is a tear in one of the knee ligaments that joins the upper leg bone with the lower leg bone. Injuries range from mild, such as a small tear, to severe, such as when the ligament tears completely or when the ligament and part of the bone separate from the rest of the bone. ACL can be injured if your knee joint is bent backward, twisted, or bent side to side. An ACL injury often occurs during footy game when you are changing direction rapidly, slowing down when running, or landing from a jump.

AFL injury data

During an AFL season, there is an average of 37.7 new injuries per team causing 156.2 home and away and finals games to be missed.
Hamstring injuries continue to be the number one injury concern (with an average of 5.2 new injuries causing 19.1 games missed per team).
Calf strains (with an average of 2.9 new injuries causing 5.9 games missed per team) continue to track above the historical average.
Groin injuries, which were once the third most common injury and cause of games missed in the AFL, now remain low (with an average of 2.2 new cases of groin strain or osteitis pubis causing 7.1 games missed per team).
ACL injury rates are on par with historical averages (with an average of 0.7 injuries causing 16.7 games missed per team).
Rates of leg and foot stress fractures are on par with levels observed in the past (with an average of 0.7 injuries causing 8.6 missed games per year in season 2015).
Rates of concussions causing missed games continues to trend up (with 1.5 new injuries causing 4.2 missed games per team).
There is a notable increase in other injuries in a number of categories (leg / foot / ankle and hip / groin / thigh).
The most common football injuries we see relate to: hamstring, groin, hip & shoulder.
Treatment for AFL injuries at Inspire Physio Care

Physiotherapy for AFL injuries

At Inspire Physio Care Physiotherapy, we have extensive experience with getting the best results working with ACL and Hamstring injuries commonly suffered in AFL. We get to the root cause of injury and determine the risk of injury and the ability to return to the sporting field. Our treatment process achieves pain relief in the shortest amount of time by using hands on Physiotherapy techniques such as soft tissue massage, joint manipulation, articulation and stretching techniques, dry needling and taping techniques. We treat all kinds of football injuries such as plantar fasciitis, calf strain, hamstring strain, groin strain, returning from an ACL or knee injury, back pain or shoulder injuries. Whilst footy is one of the most popular there is a lack of information about the injuries sustained by community-level, junior and recreational footy participants.

Pilates for AFL injuries

Hamstring injuries often involve not only a lengthy recovery period but also a long phase of increased susceptibility to re-injury. Pilates provides AFL players unique movement experiences where they can develop and challenge their coordination and body awareness, which is a key to success at a game that requires proficiency in these areas.

Strength and conditioning for AFL injuries

We know that the hamstring and groin are most commonly injured, but knee injuries (in particular) result in a greater number of games missed. Once a player has been injured, the chance of a second injury increases significantly. Therefore, a structured, specific and progressive rehabilitation is essential and must include appropriate Strength and conditioning.


The code of footy that you play can predispose you to general football related injuries or specific injuries common to footy. Contact, speed, agility, distance travelled, kicking, arm use and field spatial awareness all contribute to the injuries that are likely to suffer. With a 360-degree nature to the modern game, injuries are all too frequent, be it a slight strain or a full rupture. At Inspire Physio Care we can assess your footy injuries relating to lower limbs, ankle, knee and shoulder and teach you specific exercises to improve your strength, agility, and control. This will not only lessen the chances of injury but will usually also improve your sports performance.

Reference: 2016 AFL injury survey

Collaborators: AFL Doctors Association, AFL Physiotherapists Association & AFL Football Operations Department