1. Derby Tigers Injury Prevention and recovery Dr Steven Peterson

2. 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

3. 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

4. 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

5. 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

6. 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%

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. Avoid HARM Heat – causes further bleeding Alcohol – mask injury, interfere with recovery Running or other activity – further damage Massage – further swelling

17. (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

18. 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.

19. 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

20. 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