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hhh
19-04-2005, 09:29 AM
One of the more useless articles going round so don't bother reading it. Some points:
* The injuries on the weekend have nothing to do with players carrying chronic shoulder problems as all were acute/impact injuries.
* Players have been trying to smash the bejesus out of each other in tackles, hip and shoulders etc for years. What is Roos rabbitting on about? Didn't he watch the 1989 GF or some of the gold Hawthron v Bomber battles from the 1980s?
* How can you blame ground hardness whent he penetrometer work has been going on for years ensuring softer grounds.
* Good self promotion for the shoulder surgeon in the article, but stick to what you do best.
* It is common for players to carry shoulder injuries but this has been happening for years eg Wayne Carey and his 4 rolls of elastoplast each game. But players are carrying everything including dodgy knees and ankles.
* Major criticism of AFL injury surveillance is that only one diagnosis can be recorded when often players miss a match due to 2-3 injuries.
* It should include a list of all off and inseason surgery. This would give an accurate reflection of chronic injuries that have been carried and not caused missed matches. The AFL's injury surveillance has not evolved in 10 years, so whilst being ahead of its time initially it needs some modification.
* How many epidemiological injuries are the AFL going to fund, whilst being a necessity they do nothing in telling practitioners how to address or correct a problem.


AFL to tackle hidden joint toll
Chip Le Grand
April 19, 2005

THE AFL is investigating the hidden toll of unreported shoulder injuries as arm sockets, AC joints and collarbones bear the brunt of an increasingly brutal tackling culture.

Melbourne surgeon Greg Hoy, the shoulder specialist who repaired Pat Rafter's serving shoulder and the bowling arm of Shane Warne, believes the practice of driving opponents hard into the ground after a tackle is linked to a worrying increase in shoulder injuries.

Yet the true incidence of shoulder injuries remains hidden by the secretive nature of club football departments. It is common for footballers to carry significant shoulder injuries throughout an entire season. If they do not miss a game, the injury is not recorded.

"I am concerned about players who apply a tackle, and continue the tackle through to the ground," Hoy said yesterday. "You would have to say that the tackles are fiercer and going for a longer period of time. If the impact is carried through to the ground you will increase the trauma of the injury."

Two high-profile players sustained serious shoulder injuries in last Sunday's games, with Demon Cameron Bruce expected to miss the next six matches with a badly separated AC joint and Sydney's Paul Williams the same period with a broken clavicle. In both cases, the players were pinned in ferocious tackles and dumped heavily on the ground.

While Melbourne coach Neale Daniher and Sydney counterpart Paul Roos accepted the injuries as part of the rough and tumble of football, Roos admitted that tackling had gotten decidedly rougher in recent years and that gifted midfielders like Bruce and Williams were being targetted for heavy treatment.

"Definitely you want to take a Bruce or a Williams out of the next contest," Roos said. "You don't want them to be able to get up and run while you are on the ground because they are such good players.

"A tackle used to be a grab of the jumper. Now a tackle is stopping someone getting rid of the ball and sometimes throwing him on the ground as well. I certainly think the better players will get tackled a little bit fiercer and a little bit stronger."

Roos also questioned whether harder playing surfaces were contributing to the growing shoulder toll. St Kilda's Nick Riewoldt snapped his collarbone diving for a mark on the rock-hard Gabba surface. Williams came to grief on a bone-dry SCG and Bruce at the Telstra Dome.

Carlton midfield coach Tony Liberatore, the league's best tackler during his playing days, said there was now a greater emphasis on tackling at all clubs and tackling carried a more "savage" intent.

"You want to take them out of the play," Liberatore said. "There is more of an intent in tackling, where if you are going to do it, you do it properly, rather than the half-hearted tackles we used to see. I think the intent is a bit more savage."

This unforgiving culture was confirmed by Bruce, Melbourne's leading tackler for the 2004 season.

"He is a tough player, it was a great tackle," Bruce said of the Brent Guerra tackle which effectively ended his Brownlow Medal hopes in the opening minute of Sunday's game against St Kilda.

"If you have the opportunity to put them into the ground and prevent them from being able to run into the next contest, I'd be backing that every player would want to do that."

The shoulder has the greatest range of movement of any joint in the body and as a result, is the least stable. When players are dumped to the ground with their arms pinned, the full weight of their body plus the weight of the tackler impacts on the shoulder. Depending on the angle of impact and position of the arm, this can result in shoulder dislocation, AC joint separation or broken collarbones.

"As players get faster and stronger, the impact increases," Hoy said. "But you can't make the bones any stronger, so they are increasing the risk of shoulder injuries relative to other types of injuries."

According to the most recent national injury survey due for release later this month, shoulder injuries are one of the few injury categories to have risen over the last seven years.

Following lengthy discussion about shoulder injuries at last year's AFL Medical Officers Association conference, survey authors Hugh Seward and John Orchard vowed to unearth the real figures.

"Shoulders are one of the few categories of injuries that have been trending upwards over the last seven years," Dr Orchard said yesterday.

"We don't have a specific explanation for it. If there is a long-term, sustained trend upwards then it is possible that extra studies will be funded and their cause will be further investigated."

sydunisportsmed
19-04-2005, 12:00 PM
Agree with the mixed messages in the Australian article. Of course the Bruce and Williams and Riewoldt injuries will all be recorded in the injury survey because they will all miss weeks +++. Unless of course Cameron Bruce, who is meant to miss six weeks, gets juiced to the max in the A/C joint and misses zero (which is not out of the realms of possibility).

Agree that perhaps there is a surface correlation as the 3 injuries mentioned have occurred on the three hardest grounds in the comp (the Dome plus the 2 cricket grounds that don't get resurfaced for the footy season).

The chronic shoulder problems that lead to surgery could get surveyed if all teams are willing to hand over op details (ditto for local anaesthetic use). I wouldn't hold my breath waiting for some of the more paranoid teams to hand over the data, and basically it is all 16 in or not worth doing as far as injury surveillance goes.