Once the finals are over, it is routine to see injured players - with
knees that require reconstruction and hip joints that need repair - lining up to
go under the knife. Peter Brukner reports.
There are many who celebrate the end of the football season - weary players,
football widows, neglected gardens to name a few - but the group who most
eagerly await the end of the season are the sports orthopaedic surgeons
responsible for the 16 AFL clubs.
Every year players line up at the surgeons' doors on the Tuesday after the
season (provided that they have survived Mad Monday) to determine whether the
chronic niggling injury with which they have played the last part of the season
requires surgery or, alternatively, merely rest and a long rehabilitation
Clearly, several injuries sustained during the season require immediate
surgery. Examples of these include James Hird's facial fractures, Matthew
Lloyd's finger tendon detachment, Robert Harvey's shoulder ligament injury and
the usual spate of ACL injuries requiring knee reconstruction.
But many players who sustain relatively minor injuries late in the season, or
who develop a chronic injury during the season, are able to continue playing,
albeit with their performance frequently compro-mised, until the end of the
season and then go under the knife.
Occasionally, clubs whose finals chances have disappeared will choose to pull
their injured players out early and have surgery before the end of the season.
This season Sydney adopted this policy, with Stuart Maxfield (knee), Jason Ball
(groin) and Rowan Warfe (groin and finger) having surgery in the latter part of
Injuries that can be carried for a few weeks until the end of the season
include minor hand injuries such as fractures and ligament or tendon tears, and
minor knee and hip injuries.
Knee arthroscopy is probably the most common surgery performed post-season
and this is usually due to a small meniscal (cartilage) tear or chronic damage
to the articular cartilage (lining of the joint) that needs to be cleaned up and
the surface smoothed over.
Hip joint injuries are being more frequently diagnosed nowadays as we improve
our understanding of this previously neglected joint. Tears to the lining of
the hip joint (labral tears) sustained by mid-season require arthroscopic
surgery to repair the damage.
Chronic tendon injuries such as the achilles injuries that hindered the
performances of Melbourne's Peter Vardy and Essendon's Steve Alessio during the
season are frequently operated on at season's end. These injuries are managed
during the season by reducing the training load and trying to maintain fitness
with cross training such as swimming and cycling.
This situation is obviously unsatisfactory in the longer term so the surgeon
will have a good look at the tendon, remove any adhesions that might be
restricting movement and excise any degenerative tissue that will not heal.
Clubs are keen to get the surgery done as soon as possible as the rehabilitation
process is a long one.
We constantly hear coaches and players emphasising the importance of being
able to undertake a full pre-season training program, hence the enthusiasm for
repairing any damage that might prevent players getting the full benefit of
Chronic groin injuries - the dreaded osteitis pubis - are occasionally
operated on post-season, but the present thinking among the AFL clubs is that a
long rehabilitation program over the summer concentrating on improving the
stability of the lower back and pelvic areas is the way to go.
The clubs are now incorporating these rehabilitation techniques into their
pre-season training in the hope of preventing these injuries that have been the
curse of AFL players over the past few years.
The early indications are that this program of prevention and early
identification of groin injuries might be working to reduce their incidence.
Peter Brukner is associate professor in sports medicine at the Centre for
Sports Medicine Research and Education at Melbourne University.
UNDER THE KNIFE
Michael Doughty knee
Matthew Shir Groin
Beau McDonald shoulder
Chris Scott groin
Jason Akermanis groin
Aaron Shattock groin
Nigel Lappin finger
Tim Notting knee
Jarrad Wright thumb
Lance Whitnall knee
Trent Hotton elbow/calf
Glenn Manton knee
Adam Pickering shoulder
Brett Ratten knee
Blake Campbell shoulder
Paul Licuria knee
Ben Johnson shoulder
James Hird knee
Steven Alessio Achilles
Mark Bolton knee
Sean Wellman finger
Jason Johnson finger
Paul Salmon shoulder
Justin Longmuir knee
Corey Enright shoulder
Mark Woolnough knee
Ben Dixon shoulder
Michael Osborne thumb
Matthew Ball toe
Daniel Harford abdomen
Chance Bateman shoulder
Matthew Burton ankle
Mark Porter thumb
Joe McLaren knee
Andrew Leoncelli finger
Peter Vardy achilles
Dean Brogan thumb
Josh Carr finger
Stuart Dew finger
Damien Hardwick knee
Royce Vardy ankle
Craig Ednie hip
James Begley shoulder
Matthew Capuano shoulder
Brett Knobel knee
Steven Lawrence shoulder
Lenny Hayes shoulder
Andrew Thompson knee
Fraser Gehrig groin
Daniel Wulf ankle
Barry Hall groin
Gerrard Bennett groin
Leigh Brockman ankle
Brad Seymour shoulder
Paul Williams ankle
Glen Jakovich shoulder
David Sierakowski knee
Jeremy Humm calf
Chris Grant hip
Daniel Giansiracusa hip
Daniel Bandy hand
Luke Penny shoulder