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The Age

At season's end, surgeons are AFL players' best friend

Author: Peter Brukner
Date: 10/10/2002
Words: 680
          Publication: The Age
Section: Sport
Page: 2
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 program.

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 the season.

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 their pre-season.

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.

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
Essendon        INJURY
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
Kangaroos       INJURY
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
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