Tuesday, April 22
IT is, short of a freak accident such as that which visited Jason Snell, the most feared injury among footballers and can cut short promising careers.
This year four senior AFL players have already fallen in the field of battle to an anterior cruciate knee injury.
Western Bulldogs' skipper Chris Grant, prolific Port Adelaide onballer Josh Francou, Collingwood's Tarkyn Lockyer and last weekend Bulldogs' Mark Alvey have so far had their season cruelly cut short.
The medical fraternity is divided as to how long rehabilitation should take but most often players who rupture their anterior cruciate ligament can expect to miss a year.
Given that a footballer's sporting life at the top level will be lucky today to reach 10 years it is a fair amount of time, 10 per cent to be precise, to be out of the game.
Such is the emotion that Collingwood coach Mick Malthouse described Tarkyn Lockyer's injury in round three against Geelong as a ``football tragedy''.
Geelong's club doctor and president of the AFL Medical Officer's Association, Hugh Seward, said an average of 16 players, one per club, fell victim every year and to have four players sidelined so far this year was not unusual.
``The incidence will drop off in the next few weeks,'' he predicted.
``The first few weeks are the highest traditionally and then it drops off as the season goes on and we think it's because the grounds become softer.
``The fact we've had four so far this season is about on average given that we had a particularly good pre-season.
``There are more severe injuries but of the common injuries it is the most serious in terms that you miss the entire season.''
He said there was a school of thought that players could come back earlier, and there have been instances where they have such as David Schwarz.
But he went on to reinjure the knee a further two times.
Seward is inclined to err on the side of caution, given that the players in the highest risk category are those that have previously suffered the injury, as evidenced by Schwarz.
``I'm probably more conservative and I think give them the time, but I'm open to new evidence,'' he said. ``People are concerned that if they push people back too quickly there's a risk of recurrence and the greatest risk of having an ACL is having had one before.
``So people try and do leave the rehabilitation as long as possible to avoid that risk but there certainly is someone from the United States, a very high profile knee surgeon, who advocates a much shorter time.
``There's no real consensus yet on what we should be doing, just a broad variation of opinion.''
Seward said clubs and the AFL had come a long way in the past five years in preventative techniques and training methods to lower the incidence.
Grounds were now prepared softer and Seward noted that Telstra Dome had not recorded a higher rate of casualties despite criticism that it was a ``hard ground''.
He said clubs also focused on strength and balance training programs to increase players proprioception - the ability of joints to control position against force.
``Almost all clubs undertake balance board training and balance beam,'' he said. ``There's some research that has just come out of West Australia that suggests that that can be a significant way of reducing risks.''
He said almost half the knee injuries occurred when players landed awkwardly, which is why clubs also focused on improving players' skills at landing.
``It's always going to happen, the best you can do is to make sure all those parameters we know about are managed well,'' he said.