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Feature
Dr Jodie Richardson
The
N I A R T S is showing!
n HAMSTRUNG: Nick Riewoldt tears his early in the 2010 season.
Hamstring injuries remain the curse of the AFL footballer, and just as elusive for researchers trying to pinpoint their cause.
H
AMSTRING strains topped the recently published 2010 AFL Injury Report, again coming out as the most common injury among footballers and that responsible for the most missed playing time. It was no great surprise given that hamstring strains have been the most frequent and costly injury in the AFL for more than 10 years. No player is immune to the devastation that these injuries can bring and recent years have seen some of our biggest names hit the turf with the pain, shock and disappointment of a serious hamstring strain. Nathan Buckley, James Hird, Nick Riewoldt, Daniel Kerr and Matthew Lloyd – to name a few – limped off the field with the tell-tale hand on the back of the thigh, their supporters equally devastated. You’ll hear on the news and read in the papers that a player has “done” a hamstring or their hammy has “gone”. In both cases the player has strained a hamstring muscle. This can range from a “first degree” strain where some of the muscle fibres are torn to a “third degree” strain where the tear extends across the whole muscle. A first degree tear will usually see a player out for three to four weeks, where a high-grade tear could see a player under the knife and in rehab for months.
Not only are hamstring strains costly for the player and the club in terms of performance, they are costing the clubs a packet. The Collective Bargaining Agreement for AFL players stipulates that they are entitled to 100 per cent of their usual match payments for up to 30 games missed as a result of an injury incurred while training or playing. Given the average number of games missed through hamstring strains for each club in a year is 20, this adds up to a notional cost of hundreds of thousands of dollars annually in payments to injured players and their onfield replacements. This injury presents an age-old problem for the AFL, and mountains (or more aptly forests) of research have been conducted into this perplexing injury over many decades. Given the research into the causes and prevention, it’s surprising to see that the average number of new hamstring strains each year in AFL clubs now (six) is exactly the same as it was in 2001. The obvious question is why hamstring strains are still so common when so much research time and money has been poured into solving the problem? Even the likes of Nathan Buckley, with all of the resources of the Collingwood Football Club at his disposal and the most experienced medicos in the coun-
try working with him, was not immune to this unforgiving injury. Hamstring injuries are the most common injury in sports involving rapid acceleration and sprinting. There is no question that the speed of our game has increased phenomenally over the years, which makes for an awesome spectator sport, but this has come at a cost. A study entitled Evolution of Australian Football showed that the speed of the game doubled in the period 1961 to 1997. Of course with the introduction of a fourth interchange player, the game had never been faster. Unfortunately, an overall increase in injury rates paralleled this increase in game speed. Research has shown that the incidence of hamstring injuries decreases as running speed is decreased. However, it remains to be seen whether the latest changes to the interchange rules, replacing one interchange player with a substitute, has the desired effect of reducing game speed, hamstring injury rates and injury rates in general. The hamstrings are comprised of three muscles on the back of the thigh that cross both the hip and the knee joints. Inside Football
Picture a classic football photo of a player just after kicking the ball, support leg vertical, kicking leg horizontal to the ground with the hamstrings at full stretch, the hip joint flexed and knee joint fully extended. During activity, the hamstrings repeatedly develop force while at the same time being lengthened, which can lead to overstraining of the muscle fibres and subsequent injury. Along with these functional aspects of the muscle group, there are several risk factors that make a player more susceptible to a hamstring strain. Researchers have conclusively shown that AFL players over 24 years of age are four times more likely to suffer hamstring strains than players 18-23. Also, players who have sustained a
Wednesday, May 18, 2011
hamstring injury in the previous 12 months are at increased risk of another hamstring injury to the same leg. The problem with age and injury history is that they are irreversible risk factors. Other known risk factors that cannot be modified include indigenous race, though these players may be more likely to experience hamstring injuries purely due to their talent for speed. Previous injury to the calf, knee, ankle or groin can also render a player more susceptible to a hamstring injury. Research around other potential risk factors including hamstring strength, hamstring to quadriceps strength ratio, flexibility, fatigue, influence of warmup, neural tension, optimum knee angle
Inside the game 21 for peak hamstring torque and lumbar spine region pathology, among others, is inconclusive. It’s easy to get caught up in the stats around hamstring strains and to view the problem from an academic perspective; I too have been guilty of this. It’s not until you have a chat with someone who has experienced the most severe type of hamstring strain that you get a really good understanding of the impact of this type of injury, both personally and professionally. Bombers fans in particular will remember back in Round 3, 2006 when champion full forward Matthew Lloyd went down with a severe hamstring injury in the opening minutes of the third quarter against the BLACKOUT: Matthew Lloyd tries to regain his composure after a severe hamstring strain. Bulldogs at Etihad Stadium. Scans revealed that one of Lloyd’s hamstring muscles was three-quarters torn off the pelvic bone. Lloyd describes the pain of the injury being so great that he blacked out before he even hit the ground. hard as I could and I was only kicking the pilates three times a week for 12 months. “The first lead after half time, I was on ball 30 metres,” he said. When getting back into the game in 2007, a maximum speed lead and went to arch Lloyd describes his rehabilitation with Lloyd describes feeling like he was starting my body forward to get a bit more distance exercise physiologist John Quinn, the all over again. He felt like he’d never played away from my opponent,” Lloyd recalled. Bombers’ head fitness coach at the time, and was a rookie coming into the system “The ball was about a metre away from as first class. again. me as I went up for a mark and it was like I Quinn worked with him one-on-one “In the time I was out, there were a few just blacked out. around the needs of the rest of the team, rule changes, the game was quicker and “A couple of players crashed down on top but it was a long road. I probably wasn’t as explosive and wasn’t of me and I couldn’t get up off the ground, Lloyd’s rehabilitation initially focused on feeling as confident within myself,” he said. I had nausea, and thought to myself I can’t getting some movement in the leg and “I just felt like I fell right behind in the even get up off the ground, but with the basic weight bearing, followed by learning year that I didn’t play footy. help of some trainers I limped off. to walk again and slowly building up to “My pre-season was OK but I suffered the “The physio said to me I reckon it’s a jogging, running and sprinting over the tendonitis so I missed four or five weeks of corkie or something but I said no, I’m tellfollowing months. training through that as well. ing you, I blacked out through the pain About five months after the surgery Lloyd “I probably felt I was in the prime of my before the players even fell on top of me.” joined Quinn and Olympic athlete Lauren career when it happened and I went OK but No doubt a great disappointment about Hewitt performing hill running and sprints was never the same again.” this injury for Lloyd is that it could have to get some speed back into his legs. The same appears to be true for Nick been avoided had he rested after a prior This was combined with strength trainRiewoldt, who injured his hamstring in warning. ing and core strengthening work through Round 3 2010, according to a recent Herald “I feel like I might have strained my hamSun article by Mike Sheahan. string in a tackle on the half-time siren,” Sheahan documented Riewoldt’s goal he said. kicking accuracy as 61.8 per cent before “I went in at half time and did some tests and 46.2 per cent after his hamstring strain. and I said I reckon I can play at 80 per cent Research does show decreased perforand try and play out the game.” mance on return to competition after a You don’t get to champion status without hamstring strain but, of course, we canguts and determination, qualities that had not discount other factors that could be served him well, and together with his impacting on Riewoldt’s accuracy, not the athleticism and extraordinary skills, Lloyd least of which could be the likelihood of a was probably in the best form of his career recurrent hamstring injury. prior to his injury. Amid the doom and gloom around There was so much inflammation and hammy strains, there is some good news swelling in Lloyd’s leg in the days followfor players. ing his injury that he had to wait a week to The AFL injury report showed the loweven have it scanned to find out the extent est recurrence rate ever reported for these of the damage. injuries. The scan revealed a major tear in the Having been as high as 30 per cent in muscle, and surgery was performed to 2002, the 2010 recurrence rate was less repair the damage two weeks after the than half this at 14 per cent, meaning that incident. only one in seven players will experience This was the beginning of a long road to another hamstring injury to the same leg recovery for Lloyd. in the same football season. “Automatically after the operation, I Research shows that the highest proporinstantly felt better but I didn’t feel good tion (12.6 per cent) of hamstring strains about myself in the leg for probably nine will occur in the first week upon a player’s months,” he said. return to competition, but the risk of recurNineteen weeks after the initial injury, rence remains high for weeks thereafter Lloyd joined in with a skills session but and recurrent injuries can occur with more soon after during pre-season training for severe consequences for a player. season 2007, he suffered hamstring tenThe reduced recurrence rate demondonitis. strates that clubs are being more conservaWINGED EAGLE: Daniel Kerr. “I couldn’t kick, I felt like I was kicking as tive in their management of these injuries.
‘I’m telling you, I blacked out through the pain before the players even fell on top of me.’ – MATTHEW LLOYD
Inside Football
Wednesday, May 18, 2011
Coaching contracts courting challenge When it comes to a coach breaking a contract to change clubs, the legal argument may come down to restraint of trade versus ownership of intellectual capital, writes lawyer Andrew Crabb. AFTER HIS GRAND Final win last year, Collingwood coach Michael Malthouse spoke to assembled media about his admiration for the German Field Marshall Erwin Rommel, whose daring, risk-taking and aggression won him many battles in Africa in World War II against Allied forces that always outnumbered him and usually had better lines of supply. Malthouse’s words about game plans and strategy weren’t specific but referred to Collingwood’s game strategy of the “box formation”, which was based on combat formations of Roman legions. Given Malthouse was also answering questions about his club’s coaching succession plans, which have Nathan Buckley taking over next year, it is also STRATEGISTS: Mick true that, whether consciously or not, the Malthouse (above) and premiership coach was indirectly reminding the Erwin Rommel (top). Collingwood club board that ideas about strategy, which make its team more competitive, are a form of intellectual capital that Malthouse carries around in his head. Asked last year about Malthouse’s future when moved out of the senior coaching position at the end of this season, Magpie president Eddie McGuire said he was prepared to sue Malthouse if he breached his contract and went to another club. Ron Barrassi has defined the coach as a storehouse of strategic information that brings competitive value to a club in ways that a star player cannot. He says that the game of AFL evolves in ways that other coaches will always try to emulate as new strategies are developed and every team strives for competitive advantage. So the issue of Malthouse’s future and whether he might move to another club differs in ways that the transfer of a star player does not. When players change clubs, they can take only their football abilities with them; a champion coach swapping clubs can take trade strategies and secrets and commercial connections with him. After lifting Collingwood from as low as 15th in 2005 to a premier ship in 2010 and flag favourites for 2011, Malthouse is in the unenviable position of having to relinquish control at the peak of his career. But can coaches generally move to other clubs when they want to? Or could their contracts with their current club create a legal bar that prevent them being able to take a similar senior coaching job elsewhere? And if they are able to transfer to another club, what “intellectual property” can they take with them? Legally, the issue is known as “restraint of trade”, or sometimes “employment restraints”, and it’s been gathering a lot more attention in the courts around Australia recently as employers and corporations – in much the same way as football clubs – look to protect their intellectual capital and proprietary interests, and to stop former employees leaving a business and taking trade secrets, strategies, clients and, sometimes, other employees with them. In the courts, this has become more common with litigation in NSW and Victoria to enforce restraint of trade or employment agreements rising sharply from virtually no cases in the mid-1990s to an average of 12 per year. In the past, people were usually advised that non-compete clauses in their contracts could be ignored but now, as our workforce develops into more of a knowledge-based economy, the intellectual capital a former senior employee, or director, has with them when they leave is more commonly a worry that causes disputes. Restraint of trade is always an argument between the public interest to fairly protect the legitimate enforceable interests of a company (including a football club) against the public interest for fair competition in the broader market place. The example of coaches, and any potential issue about whether they will lawfully be able to break their contracts with clubs and coach elsewhere, may be a question of whether factors such as their inside knowledge of their club’s operations and playing strategies will constitute a legally enforceable proprietary interest of the club, or whether it is just a question of the coach’s skill supported by his ability to inspire players. With the recent $1.2 billion broadcasting rights deal it’s clear that, as professional sports like AFL become more lucrative, we will see an increase in legal disputes over vital senior positions. n Andrew Crabb is a solicitor with the law firm Taylor & Scott.