Jordan Stares1, Brian Dawson2, Peter Peeling3, Michael Drew4, Jarryd Heasman5, Brent Rogalski5, Marcus Colby2. 1. Sport Science, Exercise and Health, School of Human Sciences, The University of Western Australia, Australia; West Coast Eagles Football Club, Australia. Electronic address: jordans@westcoasteagles.com.au. 2. Sport Science, Exercise and Health, School of Human Sciences, The University of Western Australia, Australia; West Coast Eagles Football Club, Australia. 3. Sport Science, Exercise and Health, School of Human Sciences, The University of Western Australia, Australia; Western Australian Institute of Sport, Australia. 4. Department of Physical Therapies, Australian Institute of Sport, Australia; Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Australia. 5. West Coast Eagles Football Club, Australia.
Abstract
OBJECTIVES: Examine the influence of rehabilitation training loads on return to play (RTP) time and subsequent injury in elite Australian footballers. DESIGN: Prospective cohort study. METHODS: Internal (sessional rating of perceived exertion: sRPE) and external (distance, sprint distance) workload and lower limb non-contact muscle injury data was collected from 58 players over 5 seasons. Rehabilitation periods were analysed for running workloads and time spent in 3 rehabilitation stages (1: off-legs training, 2: non-football running, 3: group football training) was calculated. Multi-level survival analyses with random effects accounting for player and season were performed. Hazard ratios (HR) and 95% confidence intervals (CI) for each variable were produced for RTP time and time to subsequent injury. RESULTS: Of 85 lower limb muscle injuries, 70 were rehabilitated to RTP, with 30 cases of subsequent injury recorded (recurrence rate=11.8%, new site injury rate=31.4%). Completion of high rehabilitation workloads delayed RTP (distance: >49,775m [reference: 34,613-49,775m]: HR 0.12, 95%CI 0.04-0.36, sRPE: >1266AU [reference: 852-1266AU]: HR 0.09, 95%CI 0.03-0.32). Return to running within 4days increased subsequent injury risk (3-4days [reference: 5-6 days]: HR 25.88, 95%CI 2.06-324.4). Attaining moderate-high sprint distance (427-710m) was protective against subsequent injury (154-426m: [reference: 427-710m]: HR 37.41, 95%CI 2.70-518.64). CONCLUSIONS: Training load monitoring can inform player rehabilitation programs. Higher rehabilitation training loads delayed RTP; however, moderate-high sprint running loads can protect against subsequent injury. Shared-decision making regarding RTP should include accumulated training loads and consider the trade-off between expedited RTP and lower subsequent injury risk.
OBJECTIVES: Examine the influence of rehabilitation training loads on return to play (RTP) time and subsequent injury in elite Australian footballers. DESIGN: Prospective cohort study. METHODS: Internal (sessional rating of perceived exertion: sRPE) and external (distance, sprint distance) workload and lower limb non-contact muscle injury data was collected from 58 players over 5 seasons. Rehabilitation periods were analysed for running workloads and time spent in 3 rehabilitation stages (1: off-legs training, 2: non-football running, 3: group football training) was calculated. Multi-level survival analyses with random effects accounting for player and season were performed. Hazard ratios (HR) and 95% confidence intervals (CI) for each variable were produced for RTP time and time to subsequent injury. RESULTS: Of 85 lower limb muscle injuries, 70 were rehabilitated to RTP, with 30 cases of subsequent injury recorded (recurrence rate=11.8%, new site injury rate=31.4%). Completion of high rehabilitation workloads delayed RTP (distance: >49,775m [reference: 34,613-49,775m]: HR 0.12, 95%CI 0.04-0.36, sRPE: >1266AU [reference: 852-1266AU]: HR 0.09, 95%CI 0.03-0.32). Return to running within 4days increased subsequent injury risk (3-4days [reference: 5-6 days]: HR 25.88, 95%CI 2.06-324.4). Attaining moderate-high sprint distance (427-710m) was protective against subsequent injury (154-426m: [reference: 427-710m]: HR 37.41, 95%CI 2.70-518.64). CONCLUSIONS: Training load monitoring can inform player rehabilitation programs. Higher rehabilitation training loads delayed RTP; however, moderate-high sprint running loads can protect against subsequent injury. Shared-decision making regarding RTP should include accumulated training loads and consider the trade-off between expedited RTP and lower subsequent injury risk.
Authors: Gordon Dunlop; Clare L Ardern; Thor Einar Andersen; Colin Lewin; Gregory Dupont; Ben Ashworth; Gary O'Driscoll; Andrew Rolls; Susan Brown; Alan McCall Journal: Sports Med Date: 2020-04 Impact factor: 11.136
Authors: Rodney Whiteley; Andrew Massey; Tim Gabbett; Peter Blanch; Matthew Cameron; Greta Conlan; Matthew Ford; Morgan Williams Journal: Sports Health Date: 2020-11-05 Impact factor: 3.843