Underprepared & under-resourced; WAFL’s ACL Gamble

The argument I have heard is that the women competing in the WALF are under-equipped & have been thrust into elite sport for our entertainment. Whether you agree or not there may be some truth to that statement.

The fact are female athletes are at a greater risk of ACL injuries. To be precise about it, the evidence tells us its eight times more likely than men actually. 1   This partially explains why we’ve seen four ACL injuries in the first 4 weeks (not including the 2 in pre-season) of the inaugural Women’s AFL competition. The actual injury equation has a bunch of moving parts such as:

  • Narrower intercondylar notch and smaller ACL
  • Wider pelvis (Child bearing & Q angle) 1
  • More lax ligaments1
  • Slower reflex time
  • Greater Quadriceps/Hamstring Strength Ratio 2,3
  • Changes in estrogen levels 4
  • Flat-footed/landing & agility mechanics1
  • Age
  • Previous Injury
  • Non Contact v Contact
  • Physical Preparation
  • Time of the season

A number of athletes in the competition have come from many different sporting backgrounds & simply aren’t used to the stressed a game of evasion places on the joints. A majority of the differences above (bolded) are anatomical/biological & can’t be side skirted. We also know according to Orchard et al. 2006 there is an increase in ACL injuries in the warmer month where the grass has a greater resistance producing more torque at the knee joint. So here’s to hoping the rate of 1 per week for the women’s competition settles down as the season progresses.

So lets focus on what we can control:

The argument is always raised that elite players will always have to live on the knife’s edge of season/career ending injuries. There is some truth to this statement. You can prepare all you want but if you have a direct external blow/force (read 120kg prop) impact your knee (or Andrew Bogut’s tibia) at the wrong angle, your ACL/bone simply wont remain in tact.

However, if we look at teams such as the QLD Firebirds under strength & conditioning coach Bryn Abad he regularly informs me they had zero ACL injuries in a game that is commonly albeit jokingly described as “the sport designed by orthopaedic surgeons”.  He contributes this to the specific approach they took to managing players hip complexes for ACL safe guarding. Further to that the Australian Women’s Gold Medalist Rugby 7’s team to my knowledge have only had one member (Gemma Etheridge) with an ACL injury.

What we can all agree on is that a gym-based approach is not just for male athletes. So let’s get away from the sexist approach that women shouldn’t be in the gym training like athletes. A well prepared & implemented strength & conditioning programme that has a focus on strength, power & speed can be the best offence against an ACL tear. Lift heavy, run fast, jump, land properly, change direction effectively, mobilise the hips, develop the glutes, condition, teach skills & recovery.

From a strength & conditioning or science view point, ACL rupture incidence is increased during the ovulatory phase of the menstrual cycle, when estrogen levels are most elevated.5  While no male team strength & conditioning coach has ever had to deal with this perhaps there is some merit is personalising female athletes programmes around their cycle.

Where to from here;

Nat Medhurst of netball fame was quoted as highlighting that it took the national netball competition years to create their athletes from regular women into the elite players they are now. I totally agree but at what cost?

WAFL Crows Co Captain Erin Philips said:

“I look forward to our future where our hips are not to blame for injuries”.

What I hope Erin realises is her hips will always be a factor but if the AFL reacts quickly the damage can be drastically controlled.

AFL boss Gill McLachlan on ACL injuries said,

“I think that it will be mitigated when the women have a second year of conditioning and are better able to deal with it”

While this is true Gill, you’ve essentially thrown the women into the lion’s den & those that survive will be better for the experience for future seasons. Those that don’t literally may never play again. Unless the AFL steps up to the plate it’s not going to get better. The AFL must invest in the female athletes.

If that means finding an extra $50k per year, per team for a dedicated strength & conditioning programme, so be it. With such great crowds turning out to support, reinvesting every cent of that into a programme to keep the quality high, marquee players & part time athletes on the field shouldn’t be rocket science.