In season shoulder instability episodes in professional Australian Rules football

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variables it was possible to correctly classify 72% of the players into the injury and non injury groups. These results suggest that reduced range of hip and ankle motion may adversely affect the lower kinetic chain. In contrast, the excessive motion in the foot and through the thoracic region may represent an adaptation to reduced motion in other regions. These results also provide direction for rehabilitation programs designed to reduce injury and provide a means for monitoring the physical status of cricket athletes over the course of a season. doi:10.1016/j.jsams.2009.10.092 92 Groin pain and hip range of motion is different in Indigenous compared to non-Indigenous young Australian football players C. Taylor 1,2,∗ , J. Cook 2 , T. Pizzari 1 , N. Ames 3,4 , T. Wood 5 , B. Gabbe 6 , M. Makdissi 7 , E. Scase 8 , J. McNeil 6 , J. Orchard 9 1 School

of Physiotherapy, LaTrobe University and Nutritional Sciences, Deakin University 3 AIS-AFL Academy 4 Geelong Football Club 5 AFL Medical Officers Association 6 Epidemiology and Preventive Medicine, Monash University 7 Centre for Health, Exercise and Sports Medicine, University of Melbourne 8 Australian Institute of Sport 9 School of Public Health, University of Sydney 2 Exercise

Introduction: Anecdotally, Indigenous (I) Australian football (AF) players are more likely to suffer from soft tissue injuries compared with their non-Indigenous (non-I) teammates, and there is some evidence that being of Aboriginal descent is associated with an increased risk of hamstring injury. The current study aimed to investigate if standard hip and groin screening tests would reveal differences between Indigenous and non-Indigenous players. Methods: Two hundred and seventy elite junior Australian football players at the Under 16 National Championships and AFL Draft Camp were screened using a battery of musculoskeletal tests. The following hip and groin tests were undertaken: supine passive hip internal rotation at 90◦ , supine active hip internal rotation and external rotation in neutral, prone passive hip internal rotation, adductor squeeze test at 90◦ and 0◦ knee flexion (measuring pressure (mmHg) and pain rating (1–10)). Results: Thirty three players (12%) were Indigenous and of these players, 58% (n = 19) played in the Northern Territory. Independent groups t-test, Mann–Whitney U and Person Chi-Square tests comparing means and rankings of the Indigenous group to the non-Indigenous group demonstrated significant differences between the two groups

for right prone hip internal rotation (I X = 27.60 ± 9.16, non-I X = 33.39 ± 8.88, p = .00) and left prone hip internal rotation (I X = 25.83 ± 10.25, non-I X = 31.36 ± 8.75, p = .00), pressure on squeeze test with knees at 90◦ (I X = 165.71 ± 40.32, non-I X = 188.17 ± 62.32 p = .001) and pressure on squeeze tests with knees at 0◦ (I X = 172.57 ± 35.98, non-I X = 202.57 ± 49.14 p = .049), and pain provocation during squeeze test with knees at 90◦ (I X = 3.19 ± 2.26, non-I X = 1.03 ± 1.78). There were no significant differences between groups for supine passive hip internal rotation at 90◦ , or supine active hip internal and external rotation in neutral. Conclusion: The Indigenous players screened displayed significantly less range of hip passive hip internal rotation with the hip in neutral, reduced adductor squeeze force and higher levels of groin pain with the squeeze test at 90◦ . The differences observed between Indigenous and nonIndigenous players may indicate that the Indigenous players are at greater risk of hip and groin injuries in AF. This increased risk may be a result of training, playing, environmental or genetic differences between the groups. Based on this preliminary evidence, young Indigenous players should be screened and managed for hip and groin injury. Further research is needed to confirm if Indigenous players are more at risk during senior football. doi:10.1016/j.jsams.2009.10.093 93 In season shoulder instability episodes in professional Australian Rules football P. Jarman 1,∗ , G. Hoy 1,2 1 Australian 2 Melbourne

Orthopaedic Association Orthopaedic Group

Introduction: It has been well documented that the natural history of shoulder dislocation is to encounter further shoulder instability, especially in the young male playing a contact sport. Further, it has been documented that glenohumeral arthritis is a consequence of repeated shoulder dislocation in a third of more of cases. Australian Rules Football is the dominant winter sport at a national level. It is also unique in being a largely overhead, contact sport. We present an audit of in-season shoulder instability at AFL Level. We sought to determine the true incidence of shoulder instability injuries (including non-dislocation instability episodes) at 15 of 16 AFL clubs during season 2007. Method: We contacted all participating team doctors weekly to determine the cases of shoulder instability and dislocation episodes. We prospectively followed players who returned to elite level football following treatment, profiling performance after return to play post therapy. We compared their pre injury performance indicators to their performance after their return, and that of the following season.

Abstracts / Journal of Science and Medicine in Sport 12 (2010) e1–e232

Results: We present a catalogue of injuries sustained, surgical and non-surgical treatment modalities utilised, and the amount of training and game time lost. We also present data on specific performance criteria after return. We believe this is a unique study regarding this population of athletes. Firstly we catalogued twice the number of injuries per team as the AFL injury register; this may have been due to contemporaneous reporting. However we did not detect an increase in numbers of games lost. The injuries occurred across a wide range of players from rookies to 200-gamers. We determined 30 players with injuries, of whom 11 had dislocations rather than subluxations. The dislocators accounted for >90% of games lost. We were unable to make conclusions to tackles and contested marks, as these totals were too low in the player population as a whole. However only 2 players who sustained instability episodes were in the top 35 of these categories for the season. Discussion: Shoulder instability may be an underreported condition in the AFL via the current reporting mechanism. Players that sustain dislocation rather than subluxation of the shoulder joint are far more likely to miss matches. The modern style of AFL focuses on a possession game rather than contested football. This may allow the patient sustaining a shoulder subluxation to continue playing throughout the season. However the modern athlete needs to be counselled as to the natural history of the condition and the role of reconstructive surgery due to the potential for arthritis. doi:10.1016/j.jsams.2009.10.094 94 The effects of mild electro-stimulation on elite Australian Rules football players throughout a 14 day altitude training camp J. Crow ∗ , D. Buttifant, G. Nicholls Collingwood Football Club Purpose: Altitude training has been well presented in the literature to induce a catabolic physiological response leading to exercise-induced muscle damage. It has been suggested that the use of mild electro-stimulation may decrease inflammation and help accelerate recovery following exercise-induced muscle damage. Methodology: Twenty-one elite Australian Rules football players attended a 14-day altitude training camp and were assigned into two groups. This consisted of a control (n = 10)andan intervention (n = 11) group. The intervention group were provided with portable mild electro-stimulation units and educated about their use based on protocols recommended by the manufacturer. This included daily use on the camp and in-flight protocols for air travel. All players completed the same training and group recovery activities throughout the camp. Players completed daily diary responses, which the players were familiar with before the

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camp, relating to perceived muscle soreness, energy levels, mental state, subjective range of movement and sleep quality. Player heart rate was also recorded on a daily basis. Results: No differences between the control and intervention group were seen in terms of age, weight or skinfolds (p > 0.05), although the intervention group was taller than the control group (p < 0.05). The intervention group reported lower levels of perceived muscle soreness than the control group (p < 0.05). There were no significant differences between groups on any other variables. Conclusion: The use of mild electro-stimulation throughout a 14-day altitude training camp reduced levels of perceived muscle soreness in a group of elite Australian Football players. Study of the mechanisms of this effect are outside the scope of this study and may warrant further research. doi:10.1016/j.jsams.2009.10.095 95 Adventure race medicine - provision of medical support for an adventure race R. Newsham-West 1,∗ , J. Marley 2 , A. Schneiders 2 , A. Grey 3 1 School of Physiotherapy and Exercise Science, Griffith Uni-

versity 2 School of Physiotherapy, University of Otago, New Zealand 3 Department of Preventative and Social Medicine, University of Otago, New Zealand Introduction: Adventure racing (AR) is a wilderness multisport endurance event with the potential for significant injury and illness. Despite its increase in popularity, the medical and health implications of participation in AR have not been extensively studied. Consequently there is relatively little literature or formal guidelines to assist in the development of medical support for AR races. Methodology: This paper explores the results of a prospective cross-sectional study that recorded pre-, in- and post-race injury and illness incidence in 184 adventure race athletes competing in an expedition-length World Championship. The findings are compared with previously reported injury and illness profiles in AR in order to provide information to allied health professionals providing medical coverage for such an event. Results: Fifty-nine cases of injury or illness were recorded during the race; representing an overall rate of 2.5 injuries per 1000 race-hours and 1.0 illnesses per 1000 race h. Two competitors required air evacuation for medical attention. Respiratory conditions were the single-most common condition resulting in race withdrawal and the most common illness (52%) recorded during the race. During the race the lower limb was the most frequently injured region; the majority of these injuries were blisters or bullae to the feet, which