The AFL today released the 2013 Injury Survey, tracking injury incidence, prevalence and recurrence rates across the AFL competition as part of its annual survey for a world-leading 22nd consecutive year.

As a key part of the findings from report authors Associate Professor John Orchard and Dr Hugh Seward, it was found that eight of the 23 ACL reconstructions in 2013 were re-injuries from graft failure. Three of the eight injuries were LARS ligament grafts and the overall eight re-injuries represented a high failure rate which warranted further analysis.

The rate of ACL injury in 2013 was again far higher in pre-season and early rounds, compared to the winter months, while northern AFL teams tend to have slightly higher rates of ACL injury than southern AFL teams.

Further, the report authors stated in their executive summary that there were increases in overall injury incidence, prevalence and recurrence rates for the 2013 season, but no significant statistical change in the three year-period 2011-2013, compared to the previous three-year period covering 2008-10.

"There was a statistically-significant increase in both injury incidence and prevalence over the years 2008-2013 (“High interchange era”) compared to the years 2002-2007 (“Low interchange era”)," the report stated.

"Hamstring strains are still the number one injury in the game in terms of both incidence and prevalence (missed games)."

It was found that hamstring and groin injury incidence and prevalence in the three-year period 2011-2013 (since the introduction of the substitute rule) were both significantly lower than the previous three-year period 2008-2010 but, in contrast, calf, knee tendon and other leg/foot/ankle injury incidence and prevalence were significantly higher in the recent three-year period 2011-2013 compared to 2008-2010.

The AFL injury results were presented to the AFL Medical Officers' Association this week and authors Associate Professor John Orchard and Dr Hugh Seward said they wished to again thank all clubs for their continued full participation in the survey.

AFL General Manager Football Operations Mark Evans thanked Dr Seward and Associate Professor Orchard for their ongoing work, which will direct the AFL's thoughts in how to continue to invest money in injury research for the wider beneft of both the AFL competition and the game at all levels, including junior football.

“The AFL remains fully committed to the best interests of player health and welfare and the annual injury survey is a vital tool to address injury concerns and how to address trends within the game.

"This survey is another way the AFL looks at our primary goal of ensuring the game is safe to play and that our players have the best possible treatment and support when returning from any injury, while also providing real data for us to consider as part of the debates of rule changes that may be necessary to improve player safety across all levels of our game for both adults and children," he said.

In 2013, an 'average club list' of 46 players would now expect to have 8.2 players missing due to injury in any given week, compared to recent year totals of 7.8 players in 2012 and 8.4 players for the 2011 year.

Dr Seward said 2013 data suggested a more conservative approach to concussion management under the new guidelines, writing 'the years 2011-13 had an increase in incidence of concussion compared to the nine previous years of the injury survey, even though the incidence was still low ... on average 1 player per club missing games each year due to concussion', the report said.

"Concussion has been a major injury concern for all sports in recent years with further understanding that there is a possible link between concussions suffered in sport and neurodegenerative conditions in later life. Reflecting these concerns, the AFL and AFLDA introduced revised Concussion Management Guidelines at the beginning of the 2011 and 2013 seasons that reinforced a more conservative approach to concussion management."

Dr Orchard said hamstring injuries had been reduced in recent seasons but clearly remained the leading injury in the game.

"It is possible (although a difficult hypothesis to test) that AFL clubs have successfully implemented prevention regimes for the most common injuries (i.e. hamstring and groin injuries) but have not devoted as much specific preventive work towards less common injuries (e.g. calf injuries)," the report said.

"It is also worth noting that the recurrence rate for hamstring injuries in 2013 was, at 24%, higher than recent years, but still well below the recurrence rates seen in the 1990s."

A full pdf copy of the final report is available via return email on request.