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Characterising Anterior Cruciate Ligament (ACL) Injury Situations in the Women’s Australian Football League (AFLW)

      Background: An early trend from the Women’s Australian Football League (AFLW) is the high rate of anterior cruciate ligament (ACL) injuries. AFLW players are up to nine times more likely to suffer an ACL injury compared to male Australian Football League players. Considering the significant short- and long- term consequences following ACL injuries the alarming rate of these injuries must be addressed in the AFLW. Understanding injuries within their sporting context is important to develop effective injury prevention strategies, yet there is currently little knowledge of how ACL injuries occur to AFLW players. This study determined the common scenarios and characteristics of ACL injuries in the AFLW.
      Methods: A video analysis of 21 ACL injuries from the 2017 to 2020 AFLW seasons was performed. The analysis examined the match situation, and the player’s movements and body postures surrounding the injury. The frequency (i.e.n) and relative proportions (i.e.%) were determined for each characteristic. Relative odds (RO) were calculated to determine the relative probabilities of ACL injuries occurring with specific characteristics.
      Results: Non-contact ACL injuries were frequently observed (n=13, 61.9%). The most common match situation was direct defence (i.e. defending an opponent in possession) (n=14, 66.7%). Sidestep cutting was the most common manoeuvre (n=11, 52.4%), with this commonly paired with applying defensive pressure (n=6 of 11, 54.6%). An extended knee (n=18, 85.7%) and valgus collapse (n=17, 81.0%) were present in nearly all injuries. ACL injuries were more likely to occur with a unilateral compared to bilateral asymmetric landing (RO=5.3 [1.7, 12.9 95% CI’s] and a rear- compared to a mid- or fore-foot footfall (RO=4.5 [1.4, 10.9 95% CI’s]; RO=8.52 [1.80, 23.60 95% CI’s]).
      Discussion: Sidestep cutting manoeuvres when applying defensive pressure was the most common ACL injury scenario observed. Consistent with existing research, an extended knee and valgus collapse were prominent knee postures during ACL injuries. AFLW players may benefit from injury prevention programs incorporating agility-based training. Specifically, drills undertaken in defensive scenarios requiring a player to execute a sidestep cutting manoeuvre in response to an opposition player’s movement. This may result in safer and more desirable lower limb postures being implemented during the most common AFLW ACL injury scenario.
      Conflict of interest statement: My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this abstract.