Use of rule changes to reduce injury in the Australian Football League

AIM: Injuries are common in all professional football codes (including soccer, rugby league and union, American football, Gaelic Football and Australian football). The aim of the present study was to assess the potential effect that rule changes can have on injuries in professional football. METHODS: The Australian Football League (AFL) conducts an annual audit of injuries and makes regular rule changes on a semi-annual basis. An injury was defined as “any physical or medical condition that causes a player to miss a match in the regular season or finals” with ongoing records kept and publicly released over the decade 2004-2013. RESULTS: Over the ten years from 2004-2013, the AFL Commission made 26 rule changes, of which eight were considered to have potential impact on injury rates. The 2005 centre circle rule has significantly reduced rates of posterior cruciate ligament (PCL) injury in ruckmen. The rates of head and neck injuries dropped after initial rule changes, but rates of concussion and other head and neck injuries have increased since 2011, since a rule change that players could not re-enter the game after suffering concussion. Rates of hamstring and groin injuries have significantly fallen since the substitute rule was instituted in 2011, but rates of other lower limb injuries have risen over the same time period. CONCLUSION: Rule changes have, in some instances, had a beneficial effect on the rates of specific injuries over the last decade. However, the overall injury incidence in the AFL has not fallen, possibly because of a concurrent background increase in the speed of player movement across the decade. The AFL is in a fortunate position of being able to easily institute rule changes as it is the peak body of the sport which does not have to consider international competitions. The well established annual injury survey is able to monitor the effects of any rule changes on injury rates in a timely manner