Australian Football is one of the most popular sports in Australia – with 581,000 registered community-level participants nationwide in 2024 with an increasing proportion of women and girls.

Australian Football is a contact sport that may result in injuries from running, changing direction, tackling, kicking, and constant competition for the ball on the ground and in the air.

How many injuries?

• In 2021/22, 4718 people were admitted to emergency departments/hospitals across Australia for Australian Football-related injuries.
• Approximately one-in-four senior and older junior (U16-U18) players will have an injury during the season.^{1 2} Injury rates in younger players are lower^{3 6}, particularly in Auskick.
• Anterior cruciate ligament (ACL) injuries and concussion are significant injuries in Australian Football. Injury prevention programs and player education (e.g. importance of reporting potential concussion symptoms after a head impact) are important.
  • Concussion is one of the most common injuries. Like any injury, there is a risk of ongoing or future health problems. Senior and older junior (U16-U18) teams can expect approximately one concussion per team per season. ^{2 4} Concussion is less common in younger age-groups due to modified contact rules (U8/9/10).
  • The Management of Sports-Related Concussion in Australian Football (2024) guidelines outlines the steps in the initial management of a suspected concussion and the stages for return to training/matches following concussion including a minimum 21 days before returning to play.
  • ACL injuries are less common (less than 5% of players have experienced an ACL injury)^{1 5}. However, players miss at least a full season (or do not return at all) and there is a risk of future health problems such as osteoarthritis⁶.

Types, mechanisms and causes of injuries

The most common injuries are concussion, knee, ankle, and arm/hand injuries^{1 2}

The cause of injury is likely due to a combination of factors, but previous injury is the biggest risk factor for any future injury in all sports. It is important that after any injury players are fully rehabilitated before returning to play. All players should participate in ongoing exercise-based injury prevention programs.

Exercise-based injury prevention programs

All players, regardless of sport, age, sex/gender and competition-level should participate in injury prevention programs. These programs include a warm-up and strengthening and are used across many sports (e.g. soccer Perform+, netball KNEE program, rugby Activate, basketball/hockey/volleyball: SHRED injuries programs). They can reduce lower and upper limb injuries by up to 40-60%, when used for at least 10 minutes, twice weekly, regularly throughout the season. ^{4, 8-12}

Prep-to-Play is an Australian Football specific injury prevention program for elite (Prep-to-Play PRO) and community players, co-designed by injury prevention experts at La Trobe University with the AFL, coaches, players, and health/medical experts across the world.^{4, 13-16}  It is effective in women and U16-U18 girls⁴, and similar programs are effective (Footy First) in men’s/boys’ Australian Football. Since Prep-to-Play PRO was introduced in AFLW and professionalism has increased, ACL injury rates have reduced.

• Complete the 10-minute Prep-to-Play warm up — running, agility, jumping, landing, single leg balance, and contact activities.
• Strength over stretch — complete the three Prep-to-Play strength activities (no equipment required) instead of static stretching or a cool down lap at the end of training.
• Practice the Prep-to-Play contact skills — educate players on and practice safe technique and execution of tackling, being tackled, ground ball and aerial contests.
• You don’t need to be a health professional to use Prep-to-Play. It is easy and safe for coaches, players, parents, or trainers to use.⁴

Contact [email protected] if you require support at your club. Onsite workshops can increase coaches’ and players’ ability to use these programs¹⁰, including Prep-to-Play.⁴

Concussion-specific prevention and management

Players, parents, coaches, trainers, and clubs have a duty of care to implement best practice concussion management and prevention.

• View the Management of Sports-Related Concussion in Australian Football (2024) guidelines. The guidelines outline the steps in the initial management of a suspected concussion and the stages for return to training/matches following concussion.
• Any player who has suffered a concussion or is suspected of having a concussion must NOT be allowed to return to play in the same match or training session.
• In following the guidelines, the earliest that a community-level player may return to matches is on the 21st day following the concussion (where the day of concussion is designated day “0”).  They must complete a graded loading program, which includes being symptom free for 14 days and have a clearance from a medical practitioner before returning to full contact training. Further details on the return to play process can be found on https://play.afl/concussion
• Share this webinar Practical Guide to Concussion Management and view the AFL’s concussion resources and educational tools here: https://play.afl/concussion
• Strategies to reduce the risk of concussion may include the Prep-to-Play contact skills^{4 15}, and educating players about their duty of care to protect themselves and their opponents.
• Additional resources to help improve players’ contact skills may include the AFL’s Coach Tackling Curriculum. Coaching resources such as the Youth Coaching Currciculum and RM Coach (library of training activities, tools)

General injury and illness prevention strategies

• Ideally complete at least 4 weeks pre-season training. If going on a break/holiday, maintain regular physical activity (e.g. running, strength training). Before playing competitively, undertake training sessions to learn, practise and use correct skills and techniques, and to gain appropriate fitness and confidence.
• Avoid drinking alcohol 48 hours before a game. To optimise recovery, avoid drinking alcohol after a game.
• For female athletes, there are specific health considerations, such as menstrual, pelvic, and breast health. Direct athletes, parents and support staff to the AIS Female Performance & Health Initiative education modules

Equipment and environment

• Wear a mouthguard, preferably custom-fitted, at all times to prevent facial and dental injuries¹⁶. In partnership with the Australian Dental Association, SMA have developed a Mouthguard Policy that clubs can choose to sign up to, providing clubs advice on how to reduce the risk of dental trauma.
• Ankle braces or taping could be used to prevent ankle sprain reinjury⁹.
• Wear appropriate footwear. Seek professional advice about the most appropriate boots to wear for playing conditions.
• Provide a safe and inclusive environment. Check the ground to remove or cover hazardous objects e.g. broken glass or sprinkler heads, padded covers on goalposts. Check the AFL match day procedure checklists.
• Wear sunscreen and re-apply during breaks on sunny days.
• There is no evidence that currently available soft-padded headgear/helmets can prevent concussion or head impacts in Australian Football.¹⁷

Rules

• Play fair. Be aware of game rules, and respect opponents and umpiring decisions.
• Umpires should enforce game rules at all levels. Games for children and teenagers (U8 through to U18) should be played in accordance with the AFL Junior Rules Program Handbook.  

If an injury occurs

• Players should seek prompt attention from qualified first aid personnel.
• A healthcare practitioner should decide whether an injured player can return to the field.
• Ensure players are fully rehabilitated before returning to play after injury.

For further information

www.play.afl

Acknowledgments

This fact sheet was developed by Dr Brooke Patterson, Dr Andrea Bruder, and Dr Sallie Cowan (HER Sport Research Team, La Trobe University Sport and Exercise Medicine Research Centre), The content endorsed by the Australian Football League.

References

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5. Webster KE et al. Open Access J Sports Med 2021 doi: 10.2147/OAJSM.S250414
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