It was professional footballer Brooke Patterson's love of sport that first drew her to the profession of physiotherapy, which has now enabled her to merge her two loves via a Physiotherapy Research Foundation grant.

"I was an injured kid growing up doing too many different sports, going in too hard, which is why I was probably always destined for AFL, and hence spent some time getting to know the local physiotherapist," says Ms Patterson, a La Trobe University PhD student, who also plays for the Melbourne Demons, one of the pioneering clubs of the AFLW.

"I love having the ability to help people to get the most out of life, and continue doing the things they enjoy, whether it be sport, work, playing with their grandchildren, or being able to be independent in their daily activities."    
  
The Beryl Haynes Memorial Fund Grant from the Physiotherapy Research Foundation enabled Ms Patterson to conduct a project which investigated anterior cruciate ligament reconstructed patients at 12 months with persistent symptoms, or strength or functional deficits.

"We wanted to know if providing them with additional physiotherapy, for 3 months, could improve their function, symptoms, and quality of life.

"Whilst the project was a pilot, conducted on a small number of participants, the preliminary results are promising and have been valuable in guiding future projects."

Anterior cruciate ligament (ACL) is one of most important ligaments in the knee for stability.  When injured it usually means it is completely torn, or at least a partial tear, where some fibres are still attached.

"Usually there will be a notable event which it occurred, associated with significant pain, and the knee will give way with putting weight on it, or if the player tries to continue to play."

Which is why it's of particular interest to Ms Patterson, with this type of injury particularly common among AFLW players.

"AFL is one of the highest risk sports for ACL injury, coming second only to skiing in previous analysis of all high risk sports," says Ms Patterson.

"Australia has one of the highest rates of ACL reconstruction, likely due to participation in many high risk sports, and AFL and netball are somewhat unique to our country.

At an AFL elite level the average for male clubs is 1 player per club per season will suffer an ACL injury.

In AFLW, although this rate is the same, there has only been one season, and the season is 7 weeks compared to 23 weeks.

"A community level female player who trains 3 times per week is at a 5% risk of suffering an ACL injury, compared to 1.7% in males."

Ms Patterson says it’s important for sporting bodies such as the AFL, physiotherapists and researchers to continue to reduce and manage these injuries across all levels of participation.

"There are many factors that may be contributing to ACL injuries in AFLW, and it would be impossible to be able to pinpoint which ones are responsible.

"I think it is important for us not to dwell on these things and to focus on things that we can control."

A project in which La Trobe University and the AFL began following season 1 of AFLW, involved a review of the evidence of what best practice for injury prevention was in female contact sports, and consultation with participating clubs as to what their practices were.

"AFLW clubs are implementing all the components of an injury prevention program. The main barrier identified in AFLW is time for the athletes to dedicate to their preparation and strength programs.”

"Where I think both female and male injury prevention could be improved is the sports medicine team and coaches working more closely; that is transferring the movement patterns and footwork  into football specific skills."

"Injuries will continue to be a part of AFLW and ACL injury rates in AFLW are similar to that of other high risk female elite sports. Where these injury prevention programs can have the greatest impact is where they are not being done - at a community level”

Ms Patterson says reinjury rates, especially in young athletes, also needs to be addressed.

"Work by Professor Kate Webster has shown approximately one in three under the age of 25 will re-injure the ACL or incur an ACL injury on the other limb in the first 2-years, and the outcomes after this are much worse.

"As physiotherapists, researchers, coaches and athletes we need to continue to understand the criteria required for successful return to sport from such a significant injury."

As a professional athlete, Ms Patterson said it was fantastic to not only have the opportunity to research this area, but to also use her knowledge of the evidence, experience as a physiotherapist, footballer, and (aspiring) coach to be able to make a difference to the community.

"I think it is really important to be able to empower coaches, athletes and clubs to be able to be confident and independent in injury prevention and management practices, as this will mean more people getting or staying involved in sport, being physically active and healthy."