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Sports safety under scrutiny

March 14, 2001

The ADF should implement a physical fitness and sport safety strategy to increase health and reduce related injuries in personnel, according to a report commissioned by Defence.

The report, by Monash University's Accident Research Centre, says the expected benefits of personnel increasing safe participation in fitness include 'a realistic estimate of reduction of injuries of 25 per cent per annum' or a decrease in 51.6 injuries for every 10,000 personnel each week.

The Defence Health Service commissioned the report, Strategic Direction and Advice For Increasing Safe Participation In Physical Activity In The Australian Defence Force, last year as a result of substantial increases in the cost of invalidity retirement and compensation claims caused by injuries.

It says it is essential to establish 'which particular sporting and physical activities are associated with the greatest health benefits and the least health costs for the ADF'.

'Promotion of vigorous exercise needs to be accompanied by explicit, evidence-based strategies to promote safe participation.'

Captain Jenny Firman, RAN, Director Preventive Health, said the study was commissioned to see where the ADF could make the best interventions to prevent sport and physical training injury.

'For some time now we've been collecting data about rates of injuries from sport and physical training that made us realise that we needed to make some changes in that area,' she said.

'The most obvious way to reduce injuries from those two areas is not to do them - but that is fundamentally incompatible with lots of good things that come from exercise and sport.'

The report says the major cause of injury associated with physical activity in ADF personnel is 'Physical Training which accounts for more than three times the number of casualties than other specific activities'.

PT accounted for 14.3 per cent of total casualties among full-time ADF personnel with four sports - rugby union, rugby league, touch football and soccer - ranked among the 10 leading causes of casualties and Work Days Lost (WDL).

Other sports prominent in the ranked list of casualty-producing physical activities associated with significant proportions of WDL were:

o Running and jogging (2 per cent of all casualties).

o Australian football (1.9 per cent).

o Basketball and netball (1.8 per cent).

o Volleyball, which was ranked among the top 15 physical activities associate with WDL.

It found that the most common injuries were strains and sprains followed by muscle, tendon and soft tissue injuries, except for rugby and soccer where fractures were more common. The major injury sites were the knee, ankle and shoulder.

Injuries during PT accounted for the highest loss of working days, days of hospitalisation, sick days and light duty days.

Most moderate or severe injuries tended to occur during the first two weeks of training.

'The ADF culture of strong competitiveness in sport results in a substantial loss of personnel working capacity due to injury,' the report says.

The report recommended three overall strategies to prevent injury and increase participation in physical activity through implementation in a nine-step ADF Action Plan:

o Injury surveillance. Collect data on activity specific participation rates and exposure levels for physical activities with high-injury frequency and high WDL to identify priorities for injury prevention.

Current injury surveillance systems should also be refined to improve information on cause and circumstances of injuries.

o Strategic research. This would focus on high-risk groups and environments with the largest impact on readiness. It would include more than basic training, infantry and special forces.

Other research would study risk and protective factors and the incidence of injury, the maintenance of fitness after basic training and the cost effectiveness of injury prevention.

o Injury prevention implementation and evaluation. A trial of modified military (basic) training incorporating a smooth progression in intensity, duration and frequency should be conducted.

This could include: trials of pre-selection screening of recruits for injury-risk factors; interval training versus continuous training; modified risk factors for female recruit training; equipment design and use; strength training and effects on injury reduction; deep water running as a substitute for running.

CAPT Firman said the most important finding was that all the work the ADF had done up until the time of the report indicated that it was on the right path.

'The other is that, rather than stopping sport to prevent injuries, we actually need to do more physical activity because there are many benefits to be gained from doing more than we do now,' she said. 'We just have to do it smarter and take heed of some of the interventions that exist to make it a safer activity.'

The full report is available through the Defence Health Service web page at www.defence.gov.au/dpe/dhs/ by following links through info centre/publications/reports.

By David Sibley and CPL Jonathan Garland