Reference values for the creatine kinase response to professional Australian football match-play

Due to the importance of monitoring markers of muscle damage in high-level sport from a medical and athlete recovery perspective, this study aimed to determine the upper limits of normal (ULN) for post-match plasma creatine kinase (CK) in professional Australian footballers. Raw CK values were considered, along with intra-individual deviations from the season-mean.

Case series.

CK was collected between 36-48h following professional Australian football match-play. A total of 1565 samples from 62 players were assessed over three consecutive seasons. The ULN were determined for raw scores and as a percentage of each player's season-mean response.

The ULN for raw CK, as determined by the 97.5th, 95th and 90th percentiles were 1715 (90%CI: 1605-1890), 1380 (90%CI: 1325-1475) and 1110 (90%CI: 1050-1170) UL^-1 respectively. The ULN intra-individual response (97.5th percentile) was defined as a player's score being greater than 94% (90%CI: 84-102%) above their season-mean.

Professional Australian football elicits a profound effect on the CK response. The values provide a reference tool for athletes competing at this level of competition. The novel method of representing the CK response as a percentage difference from an individuals' season-mean enables a superior comparative ability between CK responses and reduces the high CK responder bias that occurs when using raw scores alone. The data will assist medical and conditioning staff in excluding medical emergencies and also aid in individualising the prescription of training loads and recovery to optimise athlete performance and minimise further muscle damage.