Injuries in netball

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Rachel Dunn from Australia v England - Netball Test - Adelaide, October 2008 with an ankle injury. Rachel dunn crop.jpg
Rachel Dunn from Australia v England - Netball Test - Adelaide, October 2008 with an ankle injury.

Netball is a sport that has one of the largest female participation rates within the Commonwealth, most popular in the United Kingdom, Australia and New Zealand, with more than 20 million athletes participating in the sport. Netball is a ball sport played by two teams of seven players in which goals are scored by shooting the ball through a netted ring. [1] Netball relies heavily on muscular endurance and bursts of rapid acceleration to “break free” from an opponent as well as, sudden and rapid change of directions in combination with jumping to receive a pass, intercept a ball or rebound. [2] The sudden stop-start motion of the game is what often leads to serious injuries in participants. Higher grade players, in both senior and junior competitions, are more susceptible to injuries than lower grade players, due to the high intensity and rapid pace of the game. [3] An injury is most commonly defined as one that has occurred while participating in sport and which led to one of the following consequences: a reduction in the amount or level of sports activity; need for medical advice or treatment; and/or adverse economic or social effects for the athlete. [4]

Contents

Common soft tissue injuries in netball

A soft tissue injury is the damage of muscles, ligaments or tendons in the body. The most common soft tissue injuries in netball occur to the ankles, knees and hands. The main cause of these injuries is due to incorrect landing. Other factors influencing injury include; tripping, collisions with other players, being struck by the ball, over-exertion and fatigue. [3]

Ankles

In netball the ankle joint is most susceptible to injury and accounts for 31% of the injuries sustained in the sport. [4] A sprained ankle is a tear or complete rupture of a ligament. The most commonly injured ligament is the Anterior Talofibular Ligament. This ligament is on the outside of the ankle and injury occurs when the sole of the foot rolls inwards. A minor sprain may only need a week to recover, however severe ankle sprains can result in a player being out for 6–10 weeks. [3]

Knees

Ruptured Anterior Cruciate Ligament(ACL) 918 Knee Injury.jpg
Ruptured Anterior Cruciate Ligament(ACL)

Knee injuries are the second most common injury in netball and are the most serious in regards to cost and disability. Studies show that majority of knee injuries are new injuries, and those who sustain a knee injury often withdraw from participation in netball. The most common knee injuries are meniscal and major ligament sprains/ruptures. The most commonly injured ligament is the Anterior Cruciate Ligament(ACL). The ACL allows a twisting motion at the knee. Common symptoms of an ACL rupture include a “popping” sound at the time of the injury, severe pain, swelling and a feeling of instability. ACL injuries are difficult to effectively diagnose without the assistance of Medical Resonance Imaging (MRI). A ruptured ACL will require knee reconstruction surgery that will result in the athlete being out of the game for 9–12 months. [3]

Hands/Other

Hand injuries usually involve joint ligamentous sprains and fractures. Children most commonly injure hands, in particular their fingers. [2] “Other” types of injuries in netball vary including; lower leg strain, quadriceps haematoma, rotator cuff shoulder problems, an elbow joint dislocation, a radial fracture, and back problems. [3]

Treatment

As soon as an injury occurs game time must be held until the player has been properly assessed and removed from the court if need be. It is essential that players seek immediate help from a qualified first aid provider or health practitioner. Any netball injury should be treated by using the P.R.I.C.E.S., D.R.S.A.B.C., T.O.T.A.P.S. AND R.I.C.E.R. regimes: [5]

P - Protect

R - Rest

I - Ice

C - Compression

E - Elevation

S - Stabilise

D - Danger

R - Response

S - Send for help

A - Airway

B - Breathing

C - Circulation

T - Talk

O - Observe

T - Touch

A - Active movement

P - Passive movement

S - Skills test

R - Rest

I - Ice

C - Compression

E - Elevation

R - Referral

If an injury occurs ensure that all netball players receive adequate treatment and full rehabilitation before returning to play. Serious ankle and knee ligament ruptures will require reconstructive surgery. It is essential to follow all recovery and rehabilitation programs fully to prevent any injury from re occurring. [2]

Netball Injury prevention

Good Preparation

Northern Mystics warming up for their match against the Canterbury Tactix. Tactix -7-April-3.JPG
Northern Mystics warming up for their match against the Canterbury Tactix.

In order to prevent netball injuries, essential pre-season training is required before commencing the playing season. The distance travelled by elite players over a game ranges from 7 km (shooters/ defenders) to 8.8 km (centre court players). [6] A game does not only consist of basic running; players are required to accelerate in rapid bursts for the majority of the game. In pre-season training players must undertake fitness programs that focus on power, strength, agility and flexibility, especially of muscles around the ankles and feet. It is important that fitness testing is conducted prior to competition to ensure readiness to play the game. [2]

Good Technique

Training should consist of netball specific exercises that focus on enhancing body balance, landing control, change of direction and catching passes. It is essential for coaches to undergo regular educational updates to make sure the information they have about correct training drills is current. It is very important that children are properly taught the fundamentals of netball before they participate in game situations. Any incorrect techniques should be corrected at a young age before they become a bad habit. [6]

A hard but smooth netball court surface. Jerilderie Netball Courts 001.JPG
A hard but smooth netball court surface.

Warm Up

A warm-up should never be overlooked in netball as it plays a vital and effective role in preventing injury. A warm-up is essential before physical activity to; prepare the body for vigorous exercise, reduce the risk of injury, reduce muscle stiffness and mentally prepare the athlete. Any warm-up should consist of running, dynamic movements and dynamic stretches. It should last for a minimum of ten minutes. [4]

Equipment/Clothing

In netball it is essential that the goal posts are firmly fixed to the ground and have a padded post protector around them. All courts should be a firm, smooth surfaces with no loose gravel or hazards. The most important uniform item for any netball player is the shoes. It is highly recommended that players wear netball specific shoes, as they are tailored to the demands of the game and provide the correct level of support and cushioning. It is also recommended that players should wear braces or strap their ankles to provide extra support and decrease the risk of a major injury occurring. [2]

Psychological effects of having a major injury

For many netball players a serious injury can be a traumatic life event that results in physical and psychological ramifications. The main psychological effects include the initial emotional response of experiencing an injury, the psychological factors that influence the recovery process, and the psychological impact of an injury on the athletes future performance. It is important to remember that not all injured athletes will experience the same cognitive and emotional responses. [7]

Emotional Responses

During injury and recovery players may experience different mood states. The most commonly found mood disturbances are increases in depression, tension and anger. The emotional response will depend on how extreme the injury is. Self-efficacy is defined as one’s belief in ones ability to succeed in specific situations. Physical self-efficacy is often affected by an injury. Players will often enter an extremely negative state of mind immediately after an injury, however; during recovery they often become exceedingly positive. [7]

Self-Motivation

Most often players will be highly motivated to get back to playing netball as soon as possible. However it is important to remember that injured athletes will have good and bad days. During rehabilitation an athletes motivation and enthusiasm for treatment may decrease if they are experiencing setbacks or a period of little or no improvement. It is important for athletes to have a good support network to keep them positive and focused during these harder times. [7]

Confidence

Physical recovery is critical, however, psychological rehabilitation is the most important part of recovery. Even though a player may be physically ready to return to netball, they may not be psychologically ready to play. Various doubts, fears and anxieties may surface when thinking about returning to netball. The athlete may fear they are going to be a different player, they will not meet their coach or teammates expectations or that their physical fitness will not return to pre-injury state. This will result in the athlete putting a huge amount of pressure on themselves. This anxiety and tension can lead to the following outcomes: reinjury; injury to another body part; lowered confidence resulting in a temporary or permanent performance decrement; general depression; and fear of further injury, which can sap motivation and the desire to return to competition. [7]

Dealing with psychological effects

The most successful psychological techniques that aid injury recovery are; good interpersonal communication skills, positive reinforcement, setting realistic goals, knowing methods for positive self-thoughts, coach support, and keeping the athlete involved with the team.

Returning to pre-injury levels & Goal setting

Determining a successful return to netball from injury for most athletes is the ability to train and compete at pre-injury levels and standards. Measuring this includes things such as; reaching past endurance fitness test levels (beep tests); the ability to perform and complete sport-specific training exercises; and maintaining performance. Achieving these goals at training will best prepare an athlete for what they will experience during competition standards. It is important for the athlete to set realistic goals that they are able to achieve. They must understand that these goals may need to be long term, as not everything can be achieved over night. It is important that goals are flexible because when injured the rehab progress is often unpredictable. [8]

Strong support is needed from teammates, coaches, friends and family. 141100 - Wheelchair basketball Australian team teamwork - 3b - 2000 Sydney match photo.jpg
Strong support is needed from teammates, coaches, friends and family.

Active participation in rehabilitation

Athletes that are engaged in their rehabilitation program are likely to cope with their injury more successfully. Physiotherapists state that athletes who show interest in their rehabilitation by; communicating well, asking questions, listening well to advice, and providing feedback, are more likely to have a positive psychological response to their injury. [9]

Strong Support Systems

It is very important to have social support during the injury, rehabilitation and sports returning phase. This may include coaches, trainers, friends and family. The support of these people is essential for times when the athlete may need positive encouragement around them. The athlete should talk to someone they feel most comfortable with and who is going to listen and support them. [9]

Sports Psychologist

It can be beneficial for an injured player to work with a sports psychologist. Coach and family can be helpful, however there may be times when they are too close to the situation and where an outside point of view is needed to help. [8]

Take it slow

It is important to remember that there is no rush to get back to netball. Athletes should feel prepared and confident before returning to competition. It is important to take part in game play situations at training. The athlete may also want to start in a lower grade then usual to help ease back into the game. They should aim to play one quarter in their first game back, and slowly build from there aiming to play a full game as they have progressed and experienced success.

Controversies

Hypermobility and injuries in junior netball players

Hypermobility is defined as a condition in which an individual’s synovial joints have a range of motion beyond normal limits. Hypermobile joints can be a performance enhancement in some sports, for example spin bowlers in cricket. However some studies suggest the increased risk of joint dislocations, sprains and joint hyperextension in athletes with hypermobile joints. They believe that recognising hyper mobility in young female athletes may reduce the risk of injuries occurring. On the contrary, others suggest that hyper mobility is not associated with an increased incidence of injuries in junior netball players. [10]

Serious/Career threatening injuries in elite netball players

Australian netball player Liz Ellis Liz Ellis.jpg
Australian netball player Liz Ellis

In October 2005, Australian captain Liz Ellis, suffered a career-threatening knee injury after tearing her ACL in a match against New Zealand. This injury ruled her out of the chance to play at the 2006 Commonwealth Games. Ellis said that she had to reignite her passion and love for the game that had been her life. Ellis states that “It was soul-destroying to watch my team walk out without me and realise, hey, they can play without me”.

She worked extremely hard on her rehabilitation, her knee repaired and her passion was restored. Ellis produced some of the best netball of her career in the two years that followed. She ended her 18-year career in her 122nd test with Australia winning the world championship 42-38. She overcame all critics and odds after coming back from her knee injury. [11]

West Coast Fever captain, Ashleigh Brazill, ruptured the meniscus in her left knee late in the 2012 ANZ Championship season. Brazill had been selected to represent Australia in the 2012 Constellation Cup, but unfortunately had to withdrawal from the team. Brazil worked to build the strength back in her knee and went on to resume playing in the following 2013 season.

In October 2014, Casey Kopua suffered a knee injury during the 2014 Constellation Cup. Kopua ruptured the patella tendon in her left knee and had knee surgery to repair the tendon that would result in her missing up to 6 months of netball. [12]

In April 2015, Melbourne Vixens mid courter, Madi Robinson ruptured the anterior cruciate ligament in her right knee. Robinson missed out on the 2015 Netball World Cup.

See also

Related Research Articles

<span class="mw-page-title-main">Sports injury</span> Physical and emotional trauma

Sports injuries are injuries that occur during sport, athletic activities, or exercising. In the United States, there are approximately 30 million teenagers and children who participate in some form of organized sport. Of those, about three million athletes age 14 years and under experience a sports injury annually. According to a study performed at Stanford University, 21 percent of the injuries observed in elite college athletes caused the athlete to miss at least one day of sport, and approximately 77 percent of these injuries involved the knee, lower leg, ankle, or foot. In addition to those sport injuries, the leading cause of death related to sports injuries is traumatic head or neck occurrences.

<span class="mw-page-title-main">Knee</span> Leg joint in primates

In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia, and one between the femur and patella. It is the largest joint in the human body. The knee is a modified hinge joint, which permits flexion and extension as well as slight internal and external rotation. The knee is vulnerable to injury and to the development of osteoarthritis.

<span class="mw-page-title-main">Sprain</span> Damage to one or more ligaments in a joint

A sprain is a soft tissue injury of the ligaments within a joint, often caused by a sudden movement abruptly forcing the joint to exceed its functional range of motion. Ligaments are tough, inelastic fibers made of collagen that connect two or more bones to form a joint and are important for joint stability and proprioception, which is the body's sense of limb position and movement. Sprains may be mild, moderate, or severe, with the latter two classes involving some degree of tearing of the ligament. Sprains can occur at any joint but most commonly occur in the ankle, knee, or wrist. An equivalent injury to a muscle or tendon is known as a strain.

<span class="mw-page-title-main">Anterior cruciate ligament</span> Type of cruciate ligament in the human knee

The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments in the human knee. The two ligaments are also called "cruciform" ligaments, as they are arranged in a crossed formation. In the quadruped stifle joint, based on its anatomical position, it is also referred to as the cranial cruciate ligament. The term cruciate translates to cross. This name is fitting because the ACL crosses the posterior cruciate ligament to form an "X". It is composed of strong, fibrous material and assists in controlling excessive motion. This is done by limiting mobility of the joint. The anterior cruciate ligament is one of the four main ligaments of the knee, providing 85% of the restraining force to anterior tibial displacement at 30 and 90° of knee flexion. The ACL is the most injured ligament of the four located in the knee.

<span class="mw-page-title-main">Joint dislocation</span> Medical injury

A joint dislocation, also called luxation, occurs when there is an abnormal separation in the joint, where two or more bones meet. A partial dislocation is referred to as a subluxation. Dislocations are often caused by sudden trauma on the joint like an impact or fall. A joint dislocation can cause damage to the surrounding ligaments, tendons, muscles, and nerves. Dislocations can occur in any major joint or minor joint. The most common joint dislocation is a shoulder dislocation.

A soft tissue injury is the damage of muscles, ligaments and tendons throughout the body. Common soft tissue injuries usually occur from a sprain, strain, a one-off blow resulting in a contusion or overuse of a particular part of the body. Soft tissue injuries can result in pain, swelling, bruising and loss of function.

The drawer test is used in the initial clinical assessment of suspected rupture of the cruciate ligaments in the knee.

<span class="mw-page-title-main">Anterior cruciate ligament reconstruction</span> Surgical process

Anterior cruciate ligament reconstruction is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after an injury. The torn ligament can either be removed from the knee, or preserved before reconstruction through an arthroscopic procedure. ACL repair is also a surgical option. This involves repairing the ACL by re-attaching it, instead of performing a reconstruction. Theoretical advantages of repair include faster recovery and a lack of donor site morbidity, but randomised controlled trials and long-term data regarding re-rupture rates using contemporary surgical techniques are lacking.

<span class="mw-page-title-main">Fibular collateral ligament</span> Collateral fibular ligament

The lateral collateral ligament is an extrinsic ligament of the knee located on the lateral side of the knee. Its superior attachment is at the lateral epicondyle of the femur ; its inferior attachment is at the lateral aspect of the head of fibula. The LCL is not fused with the joint capsule. Inferiorly, the LCL splits the tendon of insertion of the biceps femoris muscle.

<span class="mw-page-title-main">Cruciate ligament</span> Type of ligament shaped like an X

Cruciate ligaments are pairs of ligaments arranged like a letter X. They occur in several joints of the body, such as the knee joint, wrist joint and the atlanto-axial joint. In a fashion similar to the cords in a toy Jacob's ladder, the crossed ligaments stabilize the joint while allowing a very large range of motion.

<span class="mw-page-title-main">Sprained ankle</span> Medical condition

A sprained ankle is an injury where sprain occurs on one or more ligaments of the ankle. It is the most commonly occurring injury in sports, mainly in ball sports such as basketball, volleyball, football, and tennis.

<span class="mw-page-title-main">Anterior cruciate ligament injury</span> Ligament injury near the knee

An anterior cruciate ligament injury occurs when the anterior cruciate ligament (ACL) is either stretched, partially torn, or completely torn. The most common injury is a complete tear. Symptoms include pain, an audible cracking sound during injury, instability of the knee, and joint swelling. Swelling generally appears within a couple of hours. In approximately 50% of cases, other structures of the knee such as surrounding ligaments, cartilage, or meniscus are damaged.

Cold compression therapy, also known as hilotherapy, combines two of the principles of rest, ice, compression, elevation to reduce pain and swelling from a sports or activity injury to soft tissues and is recommended by orthopedic surgeons following surgery. The therapy is especially useful for sprains, strains, pulled muscles and pulled ligaments.

<span class="mw-page-title-main">Unhappy triad</span> Medical condition of the knee

The unhappy triad, also known as a blown knee among other names, is an injury to the anterior cruciate ligament, medial collateral ligament, and meniscus. Analysis during the 1990s indicated that this 'classic' O'Donoghue triad is actually an unusual clinical entity among athletes with knee injuries. Some authors mistakenly believe that in this type of injury, "combined anterior cruciate and medial collateral ligament disruptions that were incurred during athletic endeavors" always present with concomitant medial meniscus injury. However, the 1990 analysis showed that lateral meniscus tears are more common than medial meniscus tears in conjunction with sprains of the ACL.

<span class="mw-page-title-main">Meniscus tear</span> Rupturing of the fibrocartilage strips in the knee called menisci

A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci. When doctors and patients refer to "torn cartilage" in the knee, they actually may be referring to an injury to a meniscus at the top of one of the tibiae. Menisci can be torn during innocuous activities such as walking or squatting. They can also be torn by traumatic force encountered in sports or other forms of physical exertion. The traumatic action is most often a twisting movement at the knee while the leg is bent. In older adults, the meniscus can be damaged following prolonged 'wear and tear'. Especially acute injuries can lead to displaced tears which can cause mechanical symptoms such as clicking, catching, or locking during motion of the joint. The joint will be in pain when in use, but when there is no load, the pain goes away.

A high ankle sprain, also known as a syndesmotic ankle sprain (SAS), is a sprain of the syndesmotic ligaments that connect the tibia and fibula in the lower leg, thereby creating a mortise and tenon joint for the ankle. High ankle sprains are described as high because they are located above the ankle. They comprise approximately 15% of all ankle sprains. Unlike the common lateral ankle sprains, when ligaments around the ankle are injured through an inward twisting, high ankle sprains are caused when the lower leg and foot externally rotates.

Posterolateral corner injuries of the knee are injuries to a complex area formed by the interaction of multiple structures. Injuries to the posterolateral corner can be debilitating to the person and require recognition and treatment to avoid long term consequences. Injuries to the PLC often occur in combination with other ligamentous injuries to the knee; most commonly the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). As with any injury, an understanding of the anatomy and functional interactions of the posterolateral corner is important to diagnosing and treating the injury.

<span class="mw-page-title-main">Medial knee injuries</span> Medical condition

Medial knee injuries are the most common type of knee injury. The medial ligament complex of the knee consists of:

Paige Amber Hadley is an Australian international netball player. Primarily a wing attack and centre player, Hadley is a member of the Australian national team and plays in the Suncorp Super Netball for the New South Wales Swifts, for which she also serves as the club's Australian Netball Players’ Association delegate.

<span class="mw-page-title-main">Volleyball injuries</span>

Volleyball is a game played between two opposing sides, with six players on each team, where the players use mainly their hands to hit the ball over a net and try to make the ball land on the opposing team's side of the court. Volleyball is played by over 800 million people worldwide, making it one of the most popular sports in the world. Volleyball has some risks involved with it because there are some injuries which occur to players that are quite common; these include ankle injuries, shoulder injuries, foot injuries and knee injuries.

References

  1. ↑ Chandler, Phillip T.; Pinder, Sarah J.; Curran, Jourdan D.; Gabbett, Tim J. (2014-01-01). "Physical Demands of Training and Competition in Collegiate Netball Players". Journal of Strength and Conditioning Research. 28 (10): 2732–2737. doi: 10.1519/jsc.0000000000000486 . PMID   24983848.
  2. 1 2 3 4 5 "Netball Australia". physioworks.com.au. Retrieved 2015-09-03.
  3. 1 2 3 4 5 Hopper, D; Elliott, B; Lalor, J (1995-12-01). "A descriptive epidemiology of netball injuries during competition: a five year study". British Journal of Sports Medicine. 29 (4): 223–228. doi:10.1136/bjsm.29.4.223. ISSN   0306-3674. PMC   1332230 . PMID   8808533.
  4. 1 2 3 McManus, A.; Stevenson, M.R.; Finch, C.F. (2006-01-01). "Incidence and risk factors for injury in non-elite netball". Journal of Science and Medicine in Sport. 9 (1–2): 119–124. doi:10.1016/j.jsams.2006.03.005. hdl: 20.500.11937/45869 . PMID   16621712.
  5. ↑ "Guidelines" . Retrieved 2015-09-03.
  6. 1 2 "245 Quantifying the physical demands in netball to develop training guidelines that assess player preparation and reduce injury". Journal of Science and Medicine in Sport. 10: 85. 2007-01-01. doi:10.1016/s1440-2440(07)70252-9.
  7. 1 2 3 4 Quinn, Ann M.; Fallon, Barry J. (1999-01-01). "The changes in psychological characteristics and reactions of elite athletes from injury onset until full recovery". Journal of Applied Sport Psychology. 11 (2): 210. doi:10.1080/10413209908404201.
  8. 1 2 Podlog, Leslie; Eklund, Robert C. (2009-09-01). "High-level athletes' perceptions of success in returning to sport following injury". Psychology of Sport and Exercise. Research Quality in Sport & Exercise Psychology. 10 (5): 535–544. doi:10.1016/j.psychsport.2009.02.003.
  9. 1 2 Francis, Susan R; Andersen, Mark B; Maley, Paul (2000-01-01). "Physiotherapists' and male professional athletes' views on psychological skills for rehabilitation". Journal of Science and Medicine in Sport. 3 (1): 17–29. doi:10.1016/s1440-2440(00)80044-4. PMID   10839225.
  10. ↑ Smith, R.; Damodaran, A. K.; Swaminathan, S.; Campbell, R.; Barnsley, L. (2005-09-01). "Hypermobility and sports injuries in junior netball players". British Journal of Sports Medicine. 39 (9): 628–631. doi:10.1136/bjsm.2004.015271. ISSN   1473-0480. PMC   1725309 . PMID   16118300.
  11. ↑ "Knee injury puts Ellis's Games Hopes under cloud". The Sydney Morning Herald . October 31, 2005. Retrieved September 29, 2023.
  12. ↑ "Kopua's injury blow for Magic". ANZ Championship . 14 October 2014. Archived from the original on 20 January 2015. Retrieved 2015-09-03.
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