Injuries in Netball-A Systematic Review

Normative Standards for Isokinetic and Anthropometric Classifications of University-Level Netball Players

CONTEXT

The purpose of the study was to develop normative ranges and standards for knee and shoulder isokinetic and anthropometric values. These standards can be qualitatively interpreted and allow practitioners to classify isokinetic and anthropometric values more objectively for university-level netball players.

DESIGN

Posttest only observational study design. All players were only evaluated once during the in-season to generate normative ranges.

METHODS

A total of 51 female players volunteered. Participants were evaluated on an isokinetic dynamometer at 60° per second to obtain knee-extensor and knee-flexor values as well as shoulder-flexor and shoulder-extensor values. A total of 16 anthropometric variables were collected including stature, body mass, 8 skinfolds, and 6 circumferences. Between-group differences were calculated to determine whether playing level was a differentiating factor in data.

RESULTS

Normative standards were developed for isokinetic parameters associated with the knee and shoulder joints as well as skinfolds and circumference measures. No statistically significant between-group differences were evident (χ2Kruskal-Wallis[2] = 3.96, P = .140).

CONCLUSION

These standards can be used by coaches and practitioners to set attainable goals for individual players or those from secondary leagues, classify individual and team-based performances, and facilitate decision-making processes.

Anterior Cruciate Ligament Injury Prevention Programs in Welsh Netball: A Survey of Knowledge, Implementation and Barriers Amongst Players and Coaches

Background Anterior cruciate ligament (ACL) injury prevention programs can reduce injury risk in various sports. The perception of ACL injury prevention programs amongst professional netball players and coaches has not been studied. Purpose The aim of this study was to determine (1) the level of awareness and experience of ACL injury prevention programs, (2) the use of ACL injury prevention programs, and (3) barriers and potential facilitators to implementing a sustainable ACL injury prevention program in netball. Materials and methods Female netball players representing Welsh senior and under-21 teams and elite and amateur coaches were invited electronically to participate in this web-based cross-sectional observational study between 1st May and 31st July 2021. Information on ACL injury susceptibility and seriousness, knowledge, experience, and implementation of ACL injury prevention programs were ascertained. Results Twenty-eight players (78%) and 29 coaches (13%) completed the questionnaire. Seventeen (61%) players and 15 (52%) coaches reported that female athletes were at greater risk of sustaining ACL injuries. Over 90% of respondents identified netball as high-risk, whilst 89% (n=25) of players and 76% (n=22) of coaches reported these injuries to be preventable. Only two (7%) players and six (21%) coaches utilised an ACL injury prevention program with a lack of time and engagement from coaches and players identified. The majority of respondents indicated that their club has neither promoted, advocated the use nor demonstrated exercises for ACL injury prevention. Over 90% of respondents would utilise an ACL injury prevention program if it minimised players' risk with appropriate information and demonstration of exercises. Conclusion This study highlights limited knowledge of female athletes' increased susceptibility to ACL injuries amongst players and coaches with a lack of communication and education on ACL injury prevention programs between sporting associations, coaches, and players. However, the results demonstrate willingness amongst both players and coaches to implement an ACL injury prevention program in netball.

Health-seeking behaviors, management practices, and return to play decisions after an ankle sprain in netball: An international cross-sectional survey of 1592 non-elite netballers

OBJECTIVES

Evaluate if non-elite netballers sought health care, treatments received, and return-to-play decisions after an ankle sprain, including intercountry differences.

DESIGN

Cross-sectional survey.

METHODS

Non-elite netballers aged >14 years were recruited from Australia, United Kingdom, and New Zealand. Participants completed an online survey regarding their last ankle sprain and were queried regarding health care sought, health professionals consulted, treatments received, time missed, and return-to-play clearance. Data were described using number (proportion) for the overall cohort and countries. Between-country differences in health care use were compared using chi-square tests. Descriptive statistics were presented for management practices.

RESULTS

We received 1592 responses from Australian (n = 846), United Kingdom (n = 454), and New Zealand (n = 292) netballers. Three in five (n = 951, 60 %) sought health care. Of those, most consulted a physiotherapist (n = 728, 76 %), received strengthening exercises (n = 771, 81 %), balance exercises (N = 665, 70 %) and taping (n = 636, 67 %). Few received return-to-play clearance (n = 362, 23 %). Comparing countries, fewer United Kingdom netballers sought health care than Australian and New Zealand netballers (Australia: 60 % vs United Kingdom: 53 % vs New Zealand: 68 %, p < 0.001), consulted a physiotherapist (Australia: 79 %, United Kingdom: 63 %, New Zealand: 87 %), received strengthening (Australia: 84 %, United Kingdom: 73 %, New Zealand: 84 %) or balance exercises (Australia: 71 %, United Kingdom: 60 %, New Zealand: 80 %) or taping (Australia: 74 %, United Kingdom: 39 %, New Zealand: 82 %). More Australian netballers returned to play within 1-7 days (Australia: 25 %, United Kingdom: 15 %, New Zealand: 21 %) and fewer United Kingdom netballers received return-to-play clearance (Australia: 28 %, United Kingdom: 10 %, New Zealand: 28 %).

CONCLUSIONS

Health-seeking behaviours are adopted by some, but not all netballers after an ankle sprain. For those who sought care, most consulted a physiotherapist and were prescribed exercise-based interventions and external ankle support, but few received return-to-play clearance. Comparing countries, United Kingdom netballers had lower health-seeking behaviours and received less best-practice management than Australian and New Zealand netballers.

A cross-sectional retrospective survey of injury situation and prevalence in female recreational netball players with a focus on knee injuries

OBJECTIVES

To examine situations of injury and injury prevalence in female adult recreational netball players with a focus on knee injuries.

DESIGN

Cross sectional retrospective online survey.

PARTICIPANTS

193 female adult recreational netball players.

MAIN OUTCOME MEASURES

Any injury sustained in the previous 12 months, situation of injury, any knee injuries sustained in the previous five years, the length of time unable to play netball, and knee injury management.

RESULTS

In the previous 12 months, 61% of respondents sustained injury to the lower limb, and 27% to the upper limb. Lower limb injury situations were mostly landings (46%). Upper limb injury situations were mostly collisions with an opponent (27%). 46% reported sustaining a knee injury in the previous five years. Following knee injury, players were unable to play netball for 6.8 ± 7.0 months (training); and 8.2 ± 7.4 months (matches) respectively.

CONCLUSIONS

Lower limb injury is more common than upper limb injury in recreational adult female adult netball players. Landing was the most common situation of injury for the lower limb including knee injuries. In the previous five years, nearly half of the players had sustained a knee injury resulting in more than six months out of the game.

Consensus on a netball video analysis framework of descriptors and definitions by the netball video analysis consensus group

Using an expert consensus-based approach, a netball video analysis consensus (NVAC) group of researchers and practitioners was formed to develop a video analysis framework of descriptors and definitions of physical, technical and contextual aspects for netball research. The framework aims to improve the consistency of language used within netball investigations. It also aims to guide injury mechanism reporting and identification of injury risk factors. The development of the framework involved a systematic review of the literature and a Delphi process. In conjunction with commercially used descriptors and definitions, 19 studies were used to create the initial framework of key descriptors and definitions in netball. In a two round Delphi method consensus, each expert rated their level of agreement with each of the descriptors and associated definition on a 5-point Likert scale (1-strongly disagree; 2-somewhat disagree; 3-neither agree nor disagree; 4-somewhat agree; 5-strongly agree). The median (IQR) rating of agreement was 5.0 (0.0), 5.0 (0.0) and 5.0 (0.0) for physical, technical and contextual aspects, respectively. The NVAC group recommends usage of the framework when conducting video analysis research in netball. The use of descriptors and definitions will be determined by the nature of the work and can be combined to incorporate further movements and actions used in netball. The framework can be linked with additional data, such as injury surveillance and microtechnology data.

RESPONSES OF TAI CHI IN UPPER LIMB SPORTS INJURIES REHABILITATION ON YOUNG PEOPLE

ABSTRACT Introduction Practicing sports can strengthen the body both physically and mentally. Although Tai Chi can help injured athletes to recover quickly and shorten the return to sports training and competition, there are still no detailed studies about its effectiveness in lower limb injuries in young people. Objective Analyze the effects of Tai Chi in upper limb sports injuries rehabilitation on young people. Methods 91 patients with sports injuries are selected and randomly divided into a control group (n=44) and an experimental group (n=47). The control group received regular exercises for rehabilitation, while the experimental group used Tai Chi exercises. Mathematical statistics are used to analyze the effects before and after the activities. Results There are considerable statistical differences in the effects of exercise on the two groups of patients. Conclusion Tai Chi exercise can help young people recover from upper limb sports injuries. Evidence level II; Therapeutic Studies - Investigating the results.

The epidemiology of injury and illness at the Vitality Netball World Cup 2019: an observational study

BACKGROUND

Netball is a physical game with sudden direction changes, decelerations, jumping and landing, stop/start maneuvers and restrictive footwork rules exposing players to injury. Close contact play and shared facilities during tournaments, increase illness risk.Objective: To describe incidence, period prevalence, types and severity of injuries and illnesses during the 10-day Vitality Netball World Cup 2019 (NWC).Methods: All players from 16 teams consented (n = 192). Medical staff recorded injuries (840 exposure hours), illnesses (1440 player-days) and time-loss. Main outcome measures included incidence (I) calculated as injury/1000 player-hours and illness/1000 player-days, period prevalence (PP) and severity (time-loss) of all match injuries and illnesses.

RESULTS

39 players sustained 46 match injuries (I = 54.76; PP = 20.31%). Lower limb injuries (I = 29.76), specifically the ankle (I = 13.10) were most common with lateral ankle ligament sprains the highest (I = 17.39). Contact injuries (I = 40.48) significantly exceeded non-contact injuries (I = 14.29; p = 0.0124). Center players sustained most injuries (n = 12; 26%; I = 14.29), followed by goalkeepers (n = 10; 22%; I = 11.90) and goal defenders (n = 8; 17%; I = 9.52). Injuries occurred in almost 50% of matches, and 67% did not result in time-loss. Time-loss injuries (n = 14; 33%) were most frequent in the lower limb (n = 10; 71%) specifically involved lateral ankle ligaments (n = 4; 29%), attributable to contact (n = 11; 79%) and mostly implicated center players and goal defenders (n = 4 each; 29% each). 11 players contracted 11 illnesses (I = 7.64; PP = 5.72%) with respiratory tract illness contributing 36%. Most illnesses did not result in time-loss (91%).

CONCLUSION

This is the first study reporting injury and illness during an NWC. Contact was the main mechanism of injury, and 2/3 of injuries did not result in time-loss. The ankle is most commonly injured and center players sustain most injuries. Non-respiratory system disease was most frequent, but upper respiratory tract infection remains the most common diagnosis. Targeted surveillance studies using similar methodology are required to develop injury and illness preventative strategies in elite netball.

Epidemiology of injuries sustained in professional Australian netball: A three season cohort study

OBJECTIVES

To report the medical attention and time-loss injury epidemiology of Australia's premier netball competition.

DESIGN

Descriptive epidemiological study.

METHODS

One-hundred and nineteen players in the Suncorp Super Netball league were under surveillance during three consecutive seasons (2017-2019), inclusive of pre-, in-, and post- season phases. Medical attention injuries were recorded by medical personnel, and additionally sub-categorised according to time loss. Injury incidence rates (IIR) and injury burden were calculated per 365 player contract days, with differences between season and season phase IIRs compared using negative binomial generated incidence rate ratios (IRR).

RESULTS

Eight hundred and sixty-six medical attention injuries and 393 time-loss injuries were recorded. The majority of the players had multiple (≥2) medical attention (n = 92; 77.3%) and time-loss (n = 75, 63.0%) injuries reported. The ankle (n = 181; 20.9%), knee (n = 136; 15.7%) and foot (n = 98; 11.3%) were the body sites with the most frequently reported medical attention injuries. Overall, there was a comparable injury incidence rate between the pre-season and in-season periods (IRR = 1.13, 95%CI = 0.98-1.30, p = 0.0842), although variation in the injury burden was identified. Ankle tendon injuries (23.5 days absence) and knee joint injuries (44.9 days absence) the most burdensome injuries in the pre-season and in-season periods respectively.

CONCLUSIONS

Lower limb injuries are the most frequent in professional level netball. Knee and ankle injuries are the most burdensome overall, however the type of injuries with a high burden vary between pre- and in-season periods. Time-loss, non-time loss and subsequent injuries are prominent in professional level netball.

Current ankle sprain prevention and management strategies of netball athletes: a scoping review of the literature and comparison with best-practice recommendations

Background

Ankle sprains are the most commonly reported injury in netball. Approximately four in five netball athletes will sustain an ankle sprain, up to half will go on to sustain recurrent ankle sprains, and nine in ten report perceived ankle instability. Historically, prevention and management strategies of ankle sprains and injuries have been investigated for a variety of sports, however, no literature reviews have investigated these in netball athletes, or compared these with current best-practice within the literature. Therefore, this scoping review aims to understand how netball athletes currently prevent and manage ankle sprains and to compare these approaches with best-practice recommendations.

Methods

A literature search was conducted using MEDLINE, CINAHL, and SPORTDiscus databases using keywords to capture studies with data or information related to the prevention and management of ankle sprains and injuries in netball.

Results

The search strategy captured 982 studies across all databases, with 30 netball studies included in this scoping review. Studies suggest netball athletes are not commonly referred to health professionals, do not undertake adequate rehabilitation, and almost immediately return to court following an ankle sprain or injury. Current best-practices suggest injury prevention programs and external ankle support effectively reduce ankle sprains and injuries; however, poor compliance and implementation may be a significant barrier. Currently, there is a lack of evidence that netball-specific footwear reduces the risk of ankle sprains.

Conclusion

The findings suggest netball athletes do not implement current best-practice prevention and management strategies following an ankle sprain. This is despite evidence of the effectiveness of injury prevention programs, external ankle support, and adequate rehabilitation in reducing ankle sprain rates. Current-best practice prevention and management of ankle sprains should be considered by clinicians, coaches, and athletes to reduce the prevalence and chronicity of ankle sprains in netball.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-021-00342-9.

Body composition in professional female netball players within and between seasons: a cohort study

Background

There is limited information on the physique attributes of female netball players from the highest playing standards and the typical body composition changes that occur with training and competition in these athletes. The purpose of this study was to examine the body composition of professional female netball players and changes that occur within and between national premier netball seasons.

Methods

Dual-energy X-ray absorptiometry (DXA) assessments were conducted in 20 female netball players (age = 26.5 [4.7] years, body mass = 77.3 [9.7] kg, stature = 182.7 [9.5] cm) contracted to a Suncorp Super Netball team. Total body lean mass, fat mass, bone mass and bone mineral density were derived for 127 assessments collected over three seasons. Linear mixed effects modelling was used to examine changes in body composition measures within and between seasons.

Results

Goal circle players were heavier (12.3 [3.5] kg, p < 0.001, g = 1.51) and taller (15.0 [2.7] cm, p < 0.001, g = 2.30) than midcourt players, and midcourt players had greater lean mass (3.1 [1.6] %, p = 0.07, g = 0.85) and less fat mass (-3.3 [1.7] %, p = 0.06, g = -0.84) than goal circle players when values were normalised to body mass. Players achieved increases in lean mass (2,191 [263] g, p < 0.01, g = 0.45) and decreases in fat mass (-835 [351] g, p = 0.09, g = -0.16) following a preseason preparation period. There were no changes in lean mass (-394 [295] g, p = 0.54, g = 0.07) or fat mass (102 [389] g, p = 0.99, g = 0.04) from the start to the end of the 14-week competition period.

Conclusions

Professional female netball players achieve small changes in lean mass and fat mass during preseason preparation and maintain their physique over the competitive season. The results of this study can inform practitioners on the training content necessary to promote or maintain desired body composition changes in these athletes.