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Netball Ankle Injuries

Watching any game of netball, you’d be mistaken for thinking that ankle taping or braces are the latest accessory; such is the enormity and spread of ankle injuries amongst all grades. Ankle injuries are reported to account for 40% of all injuries within the sport (3), with recent statistics showing that netballers are three times more likely to sustain lower leg injuries than athletes of AFL, soccer, or rugby (1). In addition, players within the populous who are exposed to increased change of direction acts per game are more susceptible to ankle injuries, with mid-courters such as wing attack and wing defence, along with centres of higher risk (4). Research by Drew & Raysmith (2016) suggests that an athlete is seven times more likely to achieve their performance-based goals if they are able to complete at least 80% of their prescribed training whilst injury free. This demonstrates the monumental importance of avoiding injury, and encourages adherence to set training – a simple way to largely benefit performance. Looking to the basic principles of netball, we see a fast-paced sport which is heavily reliant on instantaneous acceleration and deceleration, jumping and landing, cutting and change of direction, along with an apparent open nature provided by variables such as opponents, skills, and weather. Given the potential for injury with each change of direction and landing effort (6), the fact that only 28% of movement in a game is that of a forward nature (6), and that landing has also been shown to account for up to 30% of all injuries within netball (4); exposure to injury is evidently high. What does all of this mean? Netballers are constantly exposed to risks which are modifiable to an extent via the likes of rule adoption and implementation, however we still have great exposure to risk, which many assume are uncontrollable. This theory holds some merit – some injuries are simply unavoidable, however appropriate training within a controlled environment can physically prepare athletes body to withstand previously potentially damaging manoeuvres, along with muscle and movement memory which will produce an imminent adjustment based on past experience. Then what exactly is appropriate training for a netballer to avoid these injuries you ask? A program developed by the University of Ballarat (now Federation University) – ‘Down 2 Earth’, has been shown to effectively decrease the risk of both ankle and knee injuries among the population, when programs are successfully adhered to. The program revolves around basic theories of 1. education – teaching appropriate form, 2. practice of skills within a variety of environments, and 3. continuity and regularity of practice. The program provides jumping and landing drills, which can be modified to incorporate passing and common skills, also improving performance. Further to this, higher levels of lower body stiffness has been found to correlate with decreased injury risk and increased performance (5). Stiffness stores elastic energy within the muscle belly to be released for activities such as repeat jumps, change of direction efforts, and basic landing and jumping sturdiness. Stiffness can be achieved through appropriate landing and repeat jump practice. From this we can draw two major target areas in which we can look to decrease risk of ankle injury – jumping and landing mechanics, along with change of direction movements. By practicing jumping and landing along with change of direction drills within a closed environment, we see the following adaptations occur:
  • Muscle memory
  • Skill specific strengthening of musculature and connective tissue
  • Autonomy of the skill (producing effective recall and adjustment when performing the skill in a game setting)
  • Muscle and connective tissue stiffness/ability to utilise stored elastic energy
What exercises exactly are we referring to? Examples include but are not limited to;
  • Basic jump and stick (landing focused) using both double and single leg landings
  • Lateral bounds (due to the high level of sideways movement within a game)
  • Use of distractions during jumping and landing (external forces such as bands pulling you off balance, landing on uneven surfaces, or catching whilst landing)
  • Jumps focused on low contact time with the ground (focuses on muscle stiffness)
  • A variety of agility drills *note – agility refers to the sudden change of speed or direction in response to a stimulus (ball being thrown etc.)
  • Mimicking lateral movement
  • Balancing on unstable surfaces e.g. foam, BOSU ball (increased awareness of the limbs in relation to the body)
In addition to this, a series of resistance-based exercises to build musculature and connective tissue strength can be used to further enhance the robustness of the joints within the ankle. What does this mean for you? One of the beauties of strength and conditioning is the individual nature of athletes, meaning that everyone will respond differently to different types of training. Get in touch with the team at Radford Athletic Development today to have a program tailored to your needs, based on factors such as your body type, position played, and previous injury history. References
  • Cowie, T. March 13, 2015. Hard court: stats show netball’s injury toll. The Sydney Morning Herald Online.
  • Drew, B., & Raysmith, M. (2016). Performance success or failure is influenced by weeks lost to injury and illness in elite Australian track and field athletes: A 5-year prospective study. Journal of Science and Medicine in Sport, 19(10), 778-783.
  • Fong, D., Hong, Y., Chan, L., Yung, P., & Chan, K. (2007). A systematic review on ankle injury and ankle sprain in sports. Sports Medicine, 37(1), 73-94.
  • Pillay, T., & Frantz, J. (2012). Injury prevalence of netball players in South Africa: the need for injury prevention. South African Journal of Physiotherapy, 68(3), 7-10.
  • Pruyn, E., Watsford, M., & Murphy, A. (2015). Differences in lower-body stiffness between levels of netball competition. Journal of Strength and Conditioning Research, 29(5), 1197-1202.
  • Williams, R., & O’Donoghue, P. (2005). Lower limb injury risk in netball: A time-motion analysis investigation. Journal of Human Movement Studies, 49(5), 315-331.