Netball Related Injuries, Recovery and Prevention

Kate Turner, July 2023

As many of you may know, netball is a huge passion of mine. I’ve played for over 35 years, umpired for over 20, coached for 10 years. I play for Coatham netball club, playing and umpiring in the South Durham and Cleveland netball league and coach at Stokesley Junior Netball Club. I know the demands of the sport and the love of it! It’s fast paced and intense but it’s not just the physical affects I love, also the social side and for my mental health too. As you can see, I love it just as much now as when I won trophies with Yeovil Under 16’s!

A very happy 15-year-old Kate!

The latest figures reveal netball to be the most participated team sport for women, ahead of football and cricket, increasing in popularity with men with the first ever England Men’s Netball series played against Australia in Autumn 2022. It’s the third most popular team sport in the UK overall behind football and rugby, ahead of cricket and basketball. 

With the 2023 Netball World Cup now upon us I thought I’d take some time to discuss what makes the demands of netball different to some other sports. Due to the nature of the specific areas on court that players are allowed, the footwork rule and the speed of the game the main demands are sudden acceleration, deceleration, change of direction, jumping and landing with balance and control and twisting movements. Let’s not forget the competitive nature of the game, it may be a non-contact sport but that certainly doesn’t mean there isn’t “contest”. Have a look at this video of the amazing Imogen Alison, England and Team Bath defender.

Common injuries that we see amongst netballers are Anterior Cruciate Ligament (ACL) and meniscal injuries in knees, fingers such as a volar plate fracture (balls on the end of the finger or having the finger forced backwards) and ankle sprains, especially in the circle with goal shooters and defenders tussling close together for high feeds into the circle and rebounds.

ACL injuries can be particularly prominent in women. Why? Well, this is due to a difference between males and females in their lower limb anatomy. The “Q-angle” is the angle between the pelvis and the knee. This is greater in women than in men due to their wider pelvis to facilitate childbirth. This puts more pressure on the knee with a less linear line of stress. 

There are also the natural changes that women go through during their life that can alter their biomechanics and risk of injury. Growth spurts is one such period, common for both genders, but for females puberty brings the hormonal changes of the onset of the menstrual cycle followed by, several years later, the menopause. This affects a female’s risk of injury as the hormone oestrogen, which fluctuates throughout the month and becomes depleted during the menopause, has a significant influence on tendon, ligament and cartilage health. This can mean injury and overload can become more likely, and recovery can take a little longer than in males. 

Breast tissue can also prove a risk to injury to shoulders, necks, and backs. Without a good fitting bra this risk is heightened. Did you know that running a marathon without the correct bra could mean finishing a mile behind the same you with the correct bra?! It can make that much difference to performance. 

Well, this sounds a bit depressing. But it isn’t! We just need to give our bodies the best possible scenario to avoid injury. Firstly, equipment. As previously mentioned, the right fitting bra is vital. Try these on before purchasing too and have a look at this previous blog on the importance of the correct bra size. Next, the correct trainers. There are important differences between running trainers and netball trainers; have a look at this short YouTube video where I talk about the benefits of wearing netball trainers. Away from the individual, a correctly inflated netball and secure posts can limit injury to fingers and collision injuries. 

Secondly, preparing yourself as an individual. General fitness is obviously important. The more fatigued we get during a match the more likely we are to sustain an injury. Strengthening exercises, particularly our gluteal muscles, are vital to keep our knee and ankle in a good alignment helping to prevent injury and maximise performance achieving propulsion and landing balance, enabling those interceptions and powerful passes from a strong base. Good balance and joint position sense, known as proprioception, can also be maximised with a weekly routine of exercises. I’ve put together a few exercises that can be performed 2-3 times a week that can be accessed here. A good warm up is vital, including all the movements that you would expect to perform in a netball match – 2 footed and 1 footed landings with correct knee alignment, jumps with turns in the air, sudden directional changes, receiving and passing on the move and in the air, just like these exercises. Many players ask me about taping or supports. There are definitely no adverse effects to taping as long as you don’t have an allergic reaction to the adhesive and supports can help provide confidence to move more freely on court. In fact, some latest evidence suggests taping and supports can help activate muscles. Ensure you fuel appropriately pre match and keep hydratedthroughout the day on building up to an evening match and through the match/training session too. Finally, good recovery taking on protein and hydration, even more important when teenagers are going through a growth spurt. 

So, as I get older or sustain an injury should I stop playing? Not necessarily! The beauty of netball is the flexibility it has to enable you to continue the social, psychological and physical benefits the sport has. You can consider changing position, moving down a division, trying out walking netball to reduce the impact (eg. Thirsk walking netball club), moving into umpiring or coaching. Be aware though that a good umpire needs to keep up with the game, sudden sprints and changes of direction are vital here too. 

What about returning to play after a baby or after injury? There are some nice tests you can try out in a sports hall to compare your rehabilitating lower limb to your fit side such as the single leg squat, the single hop test, triple hop, triple cross over hop (https://www.physio-pedia.com/Hop_Test) , side hop, and the star excursion balance test. It is recommended that your recovering limb is within 85% of your uninjured limb before returning to competitive sport. Full rehabilitation and a phased return to netball is vital to help prevent re-injury. Physiotherapy can be vital to get you back to full fitness. Post-partum, it is advisable to have a Mummy MOT to check your pelvic floor and abdominal recovery before returning. The amount of jumping can pressurise a weakened pelvic floor and could impact its recovery. Following this, work on your general fitness and strength as described above. 

As with any sport or exercise, netball helps provide regular movement and muscle activity that can support joints and our bodily systems to maintain a healthy weight and body and prevent injuries and illness throughout our lives. And it’s the best sport in the world (disclaimer – I am biased)!

For more information England Netball have put together this fantastic website which is a great resource for all things female and netball – NetballHer: https://netballher.co.uk.

As always, please get professional advice if you are unsure. Contact us to find out more how expert physiotherapy can help you continue in the sport you (and I!) love.