Prevalence of Common Injuries In Netball


Netball has been described as a game reliant on rapid acceleration to “break free” from an opponent, sudden and rapid changes in direction in combination with leaps to receive a pass, intercept a ball or rebound after attempting a goal (Steele and Milburn 1987). Thus, netball places many demands on the technical and physical skills of the player and, as a result, injuries can and do occur [Monash University, 1998].
In Australia, 95% of adult and 85% of child netball injuries occur during organised competition and practice [Monash University,1998].

The following table represents the overall statistics of netball injuries requiring hospiltisations, in Australia.

[injury issues monitor, 2006]
Injury
Percentage (%)
Fracture
-Lower radius fracture
31.9
12.9
Sprain
-ACL (anterior cruciate ligament)
25.8
14.8
Strain
-Achilles tendon
16.7
15.5
-Dislocations
27.9
injured_nb.jpg


Fractures
Fractures are the most common injuries of netball requiring hospitalisation. Fractures can be classified as a hard tissue,direct,and an acute or overuse injury. The lower radius fracture as mentioned in table above, is a common injury in netball from the result of outstretched arms absorbing impact to a fall. This injury is classified as an acute, hard tissue injury, as it is an injury to the bone, and occurring immediately during activity, therefore it is classed as an acute injury.
The best prevention is to maintain good bone health and avoid osteoporosis (decreased density of bone), and falls. Wrist guards worn on the forearms may help to prevent some fractures, but they will not prevent them all. Symptoms of a wrist fracture include; pain and swelling in the forearm or wrist, there may also be a deformity in the shape of the forearm/ wrist [University of Connecticut Health Centre, 2011],which can be seen in the Xray below (Figure1).

143447_f260.jpgThis Xray is used to diagnose the injury, and it shows the exactly where the injury site is to help with the process of rehabilitation.
Figure 1
Sprains and Strains
Sprains and strains are another common injury occurring in netball. These sprains(Figure 3) and strains (Figure 2) are classified as a soft tissue injury, as it involves damage to the ligaments (sprain), and tendons (strain). These indirect, soft tissue injuries can be classed as either acute or chronic/ overuse. Chronic injuries are the result of poor rehabilitation and reoccur after the acute stage, and can keep reoccurring until proper rehabilitation is undertaken. Overuse injuries occur through poor rehabilitation, and the continual use of the injured site. Achilles tendon injuries are a common soft tissue, overuse injury, that is very common in netball . The common cause of an injury to the Achilles tendon is due to the continual use of the injured site and degeneration on the tendon fibres that can cause it to tear or rupture. Another cause is from the usage of inappropriate footwear, placing strain on the Achilles tendon and calf muscles [Achillestendon.com,2006]. A diagram of the effects of overuse on the injured site of the achilles tendon, is shown in Figure 2. Common symptoms of injury to the Achilles tendon such as Achilles tendonitis include; inflamation in the area, tenderness in heel and tendon ( especially in morning), stiffness, decreased movement and strength in area. Symptoms may become more severe, enabling active movement, severe pain, or a loud 'pop' or 'snap' sound, indicating a rupture of the tendon [ WebMD,2011]. Prevention of strains and sprains include adequate warm up and warm down exercises before and after competition and training, and appropriate taping, ankle braces, and other preventative measures are recommended.

achilles_tendon_rupture.jpg lateral_ankle__sprain.jpgFigure 3

Figure 2
Dislocations
Dislocations are indirect(resulting from internal forces from a blow), hard tissue, acute injuries that are common in netball due to the fast, rapid nature of the sport. Dislocations of the fingers and ankles are especially common in netball. The following Xray and diagram (Figure 4 & 5) shown below, provide a clear example of what a dislocation is. Common causes of finger dislocations include; a 'Jamming' force on the tip of the outstretched finger during competition, or a force, on tip of the finger, overextending finger, resulting in dislocation [ WebMD, 2011]. Players may experience symptoms such as; tenderness at the site, crooked-like appearance of finger, and very swollen and red at site of injury [ WebMD, 2011]. To prevent from dislocation, athletes must use correct protective equipment, as well as tapping vulnerable sites, to provide extra support to area to decrease chances of possible dislocations [Mayo Clinic, 2011] .
dislocated_joint.gifdislocated-finger2.jpg
Figure 4 ( above) Figure 5 ( right hand side)


Diagnostic Measures & Tools


Various injuries are diagnosed by the following procedures, depending on the injury.

Dislocations
Dislocations are diagnosed by an examination from a doctor or another health professional, and followed up with a Xray or MRI to confirm the state of injury, and to make sure there aren't any other complications, such as broken bones. Inital treatment of RICER is used for Dislocations.

R- Rest (Rest injured site to prevent further swelling/ bleeding)

I - Ice ( Ice injured site to reduce inflammation)

C - Compression ( Apply pressure to injured site to prevent inflammation)

E - Elevate ( Elevate site to reduce swelling/ Inflammation)

R- Referral ( Refer patient on to a specialist for further treatment)

( class resources/ worksheet)

Physician will put dislocated joint back into place, usually with patient under sedation, due to the pain caused when moving injured site. This will be followed by immobilising area with either a splint or cast to promote healing and alignment, and to protect the site from further movement.
[ Packard. L, 2011]

Sprains and Strains
Sprains and strains are diagnosed in Australia by the following TOTAPS assessment tool, by a health profession or first aid officer [Mayo Clinic, 2011].

T- Talk (Talk to patient, ask what happened and find out if there has been previous history of this occurrence)

O- Observe ( Observe injured site. Look for swelling or deformities, comparing to other normal site)

T- Touch ( Touch injured area, starting away from area, then to the injured site, to locate where it is)

A- Active movement (Try and get patient to actively move the injured site, compare range of motion to other normal site)

P- Passive movement ( Move the site yourself, starting from small movements to bigger, guided by patient, until pain is experienced)

S- Skills ( See if patient can walk or stand up or bear weight)

(class resources/ worksheet)

For strains and strains the RICER treatment is used as initial treatment [ Mayo Clinic, 2011].

Fractures
For fractures the following tools are used for diagnosis. These include; Physical examinations ( TOTAPS), and Diagnostic tests such as; X rays, Computed Tomography, Magnetic Resonance Imaging, Bone Scans, and Blood Tests[Pain and Disability, 2000].The initial treatment for fractures is to immobilise the extremities in a splint and elevate the area in a sling to prevent inflammation [ Mediciene.Net, 2011]. Ice is applied to the injured site in a tea towel, to prevent inflammation, but should be applied for a maximum of 5 minutes [ Pallas.A, 2003].


The following link provides excellent information on netball injuries http://www.sportsinjuryclinic.net/sports/netball.php
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