Netball and ACL Injuries

The game of netball is the highest participation sport for young females, with over 1 million players across Australia.

If you or someone you know is one of these females, this blog is a MUST-read.

The sport of netball consists of 60 minutes of acceleration and deceleration force changes, relying on the individual athlete’s eccentric strength. This fast-paced, high-impact game requires hard rotational movements, pivoting and eccentric controlled landing patterns.

Currently 50% of all ACL injuries in netball are from “indirect contact”, suggesting that ACL injuries in the sport can be directly linked to incorrect landing mechanisms.

In the current Australian-wide Suncorp Super Netball competition, an athlete is playing a maximum of 17 games a season with an extended 35 week off season and preseason.

So in these 35 weeks, are we doing enough to decrease the high incidence of injuries within the playing season? Could we be doing more?

Let’s dive in

Evidence suggests that the longer preseasons allow a gradual increase in training load and intensity, which protects injury rates.

The risk is never going to be 0% for ACL injuries in netball, but over time, especially from a community to elite level, we can work to reduce the incidence – especially at a community and club level.

Research has identified the various possible mechanisms that increase the probability of an ACL rupture. Specific mechanisms being flawed movement patterns during a dynamic movement – which correlates to most netball movements, causing extreme knee valgus forces.

This faulty pattern can be a result of various biomechanically incorrect movements; displacement of the trunk, lack of quadriceps control to correct knee valgus and bilateral differences in loading. Basically, this means any alteration or change in the athletes’ normal biomechanics or muscular strength and control place the anterior cruciate ligament at a very high risk of a rupture.

Due to the nature of the sport and inability to reduce the risk to 0%, we need to know what to do when these injuries occur and the preventable risk factors that each athlete, club and association should be focusing on.

As a player, coach, parent, or guardian, it is important to know the common injuries in the sport and how to minimise the risk of these injuries.

You can delve into the endless research for ACL rehabilitation, especially when associated with netball. Specific evidence most exercise professionals stick to and base any ACL rehabilitation around is the Five Phases of ACL Rehabilitation.

The Five Phases hit the structure from start to finish of ACL rehabilitation for netball athletes. Absolutely every athlete is individually considered and focuses may need to change depending on this.

Importantly, these injuries are in the game of netball, therefore it’s crucial for the sport to recognise controlling this in an elite program for each netballer.

The Five Phases of ACL Rehabilitation for Netball players:

An Athlete’s Perspective

Each ACL injury is different, and each athlete’s journey can be completely unalike or alike.

Ashlee Unie, a contracted SSN Sunshine Coast Lightning player, knows the pain of a season ending injury.

Ashlee recently suffered a ruptured ACL during a preseason match against the GIANTS netball this year.

Ashlee grew up on the Sunshine Coast and followed the typical netball pathway from club, school and representative honours. She has played in almost everything – underage state netball, Hart Sapphire Series, Australian National League, to being a training partner for the Queensland Firebirds and Sunshine Coast Lightning, with the final role of being in the ten for the Sunshine Coast Lightning and a contracted player.

So, to really get the perspective of an elite netballer who suffered an ACL injury and has experienced each level of the sport– why not hear exactly her perspective?

Do you believe clubs/associations programs for underage athletes are doing enough for ACL risk reduction?

Netball Australia do a great Knee Program aimed at prevention of ACL/knee injuries (similar to the FIFA11 in soccer which has shown great results). Perhaps more awareness that there are preventable risk factors!

How do you believe the process is different from an ACL injury in club level sport VS Suncorp Super Netball (SSN)?

The support and financial burden differ greatly.

Being a paid athlete, an injury during a game is considered an injury at work, so there is greater financial support. Conversely, at the SSN level, netball can be all consuming and leaves little room for pursuits outside the sport.

If the sport is taken away by injury at the SSN level, it can leave athletes in the lurch. In club land, as there isn’t the reliance on netball as an income stream, club athletes often have more scope outside of the sport that they are (hopefully) able to still remain involved in.

In this sense there is less of a loss of identity. Additionally, for SSN athletes, as part of a larger company, there is often greater clarity and support in regard to the rehabilitation pathway – surgeon appointments are more readily available, physios are at their disposal – than for club athletes who are often left to navigate the health system on their own.

Are preseasons in your level too long/too short? If one over the other do you think this impacts ACL incidence?

Preseasons, in my experience, have had very varied timeframes, particularly given the recent impacts of Covid-19. Long preseasons should not hinder the athlete, so long as the load throughout the extended prep is managed properly. In shorter preseasons, there is a risk that an athlete is not yet up to the physical demands of the sport and is, therefore, at greater risk of injury.

How have you personally found rehabilitation so far?

Very challenging on many levels; threatened my notions of identity, physically taxing, mentally exhausting, feeling of isolation, and hard hard work.

Reach out!

With the vast difference of rehabilitation available from club level athletes to the Suncorp Super Netball, it’s crucial for each athlete to have an established program to address prevention of ACL/knee injuries. If your club doesn’t have this, reach out to your closest accredited exercise professional and learn what they can do for your athletes TODAY!

Speak with a professional

Everyone has individual traits and abilities and if you’re new to exercise and sport it can be tough to know where to start safely.

Accredited exercise professionals are university-qualified who are equipped with the knowledge and skills to improve health, fitness, well-being, performance, and assist in the prevention of chronic conditions.

To find an accredited exercise professional near you, click here.



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Written by Accredited Exercise Physiologist, Renae Pollock. We have partnered with Nike Australia Pty Ltd for this article series. The views expressed in this article, unless otherwise cited, are exclusively those of the author, Exercise & Sports Science Australia (ESSA). ESSA is a professional organisation committed to establishing, promoting and defending the career paths of tertiary trained exercise and sports science practitioners.

Nike had no role in the collection, analysis, or interpretation of data or research or the writing of this article.