PURPOSE: Lower-limb injury prevention in netball, particularly to the anterior cruciate ligament (ACL) is crucial. Previous injury prevention programmes (IPPs) have not always been implemented effectively by their sporting community. One of the challenges is the ‘research-to-practice‘ gap; results of controlled injury prevention studies haven’t easily translated into real-world sports settings. The Accident Compensation Corporation (ACC) (a no-fault national insurance system) invests in injury prevention and partnered with Netball New Zealand (NNZ) to create the ’NetballSmart’ injury prevention programme (NIPP).

METHODS: Targeted research was utilised to inform the successful implementation, dissemination and adoption of the NIPP. Five studies were undertaken, including epidemiological to explore age incidence differentials in two body site areas, observational video analysis investigating netball maneuvers that pose increased injury risk and two intervention studies exploring the effectiveness of two NIPP warm-up resources in improving netball specific physical capability amongst youth netball players.  

RESULTS: The largest increases in injury incidence over a 10-year period was in 10-19-year-olds with the highest cost and rate in the 20-24-year-olds. There was a spike in the injury incidence of school-age netball players at season start and prior to tournaments. Findings led-to the creation of age specific educational workshops and resources focused on effective preparation, skill transition, strengthening and balance. Observational video analysis highlighted behaviours that increased the risk of ACL injury, including landing from a jump with an extended knee, a wide base of support, fixed foot, ball placement brought low after catching and turned head position. Results led to the development of a progressive landing-skills programme. The two warm-up resources; NetballSmart Dynamic Warm-up (NSDW) and Power-Warm-up (PWU) significantly improved Y-balance, isometric mid-thigh pull ground reaction force, landing error scoring system and frontal plane projection angles. These findings supported incorporation of the PWU for all intermediate school age games before play at netball centres and at the intermediate school national tournament. This provided space, time and guidance on warming-up whilst subsequently reducing workload by 25% over tournament periods. ACC data shows between 2016-2020 a 36% reduction in overall injury claims an 11% decrease in fractures and dislocations, a 13% decrease in soft tissue injuries and a 24% decrease in ACL injury claims. During this delivery period ACC reported that the whole of life (WoL) returns on investment (ROI) increased from to NZD$4.10.

 
CONCLUSION: Creating a practical implementation plan utilizing a collaborative group and guided by targeted research contributed to effective implementation of the NIPP. A targeted social media and ambassador endorsement plan increased dissemination and use of the NSDW/PWU by 14% prior to game and 15% before training between 2017-2020.

Conflict of interest

During the preparation of the manuscript Suzanne Belcher and Sharon Kearney were employed by Netball NZ for varying periods of time. Their remuneration was not contingent upon preparing or publishing the manuscript. 

 

Minimal financial support was offered by Netball NZ for Suzanne Belcher in the form of paid transport to meetings amongst the authors regarding this publication. Otherwise, no other external financial support was given.