The epidemiology of injury and illness at the Vitality Netball World Cup 2019: an observational study

ABSTRACT

Background

Netball is a physical game with sudden direction changes, decelerations, jumping and landing, stop/start maneuvers and restrictive footwork rules exposing players to injury. Close contact play and shared facilities during tournaments, increase illness risk.

Objective: To describe incidence, period prevalence, types and severity of injuries and illnesses during the 10-day Vitality Netball World Cup 2019 (NWC).

Methods: All players from 16 teams consented (n = 192). Medical staff recorded injuries (840 exposure hours), illnesses (1440 player-days) and time-loss. Main outcome measures included incidence (I) calculated as injury/1000 player-hours and illness/1000 player-days, period prevalence (PP) and severity (time-loss) of all match injuries and illnesses.

Results

39 players sustained 46 match injuries (I = 54.76; PP = 20.31%). Lower limb injuries (I = 29.76), specifically the ankle (I = 13.10) were most common with lateral ankle ligament sprains the highest (I = 17.39). Contact injuries (I = 40.48) significantly exceeded non-contact injuries (I = 14.29; p = 0.0124). Center players sustained most injuries (n = 12; 26%; I = 14.29), followed by goalkeepers (n = 10; 22%; I = 11.90) and goal defenders (n = 8; 17%; I = 9.52). Injuries occurred in almost 50% of matches, and 67% did not result in time-loss. Time-loss injuries (n = 14; 33%) were most frequent in the lower limb (n = 10; 71%) specifically involved lateral ankle ligaments (n = 4; 29%), attributable to contact (n = 11; 79%) and mostly implicated center players and goal defenders (n = 4 each; 29% each). 11 players contracted 11 illnesses (I = 7.64; PP = 5.72%) with respiratory tract illness contributing 36%. Most illnesses did not result in time-loss (91%).

Conclusion

This is the first study reporting injury and illness during an NWC. Contact was the main mechanism of injury, and 2/3 of injuries did not result in time-loss. The ankle is most commonly injured and center players sustain most injuries. Non-respiratory system disease was most frequent, but upper respiratory tract infection remains the most common diagnosis. Targeted surveillance studies using similar methodology are required to develop injury and illness preventative strategies in elite netball.

KEYWORDS:

• Netball
• epidemiology
• severity
• injuries
• illness
• clinical characteristics

Acknowledgments

INF and the organising committee of the Vitality Netball World Cup for allowing us to conduct this important work; Clare Briegal, Chief Executive Officer of the International Netball Federation for all the assistance and advice to successfully complete this study; Medical staff that collected data; Players that consented to participate; Brenda Weder for grammar editing.

Declaration of interest

Dr Grace Bryant was the medical representative of the International Netball Federation at the Vitality Netball World Cup, Liverpool 2019 where the data used in this study was collected. The INF paid Dr Bryant’s travel and accommodation expenses. The other authors declare that there are no financial or non-financial competing interests to report.

Ethics approval

Prior to the onset of the study, the Research Ethics Committee of the Faculty of Health Sciences, University of Pretoria (REC466/2019). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

Consent to participate

All participants received information regarding the study before the start of the tournament and gave consent for the usage of their data for research.

Consent for publication

The International Netball Federation, as the custodian of the data, agreed to publication.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials (https://www.sasma.org.za/wp-content/uploads/2021/05/Supplementary-Table-1.pdf).

Authors’ contributions

Dina C (Christa) Janse van Rensburg: study concept, study planning, data cleaning, data interpretation, data analysis, manuscript writing (first draft), manuscript review & editing, approved the version to be published

Grace Bryant: study planning, manuscript review & editing, approved the version to be published

Sharon Kearney: study planning, manuscript review & editing, approved the version to be published

Praimanand Singh: study planning, manuscript review & editing, approved the version to be published

Arnold Devos: study planning, developed electronic data capturing form, manuscript review & editing, approved the version to be published

Audrey Jansen van Rensburg: study planning, data cleaning, data interpretation, data analysis, writing of the manuscript (first draft), manuscript review & editing, approved the version to be published Martin P. Schwellnus: data interpretation, manuscript review & editing, approved the version to be published

Tanita Cronje: study planning, data cleaning, data interpretation, statistical analysis, manuscript writing, manuscript review & editing, approved the version to be published

Supplementary material

Supplemental data for this article can be accessed here.

Clinical Implications

1. The most common mechanism of injury involved contact (73.9%), primarily with an opposition player (91.2%).

2. Injuries involve mostly the lower limb (54% of all injuries), and specifically lateral ankle ligament sprains (17.4% of all injuries).

3. Injuries are mostly sustained by centre players (26%), goalkeepers (22%) and goal defenders (17%).

4. Only 1/3 of injuries resulted in players not being able to compete in consecutive matches. The lower limb (71%) specifically the ankle (29%) was mostly involved. Contact was the main mechanism of injury (79%), and centre players and goal defenders mostly implicated (29%each).

5. Upper respiratory tract illness (36%) remains the most common diagnosis.

6. More studies applying the same methodology are required to provide insight on injury and illness in elite netball players and to develop appropriate prevention strategies.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The authors have no funding to report.