A systematic video analysis of 21 anterior cruciate ligament injuries in elite netball players during games

ABSTRACT

This systematic video analysis of 21 anterior cruciate ligament (ACL) injuries sustained by elite-level netball players during televised games, describes the situation, movement pattern and player behaviour, providing insight regarding the injury mechanism. Seventeen of the ACL injuries occurred from jump-landing actions and only two from cutting manoeuvres. A common scenario was identified for 11 players. In this scenario, players were decelerating rapidly after jumping to receive a high pass, utilising a double-footed landing with a wide base of support (WBOS). Deceleration appeared to be applied predominantly via the injured leg with the knee extended and foot planted. Often the players appeared unbalanced on landing leaning too far back. ACL injury risk was possibly exacerbated by the players head turning away from the injured side. A further compressive knee moment may have been placed on the lateral aspect of the knee by bringing the ball from a high position to a low position at the estimated time of injury. Players may benefit from landing technique training programmes that encourage shoulder-width foot landings, with ≥30° knee flexion, a small amount of plantar-flexion and good balance. Incorporating challenges to players balance and ability to cope with perturbations may also be beneficial. Training programmes should include instruction on securing the ball in a stable above pelvis-level position after receiving a pass and bringing their whole body around during landing into the direction of their next pass, rather than simply turning their head to look.

KEYWORDS:

• Sports injury
• Netball
• knee
• female athletes
• motion-analysis

Practical implications

• Coaches, sport and exercise professionals and physical education teachers should instruct their players in targeted landing technique training. Instructions should encourage controlled deceleration from jumping movements, aiming for a shoulder-width apart fore-foot landing position, > 30° knees flexion and balance.

• Coaches should give specific instruction on receiving the ball and then securing it in a stable position that is not too low, as well as bringing their whole body around into the direction of their next pass rather than simply turning their head to look.

• Incorporating challenges to players balance and ability to cope with perturbation, may also be beneficial.

• Adding core, pelvic and abdominal strengthening to NMT or IPPs could be beneficial in controlling trunk motion during jump-landing and cutting mechanics.

Acknowledgments

The authors acknowledge the roles of the Netball New Zealand in providing support, as well as a meeting venue for the expert group of observers to undertake a workshop in video analysis and consensus meetings. Also acknowledged are the individuals of the expert group, who gave up their valuable time to observe the videos and supply their findings.

Data accessibility

Access to further raw or processed research data/video can be accessed through written request to the corresponding author.

Declarations

The authors declare the following financial interests/personal relationships, which may be considered as potential competing interests:

Disclosure statement

Suzanne Belcher was employed by Netball NZ throughout the period of the preparation of the manuscript. Their remuneration was not contingent upon preparing or publishing the manuscript.

Financial support

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.

Ethics

This study was granted an exemption from the need for ethics approval by Auckland University, as all video footage is publicly available and no personal player information was accessed.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.