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Netball Injuries – Rehabilitation

Published: 01 Jun 2022

As we have seen previously,  and in my personal experience, netball has its fair share of injuries. The sudden changes in speed and direction, jumping and landing, pivoting, and often falls place high impacts on the body. Whilst traumatic injuries can occur, the risk of overuse and attritional injuries is also high. Regardless of the type of injury it is important to get a thorough assessment with your physiotherapist who will be able to create an individualised rehabilitation program to ensure minimal time is spent on the side-line. We will discuss these common injuries and the rehab required below.  We have written about the importance of the correct gear to prevent injury, and we suggest you also have a look at that information.

So you’ve hurt yourself in the second quarter on the weekend. Where to from here? This is where a physiotherapist steps in. Your physio will be able to:

• Assist with the diagnosis of the injury and find the cause
• Use a range of suitable treatment options to assist with your injury symptoms
• Implement a progressive rehabilitation program to assist with your return to netball and reach peak performance
• Provide you with the knowledge required to prevent further injuries

Sprains

When one of your ligaments is stretched beyond its normal range and can result in the ligament tearing. Most commonly in your ankle, knee or thumb.

• Grade I (mild) – little tearing, pain or swelling; good joint stability
• Grade II (moderate) – partially torn ligament but still intact, some instability with moderate to severe pain and swelling
• Grade III (severe) – complete ligament rupture, the joint is unstable, severe pain and swelling, can involve other tissues being damaged.

Strains

When one of your muscles is stretched beyond its normal range, which can result in the muscle tearing. Most commonly your hamstring, quadriceps, calf or groin.

• Grade I (mild) – little tissue tearing, tenderness and pain; full range of movement
• Grade II (moderate) – partially torn muscle of tendon tissue, moderate to severe pain, limited range of movement, some swelling or depression at the injury site
• Grade III (severe) – completely torn muscle fibres, limited or no movement, severe pain initially then it may be painless once it settles.

Typical rehabilitation of some common netball injuries:

Sprains and Strains (Grade I-II)

Phase 1 – Protection Phase (Weeks 0-1)

• Rest, ice, compression, elevation
• Swelling and pain management
• You may require a boot for stability and crutches to assist with pain for ankle sprains
• Gentle movement exercises as directed by your physiotherapist
• Non-impact program such as stationary bike or pool exercises

Phase 2 – Range of movement and gentle strengthening (Weeks 1-2)

• Continue with swelling and pain management as required
• Wean off crutches and boot (if using)
• Gait re-training education and practice (no limping)
• Movement and gentle stretching exercises
• Strength exercises such as theraband, bilateral squats, calf raises, toe raises as able
• Commence light proprioception drills
• Cycling, swimming, cross-trainer, treadmill walking as pain allows

Phase 3 – Restore Muscle Strength (Weeks 2-3)

This image is a representation of the degree of damage in varying grades of muscle strain.

• Strengthening and proprioception progressed
• Restore full range of motion
• Open and closed chain strengthening exercises
• Progress proprioception skills
• Begin straight dry land running
• Controlled agility exercises

Phase 4 – Advanced Strengthening and Return to Sports (Weeks 3-8)

• Continue with end range stretching
• Progress strengthening and proprioception
• Advance to sprinting and agility drills (you may require taping or a brace to assist with stabilising your ankle)
• Sport-specific drills (or simulation of skills)
• Education on use of brace to prevent further ankle sprains
• Muscle strengthening, balance and stretching will be emphasised to prevent reoccurrence

Tendinopathies

Tendons connect muscle to bone. Tendinopathy is a term used to refer to swelling (inflammation) and micro tears within the tendon itself from repetitive use. The most common tendinopathies seen in netball is within the Achilles tendon, patella tendon (‘Jumper’s Knee’) and the rotator cuff muscles around the shoulder.

Phase 1 – Protection Phase (Weeks 1-2)

• Rest, ice, compression, elevation
• Swelling and pain management
• Gentle movement exercises as directed by your physiotherapist

Phase 2 – Restore Range of Motion (Weeks 2-4)

• Continue with swelling and pain management as required
• Movement and stretching exercises
• Closed chain strength exercises
• Cycling, cross-trainer, treadmill walking as pain allows

Phase 3 – Restore Muscle Strength and Function (Weeks 4-6)

• Strengthening and proprioception progressed
• Open and closed chain strengthening exercises
• Jogging as pain allows

Phase 4 – Advanced Strengthening and Return to Sports (Weeks 6-12)

• Continue with end range stretching
• Advance to sprinting and agility drills
• Sport-specific drills (or simulation of skills)
• Continuation of the strengthening and stretching exercises may be recommended for up to 6 months

Dislocations

This is a displacement of one or more bones in a joint. The most common sites for netballers are fingers, followed by knee cap and shoulders.

• After the initial dislocation, it needs to be relocated as soon as possible by a qualified medical professional. An x-ray may be required to exclude a fracture
• A sling, brace or taping may be required following relocation, which your physiotherapist can assist with
• Finger dislocations may be able to return to sport once your finger has been realigned (with support) as long as it is cleared as stable and no fractures are present, although if surgery is required it can take up to 4-6 weeks
• Knee cap dislocations may take 4 weeks to 3 months for full return to netball
• Shoulder dislocations may take as long as 3 to 9 months before returning to netball
• Rehabilitation will include gradual strengthening and stabilising exercises
• Before you return to training or games, there will need to be no pain, swelling or instability, as well as you will need to have full range of motion of the joint with almost even strength to the unaffected side (approx. 90%)

Treatment for all of the above may include muscle releases (massage), ice or heat, gradual stretching and strengthening exercises, joint mobilisation, shock wave therapy, TENS machine, dry needling, biomechanical corrections (to improve techniques), shockwave therapy and education.

All rehabilitation programs require persistence and dedication to enable optimal recovery. Your physiotherapist will guide you through each stage and only progress you once able to ensure you can return to netball as soon as possible.