At the wrap-up of the 2021 season, Suncorp Super Netball, Netball Australia and the Australian Institute of Sport released their Annual Injury Epidemiology report detailing the injuries of the most recent season and comparing them to seasons past.

This data can be used by teams to assist in managing injuries for future years. Resident Netball Post physiotherapist and #nettytwitterphysio Georgia cast her eye over the report and pulled out some of the more notable points to give fans an insight.

The breakdown

Across the five years of SSN, 2017–2021, a total of 1410 injuries were reported in contracted athletes, with 93.4% of players having been injured at least once. Injury numbers were relatively consistent across the five seasons, with 2019 recording the least, 241, and 2017 recording the most, 315. The larger number of injuries in the first season of SSN could be attributed to a few things, including the shorter preseason, an increase in competition intensity and a significant number of new players being introduced to the high-performance environment.

Injuries to the ankle joint were the most common, with 158 instances – the majority of these being lateral ankle sprains – reported over the five-year period. Though ankle injuries were most common, it was knee injuries that resulted in athletes either not training or participating modified training for the greatest amount of time.

This isn’t a surprise given that athletes with anterior cruciate ligament (ACL) injuries tend to take up to nine months to return to full training and 18 of these injuries have been recorded throughout SSN. Of these ACL injuries, 13 occurred during game play, one during warm-up, two during training and two were not recorded. These injuries occurred most commonly during contested landings.

Earlier seasons also saw an increased frequency of ACL injuries, with 14 recorded across 2017–2019 and only four in the last two years. Interestingly, in the earlier years more junior players sustained these injuries, such as Cody Lange, Emily Burgess, Mahalia Cassidy and Shannon Eagland, whereas in later years it was players with consistent court time, such as the Browne sisters, Kiera Austin, Ingrid Colyer and Tara Hinchliffe.

The reason for this is unclear, particularly because high-performance staff in netball have long had a focus on avoiding these injuries.

The most common injuries

The most commonly reported injuries across the history of SSN to date are lateral ankle sprains, 113, Achilles tendinopathies, 70, and patellofemoral (knee) pain, 62.

Of these three injuries, the latter two are related to repeated load and activity, while ankle sprains are more of an acute or traumatic occurrence. Despite two of the three top reported injuries being a result of prolonged loading, more than half of injuries reported in 2021 were a traumatic/acute onset, a total of 159.

Of the six reported cases of low back pain in SSN, five occurred in 2021. While nerve/brain injuries, such as concussion, had above average occurrence in 2021, this could potentially be due to an increased awareness of the dangers of concussion leading to increased effort in detection and treatment. The most commonly injured structures of the body were joints and ligaments, followed by muscles and tendons.

When and what injuries occur?

The incidence of injuries differs between preseason and in-season, with knee injuries more common during the preseason phase, and foot and ankle injuries more common during the season.

This could potentially be related to the high loading that occurs during preseason, which can cause issues such as the previously mentioned patellofemoral pain. In contrast, ankle sprains and other foot injuries are often more traumatic and tend to occur during play, either in games or during practice matches at training during the season.

More injuries were reported as being a result of training, 141, compared to 71 during games, which is to be expected when you compare the amount of time players spend training each week with their 60 minutes of game time.

Of those injuries occurring during a game, the majority were during the third quarter – likely due to fatigue setting in.

During the 2021 season there was an average of 6.5 injuries reported per round, with Round 10 being responsible for 14, the most of the year.

Interestingly, this was the round after the bye, bringing into question whether having a week off is actually beneficial or detrimental to player welfare in the long run. As expected, more injuries were reported in the second half of the 2021 season. Not only is this when loading injuries start to come into play in a regular season, but in 2021 this was when the season was condensed as COVID-19 appeared to chase the league around the country.

Where on the court did injuries occur?

Injuries were also broken down into the area of the court they occurred, with the attacking third outside of the goal circle being the most common location, followed by the centre third.

For injuries that occurred during games, the position of the player could also be noted. The positions in which athletes were injured most commonly were centre, wing attack and goal attack, which also aligns with the most common locations for injuries. Goal defence was the position that recorded the fewest injuries.

Injury reporting varied considerably among teams, but all data within the report was de-identified, meaning we can’t tell which teams suffered more with injury. Interestingly, one team consistently scored in the top two for injuries recorded across the past five years of SSN and had the highest rate of injury for the two most recent seasons.

The first main takeaway from this report is that fans don’t know even a quarter of what goes on behind club doors in terms of injuries. While we don’t need to know every minor detail, I think a more open line of communication would be fantastic. Remember this season when Maddy Proud missed a few games for injury, but no one knew what was going on? Transparency goes a long way in a league trying to increase fan engagement.

It’s also clear that injury management is continuing to improve, with injury numbers dropping as SSN progresses. For that we have all the high-performance teams to thank, because we always want to be seeing the best players out on court at full fitness.

Georgia Doyle, Physiotherapist

Header Image courtesy of @SuperNetball Twitter