When designing appropriate strength and conditioning programs for team sports athletes, a systematic approach must be taken. Protocols exist that must be adhered to. These protocols will allow the strength and conditioning coach to individually analyze each athlete and apply those findings to the sporting discipline that the athlete participates in. In a general sense, this series of protocols is called a Needs Analysis.
Needs Analysis for Sport
Application of a needs analysis for sport is used for two incredibly important reasons. The first reason is for the correct identification of the primary energy systems utilized during actual sports play. Correctly analyzing these systems allows the strength and conditioning professional to design a program geared towards performance enhancement (I will go more in-depth about this in a future post). The second reason for the needs analysis (and also the primary focus of this post) is to identify common injury sites associated with the sport. Once established, the strength coach then must familiarize him or herself with the mechanism of those common injuries and develop successful strategies for prevention/reduction.
Netball and Injury
Netball is known for its high incidence of injuries. Specifically knee and ankle injuries. For simplicities sake, I am going to stick with discussing youth/adolescent netball injuries. Implementation of effective injury prevention programs is paramount for youth athletes. Inclusion of appropriate protocols at younger ages could mean the difference between a lifetime of sports experience and a career cut short/plagued by injury.
Netball is primarily played by female athletes. Anyone involved with sports coaching or strength and conditioning knows that female youth athletes have an incredibly high instance of ACL and lower body non-contact injuries. In fact, a study revealed 70% of ACL injuries occurred during a non-contact condition (1). Netball is no different with the majority of injuries being of the knees and ankles. Although no singular cause can be identified, the high instance of these injuries is most likely attributed to a combination of factors ranging from anatomical, hormonal, and neuromuscular. We can’t do much in terms of the hormonal and anatomical aspects of youth female athletes. However, from a strength coaching and programming standpoint, we can work on correcting some of the neuromuscular components.
Incredibly high joint forces are evident during netball practice and competition. Including; jockeying for position, receiving/sending passes, and taking shots on the basket all require a series of intense jumps and landings as well as explosive stepping and pivoting. With this high tensile shear force amplifying movements, technique, and preparation for these scenarios is key to injury prevention and reduction.
Modalities for Injury Prevention
All human movement can be broken down into three separate segments. Concentric muscle activity involves the shortening of a muscle. This is when joint angle decreases and the muscular effort is higher than the external resistance. Isometric muscle activity, involves no change in the length of a muscle, no change in joint angle, and the muscular effort and external load is equal. Eccentric muscle action, is the lengthening of a muscle, increase in joint angle, and (most importantly for this discussion) when the external load is greater than the muscular effort. Control of eccentric muscle action is critical for efficient deceleration and changing of direction (which are commonly performed in netball). When eccentric control is poor in the lower body, it can negatively affect landing mechanics and knee stability during all movements placing the netball athlete at a higher risk of injury.
In the chaos and unpredictability of Netball gameplay, players will perform an average of one jump per minute (2). A study showed 42% of those jumps involve forward displacement whilst 26% involve jumping and landing laterally (2) 32% of jumps performed in gameplay are vertical and most players utilize this displacement when passing or receiving the ball (2). This adds a whole other aspect of jumping and landing mechanics when focused on ball control and accuracy. With all of these statistics in mind, 67% of all jumps during games, regardless of directional displacement, resulting in a unilateral (one-legged) landing (2). So, with this information, we can see how important an injury prevention training program that reinforces proper landing mechanics is for the total, overall development of netball players.
Injury Prevention Programming
Year-round emphasis must be placed on improving dynamic knee and ankle stability for all youth netball players. The best way to ensure these qualities are sufficiently developed is to design a program with a combination of resistance training exercises geared towards improving lagging muscle groups involved with shock absorption and ground reaction force load dissipation. Further, including plyometric training with a large emphasis on landing mechanics and maintaining joint integrity is vital.
Adherence to a structured Neuromuscular Training Program has been shown to reduce ACL injuries by 88% in 12-17-year-old female athletes participating in high-impact, intense team sport play (3). Other studies have also found an instance of serious knee injury was 2.4 to 3.6 times higher in high school-aged female volleyball, soccer, and basketball players that had no previous training oriented towards injury prevention and controlled eccentrics (4). As little as two 15 minute sessions a week were effective in the reduction of ACL and knee-related injuries (5).
Neuromuscular Training Programs should begin early in the offseason. A yearly training plan should follow this general outline:
- The initial weeks should be focused on instruction of landing and jumping mechanics and allow ample time for athletes to practice these skills. Becoming proficient in multi-joint, compound resistance exercises like squats, front squats, and deadlifts should take priority as well. This is called the “Accumulation Block” of the training cycle. The key goals are to recover from the previous season, improve technique on all training modalities, to introduce new skills, improve all of the general energy system components of gameplay, and to reevaluate/retest athletes in all fitness based assessments being used.
- Once technique has improved, progressing into eccentric emphasized training is key. After several weeks and visible improvement in eccentric control, the plyometric aspect should start becoming more sport specific as the season approaches and include more change of direction and ground reaction force based skills. This part of training is the “Intensification Block.” Since proficiency has been established in all technical aspects of training, not general strength qualities should take priority.
- Strength training should move more towards improving overall maximal absolute strength qualities. As the season approaches, emphasis should continue to be placed on change of direction skills, dynamic joint stability qualities, with a shift in emphasis to explosive strength based resistance training. This is the “Transformation Block.” This is the time for all aspects of training to be 100% geared towards transitioning what was gained in the weight room in the offseason to actual on field performance.
- In season training is the “Maintenance Block,” and should be designed to keep, or at least not degrade, all of the gains made in previous blocks. A huge emphasis should be placed on maintaining all eccentric based control and dynamic joint stability in order to achieve maximum benefit from injury prevention/reduction strategies.
The duration of each training block as well as specific session structure should be totally based on the needs of each individual athlete, previously established by a structured Needs Analysis. Ideally, programming should be constructed by an experienced, educated, and credentialed strength and conditioning coach. The next part of this series will go a little more in-depth as far as the organization of training and how to fit everything into a yearly plan.
1. McNair PJ, Marshall RN, and Matheson JA. Important features associated with acute anterior cruciate ligament injury. The New Zealand Medical Journal 103: 537-539, 1990
2. Davidson A and Trewartha G. Understanding the Physiological Demands of Netball: a time-motion investigation. International Journal of Performance Analysis in Sport 8: 1-17, 2008
3. Hägglund M, Atroshi I, Wagner P, and Waldén M. Superior compliance with a neuromuscular training programme is associated with fewer ACL injuries and fewer acute knee injuries in female adolescent football players: secondary analysis of an RCT. British Journal of Sports Medicine 47:974-979, 2013.
4. Hewett TE, Lindenfeld TN, Riccobene JV, and Noyes FR. The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study. The American Journal of Sports Medicine 27: 699-706, 1999.
5.Waldén M, Atroshi I, Magnusson H, Wagner P, and Hägglund M. Prevention of acute knee injuries in adolescent female football players: cluster randomised controlled trial. BMJ 344: e3042, 2012.