Netball is one of Australia’s most important team sports with over 1.2 million men, women and children playing each week, backed by a nationwide presence of more than 4,000 community clubs.
Worldwide, more than 20 million people play netball in more than 70 countries. And it’s not just for young women; men play in mixed and only male competitions, children aged 5 to 7 play in the NETSetGO program and older players play in the Walking Netball competition.
Despite its popularity, netball continually has a bad reputation for joints. Over and over again at physiotherapy clinics, we hear patients say, “I have bad knees because I played clean” or “I’m afraid to let my child play clean, isn’t it terrible for the joints?”
The research, however, shows a more nuanced story.
Yes, there is the risk of injury while playing clean, but the overall risk of serious injury is relatively small, and much more than offset by the benefit of being fit, active, and part of a team.
What are the risks of knee and ankle with netball?
Unlike other track-based sports, netball has strict rules about footwork.
Players can only take an extra step and a half after receiving the ball.
They are also restricted to certain areas of the court, depending on the position they play.
The sudden braking required by netball players requires good strength, body control and footwork.
A recent systematic review reports that netball injuries in people over the age of 15 occur primarily in the lower extremity, especially the ankle and knee. Ligament sprains are the most common injury.
Ankle injuries are more common than knee injuries, the systematic review found. And younger players tend to suffer more upper limb injuries (such as fractures) than lower limb injuries.
There are more injuries in matches than in training. Pain in the front of the patella is also very common in teenage girls who participate in jumping and pivot sports such as netball.
Insurance claim data indicates that damage to the ACL (anterior cruciate ligament, a major knee stabilizer) accounts for about 13% of the most serious netball injuries presented to emergency services.
This equates to a rate of only one injury per 2,500 participants. However, this figure probably underestimates the actual rate of injuries, as many people with these injuries go directly to their local GP or physiotherapist (rather than the hospital).
The limited data available makes it difficult to pinpoint the injury rate in community netball. But in similar court-based sports (such as handball or basketball), the ACL injury rate is one in 100-200 players per calendar year.
Although ACL injuries are rare, they are a serious injury that often requires free time from work or study and are costly to the individual and the health care system due to an increased risk of arthritis.
So is netball much worse than other sports because of the risk of joint injuries? We do not have enough data to answer this question conclusively. But what we can say from the limited evidence available is that the overall risk of knee and joint injuries in community netball is low.
Can anything be done to reduce the risk of injury to network players?
Yes! There is great evidence that injury prevention programs work, reducing ACL injuries in female athletes by up to 67%, other knee injuries by up to 50%, and all lower limb injuries by 30%. .
Netball even has its own injury prevention program, known as the KNEE program (KNEE means knee injury prevention for network players to improve performance and expand the game).
The KNEE program is a warm-up program on the court aimed at all levels of netball. It aims to improve the way players run, change direction, jump and land (as this causes knee and ankle injuries).
For pain in the front of the patella (patellofemoral pain), there is also great evidence that exercises that strengthen the hip and knee muscles, combined with tips on modifying activity, can help.
For adolescents, patellofemoral pain often occurs during periods of rapid growth, but it is important to consult a health care professional for exercise and advice, as one in three continues to experience pain after 12 months.
Yes, there are risks with netball, but the benefits far outweigh them
As a fast-moving contactless sport, netball is a great way to stay active, improve eye-manual coordination, and reap the physical, mental, and social benefits of participating in a team sport.
Being fit and strong can improve your health and reduce your risk of getting sick.
The knees in particular like to exercise; recreational runners have healthier knees than those who lead a sedentary lifestyle.
Participation in sport is especially important for teenage girls, who leave the sport at an alarming rate.
Girls who do sports have a more positive body image and better psychological well-being.
Being part of a team also helps girls enjoy shared experiences, reduce isolation, and be part of something bigger than themselves.
Many sports offer similar benefits, but all sports have some risks. If you or your children like netball, keep playing: the overall benefits of netball outweigh the potential risks.
It is important to note that netball in Australia can serve as a vehicle for empowerment, providing strong female role models to inspire current and future generations.