Abstract
Background
Netball is a female dominated dynamic and power-based sport with an inherent risk for anterior cruciate ligament (ACL) injury. The Accident Compensation Corporation (ACC) statistics (Accident Compensation Corporation Statistics, 2014) clearly illustrate a high ACL injury and reconstruction rate in netball players in New Zealand. The New Zealand netball team (the Silver Ferns) is ranked number one in the world and compared with its main opposition (Australia) has a small population base of athletes. To maintain this position, effective programmes to minimise injury risk are needed while concurrently maintaining and improving performance. Minimising risk of an ACL injury is particularly important at an International level of netball as these injuries typically prevent play at an international level for up to a year or more. Furthermore, the long term effects of such an injury can be debilitating and costly.
Strength and conditioning coaches and physiotherapists directly influence strength, conditioning and injury prevention programmes of the elite athlete, and their knowledge and beliefs determine the detail of the programmes delivered and the messages give to their athletes. In the absence of a Netball New Zealand developed and driven ACL injury prevention programme, education and delivery of ACL injury prevention is determined by strength and conditioning coaches and physiotherapists.
Objective
To explore the knowledge and understanding of perceived risk factors for ACL injury, and knowledge of evidence based ACL injury prevention strategies by physiotherapists’ and strength and conditioning coaches’ working within the high performance frame work of New Zealand Netball. Furthermore, to investigate what, if any, evidence based injury prevention strategies are being implemented by these providers.
Participants
The thirteen participants involved in the research were a purposive, convenience sample of strength and conditioning coaches and physiotherapists working within high performance netball in New Zealand.
Method
A qualitative research design using an interpretive constructive approach was selected for this research. The study involved a semi-structured open-questioning technique and a general inductive reasoning theory was used for data analysis to determine key themes from the interviews. A thematic model was developed.
Results
Based on a thematic content analysis, four key themes were identified: fragmented knowledge of ACL risk factors and link to mechanism of injury, limited knowledge of current evidenced based ACL injury prevention programmes, implementation of a comprehensive prevention strategy is ad hoc, and lack of funding, resources and faith. The study found collectively there was good overall knowledge amongst the high performance New Zealand Netball providers about intrinsic and extrinsic ACL risk factors, however individually there were gaps in knowledge and knowledge was fragmented. The providers applied individual evidence based ACL injury prevention strategies but not an overarching programme. There appeared to be a lack of a consistent, cohesive and comprehensive approach to the implementation of any ACL injury prevention programme in high performance netball in New Zealand.
Conclusion
To date, the injury prevention strategies used in high performance netball in New Zealand have maintained the ACL injury rate at a similar level to other high risk sports, potentially indicating efficacy. Past international research has focused predominantly on high school and community level athletes, consequently the effectiveness of an ACL injury prevention strategy at a high performance level has yet to be determined. There needs to be evidence based, organisationally supported approach to ACL injury prevention in New Zealand Netball as a result in this research.