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SMA Conference

  • FOOT AND ANKLE CONSIDERATIONS FOR THE NETBALL ATHLETE, BEN SWEETING
  • BENCH PRESS TECHNIQUE, LISA NOTEBOOM
  • CONCUSSION PREVENTION, DR KERRY PEAK
  • FOOT AND ANKLE TAPING TECHNIQUES, KURT ROBERSTON

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Netball Foot and ankle

  • Ben sweeting- high level netball physio , and podiatrist
  • High exposure to ankle /foot forces and therefore injuries
  • 68% of Netball injuries are LL
  • Ankle sprain – median 17 days lost
  • 40% lateral ankle sprain get chronic instability- very frequent
  • Related to poor landing mechanics- need to train this! (Axit)

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Lower limb screening - General

  • Single leg calf raise (endurance testing) aim 30+
  • Single leg bridge endurance aim 25+
  • 3RM calf raise (standing/seated – smith machine)
  • Leg press strength
  • Toe grip strength (dyno)
  • ROM (knee to wall, Thomas test, STJ, MTJ, 1st MTP
  • Single leg squats
  • Y – balance (L V R) and SL balance
  • 40cm side hop test/triple hop/triple crossover tests
  • Landing error scoring system – step off a box, land and rebound – assess for errors in technique

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Injury prevention

  • Include plyometric drills into training
  • Sprint training
  • Countermovement jumps – explosive power (squat jump)
  • Individual preparation work – activation exercises
  • Wellness questionnaires – body soreness, sleep quality, fatigue, menstural cycles
  • The KNEE program – Netball Australia to reduce overall injury risk (includes ankle injuries).

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Assessment of Ankle Sprains

  • ROAST (Rehabilitation Oriented Assessment)
    • Mechanism of injury: Inversion/IR ~ LAS, ER/eversion of talus/DF ~ syndesmosis
    • History
    • Weight- bearing status: Ottawa Ankle Rules (inability to WB 4 steps post injury and bony tenderness ~ possible fracture).
    • Clinical Assessment of ligaments:
      • ATFL: pain with passive PF/inversion and anterior draw test
      • CFL: pain with passive DF/inversion
      • Syndesmosis: Squeeze test, pain on palpation of the AITFL/PITFL

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Assessment continued..

  • Gait
  • Pain levels
  • Oedema (figure 8 measurement)
  • ROM
  • Strength
  • Balance

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Return to play guidelines

  • PAAS framework:
    • Pain Severity
        • During sport participation and over last 2 hours
    • Ankle Impairements
        • Ankle ROM, Strength, endurance, power
    • Athlete perception
        • Confidence, perceived ankle stability. Psychological readiness
    • Sensorimotor control
        • Proprioception, dynamic postural control/balance
    • Sport/functional performance
        • Hopping/Jumping/Agility (Illinois/505 test), sport specific activities, complete full training session

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Illinois Agility Test

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505 Agility Test

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Rehabilitation

  • Continue to watch out for osteochondral lesion/syndesmoses – ask about instability type symptoms
  • Tape and brace works well especially getting back into full gameplay.
    • Recommended for 12 months post LAS
  • Some research on tape wearing off quickly- even as fast as 15 mins
  • Clinical applications? Tape just before game if possible

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Bench press technique- new study

  • Lisa Noteboom

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  • Shoulder issues with bench press- glenohumeral instability, Rotator cuff impingement and pec rupture
  • Variation’s :
  • grip width 1,1.5,2 bi-acromial widths
  • Abduction angle- 45, 70 , 90 degrees
  • Scapula pose- neutral or retracted
  • Measured forces through the shoulder joint and muscle

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Bench Press technique

  • Wide grip effect on muscles: increased force at pec major, anterior deltoid and supraspinatus
  • narrow grip effect on muscles: increased force at triceps, traps , infraspinatus
  • Abduction angle- results unclear
  • Wide grip effect on joints: increased force through AC and increased compression, no difference in glenohumeral joint
  • Clinical implication’s: �wide grip –Increased risk of rupture, more pec force but good training effect? May be useful for end stage pec rehab
  • Similar for rehab of AC joint rehab- be careful with Bench press, more useful at end stage? Start with narrow grip first
  • No information on scap pose

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Concussion prevention- Neck muscle training

  • Dr Kerry Peek- neck muscle training – A potential weapon to reduce sports related Head and neck injuries
  • Encouraging results in research – more to come, hasn’t published yet

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  • Warm up before sport- Hip rocks/rolls with head turns

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Ankle and Foot taping techniques

  • Achilles Taping: cross over or split tape
  • Syndesmosis Taping
  • MCL/LCL 1st Ray
  • Turf Toe
  • Plantar Plate for digits 2-5
  • 1st MT Bursitis

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Plantar Plate

Turf Toe

Achilles

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ACL Bracing Protocol

  • Criteria: need to be braces within 21 days of injury, preferably straight away
  • Exclusion Criteria
    • Displaced bucket handle tear of meniscus
    • Osteochondral loose body
    • Severe PCL injury
    • Past or prevent DVT
    • Family Hx Thrombosis

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    • Considerations: mobility, social support, medial conditions

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ACL Bracing Protocol

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ACL Bracing Protocol

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ACL Bracing Protocol

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ACL Bracing Protocol

https://balmainsportsmed.com.au/wp-content/uploads/2022/10/ACL-Bracing-October-12th.pdf