Table 2 Current prevention practices of ankle sprains in netball compared to best practice recommendations

Injury Prevention Program

The NetballSmart and KNEE programs are currently endorsed by netball-governing bodies to reduce lower limb injuries, including ankle sprains. There is evidence that neuromuscular, proprioceptive, and lower limb strengthening improves proprioception, dynamic balance, and landing mechanics in netball athletes. However, poor implementation of injury prevention programs in netball may limit their effectiveness

The evidence suggests injury prevention programs are highly effective in reducing ankle sprain rates in many sports. The early signs of the netball-specific program are promising, however, further data is required to determine their effectiveness and implementation at all competition levels. This may be of benefit for NetballSmart and KNEE programs at the community level to improve adoption and implementation rates

External Ankle Support

Less than half of netball athletes wear external ankle support during netball. Two-in-three did not have external ankle support implemented when they sustained an ankle injury. Higher implementation rates are shown in netball athletes with CAI. External ankle support restricts sagittal and frontal plane kinematics but has minimal influence on kinetics. External ankle support is currently not endorsed by netball-specific injury prevention programs

There is strong evidence that taping and bracing reduces the rate of ankle sprains. As both types of external ankle support are effective, netball athletes may preferentially choose between taping and bracing. There may also be some merit for netball-governing bodies to include external ankle support as a recommendation within their injury prevention programs to improve implementation rates

Footwear

Mid-cut footwear is most commonly worn by netball athletes. Most were wearing mid-and low-cut footwear during ankle injuries. Netball-specific footwear has minimal influence on ankle kinematics but increases time to peak impact and reduce loading which may have the potential to reduce netball injuries

There is inconclusive evidence that specific types of footwear reduce the rates of an ankle sprain. Further studies are necessary for determining whether footwear types may influence ankle biomechanics during netball-specific tasks that predispose netball athletes to sustain an ankle sprain