Natalie Saunders

Ensuring implementation success: how should coach injury prevention education be improved if we want coaches to deliver safety programmes during training sessions?

Coaches play a major role in encouraging and ensuring that participants of their teams adopt appropriate safety practices. However, the extent to which the coaches undertake this role will depend upon their attitudes about injury prevention, their perceptions of what the other coaches usually do and their own beliefs about how much control they have in delivering such programmes. Fifty-one junior netball coaches were surveyed about incorporating the teaching of correct (safe) landing technique during their delivery of training sessions to junior players. Overall, >94% of coaches had strongly positive attitudes towards teaching correct landing technique and >80% had strongly positive perceptions of their own control over delivering such programmes. Coaches’ ratings of social norms relating to what others think about teaching safe landing were more positive (>94%) than those relating to what others actually do (63–74%). In conclusion, the junior coaches were generally receptive towards delivering safe landing training programmes in the training sessions they led. Future coach education could include role modelling by prominent coaches so that more community-level coaches are aware that this is a behaviour that many coaches can, and do, engage in.

Activity profiles of the Australian female netball team players during international competition: implications for training practice.

Abstract In elite sport, to remain competitive at the international level, it is critical to understand the game demands on players to ensure sport specific training programmes are designed for optimal athlete preparation and conditioning. In netball, recent research examining the activity patterns of players at the elite level is lacking, with only one study undertaken on this level of competition in the past 30 years. Therefore, the aim of this study was to provide coaches with up to date knowledge of player activity patterns as a basis for the design of optimal sport specific training programmes. The Australian female netball team were analysed using video footage of three international test matches. Player activity was categorised into five movement and eight game-based activities; and further classified as work or rest. Results suggest that differences in the current game exist when compared to the previous analysis. Positional differences were also found with regard to player activity confirming the need for an individualised component of training based on player position.

What is Normal? Female Lower Limb Kinematic Profiles During Athletic Tasks Used to Examine Anterior Cruciate Ligament Injury Risk: A Systematic Review

BackgroundIt has been proposed that the performance of athletic tasks where normal motion is exceeded has the potential to damage the anterior cruciate ligament (ACL). Determining the expected or ‘normal’ kinematic profile of athletic tasks commonly used to assess ACL injury risk can provide an evidence base for the identification of abnormal or anomalous task performances in a laboratory setting.ObjectiveThe objective was to conduct a systematic review of studies examining lower limb kinematics of females during drop landing, drop vertical jump, and side-step cutting tasks, to determine ‘normal’ ranges for hip and knee joint kinematic variables.Data SourcesAn electronic database search was conducted on the SPORTDiscusTM, MEDLINE, AMED and CINAHL (January 1980–August 2013) databases using a combination of relevant keywords.Study SelectionStudies identified as potentially relevant were independently examined by two reviewers for inclusion. Where consensus could not be reached, a third reviewer was consulted. Original research articles that examined three-dimensional hip and knee kinematics of female subjects during the athletic tasks of interest were included for review. Articles were excluded if subjects had a history of lower back or lower limb joint injury or isolated data from the female cohort could not be extracted.Study Appraisal and Synthesis MethodsTwo reviewers independently assessed the quality of included studies. Data on subject characteristics, the athletic task performed, and kinematic data were extracted from included studies. Studies were categorised according to the athletic task being examined and each study allocated a weight within categories based on the number of subjects assessed. Extracted data were used to calculate the weighted means and standard deviations for hip and knee kinematics (initial contact and peak values). ‘Normal’ motion was classified as the weighted mean plus/minus one standard deviation.ResultsOf 2,920 citations, a total of 159 articles were identified as potentially relevant, with 29 meeting all inclusion/exclusion criteria. Due to the limited number of studies available examining double-leg drop landings and single-leg drop vertical jumps, insufficient data was available to include these tasks in the review. Therefore, a total of 25 articles were included. From the included studies, ‘normal’ ranges were calculated for the kinematic variables of interest across the athletic tasks examined.LimitationsJoint forces and other additional elements play a role in ACL injuries, therefore, focusing solely on lower limb kinematics in classifying injury risk may not encapsulate all relevant factors. Insufficient data resulted in no normal ranges being calculated for double-leg drop land and single-leg drop vertical jump tasks. No included study examined hip internal/external rotation during single-leg drop landings, therefore ranges for this kinematic variable could not be determined. Variation in data between studies resulted in wide normal ranges being observed across certain kinematic variables.ConclusionsThe ranges calculated in this review provide evidence-based values that can be used to identify abnormal or anomalous athletic task performances on a multi-planar scale. This may be useful in identifying neuromuscular factors or specific muscular recruitment strategies that contribute to ACL injury risk.

The acute effects of conventional, complex, and contrast protocols on lower-body power.

Abstract Talpey, SW, Young, WB, and Saunders, N. The acute effects of conventional, complex, and contrast protocols on lower-body power. J Strength Cond Res 28(2): 361–366, 2014—This study compared conventional, complex, and contrast protocols on peak power (PP) output. Static vs. dynamic contractions were also manipulated to determine the effect of these confounding variables. Eighteen recreationally trained men [age, 21.1 ± 3.3 years; body mass, 81.7 ± 15.9 kg; height, 182.8 ± 6.2 cm; 5 repetition maximum (5RM) half back squat, 119.2 ± 25.4 kg; 5RM/BW, 1.5 ± 0.2 kg] involved in sports including Australian Rules football, basketball, soccer, and rugby participated in this investigation. Five protocols were executed in a randomized order, a conventional protocol in which 3 sets of 4 countermovement jumps (CMJs) were performed 2 minutes apart. Contrast protocols using a heavy resistance conditioning action of either 4 repetitions with a 5RM load or a 5-second static back squat were alternated with sets of 4 CMJs. Complex conditions with 3 sets of 4 repetitions of a 5RM back squat or a 5-second static back squat were performed before the 3 sets of CMJs. In all conditions, 4 minutes of rest followed sets of heavy resistance exercises and 2 minutes of rest followed each set of CMJs. Individual set means and a total session mean were calculated from each CMJ performed during the session. Results showed that the conventional protocol produced significantly greater PP than all conditions except for the dynamic complex and the static contrast. Results suggest that the use of the complex and contrast protocols used in this investigation should not be used for acute increases in lower-body PP in recreationally trained individuals.

A Systematic Evaluation of Field-Based Screening Methods for the Assessment of Anterior Cruciate Ligament (ACL) Injury Risk

BackgroundLaboratory-based measures provide an accurate method to identify risk factors for anterior cruciate ligament (ACL) injury; however, these methods are generally prohibitive to the wider community. Screening methods that can be completed in a field or clinical setting may be more applicable for wider community use. Examination of field-based screening methods for ACL injury risk can aid in identifying the most applicable method(s) for use in these settings.ObjectiveThe objective of this systematic review was to evaluate and compare field-based screening methods for ACL injury risk to determine their efficacy of use in wider community settings.Data SourcesAn electronic database search was conducted on the SPORTDiscus™, MEDLINE, AMED and CINAHL databases (January 1990–July 2015) using a combination of relevant keywords. A secondary search of the same databases, using relevant keywords from identified screening methods, was also undertaken.Study SelectionStudies identified as potentially relevant were independently examined by two reviewers for inclusion. Where consensus could not be reached, a third reviewer was consulted. Original research articles that examined screening methods for ACL injury risk that could be undertaken outside of a laboratory setting were included for review.Study Appraisal and Synthesis MethodsTwo reviewers independently assessed the quality of included studies. Included studies were categorized according to the screening method they examined. A description of each screening method, and data pertaining to the ability to prospectively identify ACL injuries, validity and reliability, recommendations for identifying ‘at-risk’ athletes, equipment and training required to complete screening, time taken to screen athletes, and applicability of the screening method across sports and athletes were extracted from relevant studies.ResultsOf 1077 citations from the initial search, a total of 25 articles were identified as potentially relevant, with 12 meeting all inclusion/exclusion criteria. From the secondary search, eight further studies met all criteria, resulting in 20 studies being included for review. Five ACL-screening methods—the Landing Error Scoring System (LESS), Clinic-Based Algorithm, Observational Screening of Dynamic Knee Valgus (OSDKV), 2D-Cam Method, and Tuck Jump Assessment—were identified. There was limited evidence supporting the use of field-based screening methods in predicting ACL injuries across a range of populations. Differences relating to the equipment and time required to complete screening methods were identified.LimitationsOnly screening methods for ACL injury risk were included for review. Field-based screening methods developed for lower-limb injury risk in general may also incorporate, and be useful in, screening for ACL injury risk.ConclusionsLimited studies were available relating to the OSDKV and 2D-Cam Method. The LESS showed predictive validity in identifying ACL injuries, however only in a youth athlete population. The LESS also appears practical for community-wide use due to the minimal equipment and set-up/analysis time required. The Clinic-Based Algorithm may have predictive value for ACL injury risk as it identifies athletes who exhibit high frontal plane knee loads during a landing task, but requires extensive additional equipment and time, which may limit its application to wider community settings.

Neuromuscular dysfunction that may predict ACL injury risk: a case report

This case report examined the neuromuscular function of a competitive female netball player six days prior to an incident where she sustained an acute anterior cruciate ligament injury during normal sports activity. Electromyography was used to examine activation onsets of four lower limb muscles (rectus femoris, biceps femoris, medial hamstrings and gluteus medius) relative to initial contact (IC) during netball-specific landings of varying complexity. The results of the injured participant were compared to the remaining participants in the study (n=8), and the injured participants injured limb was compared to the contralateral limb. The injured participant was the only player to record delayed pre-injury muscle onsets after IC for all muscles tested in the injured limb, while her non-injured limb was comparable to the other participants tested. Furthermore, delayed muscle onset after IC occurred more frequently as landing complexity increased. This case report suggests that delayed muscle activity onset after IC during landing may be an important risk factor for ACL injury.

Offensive Agility Techniques Performed during International Netball Competition

Netball is a sport characterised by sharp changes-of-direction to break free from opponents. The ability of players to use changes-of-direction to evade opponents is, therefore, an important aspect of attacking play. The purpose of this study was to examine the performance and outcomes of offensive agility techniques utilised by netball players. Offensive agility techniques were assessed for the type of manoeuvre performed and performance outcome using video footage of three international matches. Mid and attacking playing positions performed a greater frequency of manoeuvres than defensive playing positions. The type of manoeuvre was found to have no influence on the performance outcome. The performance outcome is likely influenced by additional factors, such as location on the court, time constraints, or features of defensive opponents. Overall, the use of offensive agility manoeuvres was identified as an important aspect of attacking play in netball, particularly for the mid and attacking playing positions.

Gait retraining versus foot orthoses for patellofemoral pain: a pilot randomised clinical trial

OBJECTIVES To determine the feasibility of a clinical trial that compares a 6-week, physiotherapist-guided gait retraining program with a foot orthoses intervention in runners with patellofemoral pain. DESIGN Pilot randomised controlled trial. METHODS Runners aged 18-40 years with clinically diagnosed patellofemoral pain were randomly allocated to either a 6-week gait retraining intervention of increasing cadence and use of a minimalist shoe or prefabricated foot orthoses. Outcomes at baseline and 12-weeks included recruitment, retention, adherence, adverse events, global improvement, anterior knee pain scale, worst and average pain on a 100mm visual analogue scale. RESULTS Of the 16 randomised participants, two withdrew prior to commencing treatment due to non-trial related matters (n=1 from each group) and 14 completed the pilot trial. Minor calf muscle soreness was reported by 3 participants in the gait retraining group while no adverse events were reported in the foot orthoses group. There were no deviations from the treatment protocols. There was a large between-group difference favouring gait retraining at 12-weeks in the anterior knee pain scale and the worst pain in the past week, which was reflected in the number needed-to-treat of 2. CONCLUSIONS This study supports the feasibility of a trial comparing gait retraining with foot orthoses and provides point estimates of effect that informs the design and planning of a larger clinical trial. It appears that a 6-week gait retraining program has a clinically meaningful effect on runners with patellofemoral pain when compared to an evidence-based treatment of foot orthoses.

Gait kinematics in individuals with acute and chronic patellofemoral pain

PurposeThis study aimed to identify the discriminating kinematic gait characteristics between individuals with acute and chronic patellofemoral pain (PFP) and healthy controls. MethodsNinety-eight runners with PFP (39 male, 59 female) and 98 healthy control runners (38 male, 60 female) ran on a treadmill at a self-selected speed while three-dimensional lower limb kinematic data were collected. Runners with PFP were split into acute (n = 25) and chronic (n = 73) subgroups on the basis of whether they had been experiencing pain for less or greater than 3 months, respectively. Principal component analysis and linear discriminant analysis were used to determine the combination of kinematic gait characteristics that optimally separated individuals with acute PFP and chronic PFP and healthy controls. ResultsCompared with controls, both the acute and chronic PFP subgroups exhibited greater knee flexion across stance and greater ankle dorsiflexion during early stance. The acute PFP subgroup demonstrated greater transverse plane hip motion across stance compared with healthy controls. In contrast, the chronic PFP subgroup demonstrated greater frontal plane hip motion, greater knee abduction, and reduced ankle eversion/greater ankle inversion across stance when compared with healthy controls. ConclusionsThis study identified characteristics that discriminated between individuals with acute and chronic PFP when compared with healthy controls. Certain discriminating characteristics were shared between both the acute and chronic subgroups when compared with healthy controls, whereas others were specific to the duration of PFP.

Challenges in the development of standards for synthetic turf for Australian football and cricket

Given the escalating drought conditions in Australia, synthetic surfaces have recently been explored as a viable surface option for community-level Australian football-cricket ovals. The vast majority of Australian football ovals are transformed into cricket pitches during the football off-season and hence the characteristics of both sports had to be duly considered in the development of standards that could be tested in a laboratory setting, for a synthetic turf surface. This paper describes the data collection and test methods undertaken in the development of the standards for synthetic surface use in Australian football and cricket. The paper also discusses the issues and challenges encountered during the development of standards for multi-sport synthetic surfaces to ensure player safety while maintaining the performance characteristics of both sports. Surface property and ball interaction tests were undertaken on natural playing surfaces, both in situ and in the laboratory to determine the properties of the current playing surface for each sport. This paper highlights the importance of careful consideration of the characteristics of both games and the use of equipment from both sports in the testing methods. The standards described in this paper have now been accepted by the Australian Football League and Cricket Australia and the product approval process and use of synthetic surfaces for Australian football and cricket is imminent.