Abstract
Volleyball is an increasingly popular team sport. As with any competitive sport, there is an inherent risk of injury that must be recognized and collaboratively managed. This article provides a practical approach to the management of volleyball injuries within a team or organization. A brief review of the epidemiological data is presented which establishes (i) ankle sprain, (ii) shoulder overuse injury, (iii) patella tendinopathy, and (iv) anterior cruciate ligament injury as the primary injuries to address amongst these athletes. The interaction of modifiable and non-modifiable risk factors for these injuries are used to classify athletes into high-, medium- and low-risk groups. Targeted training interventions are suggested, based upon the risk level of the athlete, to minimize the occurrence of these injuries. Practical methods for integrating these activities into a training plan are also discussed.
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Verhagen E, Van der Beek A, Bouter L, et al. A one season prospective cohort study of volleyball injuries. Br J Sports Med. 2004;38(4):477–81.
Reeser JC, Verhagen E, Briner WW, et al. Strategies for the prevention of volleyball related injuries. Br J Sports Med. 2006;40(7):594–600.
Bahr R, Krosshaug T. Understanding injury mechanisms: a key component of preventing injuries in sport. Br J Sports Med. 2005;39(6):324–9.
Bahr R. No injuries, but plenty of pain? On the methodology for recording overuse symptoms in sports. Br J Sports Med. 2009;43(13):966–72.
Seminati E, Minetti AE. Overuse in volleyball training/practice: a review on shoulder and spine-related injuries. Eur J Sport Sci. 2013;13(6):732–43.
Fuller CW, Ekstrand J, Junge A, et al. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Scand J Med Sci Sports. 2006;16(2):83–92.
Bahr R, Lian Ø, Bahr I. A twofold reduction in the incidence of acute ankle sprains in volleyball after the introduction of an injury prevention program: a prospective cohort study. Scand J Med Sci Sports. 1997;7(3):172–7.
Bahr R, Karlsen R, Lian Ø, et al. Incidence and mechanisms of acute ankle inversion injuries in volleyball: a retrospective cohort study. Am J Sports Med. 1994;22(5):595–600.
Schafle MD, Requa RK, Patton WL, et al. Injuries in the 1987 national amateur volleyball tournament. Am J Sports Med. 1990;18(6):624–31.
Yeung M, Chan K-M, So C, et al. An epidemiological survey on ankle sprain. Br J Sports Med. 1994;28(2):112–6.
Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train. 2002;37(4):364.
Lian ØB, Engebretsen L, Bahr R. Prevalence of jumper’s knee among elite athletes from different sports. A cross-sectional study. Am J Sports Med. 2005;33(4):561–7.
Aagaard H, Jørgensen U. Injuries in elite volleyball. Scand J Med Sci Sports. 1996;6(4):228–32.
Agel J, Palmieri-Smith RM, Dick R, et al. Descriptive epidemiology of collegiate women’s volleyball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 through 2003–2004. J Athl Train. 2007;42(2):295.
Malliaras P, Cook JL, Kent PM. Anthropometric risk factors for patellar tendon injury among volleyball players. Br J Sports Med. 2007;41(4):259–63.
Wang H, Cochrane T. A descriptive epidemiological study of shoulder injury in top level English male volleyball players. Int J Sports Med. 2001;22(02):159–63.
Mjaanes J, Briner W. Trends in shoulder injuries among elite volleyball players in the USA. Br J Sports Med. 2005;39(6):373–408.
Ferretti A, Papandrea P, Conteduca F, et al. Knee ligament injuries in volleyball players. Am J Sports Med. 1992;20(2):203–7.
Griffin LY, Albohm MJ, Arendt EA, et al. Understanding and preventing noncontact anterior cruciate ligament injuries. A review of the Hunt Valley II Meeting, January 2005. Am J Sports Med. 2006;34(9):1512–32.
Bahr R, Holme I. Risk factors for sports injuries: a methodological approach. Br J Sports Med. 2003;37(5):384–92.
Bahr R, Bahr I. Incidence of acute volleyball injuries: a prospective cohort study of injury mechanisms and risk factors. Scand J Med Sci Sports. 1997;7(3):166–71.
Konradsen L. Factors contributing to chronic ankle instability: kinesthesia and joint position sense. J Athl Train. 2002;37(4):381.
Beynnon BD, Renström PA, Alosa DM, et al. Ankle ligament injury risk factors: a prospective study of college athletes. J Orthop Res. 2001;19(2):213–20.
Delahunt E, Monaghan K, Caulfield B. Altered neuromuscular control and ankle joint kinematics during walking in subjects with functional instability of the ankle joint. Am J Sports Med. 2006;34(12):1970–6.
Willems TM, Witvrouw E, Delbaere K, et al. Intrinsic risk factors for inversion ankle sprains in females: a prospective study. Scand J Med Sci Sports. 2005;15(5):336–45.
de Noronha M, Refshauge KM, Herbert RD, et al. Do voluntary strength, proprioception, range of motion, or postural sway predict occurrence of lateral ankle sprain? Br J Sports Med. 2006;40(10):824–8.
Willems TM, Witvrouw E, Delbaere K, et al. Intrinsic risk factors for inversion ankle sprains in male subjects a prospective study. Am J Sports Med. 2005;33(3):415–23.
Augustsson S, Augustsson J, Thomeé R, et al. Injuries and preventive actions in elite Swedish volleyball. Scand J Med Sci Sports. 2006;16(6):433–40.
Stanish W, Curwin S, Rubinovich M. Tendinitis: the analysis and treatment for running. Clin Sports Med. 1985;4(4):593.
Cook J, Purdam CR. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med. 2009;43(6):409–16.
Ferretti A, Ippolito E, Mariani P, et al. Jumper’s knee. Am J Sports Med. 1983;11(2):58–62.
Langberg H, Skovgaard D, Asp S, et al. Time pattern of exercise-induced changes in type I collagen turnover after prolonged endurance exercise in humans. Calcif Tissue Int. 2000;67(1):41–4.
Visnes H, Aandahl HÅ, Bahr R. Jumper’s knee paradox: jumping ability is a risk factor for developing jumper’s knee: a 5-year prospective study. Br J Sports Med. 2013;47(8):503–7.
Ferretti A. Epidemiology of jumper’s knee. Sports Med. 1986;3(4):289–95.
Gaida J, Cook J, Bass S, et al. Are unilateral and bilateral patellar tendinopathy distinguished by differences in anthropometry, body composition, or muscle strength in elite female basketball players? Br J Sports Med. 2004;38(5):581–5.
Witvrouw E, Bellemans J, Lysens R, et al. Intrinsic risk factors for the development of patellar tendinitis in an athletic population. A two-year prospective study. Am J Sports Med. 2001;29(2):190–5.
Bisseling RW, Hof AL, Bredeweg SW, et al. Relationship between landing strategy and patellar tendinopathy in volleyball. Br J Sports Med. 2007;41(7):e8.
Bisseling RW, Hof AL, Bredeweg SW, et al. Are the take-off and landing phase dynamics of the volleyball spike jump related to patellar tendinopathy? Br J Sports Med. 2008;42(6):483–9.
Edwards S, Steele JR, McGhee DE, et al. Landing strategies of athletes with an asymptomatic patellar tendon abnormality. Med Sci Sports Exerc. 2010;42(11):2072–80.
Reeser JC, Joy EA, Porucznik CA, et al. Risk factors for volleyball-related shoulder pain and dysfunction. PM R. 2010;2(1):27–36.
Wagner H, Pfusterschmied J, Tilp M et al. Upper-body kinematics in team-handball throw, tennis serve, and volleyball spike. Scand J Med Sci Sports. 2014;24(2):345–54.
Burkhart SS, Morgan CD, Morgan CD, Ben Kibler W. The disabled throwing shoulder: spectrum of pathology part III: the SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Arthrosc J Arthrosc Relat Surg. 2003;19(6):641–61.
Hadzic V, Sattler T, Veselko M et al. Strength asymmetry of the shoulders in elite volleyball players. J Athl Train. Epub 27 Mar 2014.
Quatman CE, Hewett TE. The anterior cruciate ligament injury controversy: is “valgus collapse” a sex-specific mechanism? Br J Sports Med. 2009;43(5):328–35.
DeMorat G, Weinhold P, Blackburn T, et al. Aggressive quadriceps loading can induce noncontact anterior cruciate ligament injury. Am J Sports Med. 2004;32(2):477–83.
Goshima K, Kitaoka K, Nakase J, et al. Clinical evidence of a familial predisposition to anterior cruciate ligament injury. Br J Sports Med. 2011;45(4):350–1.
McLean SG, Felin RE, Suedekum N, et al. Impact of fatigue on gender-based high-risk landing strategies. Med Sci Sports Exerc. 2007;39(3):502.
Murphy D, Connolly D, Beynnon B. Risk factors for lower extremity injury: a review of the literature. Br J Sports Med. 2003;37(1):13–29.
Myklebust G, Engebretsen L, Brækken IH, et al. Prevention of anterior cruciate ligament injuries in female team handball players: a prospective intervention study over three seasons. Clin J Sport Med. 2003;13(2):71–8.
Pasanen K, Parkkari J, Pasanen M, et al. Effect of a neuromuscular warm-up programme on muscle power, balance, speed and agility: a randomised controlled study. Br J Sports Med. 2009;43(13):1073–8. doi:10.1136/bjsm.2009.061747.
Waldén M, Atroshi I, Magnusson H et al. Prevention of acute knee injuries in adolescent female football players: cluster randomised controlled trial. BMJ. 2012;344:e.3042. doi: 10.1136/bmj.e3042.
Celebrini RG, Eng JJ, Miller WC, et al. The effect of a novel movement strategy in decreasing ACL risk factors in female adolescent soccer players. J Strength Cond Res. 2012;26(12):3406–17.
James L, Beckman EM, Kelly VG. The impact of prehabilitation training on the development of strength and power in a block periodised training plan. J Aust Strength Cond. 2014;22(1):5–16.
Leumann A, Ebneter L, Von Tscharner V, et al. Neuromuscular patterns in chronic ankle instability. Br J Sports Med. 2011;45(4):323–4.
Kaminski TW, Hartsell HD. Factors contributing to chronic ankle instability: a strength perspective. J Athl Train. 2002;37(4):394.
Brown CN, Mynark R. Balance deficits in recreational athletes with chronic ankle instability. J Athl Train. 2007;42(3):367.
Ross SE, Guskiewicz KM, Yu B. Single-leg jump-landing stabilization times in subjects with functionally unstable ankles. J Athl Train. 2005;40(4):298.
Ross SE, Guskiewicz KM. Examination of static and dynamic postural stability in individuals with functionally stable and unstable ankles. Clin J Sport Med. 2004;14(6):332–8.
Docherty CL, Arnold BL. Force sense deficits in functionally unstable ankles. J Orthop Res. 2008;26(11):1489–93.
Eils E, Rosenbaum D. A multi-station proprioceptive exercise program in patients with ankle instability. Med Sci Sports Exerc. 2001;33(12):1991–8.
Mattacola CG, Dwyer MK. Rehabilitation of the ankle after acute sprain or chronic instability. J Athl Train. 2002;37(4):413.
Hale SA, Hertel J, Olmsted-Kramer LC. The effect of a 4-week comprehensive rehabilitation program on postural control and lower extremity function in individuals with chronic ankle instability. J Orthop Sports Phys Ther. 2007;37(6):303–11.
Stracciolini A, Meehan WP III, D’Hemecourt PA. Sports rehabilitation of the injured athlete. Clin Pediatr Emerg Med. 2007;8(1):43–53.
McKeon PO, Mattacola CG. Interventions for the prevention of first time and recurrent ankle sprains. Clin Sports Med. 2008;27(3):371–82.
Mickel TJ, Bottoni CR, Tsuji G, et al. Prophylactic bracing versus taping for the prevention of ankle sprains in high school athletes: a prospective, randomized trial. J Foot Ankle Surg. 2006;45(6):360–5.
Persson UM, Arthurs C. Dynamic postural stability in gaelic football players during a single leg drop-landing, a comparison of ankle tape and lace-up brace. Br J Sports Med. 2011;45(4):362.
Scott A, Khan K, Heer J, et al. High strain mechanical loading rapidly induces tendon apoptosis: an ex vivo rat tibialis anterior model. Br J Sports Med. 2005;39(5):e25.
Heinemeier K, Langberg H, Olesen JL, et al. Role of TGF-β1 in relation to exercise-induced type I collagen synthesis in human tendinous tissue. J Appl Physiol. 2003;95(6):2390–7.
Öhberg L, Alfredson H. Effects on neovascularisation behind the good results with eccentric training in chronic mid-portion Achilles tendinosis? Knee Surg Sports Traumatol Arthrosc. 2004;12(5):465–70.
Kugler A, Krüger-Franke M, Reininger S, et al. Muscular imbalance and shoulder pain in volleyball attackers. Br J Sports Med. 1996;30(3):256–9.
Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med. 2006;36(3):189–98.
Hamlyn N, Behm DG, Young WB. Trunk muscle activation during dynamic weight-training exercises and isometric instability activities. J Strength Cond Res. 2007;21(4):1108.
Nuzzo JL, McCaulley GO, Cormie P, et al. Trunk muscle activity during stability ball and free weight exercises. J Strength Cond Res. 2008;22(1):95–102.
Plawinski MP. An analysis of the different spike attack arm swings used in elite levels of men’s volleyball [dissertation]. Kingston (ON): Queen’s University;2008.
Seminati E, editor. The shoulder range of motion of alternative spike/serve techniques as a potential injury predictor in volleyball. In: 17th ECSS (European College of Sport Science) Congress, 2012; Bruges, Belgium.
Zebis MK, Bencke J, Andersen LL, et al. The effects of neuromuscular training on knee joint motor control during sidecutting in female elite soccer and handball players. Clin J Sport Med. 2008;18(4):329–37.
Garrett Jr W, Yu B, editors. Congruence between existing prevention programs and research on risk factors and mechanisms of noncontact ACL injury. Hunt Valley II Meeting;2005.
Henderson J, Hunter S, Berry W. The biomechanics of the knee during the parachute landing fall. Mil Med. 1993;158(12):810.
van der Worp H, van Ark M, Roerink S, et al. Risk factors for patellar tendinopathy: a systematic review of the literature. Br J Sports Med. 2011;45(5):446–52.
Beynnon BD, Fleming BC, Johnson RJ, et al. Anterior cruciate ligament strain behavior during rehabilitation exercises in vivo. Am J Sports Med. 1995;23(1):24–34.
Fleming BC, Renstrom PA, Ohlen G, et al. The gastrocnemius muscle is an antagonist of the anterior cruciate ligament. J Orthop Res. 2001;19(6):1178–84.
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No sources of funding were used to assist in the preparation of this article. The authors have no potential conflicts of interest that are directly relevant to the content of this article.
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James, L.P., Kelly, V.G. & Beckman, E.M. Injury Risk Management Plan for Volleyball Athletes. Sports Med 44, 1185–1195 (2014). https://doi.org/10.1007/s40279-014-0203-9
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DOI: https://doi.org/10.1007/s40279-014-0203-9