Volleyball
Emily A. Darr
OVERVIEW
Volleyball has become an incredibly popular sport, both recreationally and competitively. It is now one of the big five international sports (soccer, cricket, field hockey, tennis, and volleyball), and the Fédération Internationale de Volleyball (FIVB) claims it is the largest international sporting federation in the world with 220 affiliated national federations. Volleyball became an Olympic sport in 1964, and beach volleyball was added in 1996 (14).
Volleyball skills require quick, forceful movements of the entire body all at once in multiple planes, making injuries inevitable. Although considered a noncontact sport, the rate of injury had been found to be 2.6 in 1,000 hours of play. Fortunately, the incidence of serious injury is relatively low (15).
Players on the volleyball court engage in many different sport-specific skills, each with its own typical activity-related injuries. Serving, passing, and setting have not been associated with high numbers of injuries. Spiking, or attacking, has been associated with a fairly high incidence of injury, and blocking has been implicated in causing the highest rate of injury. The hand, shoulder, knee, and ankle are among the most commonly injured areas (4).
Consideration must also be given to certain injuries common to specific surfaces because volleyball is played on a variety of surfaces, such as wood, grass, concrete, and the increasingly popular sand.
LOWER EXTREMITY
Many lower extremity injuries in volleyball are due to repetitive motions, such as jumping, landing, and twisting during play. These repetitive stresses seem to be often implicated because a player may jump 150 times in the course of a match (13).
The majority of lower extremity injuries occur when the athletes are playing in the front three positions. Studies suggest that 63% of the musculoskeletal injuries result from jumping and landing, which most often occur in these positions (15). Lower extremity injuries account for the majority of volleyball injuries. In a recent review of collegiate women’s volleyball players, the lower extremity accounted for more than 55% of all game and practice injuries, with ankle ligament sprains representing 44.1% of game injuries and 29.4% of practice injuries (1).
Knee
The most commonly seen overuse injury in volleyball is patellar tendonitis or jumper’s knee. Players tend to have pain at the lower pole of the patella and, less frequently, at the upper pole and tibial tuberosity. It often has an insidious onset with pain seen with hyperextension of the knee. Initial treatment should include rest, ice, compression with a neoprene sleeve, and nonsteroidal anti-inflammatory drugs (NSAIDs). Long-term management should include vastus medialis strengthening (10).
Acute knee injuries ranging from mild sprains of the collateral ligaments to more serious anterior cruciate ligament and meniscal tears tend to be caused by quick changes in direction with landing, cutting, and pivoting on the court. This most frequently occurs while landing near the net after an attack.
For unclear reasons, these acute ligamentous injuries occur more often in females than in males. Immediate treatment includes ice and removal from play (6).
Leg
“Shin splints” or tibial periostitis can be seen in players early in the season when a sudden increase in training can cause an inflammation of the anterior and posterior tibialis muscles. Ice, rest, NSAIDs, and adjusting training regimens will typically improve the symptoms.
Prolonged or worsening typical anterior shin pain beyond the time of intense activity is concerning for stress fracture. Delayed-phase bone scans and magnetic resonance imaging (MRI) are the most sensitive tests for diagnosing this.
Foot and Ankle
Ankle injuries are the most common acute volleyball injury and account for 44% of all volleyball-related injuries according to a recent study (15). They are typically inversion sprains involving the lateral ligaments and are often a result of a blocker landing on the foot of an attacker from the opposing team under the net (12).Related posts:
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