Volleyball

Gregory M. Cibor

Rochelle A. Cameron

Since its invention in 1895 in Massachusetts by William G. Morgan, volleyball has been one of the most popular team sports. According to its international governing body, the Federation Internationale de Volleyball (FIVB), volleyball is one of the big three international sports. With its 218 affiliated national organizations, the FIVB is the largest international sporting federation in the world. Men and women of all ages and skill levels participate on both indoor hard and outdoor sand courts. The first world championships took place in Prague, Czechoslovakia, in 1949. Volleyball made its Olympic debut in 1964 in Tokyo, and beach volleyball made its Olympic debut in 1996 in Atlanta. All levels of sport participation continue to grow exponentially today.

DESCRIPTION

Volleyball is a game played by two teams consisting of six players per team on a court measuring 60 ft in length by 30 ft in width and separated by a net. Beach volleyball consists of two teams with two players each. The net height measures 7 ft 4 in. in women’s play and 8 ft 0 in. in men’s play. Volleyball is purely a rebound sport (one cannot hold the ball). The game consists of passing (bumping), setting, spiking, digging, blocking, and serving the ball. Players each have starting positions and rotate each time a sideout occurs. A sideout occurs when a team fails to serve the ball over the net, hits the ball out of bounds, lets the ball touch the ground, or fails to return the ball back over the net after touching it three times.

Traditionally, the six positions are back right, back center, back left, front right, front center, and front left, with each player having a special assignment. One team initiates play by serving the ball over the net. The opposing players in the back row pass (dig/bump) the ball to the setters. The setters set the ball up to the spikers. Spikers (hitters/attackers) hit the ball over the net into the opponent’s court. This is called a bump-set-spike pattern. Blockers try to block the spiked ball as it crosses the net. If the block fails, then the opposing team initiates the bump-set-spike pattern, and so on. Depending on the level of play, a point is awarded to the serving team each time the opponent makes a sideout. During rally scoring, a new type of scoring adopted by colleges and international play, a point is awarded with every sideout regardless of which team actually served the ball.

The sport is played at many different levels including grade school, high school, college, professional, and Olympics. Scoring differs among different levels of competition. Currently, the best three out of five games are played at the high school level, and the first team to score 15 points wins the game. In college, club volleyball, professional, and Olympic competitions, the match is also played for best three out of five games, but the first team to score 25 or 30 points wins. Usually, a team has to win the set by two points.

REQUIRED SKILLS

Pass. This is also known as bump. The player passes or bumps a serve or a free-ball. If a ball comes over the net via a spike, the return is normally called a dig. In order to pass a ball, the player’s elbows are extended
out in front of him or her with hands clasped together below the waist to form a platform to pass the ball to the desired target. The player is also in a ready position characterized by feet shoulder width apart and knees bent at approximately 30 degrees. This allows the player to be able to move quickly to the ball and get in the desired position to pass the ball as accurately as possible to the setter.
Set. To set the ball, a player’s hands must be open and relaxed. The hands are placed about 6 in. from the player’s forehead with index fingers and thumbs forming a triangle. In addition, the elbows are flexed at about 90 degrees. When the ball approaches the hands, the ball falls into the player’s hands and then the wrists flex and the elbows extend to send the ball to the desired target, the hitter (attacker/spiker).
Spike. First, the player must approach the net to get momentum to jump and attack the ball. The approach consists of either a three-step or four-step approach taken from the 10-ft line. During the last two steps, the player flexes his or her knees, plants the heels, swings the arms back, and then explodes upward and swings at the ball at the top of his or her jump. The player uses a forward overhead arm swing to spike the ball over the net and into the opponent’s court.

Block. The player faces the net approximately one step back from the net with his or her body in ready position (elbows and shoulders at 90 degrees of flexion and knees slightly flexed). This allows the player to be able to move side to side and then to jump with the arms straight overhead to attempt to block the opponent’s spike from reaching his or her side of the court.

TABLE 39.1. REQUIRED QUALITIES FOR EXCELLING IN VOLLEYBALL

Quick coordinated movements (start/stop/change direction)	Endurance (for long matches/tournament play)
Good vertical jump (powerful legs)	Hand-eye coordination
Accuracy	Soft touch (for setting)
Flexibility Good core strength/balance	Strong rotator cuff (for serving/spiking)
Strong triceps/pectorals (for setting)	Strong latissimi (for blocking)
Good lateral speed

Serve. Serves can be either overhead or underhand. A player can perform an overhead serve from either a stationary position or perform a jump serve. From a stationary position, the player tosses the ball up into the air with the nondominant hand so that upon impact the ball will be able to clear the net on a fly. The player can either serve a floater or a top-spin serve, both of which use and stress different muscle groups. The jump serve is performed exactly like a spike approach except that it is served from the back line of the court.
Dig. A dig is very similar to a pass or bump, but the player must be able to get very low to the ground. This allows the athlete to reach the arms out as far or as low as possible to dig up the hard-hit ball by the opponent spiker. The athlete may even have to dive out onto the floor or sand to attempt to get the ball.

By its nature, volleyball is a quick sport that demands both power and finesse. As such, many qualities allow the athlete to excel in volleyball (Table 39.1).

TRAINING

A comprehensive training program that emphasizes maximizing the aforementioned qualities is essential for athletes to excel in
volleyball and minimize injury (1). Practices should include a combination of weight training, stretching, aerobic fitness, plyometrics, court/agility drills, scrimmaging, and psychological preparation. Scrimmaging and psychological preparation help develop accuracy and hand-eye coordination. Aerobic training provides good endurance to play in 8-hour tournaments. Weight training, stretching, plyometrics, and court drills enhance power, flexibility, and agility. In particular, plyometrics has become a staple of female conditioning programs because the exercises reduce the risk of anterior cruciate ligament (ACL) injury (1,2). Recent evidence suggests that teaching players to land on both feet with the knees slightly flexed and the ankles plantarflexed helps to minimize knee injuries (especially ACL tears) by dissipating the forces more evenly. Indeed, most takeoffs occur using both feet, and as a result very few acute knee injuries occur during the jumping phase. On the other hand, fewer than half of the landings occur with both feet, which causes the vast majority of acute knee injuries (3).

PREVENTIVE EXAMINATION

The pre-participation examination provides an excellent opportunity to address specific areas of the body that require proper function, strength, and range of motion prior to engaging in any activity. Ankle stability, strength, and range of motion are imperative in volleyball due to the quick starts and stops, lateral movement, and jumping/landing. Likewise, shoulder range of motion (especially external rotation), stability, and rotator cuff strength are important for serving and spiking. Normal wrist flexion and extension are essential for setting, as are strong triceps and pectorals. Strong latissimi are required to withstand the force sustained from the ball during a block. Obviously, jumping requires proper strength and flexibility of the quadriceps, the hamstrings, and the ankle complex of the gastrocnemius, soleus, and Achilles tendon. The ten-step osteopathic screening examination, as described by Greenman, helps to identify treatable somatic dysfunction lesions in all parts of the body (4).

Abdominal strength and thoracolumbar strength and mobility are essential for overall performance and endurance. Volleyballers with chronic shoulder problems may be suffering from a weak core, especially if the shoulder pain is worse when serving. The player leaps with the back extended, then flexes and torques the core to aid the shoulder in generating the arm speed and angle to drive the ball with velocity. Always evaluate the volleyball player for core abdominal strength when evaluating subacute and repetitive injuries.

TYPES OF INJURIES

Volleyball injuries can be characterized as either acute or chronic (overuse), with overuse injuries being more common than acute injuries. The majority of injuries are associated with blocking and spiking, presumably due to jumping and landing. Defense, serving, passing, and setting are associated with fewer injuries, but since all players rotate through each position they are all exposed to approximately the same rate of injury. Data from competitions show that the injury rate may be 1 in every 25 to 50 player-hours. One report showed that 53% of players suffered an injury during the course of 1 year; however, few were season-ending injuries. In addition, the type of court surface has an influence on the rate and type of injuries. For example, patellar tendinitis is more prevalent in those who play on concrete or linoleum than in those who play on softer-impact wood courts. The injury rate was five times as great when elite collegiate players played on hard indoor courts rather than soft sand courts (3,6,7,8,9,10).

The type and approximate prevalence (if available) of acute and overuse injuries are presented in Tables 39.2 and 39.3, respectively (1,2,3,4,5).

Knee

Volleyball players are prone to acute knee injuries. The most common are meniscal, medial
collateral ligament (MCL), and anterior cruciate ligament (ACL) injuries. Meniscus tears are often caused by a loaded, twisting mechanism. There is often a sudden pop and pain, with subsequent locking as well. The volleyballer diving for a dig may twist and flex the knee while falling, which can set up this injury. MCL injuries are caused by valgus and varus stresses to the knee, respectively. Jumping and landing awkwardly after a spike or serve can traumatically overload the MCL, causing sudden pain in the area of the ligament. Surgery is usually not necessary in isolated injuries, and a prophylactic knee brace to prevent varus/valgus stress aids in recovery.

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