Whether it’s indoor, beach, or grass, volleyball season is always upon us in the Lower Mainland. With its dynamic movements, lightning reflexes, and explosive jumps, volleyball is a sport that epitomizes athleticism and grace. Yet, within the hustle and bustle of the game lies a silent adversary: injuries. From sprains to strains to fractures and concussions, volleyball players are no strangers to the pains that can sideline them from the sport they love. By Jolie Wong

Let’s take a dive into the world of volleyball injuries, exploring some common ones, reasons they occur, and how athletes can prevent them, amongst other things. Whether you’re a seasoned athlete, a coach, a trainer, or simply someone passionate about the game, having some foundational knowledge of injury risks is vital for safeguarding your performance and longevity in the sport. So, grab your knee pads and let’s explore the bumps, sets, and spikes of volleyball injuries.

In a sport that celebrates and highlights athleticism, every dive, spike, or block confronts its athletes with the reality of physical strain and potential injury. As you can probably guess, the most common injuries in this sport occur at the knees, ankles, and shoulders. Some examples are ankle sprains, ACL tears, shoulder impingement, rotator cuff injuries, quadricep strains, MCL tears, meniscal injuries, and shoulder dislocations. Now, you may have wondered why some people just seem more prone to these than others.

Behind every sprain, tear, or fracture lies a complex interplay of factors, both intrinsic and extrinsic, that alter the risk level for volleyball players.

Intrinsic factors are those originating from within your own body and physiology that can often be controlled or modified. Here are some examples: 

• Biomechanics: individual variations in body mechanics (ie. joint alignment, muscle imbalances, movement patterns)
• Previous injuries and joint instability: can predispose players to re-injury or compensatory movement patterns that increase risk of injury
• Neck or thoracic (upper and mid back) pain: can predispose athletes to shoulder injuries
• Joint and/or muscle stiffness
• Strength and mobility limitations
• Poor movement quality and muscular control during serving, jumping, landing, blocking, diving, and hitting
• Fitness level: poor conditioning, inadequate strength or flexibility, and fatigue
• Age, growth, and gender (unmodifiable factors)

Extrinsic factors are those often outside of an athlete’s control and can stem from the environment, training regimen, or equipment. These can include:

• Individuals on/around the court: having to maneuver around other athletes and potential collisions during a play
• Weather: imagine having to adjust your hit if the set is blown off course by a gust of wind at the beach
• Playing surface: hardwood vs sand vs grass – hard or uneven surfaces increase the risk of impact-related injuries
• Training intensity and load (modifiable): sudden increases in training volume, intensity, or frequency without sufficient rest or adequate progression of load can lead to overuse injuries

The sport pathology of volleyball encompasses a range of injuries and conditions that can affect players due to the physical demands and repetitive movements involved in the sport. Having spent a handful of years working and volunteering with elite volleyball athletes on the UBC Men’s Volleyball Team, Women’s National Volleyball Team, and Canadian Men’s Youth National Team, there are some common pathologies that I have seen among volleyball players.

Foot and Ankle Injuries:
• Ankle Sprains: due to different playing surfaces, frequent jumping and landing, and rapid changes in direction, volleyball players are more prone to rolling their ankles than most other athletic populations
• Lisfranc Injury: as a result of significant rotational force on the foot during landing or sudden changes in direction during play, volleyball players can sustain a Lisfranc if there is excessive stress on the midfoot region

Knee injuries:
• Patellar Tendinopathy (aka Jumper’s Knee): this is an overuse injury of the patellar tendon, typically caused by repetitive jumping and landing
• ACL tears: this is an injury that can occur due to sudden stops, pivots/plant-and-twist mechanisms, or awkward landings or single leg landings
• Meniscus Tears: a common mechanism of injury for the menisci are twisting movements, particularly when loaded/weightbearing

Shoulder Injuries:
• Rotator Cuff Tendinopathies: inflammation and overuse of the shoulder can occur due to the repetitive hitting and serving demands of the sport
• Labral Tears: similar to rotator cuff tendinopathies, tears in the labrum of the shoulder can happen over time from repetitive overhead motions such as hitting and serving

Hand and Finger Injuries:
• Finger Sprains and/or Fractures: these injuries most often occur from contact with the ball, such as when blocking or setting

Thumb Injuries:
the most common being skier’s thumb (affecting the ulnar collateral ligament of the thumb), which can occur from blocking or setting as well

Back Injuries:
• Spinal Compression: this typically occurs due to repetitive jumping and landing and can lead to complaints of back pain
• Muscle Strains: this is most commonly reported in the low back and can be the result of overuse, insufficient rest, twisting motions, and quick movements, amongst other mechanisms

Head and Facial Injuries:
• Concussions: this usually occurs from collisions involving other players or direct contact with the ball moving at high speed
• Other overuse Injuries not mentioned above: aside from the tendinopathies discussed above, another common overuse injury seen in volleyball players is stress fractures. These typically occur in the lower legs and feet and are the result of repetitive jumping, landing, and even running.

Have you ever had any previous or current experiences with any of the above mentioned injuries?
If yes, keep reading to learn more about what you can do!

Prevention and management strategies for these pathologies include proper conditioning and strengthening programs, correct training technique, adequate rest and recovery, use of appropriate protective equipment or preventative measures, and maintaining overall fitness and flexibility. Prompt medical evaluation and individualized rehabilitation are crucial for ensuring timely recovery and return-to-play, as well as minimizing long-term consequences or secondary impairments of said injuries.

Rehabilitating injuries requires a structured approach to ensure proper healing, regaining of strength, flexibility, and coordination, while preventing recurrence of these injuries in the future. The general guidelines for rehabilitation are as outlined below; keep in mind that some of these steps can happen in conjunction with one another! It’s important to consult a healthcare professional to discuss individualization within these steps as well because no two athletes are the same and neither are their needs to get them back into the game!

• Medical evaluation: starting with a thorough assessment conducted by a qualified healthcare professional is an important first step to diagnosing and understanding your injury and creating an individualized rehabilitation plan

• Rest and protect: active rest and protecting the injured area to prevent further damage initially, followed by a graded progression of movement to get you moving better and more. This can include use of a brace, splint, or gait aids such as crutches

• Reduce inflammation and pain: use of appropriate exercises and modalities to manage swelling and pain

• Range of motion exercises: as pain and swelling decrease, gentle range of motion exercises are used to maintain joint flexibility and prevent stiffness that may ultimately cause more pain and increase the complexity of your rehabilitation. It is typically recommended that these exercises be performed within pain-free limits

• Strength training: gradually progressing strengthening exercises, focusing on the injured area and muscles surrounding the region. This can function to improve muscle imbalances, increase stability of joints, and simply enhance muscular strength. Depending on the stage of recovery and what your specific injury is, exercises may be bodyweight, include resistance bands, or even weightlifting.

• Balance and proprioception: incorporating exercises that challenge balance and proprioception (your body’s awareness of its position in space) can help to restore neuromuscular control and reduce the risk of injury or re-injury

• Sport-specific training: as your rehabilitation process progresses, including exercises and drills that mimic volleyball movements (ie. jumping, hitting, diving) will help further you on your return-to-sport journey

• Functional rehabilitation: progressing to activities that simulate the demands of volleyball, such as agility drills, plyometrics, and practice/scrimmages under supervision will again aid in your return-to-sport process. The importance of monitoring for any signs of discomfort or weakness during these activities should be emphasized, as they will affect the progressions and regressions made to your personalized rehabilitation plan

• Cardiovascular fitness: maintaining cardiovascular conditioning through low-impact and/or non-weightbearing activities such as swimming or stationary biking can enhance your rehabilitation, especially if weightbearing exercises are limited due to your injury or stage of recovery

• Gradual return to play: ensure you are cleared to return to full, competitive play by a qualified healthcare professional. It’s important to note that you, the athlete, should feel confident and comfortable with your ability to return to your sport. A helpful method is to start with controlled practices and gradually increasing the intensity and duration while monitoring for signs and symptoms

Throughout the rehabilitation process, it is essential to follow the guidance of your healthcare team and adjust your rehabilitation program based on your progress and any setbacks that may occur along the way. Each injury and individual response to rehabilitation may vary, so personalized care and patience are key to achieving a successful return to play and preventing future injuries/re-injuries.

Many volleyball athletes I have treated report a common piece of advice they are given: do a proper warm-up and you will not get injured. While I agree with that sentiment to some extent, I think it’s fair to say that based on the discussion presented today, there are often factors that we cannot control or complex factors that require additional intervention. It’s best to get assessed to identify any limitations that may be affecting your game or ability to return to your sport.

At One Performance Institute, we’re dedicated to enhancing your game and keeping you soaring above the net, injury-free. Book in today for your injury rehabilitation needs or a comprehensive assessment to identify how you can improve your performance today! We look forward to devising a plan to help you return to volleyball pain-free and keep you performing optimally in the sport for years to come.