Guest post by:

Emily A. Darr, M.D.
Assistant Professor of Physical Medicine and Rehabilitation
Department of Orthopaedic Surgery

Deanna Roberts, MS ATC
Department of Orthopaedic Surgery

Chances are, you've participated in the great sport of volleyball at a very young age. Whether it was in gym class, on a school team, or just out at the beach having fun with friends, volleyball is one of our country's favorite sports. Volleyball seems like a fairly safe, non-contact, low injury kind of a sport, right? Well, as popular as the sport has become both on the court and in the sand, a fair amount of injuries occur. Although considered a noncontact sport, the rate of injury is surprisingly high. Volleyball skills require quick, forceful movements of the entire body all at once in multiple planes, making injury inevitable. Both knee and shoulder injuries are commonly seen in volleyball players.

The shoulder accounts for 8%-20% of volleyball injuries. The majority of shoulder injuries are related to chronic overuse especially of the rotator cuff. Frequent motions involving high forces at the shoulder in multiple directions during the spiking motion are often the cause of these chronic injuries.  Muscular imbalances appear to be strongly associated with these overuse type injuries so keeping the rotator cuff super strong is very important with special attention given to stretching the shoulder. This can get rather tricky so having a Physical Therapist or Athletic Trainer show you the right way is recommended.

Rotator cuff injuries are caused by repetitive overhead hitting of the ball and/or from underlying joint instability. It can be as mild as a tendonitis or as serious as a complete rotator cuff tear. See a sports medicine specialist if you think you have an injury to your rotator cuff that doesn’t seem to get better. Treatment varies from anti-inflammatories and physical therapy to surgery depending on the severity.

Impingement syndrome occurs when the supraspinatus tendon (one of the rotator cuff muscles) becomes irritated and painful as it passes through a tight space called the subacromial space. Sometimes anatomic variances and/or joint instability from muscular imbalances can contribute to the pinching of this tendon. Painful shoulder motion, in addition to night pain, is a result of these muscular imbalances, overuse and anatomical variances. Surgical intervention may be necessary if conservative therapy fails to allow you to return to play. In some instances a corticosteroid injection is beneficial.

At the knee, you have similar forces coupled with gravity and a twisting, flexing force when you land from that high vertical. The most commonly seen overuse injury in volleyball is patellar tendonitis or jumper’s knee.

Patellar tendonitis, better known as jumper's knee, is an overuse injury that results in inflammation of the patellar tendon. In volleyball, this occurs as repetitive jumping places stress on the patellar tendon in an effort to straighten the knee. In most cases, patellar tendonitis will resolve with rest, activity modification, ice, anti-inflammatories and strengthening of the supporting muscle groups in the thigh, hip and buttocks. However, repetitive jumping without rest or treatment can lead to further injury of the tendon including rupture, which can require surgery.

Anterior cruciate ligament (ACL) injuries, although not as common in volleyball as patellar tendonitis, can occur as a result of an awkward or improper landing, or when performing a cutting or twisting movement. The ACL functions to prevent the tibia from sliding forward on the femur bone and provides rotational stability for the knee. The repetitive cutting, jumping and rotational movements involved in volleyball place players at an increased risk of ACL injuries. Depending on the severity of injury to the ACL, surgery and a lengthy rehabilitation program are considerations for most athletes. Due to the increasing number of ACL injuries occurring in the sport, many athletes are being trained with a focus on proper body mechanics and control, as well as safe landing and deceleration techniques.

Also keep in mind that some volleyball injuries are common to specific surfaces because volleyball is played on a variety of surfaces, such as wood, grass, concrete, and the increasingly popular sand!

Briner et al. Sports Med. 1997;24(1):65-71.