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Principles of Prevention and
Treatment of Common Volleyball
Injuries are, regrettably, an unavoidable hazard of sports
participation. Although volleyball and beach volleyball
are by most estimates relatively safe sports – particularly
in comparison to other sports such as football (soccer)
– epidemiologic research has revealed that volleyball
athletes are at risk for certain types of injuries. Serious
injuries which interfere with the athlete’s ability to
participate have obvious immediate consequences
(time lost from training and competition) and may
have long term implications as well (chronic disability
and functional limitation). Coaches and trainers should
therefore have an understanding of the most common
volleyball-related injuries in order to appreciate the
potential impact injuries may have on the both on the
athlete and the team.
One of the first considerations in discussing the injuries
for which volleyball athletes are at risk is to define what
constitutes an injury. One accepted definition used in
research is that an injury is any condition for which
an athlete seeks medical attention. Injuries so defined
may in turn be further subdivided into conditions that
result in “time lost” from either competition or training
and those that do not limit playing time. The length of
time loss (typically reported in days or weeks) therefore
provides a measure of injury severity that can be used to
compare different types of injury. For example, in their
2004 study chronicling the injuries that occurred during
one volleyball season in the Dutch professional league,
Verhagen et al determined that shoulder injuries resulted
in an average time lost from training or competition
of 6.5 weeks – by far the longest mean absence from
participation compared to other injury sites documented
in their study.
Injuries are also commonly categorized by and compared
based upon the body part affected (e.g. shoulder, knee,
ankle, lower back). One additional useful classification
criterion is whether the athlete was injured as the result of
acute tissue overload or whether the injury resulted from
chronic overuse. Acute injuries, such as ligament sprains
and muscle strains, occur when the limits of tissue
distensibility and integrity are suddenly overwhelmed.
The athlete is usually able to recall an exact mechanism
of injury to correspond to the sudden onset of pain and
functional limitation. In contrast, overuse injuries (e.g.
tendinopathies) often occur insidiously. As a result the
injured athlete often cannot recall a specific traumatic
incident or a definite mechanism of injury. A hybrid
of these two injury mechanisms occurs when tissue
that has been weakened from overuse suddenly fails in
response to an acute load. The athlete will identify the
moment of “injury”, but may not appreciate the impact
of the chronic tissue overload that predisposed him (or
her) to ultimately develop outright tissue failure.
Numerous studies reporting on injury patterns
in volleyball have been published. Unfortunately,
differences in the definition of injury and in calculation
of incidence rates make it difficult (if not impossible)
to directly compare these studies. Nevertheless, it is
generally accepted that the most commonly occurring
injuries are acute ankle sprains, followed by overuse
conditions of the knee (patellar tendinopathy) and
shoulder (multidirectional instability, impingement) and
the lower back (nonspecific mechanical low back pain).
Chapter XII
Medical Aspects
by Dr. Roald Bahr, President of Medical Commission and Jonathan C. Reeser MD. PhD
Chapter XII -
Medical Aspects