As one of the most popular team sports, volleyball is an easy game to learn, play and enjoy.
But for many players, both professional and amateur, the resulting injuries can take time to recover from. In my own personal experience playing volleyball and working with recreational athletes to elite, professional players like Kerri Walsh Jennings, I’ve witnessed a wide range of injuries both on and off the court.
Whether from overuse injuries or sudden strain, it’s a good idea to be aware of the most common volleyball injuries: so that you’ll know what to discuss with your physician or physical therapist to help get you on the mend quickly.
Types of Volleyball Injuries
Volleyball injuries are most often caused by jumping and landing. Considering that the ball can reach speeds of up to 80 mph quickly, acute injury can also happen from hitting and blocking.
Repetitive stress and overuse injuries are common because of the nature of the sport of volleyball and the parts of the body involved. Overuse injuries are typically more common than acute injuries.
The Féderation Internationale de Volleyball conducted a study among world-class professional beach volleyball players to determine the scope of the most common injuries they received. Of the 178 male and female players surveyed, their injuries could be categorized into two groups: acute and overuse.
Among acute injuries:
- 30% affected the knees
- 17% affected the ankles
- 17% affected the fingers
Among those with overuse injuries, the parts of the body most affected included:
- The lower back (19%)
- The knee(s) (12%)
- The shoulder(s) (10%)
In this detailed guide, we’ll walk through each part affected to better help both volleyball players, physical therapy professionals and sports medicine practitioners diagnose and treat the issue.
Shoulder Injuries in Volleyball
Shoulder pain occurs because the shoulder joint is the most mobile joint in the body that relies on the connecting ligaments and muscles to control its motion.
If any of these connecting or supporting structures are not working in harmony, injury can occur. When serving, setting, spiking and blocking, the stress on these different areas can cause prolonged pain or even injury. Fortunately, many shoulder injuries can be helped with the right rehabilitation exercises.
#1: Shoulder Instability
Shoulder instability refers to excessive motion of the humeral head in the glenoid. Injury or trauma, repetitive overhead sports or ligamentous laxity can lead to partial subluxation or complete dislocation of the shoulder joint.
#2: Rotator Cuff Disorder
Considering that volleyball players make thousands of hits and serves in a season, it’s understandable that the rotator cuff would be an area that’s commonly affected. Rotator cuff disorders can include a variety of issues including tendonitis, tendinopathy, partial tearing or bursitis, where the small fluid-filled sac that cushions the shoulder, becomes inflamed.
#3: Internal Impingement
When repetitive contact happens in extreme ranges of rotation within the arm and shoulder, internal impingement can occur. Proper stretching as well as exercises that help to strengthen the rotator cuff and normalize shoulder blade motion are often enough to help properly balance the shoulder joint.
#4: GIRD (Glenohumeral Internal Rotational Deficit)
Another type of injury caused by extreme external rotation, as well as an extended position of the arm and shoulder in late and early cocking is glenohumeral internal rotational deficit. Although this is more of an adaptive process rather than a specific injury, it is associated with other conditions including:
- posterior superior labral tears
- partial articular-sided rotator-cuff tears and
- superior labral anterior-to-posterior tears.
In most cases, the general treatment is to help strengthen and improve scapular mechanics by stretching and rehabilitation exercises. If non-operative physical therapy is unsuccessful, a shoulder arthroscopy can be performed to help restore the athlete to their functional baseline.
#5: Suprascapular Neuropathy
This refers to irritation and damage to the suprascapular nerve. The results of this condition can be pain or weakness in the distribution of the nerve, or both. When there’s traction or compression across extreme arm motions (such as during cocking or follow-through phases), as well as serving or hitting, this type of injury can occur. In addition, the float serve, which causes strong eccentric contraction of the infraspinatus muscle, can lead to suprascapular neuropathy.
#6: Infraspinatus Muscle Weakness and Atrophy
A stretching neuropathy of the suprascapular nerve can also cause the infraspinatus muscle to weaken, which can become permanent if left untreated. In elite, professional players there is often no pain associated with this injury, making the condition harder to detect.
The knees are another area commonly affected by strain and acute volleyball injury. ACL sprains and patellar tendinitis, described below, are two of the most common.
Fortunately, knee rehabilitation exercises can help restore baseline function and prevent injury from recurring.
#7: Patellar Tendinitis
Indoor volleyball tends to have a greater incidence of patellar tendinitis, whereas beach volleyball has a lesser tendency of this injury owing to the softness of sand, the decreased jump height and less of an eccentric load on the quadriceps when landing. Patellar tendinitis is one of the most common causes of knee problems in volleyball, and depending on the issue, the use of a brace may be a smart option to temporarily reduce pain andhelp the body recover more quickly.
#8: ACL Sprain
If a volleyball player lands awkwardly after jumping, they might hear a pop and notice their knee swelling suddenly. This can indicate a tear of the ACL or Anterior Cruciate Ligament. ACL tears do not heal on their own and reconstruction should be strongly considered if an athlete plans to return to play. Recovery time can last six months or longer. During that time, proper training techniques can help decrease the risk of reinjury.
Feet & Ankle Injuries
Foot and ankle injuries in volleyball can happen due to the quick changes in direction of the lower extremities coupled with the close contact at the net in indoor volleyball.
Considering that in a given season, volleyball players conduct thousands of serves and landings, the potential for foot and ankle injuries is high. Below are some of the most common injuries connected to volleyball.
#9: “Sand Toe”
Although the most widespread type of volleyball injury overall is ankle sprains, beach volleyball in particular has its own set of unique concerns. In addition to issues caused by foreign bodies in the sand (such as lacerations to the foot and toes caused by shells or glass), “sand toe” is another cause for concern.
Sand toe occurs when the top of the first metatarso-phalangeal joint (the joint that connects your big toe to your foot) is hyperflexed. This can happen when the foot hits the ground or is dragged forward.
#10: Inversion Ankle Sprains
An inversion ankle sprain occurs when the foot turns inward or outward at an eccentric angle. Most often, ankle injuries occur due to plantarflexion and inversion. The foot points downward and inward, causing damage to the lateral ligaments. In some cases, an ankle brace may be beneficial to stabilize the affected area.
Here again, supervised rehabilitation, as well as the old standby of RICE – rest, ice, compression and elevation, are vital to recovery. Once an ankle is sprained, recurrent sprains are common. In fact, according to Bahr et. al, there is a 42% risk of resprain in volleyball players within 6 months of the initial sprain.
#11: Achilles Tendinopathy
The Achilles tendon is what connects your heel bone to your calf muscle. Repeated tiny injuries over time, which include overuse, can cause this tendon to become inflamed and irritated. Fortunately, ice and rest, as well as special rehabilitative exercises to help strengthen and stretch the tendon, are generally enough to alleviate the symptoms of Achilles tendinitis.
Most back injuries in volleyball are centered around the lower back and are caused by muscle or ligament strain. Because players often lean forward with their arms held in front of their body, this places excessive strain on the lower back.
Also, repetitive hyperextension when hitting, serving or backsetting can cause an increased risk of back pain or possibly spondylolysis. A quality back brace, along with rest and stretching exercises, can help alleviate much of this type of pain.
#12: Low Back Pain
Although not as prevalent as ankle and shoulder injuries, lower back pain can happen on account of the players having their arms in front of their body, causing repetitive stress on lumbar joints. If the cause comes with pain that radiates down the leg or causes numbness or weakness in the foot or ankle, it may be prudent to order an MRI to detect the possibility of a herniated disc.
In addition, spondylolysis, a kind of stress fracture in the low back, can occur as a result of hyperextension when hitting the ball. Repetitive spiking and serving, as well as jump serving can increase the risk of this condition if proper rest, recovery and mechanics are not followed.
Hand and Finger Injuries
Although we’ve focused a lot on the shoulders, the hands and wrists can also be injured. In addition, finger injuries can be widespread because of the unrelenting force of the ball hitting the hand and finger joints.
Sprains, fractures, dislocations and hyperextensions can result from a focused axial load to the fingertip. In addition, other common volleyball finger injuries beyond hand and finger sprains or fractures include:
#14: PIP Ligamentous Injuries
This type of volleyball hand injury happens when trauma causes the bones in the middle joint of the finger to dislodge, causing pain and an inability to move the finger properly. There may be bruising, swelling and pain in the affected finger.
#15: Mallet Finger
This injury is also known as “baseball finger” and happens when a flying object (like a ball) strikes the tip of the finger and causes it to bend further than it should. It may also affect the thumb in a similar fashion. Typically the tip of the finger is flexed slightly and cannot be straightened without the assistance of the other hand.
Recovering from Volleyball Injuries
As you can see, there are a number of possible areas of the body that can be affected due to overuse or sudden impact from playing volleyball. However, by keeping these points in mind, not only will physiotherapists and sports medicine practitioners be able to advise their patients more confidently, but players will also be able to return to the beach faster, stronger and more agile than ever.