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Volleyball Injuries: Shoulder, Knee, and Ankle

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Key takeaways:

  • Volleyball commonly stresses the shoulder, knee, and ankle, leading to injuries like sprains and tendinopathy.
  • Prevent ankle sprains effectively with proprioception exercises, peroneal strengthening, and proper landing techniques.
  • Manage patellar tendinopathy (jumper’s knee) through eccentric exercises, heavy slow resistance training, and careful jump volume.
  • Utilizing specific prevention programs significantly reduces injury risk, allowing safer, more enjoyable participation in volleyball.

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Table of Contents

Volleyball injuries

Volleyball is a sport characterized by repeated jumps, explosive upper limb movements, and rapid defensive reactions that significantly stress the musculoskeletal system. With over 500 million practitioners worldwide, it is one of the most popular team sports. Volleyball injuries focus on three main areas: shoulder (spike and serve), knee (landing from jumps), and ankle (landing on an opponent’s foot). Knowledge of specific pathologies and prevention programs allows for practicing this sport while significantly reducing the risk of injury.

Table of Contents

Epidemiology

Location Frequency Main pathologies
Ankle 25-30% Sprain (landing on another’s foot)
Knee 20-25% Patellar tendinopathy (jumper’s knee), ACL
Shoulder 15-25% Impingement, rotator cuff tendinopathy, SLAP
Fingers 10-15% Sprains, dislocations, fractures
Lumbar spine 5-10% Low back pain, spondylolysis

The injury rate is approximately 3-5 per 1000 hours of play, higher in matches than in training.

Ankle Injuries

Lateral sprain

The most frequent injury in volleyball, typically caused by landing on a teammate’s or opponent’s foot after a jump at the net. The mechanism is forced ankle inversion.

Prevention (very effective):

  • Proprioception: single-leg balance exercises after every training session
  • Peroneal strengthening: eversion with resistance band, 3&215;15
  • Ankle taping or brace: recommended especially for those who have already had a sprain — reduces recurrence risk by 50%
  • Landing training: land on both feet, control knee valgus

Knee Injuries

Patellar tendinopathy (jumper’s knee)

Jumper’s knee is the most frequent overuse pathology in volleyball, with a prevalence reaching 40-50% in high-level players. The patellar tendon is subjected to enormous forces during jumping and, especially, during landing.

Risk factors:

  • High volume of jumps (> 100 jumps/training)
  • Hard surface (floor compared to taraflex)
  • Quadriceps and hamstring retraction
  • Inadequate quadriceps strength
  • Incorrect landing technique (stiff knee)

Symptoms:

  • Pinpoint pain at the inferior pole of the patella
  • Pain at the start of activity, which improves with warm-up and worsens afterwards
  • In advanced cases, pain during activity and at rest

Treatment and prevention:

  • Eccentric exercises: eccentric squat on a 25° inclined plane (modified Alfredson protocol). 3 sets of 15, twice a day
  • Heavy slow resistance (HSR): slow squats and leg presses (3s up, 3s down). 3-4 sets of 6-8 repetitions
  • Quadriceps and hamstring stretching
  • Jump volume management: monitor and limit jumps in training
  • Patellar strap (infrapatellar band) during play

ACL Injury

Anterior cruciate ligament injury is less frequent than in soccer, but it represents the most severe injury. The mechanism is landing from a jump with the knee in valgus and rotation. Female athletes have a 4-6 times higher risk.

Prevention:

  • Neuromuscular programs (like FIFA 11+ adapted for volleyball)
  • Landing technique training: knees flexed, knees aligned with feet
  • Strengthening of the hamstrings and glutes

Shoulder Injuries

Volleyball player’s shoulder

The spike and jump serve produce internal rotation speeds of the arm exceeding 1500°/second, with enormous eccentric forces on the rotator cuff during the deceleration phase.

Frequent pathologies:

  • Subacromial impingement: conflict between the rotator cuff and acromion during abduction
  • Supraspinatus and infraspinatus tendinopathy: due to eccentric overload
  • GIRD (Glenohumeral Internal Rotation Deficit): loss of internal rotation due to posterior capsule retraction, typical of overhead sports
  • SLAP lesion: biceps traction on the glenoid labrum

Prevention:

  • Posterior capsule stretching (sleeper stretch): 30 seconds, 3 repetitions after each training session
  • External rotator strengthening with resistance band: at 0° and 90° of abduction, 3&215;15
  • Scapular stabilization: rowing, prone Y-T-W
  • Monitored spiking volume: avoid excessive peaks

Finger Injuries

Epidemiology is the study of injury patterns, frequencies, and causes across populations to identify risk factors and guide prevention strategies in volleyball. Fingers are frequently injured during blocking and reception. The most common injuries are:

  • Interphalangeal sprain: hyperextension mechanism during blocking
  • Dislocation: especially of the proximal interphalangeal joint
  • Phalangeal fracture: direct impact with the ball

Prevention:

  • Taping of vulnerable fingers (buddy taping or “X” taping)
  • Correct blocking technique: stiff and spread fingers
  • Strengthening of intrinsic hand muscles

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Spine Injuries

Low back pain

Hyperextension of the spine during spiking and serving, combined with trunk rotation, can cause muscular low back pain and, in young people, spondylolysis (stress fracture of the vertebral pars interarticularis).

Prevention:

  • Core stability: plank, dead bug, Pallof press
  • Thoracic spine mobility (dorsal stiffness transfers stress to the lumbar spine)
  • Correct technique: use the entire kinetic chain in the spiking motion

Prevention Program for Volleyball Players

Warm-up (15 minutes)

  • Light jogging with changes of direction (3 min)
  • Dynamic mobilization: arm circles, skips, carioca, lunges with rotation
  • Rotator cuff activation: external rotation with resistance band (2&215;10)
  • Glute activation: monster walk with resistance band (2&215;10 per side)
  • Progressive jumps: small jumps → vertical jumps → jumps with controlled landing

Strengthening program (2-3 times/week)

Shoulder:

  • External rotation with resistance band: 3&215;15
  • Sleeper stretch: 3&215;30 seconds
  • Scapular push-up: 3&215;12
  • Prone T-Y-W: 2&215;10 per position

Knee:

  • Eccentric squat on inclined plane: 3&215;15 (if symptomatic patellar tendon)
  • Nordic hamstring curl: 3&215;6-8 (ACL prevention)
  • Controlled step-down: 3&215;10 per leg
  • Single leg squat: 3&215;8 per leg

Ankle:

  • Single-leg calf raise: 3&215;15
  • Eversion with resistance band: 3&215;15
  • Single-leg balance: 3&215;30 seconds per side (eyes open, then closed)
  • Controlled single-leg landings

Core:

  • Front and side plank: 3&215;30-60 seconds
  • Dead bug: 3&215;10 per side
  • Pallof press: 3&215;10 per side

Cool-down (5-10 minutes)

  • Static stretching: shoulder, quadriceps, hamstrings, calf, adductors
  • Foam rolling of the quadriceps and IT band
  • Cryotherapy on knee and shoulder if symptomatic

Frequently Asked Questions (FAQ)

Does jumper’s knee heal?

Yes, but it requires careful load management and a specific exercise program (eccentric or heavy slow resistance) maintained for at least 3-6 months. Complete rest is generally not the best solution: it is better to reduce the volume of jumps and continue playing if the pain is tolerable (< 3/10).

Should I wear an ankle brace if I’ve already had a sprain?

Yes, it is strongly recommended. Evidence shows that taping or a semi-rigid brace reduces the risk of sprain recurrence by 50%. The brace does not weaken the ankle if used in conjunction with a strengthening and proprioception program.

How do I prevent an ACL injury in volleyball?

Neuromuscular prevention programs (similar to FIFA 11+) reduce the risk by 30-50%. Key elements are: landing training with flexed and aligned knees, hamstring strengthening, balance exercises, and controlled plyometrics.

Can I play with taped fingers?

Yes, finger taping is a very common and recommended practice in volleyball to protect the joints during blocking and reception. It does not significantly limit functionality and reduces the risk of sprains and dislocations.

Is volleyball bad for your back?

Not intrinsically, but repetitive hyperextension from serving and spiking can cause lumbar problems if not accompanied by good core stability and correct technique. A regular core stability program is the best prevention.

Frequently Asked Questions

How can volleyball players generally reduce their risk of common injuries?

Implementing a comprehensive prevention program is crucial for volleyball players. This typically includes a structured warm-up, a strengthening program targeting key muscle groups, and a cool-down routine. Utilizing specific exercises for proprioception and muscle balance can significantly lower injury incidence.

What are the most common shoulder injuries observed in volleyball players?

Volleyball players frequently experience shoulder issues due to repetitive overhead movements inherent in the sport. Common pathologies include impingement syndrome, rotator cuff tendinopathy, and SLAP lesions. These conditions often result from overuse and biomechanical stresses during actions like spiking and serving.

What specific exercises are recommended to prevent ankle sprains in volleyball?

Preventing ankle sprains in volleyball involves targeted exercises to enhance stability and strength. Proprioception exercises, such as balance training, are vital for improving joint awareness and reaction time. Additionally, strengthening the peroneal muscles and practicing proper landing techniques can significantly reduce the risk of injury.

What are the primary management strategies for patellar tendinopathy in volleyball players?

Managing patellar tendinopathy, commonly known as jumper’s knee, typically involves a structured rehabilitation approach. Key strategies include eccentric exercises and heavy slow resistance training to strengthen the patellar tendon. Careful monitoring and adjustment of jump volume are also essential to facilitate recovery and prevent recurrence.

Medical disclaimer: The information in this article is for educational and informational purposes only. It does not replace the advice of a doctor or physiotherapist. For diagnosis and treatment, please consult your trusted doctor or physiotherapist.

Sources and Scientific References

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  2. Sadaak MM et al. (2024). Effect of aquatic versus conventional physical therapy program on ankle sprain grade III in elite athletes: randomized controlled trial. J Orthop Surg Res. 19:400. DOI | PubMed
  3. Rio E et al. (2015). Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. Br J Sports Med. 49:1277-83. DOI | PubMed
  4. Cools AM et al. (2015). Prevention of shoulder injuries in overhead athletes: a science-based approach. Braz J Phys Ther. 19:331-9. DOI | PubMed
  5. Tomás CC et al. (2016). Proceedings of the 3rd IPLeiria’s International Health Congress : Leiria, Portugal. 6-7 May 2016. BMC Health Serv Res. 16 Suppl 3:200. DOI | PubMed