Volleyball Injuries: Protecting Shoulders and Knees

Volleyball combines explosive jumping, powerful hitting, and quick lateral movements, creating unique injury risks for players at all levels. Whether you play indoor, beach, or recreational volleyball, understanding common injuries and prevention strategies is essential. At M.O. Therapy in Markham, we help volleyball players stay healthy and perform at their best.

Understanding Volleyball Injury Patterns

Volleyball injury statistics reveal consistent patterns:

• Ankle sprains are the most common acute injury (41% of all volleyball injuries)
• Shoulder injuries affect 8-20% of players, primarily hitters
• Knee injuries, especially patellar tendinopathy, affect 40-50% of elite players
• Finger injuries occur frequently from blocking and setting
• Back pain is common due to repetitive extension and rotation

Understanding these patterns helps players focus prevention efforts effectively.

Shoulder Injuries in Volleyball

The overhead hitting motion places tremendous stress on the shoulder, making it one of the most vulnerable areas for volleyball players.

Common Shoulder Problems

Rotator Cuff Tendinopathy:

• Most common shoulder injury in volleyball
• Results from repetitive hitting and serving
• Causes pain with overhead activities
• Can progress to partial or full tears if untreated

Shoulder Impingement:

• Compression of rotator cuff under acromion
• Pain when arm raised above shoulder level
• Often accompanies rotator cuff problems
• May cause night pain

SLAP Tears:

• Superior labrum anterior-posterior tears
• Result from repetitive overhead stress
• Can cause clicking, catching, or instability
• May require surgical repair

Shoulder Instability:

• More common in players with naturally loose shoulders
• Can be microinstability (subtle) or frank dislocations
• Affects hitting power and accuracy
• Requires comprehensive strengthening

Why Volleyball Players Develop Shoulder Problems

Repetitive Overhead Motion:

• Each spike requires extreme shoulder rotation
• High forces generated during acceleration
• Deceleration phase creates eccentric stress
• Thousands of repetitions during training

Muscle Imbalances:

• Internal rotators become dominant
• External rotators and scapular stabilizers lag
• Creates abnormal shoulder mechanics
• Leads to impingement and rotator cuff stress

Training Volume:

• High hitting volume without adequate recovery
• Serving practice adds additional stress
• Year-round play without periodization
• Insufficient rest between sessions

Shoulder Injury Prevention

Rotator Cuff Strengthening:

1. Side-lying external rotation (3x15)
2. Prone Y's, T's, and W's (3x10 each)
3. Standing external rotation with band (3x15)
4. 90/90 external rotation (3x12)

Scapular Stability:

1. Wall slides (3x15)
2. Prone scapular retraction (3x12)
3. Push-up plus (3x10)
4. Low rows with pause (3x12)

Flexibility and Mobility:

• Sleeper stretch for internal rotation
• Doorway pec stretch
• Thoracic spine rotation exercises
• Lat stretches

Training Modifications:

• Limit hitting volume during practice
• Vary serving types to reduce repetition
• Allow recovery between hitting sessions
• Address technique issues early

Knee Injuries in Volleyball

Patellar Tendinopathy (Jumper's Knee)

Jumper's knee affects up to 50% of elite volleyball players, making it one of the sport's signature injuries.

Understanding the Problem:

• Repetitive jumping creates microtrauma to patellar tendon
• Tendon degenerates faster than it can heal
• Pain develops at bottom of kneecap
• Can become chronic without proper management

Risk Factors:

• High jump frequency
• Hard playing surfaces
• Rapid increase in training volume
• Poor landing mechanics
• Weak quadriceps and hip muscles

Symptoms by Stage:

Stage 1: Pain only after activity Stage 2: Pain at start of activity, resolves with warm-up Stage 3: Pain during and after activity, affects performance Stage 4: Complete tendon rupture

Treatment Approach:

Load Management:

• Modify jump volume temporarily
• Maintain fitness with low-impact activities
• Gradual progression back to jumping

Strengthening Program:

• Isometric holds (45 seconds at 70% max)
• Heavy slow resistance training
• Eccentric decline squats
• Hip and core strengthening

Landing Mechanics:

• Soft landing with bent knees
• Distribute force through hips and ankles
• Avoid landing stiff-legged
• Train bilateral and single-leg landings

ACL Injuries

ACL tears are less common than jumper's knee but represent the most significant knee injury in volleyball.

Risk Factors:

• Female sex (4-6 times higher risk)
• Landing mechanics (knee valgus)
• Fatigue
• Single-leg landings
• Previous injury

Prevention Programs:

• Neuromuscular training
• Landing mechanic drills
• Hip and core strengthening
• Balance and proprioception work

Ankle Injuries

Ankle Sprains

Ankle sprains are the most common acute injury in volleyball, typically occurring when landing on another player's foot at the net.

Prevention Strategies:

• Ankle strengthening exercises
• Proprioception training (balance board work)
• Ankle bracing (especially after previous injury)
• Awareness during net play

Treatment:

• RICE protocol initially
• Progressive rehabilitation
• Return-to-sport when strength and balance restored
• Consider bracing for return

Finger Injuries

Finger injuries occur frequently from blocking and setting:

Common Injuries:

• Joint sprains
• Dislocations
• Fractures
• Tendon injuries

Prevention:

• Buddy taping unstable fingers
• Proper blocking technique
• Strengthening exercises
• Controlled setting practice

Treatment:

• Splinting or taping
• Range of motion exercises
• Gradual return to full contact

Back Injuries

The repeated extension and rotation during serving and hitting stress the spine.

Common Problems:

• Muscle strains
• Facet joint irritation
• Disc problems
• Spondylolysis (stress fracture)

Prevention:

• Core stability program
• Hip mobility work
• Proper hitting technique
• Gradual progression of training load

Position-Specific Injuries

Outside Hitters

• Shoulder injuries (highest risk)
• Jumper's knee
• Ankle sprains

Middle Blockers

• Finger injuries (blocking)
• Ankle sprains (net play)
• Jumper's knee (repeated jumping)

Setters

• Finger injuries
• Wrist and hand problems
• Shoulder injuries (dump shots)

Liberos/Defensive Specialists

• Diving injuries (shoulders, hips)
• Knee contusions
• Back strain

Comprehensive Prevention Program

Pre-Season Preparation

Strength Training Focus:

• Lower body power (squats, deadlifts)
• Single-leg strength
• Rotator cuff and scapular stability
• Core anti-rotation and stability

Jumping Progression:

• Start with submaximal jumps
• Progress volume before intensity
• Include landing drills
• Build to full-intensity hitting

In-Season Maintenance

Weekly Structure:

• 1-2 strength sessions (reduced volume)
• Daily mobility work
• Recovery strategies between matches
• Load monitoring

Practice Considerations:

• Limit hitting repetitions
• Vary training intensity
• Include recovery time
• Monitor athlete fatigue

Warm-Up Protocol

Dynamic Warm-Up (10-15 minutes):

1. Light jogging (2-3 minutes)
2. High knees and butt kicks
3. Lateral shuffles and carioca
4. Leg swings
5. Arm circles and shoulder prep
6. Volleyball-specific movements
7. Progressive jumping

Treatment at M.O. Therapy

Physiotherapy

• Comprehensive injury assessment
• Manual therapy techniques
• Exercise prescription
• Return-to-sport programming
• Prevention strategies

Massage Therapy

• Sports massage for recovery
• Deep tissue work
• Pre and post-match treatment
• Maintenance during season

Chiropractic Care

• Spinal and extremity assessment
• Joint mobilization
• Movement optimization
• Injury prevention

Frequently Asked Questions

How do I prevent jumper's knee in volleyball? Prevention involves managing jump volume, proper landing mechanics, strength training (especially quadriceps and hips), adequate recovery between sessions, and addressing any biomechanical issues early.

Should I wear ankle braces for volleyball? If you've had a previous ankle sprain, wearing ankle braces is strongly recommended. Even without prior injury, braces provide additional support during high-risk net activities.

How long does it take to recover from a shoulder injury? Recovery time varies significantly. Minor rotator cuff issues may resolve in 4-6 weeks, while more significant problems or labral tears can take 3-6 months or longer. Early treatment typically results in better outcomes.

Can I play volleyball with patellar tendinopathy? It depends on severity. Early-stage jumper's knee may allow modified play with proper load management, but more advanced cases require significant rest and rehabilitation. Playing through significant pain typically worsens the condition.

Book Your Assessment

If you're dealing with a volleyball injury or want to develop a prevention program, M.O. Therapy in Markham can help. Our team understands the demands of volleyball and provides specialized care.

Call (905) 201-5827 or book online for your assessment. We offer direct billing and same-day appointments for acute injuries.