Common Volleyball Injuries

The Below information does not substitute evaluation by a trained physician or trainer.  Please consult with your physician before beginning any diagnosis and treatment.

Rotator Cuff Injury

What are the rotator cuff muscles?

The rotator cuff muscles control rotation of the shoulder. They consist of the infraspinatus, teres minor and supraspinatus which rotate the shoulder outwards and the subscapularis which is one of the muscles which rotate the shoulder inwards. These muscles are put under a great deal of strain especially in throwing events and racket sports where your arm is above your head a lot. A sudden sharp pain in the shoulder would indicate a possible rupture of a tendon, while a gradual onset is more likely to be inflammation.

Symptoms also include:

Pain on overhead activity such as throwing or racket sports

Pain when you bend the arm and rotate it outwards against resistance.

Pain on the outside of the shoulder possibly radiating down into the arm.

Pain in the shoulder which is worse at night.

Stiffness in the shoulder joint.

What can the athlete do?

Rest and ice the shoulder for 2 to 4 days depending on how bad the injury is.

If the acute stage is over, pain and inflammation have settled down apply heat.

See a sports injury professional who can advise on treatment and rehabilitation.

What can a sports injury specialist or doctor do?

Prescribe anti-inflammatory medication.

Apply ultrasound or laser treatment.

Prescribe a rehabilitation program.

Use sports massage and stretching techniques.

Give a steroid injection.

Operate if needed.

It is easier to prevent this injury from occurring in the first place. Careful attention should be applied to strengthening the rotator cuff muscles by doing outward rotation exercises with elastic or light weights.

 

Hand Injuries

Hand injuries are common when attempting to block a a spiked ball. Sprains and strains are most common, followed by fractures and contusions and dislocations with the thumb and little finger being most at risk. The metacarpophalangeal joint of the thumb is the most commonly injured ligament in the hand (known as a thumb sprain ) along with finger sprains .

 

Thumb sprain

When the thumb is bent out of it’s normal range of movement (usually backwards), damage occurs to the ligaments supporting the joint at the bottom of the thumb (metacarpo-phalangeal joint). It is common in skiing, contact sports and ball sports such as basketball and netball.

What are the symptoms?

Pain when the thumb is bent backwards.

Pain in the web of the thumb when it is moved.

Swelling over the joint at the bottom of the thumb.

Laxity and instability in the joint.

What can the athlete do?

Rest. A good taping technique can help the joint rest by providing support and preventing further damage.

Apply Ice – this will help reduce pain and swelling. Never apply ice directly to the skin as it may burn the skin. A wet tea towel or similar should prevent this.

Compress with a compression support bandage.

What can a sports injury specialist or doctor do?

Check the injury to rule out a total rupture of the ligament.

Advise on mobilization exercises.

Operate if required.

How long will it take to heal?

Most athletes are able to return to sport within 4 to 6 weeks depending on severity of injury – sometimes sooner

It is important that strengthening exercises are done to restore stability and prevent re-injury.

If the injury is not treated properly then there is a greater risk of re-injury and permanent instability, which will eventually require surgery.

 

Finger Sprain

A sprained finger occurs when the finger is bent in some way causing damage to the ligaments which connect bones together. It is common in ball games such as American football, basketball, cricket, handball etc. It is common for the ligaments at the side of the finger (collateral ligaments) to be damaged

Symptoms:

Pain over the joint in the finger where the damage has occurred.

Pain when bending the finger and stressing the injured ligament.

Possible swelling over the joint.

Restricted mobility and movement in the finger.

Instability in the finger if the injury is severe or a complete rupture of the ligament has occurred.

What can the athlete do?

Rest the finger and apply ice.

Ice massage with a single ice cube may be suitable.

Tape the finger to protect it while it is healing.

What can a sports injury specialist or doctor do?

Advise on rehabilitation.

Tape the finger for support.

Operate if required for example on a complete rupture.

 

Jumpers Knee

The patella tendon (or ligament as it is sometimes called) connects the kneecap to tibia bone. Under extreme stresses such as those involved in jumping a partial rupture can occur. This can often lead to inflammation and degeneration of the tissue. Inflammation can also result from overuse. Injury to this often affects athletes involved in jumping or throwing sports. Weight lifters, Tennis and Badminton players can also be affected. Rest in the early stages is important.

What are the symptoms?

Pain at the bottom of the kneecap especially when pressing in.

Aching and stiffness after exertion.

Pain when you contract the quadriceps muscles. 

What the athlete can do depends on the extent or grade of the injury:

Grade 1: Pain only after training

Continue training but apply ice or cold therapy to the injury after each training session

Wear a heat retainer or support

See a sports injury specialist/therapist who can apply sports massage techniques and advise on rehabilitation. An eccentric strengthening programme is generally recommended

Grade 2: Pain before and after exercise but pain reduces once warmed up.

Modify training activities to reduce the load on the tendon. Stop jumping or sprinting activities and replace them with steady running or swimming / running in water if necessary.

See a sports injury specialist/therapist who can apply sports massage techniques and advise on rehabilitation.

Grade 3: Pain during activity which prevents you from training/performing at your best.

Rest completely from the aggravating activity. Replace it with swimming/running in water (if pain allows).

See a sports injury specialist/therapist who can apply sports massage techniques and advise on rehabilitation.

Grade 4: Pain during every day activities, which may or may not be getting worse.

Rest for a long period of time (at least 3 months!).

See a sports injury specialist/therapist who can apply sports massage techniques and advise on rehabilitation.

If the knee does not respond to rehabilitation then consult an Orthopaedic Surgeon as surgery may be required.

A Sports Injury Specialist or Doctor could:

Prescribe anti-inflammatory medication e.g. ibuprofen.

Use ultrasound or laser treatment.

Use cross friction massage techniques.

Prescribe and supervise a full rehabilitation program.

 

Sprained Ankle

The most common type of ankle injury is a sprain. A sprain is stretching and tearing of ligaments. (You sprain a ligament and strain a muscle). The most common damage done in an ankle sprain is to the talo-fibula ligament. If the injury is worse you might also damage the calcanao-fibula ligament. In addition to the ligament damage you could well have damaged tendons as well.

There are three degrees of ligament sprain:

First degree:

Some stretching or perhaps tearing of the ligament.

Little or no joint instability.

Mild pain

Little swelling

Some joint stiffness.

Second degree:

Some tearing of the ligament fibres

Moderate instability of the joint

Moderate to severe pain

Swelling and stiffness  

Third degree:

Total rupture of a ligament

Gross instability of the joint

Severe pain initially followed by no pain

Severe swelling

What can the athlete do?

Aim to reduce the swelling by R.I.C.E. (Rest, Ice, Compression, Elevation) as soon as possible.

Protect the injured ankle by taping or a support (although do not rely on them for ever as this will weaken the joint).

Rest the injured ankle – use crutches if necessary – no weight bearing for 24 hours, longer if necessary.

See a sports injury specialist who can advise on rehabilitation including mobility, and strengthening.

What can a sports injury specialist do about it?

Prescribe anti inflammatory medication.

Reduce swelling by compression devices.

Use ultra sound and laser treatment.

Use cross friction massage

Prescribe a full rehabilitation programme.

Back Injuries

Back injuries account for up to 14% of all Volleyball Injuries. The back is placed under a huge amount of strain when jumping, bending backwards and twisting. Back injuries can be complex in nature and require the attention of expert and experienced therapists.

 

Suprascapular Neuropathy

This is a condition found in Volleyball players and other ‘overhead sports’ where the nerve that runs along the top of the shoulder blade becomes compressed. It is thought to be caused by the “floater serve” where the player must stop the overhead follow through immediately after striking the ball.

 

Shin Splints

Shin splints is the name given to pain at the front of the lower leg. The most common cause is inflammation of the periostium of the tibia (sheath surrounding the bone). The injury is an overuse injury and can be caused by running on hard surfaces or running on tip toes. It is also common in sports where a lot of jumping is involved. If you over pronate then you are also more susceptible to this injury.

Symptoms include:

Tenderness over the inside of the shin.

Lower leg pain.

Sometimes some swelling.

Lumps and bumps over the bone.

Pain when the toes or foot are bent downwards.

A redness over the inside of the shin

What can the athlete do about it?

Rest. The sooner you rest the sooner it will heal.

Apply ice in the early stages when it is very painful

Wear shock absorbing insoles in shoes

Maintain fitness with other non weight bearing exercises.

Apply heat and use a heat retainer after the initial acute stage, particularly before training.

See a sports injury specialist who can advise on treatment and rehabilitation.

What can a sports injury specialist or doctor do?

Prescribe anti-inflammatory medication e.g. ibuprofen. (Always consult a doctor before taking medication).

Tape the ankle for support. – A taping worn all day will allow the shin to rest properly.

Analyse running style for over pronation

Use sports massage techniques on the posterior deep muscle compartment but avoid the inflammed periostium.

Operate

Important

Anti inflammatory drugs along with rest and ice can help reduce inflammation, particularly in the early stages. However if the underlying causes such as tight muscles are not treated through stretching and sports massage techniques then the likelyhood of the injury returning is higher.

 

Groin Strain

There are five adductor muscles, the pectineus, adductor brevis and adductor longus (called short adductors) go from the pelvis to the thigh bone and the gracilis and adductor magnus (long adductors) go from the pelvis to the knee. The main function of these muscles is to pull the legs together. They are also used quite a lot in sprinting, playing football, horse riding and hurdling. A rupture or tear in the muscle usually occurs when sprinting, twisting or when kicking something that doesn’t move.

Symptoms include:

Tightening of the groin muscles that may not be present until the day after competition.

A sudden sharp pain in the groin area or adductor muscles.

Bruising or swelling (this might not occur until a couple of days after the initial injury)

Lumps and bumps over the bone.

Inability to contract the adductor muscles

A lump or gap in the adductor muscles.

Grade 1, 2 or 3?

Groin strains are graded 1, 2, or 3 depending on how bad they are.

The athlete with a grade 1 strain might feel mild discomfort, possibly a little tenderness at a particular point but no swelling.

A grade 2 strain might feel more painful with swelling, pain to touch, reduced range of motion and interference with running.

A grade 3 strain may be very painful, lots of swelling and total inability to run or even walk.

 

What can the athlete do?

Apply R.I.C.E. (Rest, Ice, Compression, Elevation) immediately.

Rest and use crutches if needed.

See a sports injury professional who can advise on rehabilitation of the injury.

For a grade 3 strain seek professional help immediately

 

What can a sports injury specialist or doctor do?

Use ultrasound or laser treatment.

Use sports massage techniques after the acute phase (very important).

Operate if the muscle has torn completely.

Advise on a rehabilitation programme consisting of soft tissue treatment, stretching, strengthening and sports massage.

A partial rupture of the adductor muscles will often lead to inflammation after the initial rupture has healed.

 

Hamstring Strain

A hamstring strain or a pulled hamstring as it is sometimes called is a tear in one of the hamstrings muscles (Semitendinosis, Semimembrinosis and Biceps femoris). It often results from an overload of the muscles or trying to move the muscles too fast. If you have taken an impact in the back of the leg it must be treated as a contusion. Otherwise read on. Strains are common in all sports especially ones where sprinting is involved. Running injury to the hamstring is very common. They range from a complete rupture of the muscle to small micro tears that the athlete will probably not notice at the time.

Symptoms include:

A sudden sharp pain at the back of the leg.

Muscles going into spasm.

Swelling and bruising.

If the rupture is very bad you may feel a gap in the muscle

 

Strains are graded 1, 2 or 3 depending on severity. A grade 1 might consist of small micro tears in the muscle. A grade 2 would be a partial tear in the muscle and grade 3 is a severe or complete rupture of the muscle.

 

Grade 1: What does it feel like?

Might have tightness in the thigh.

May be able to walk properly.

Probably won’t have much swelling.

Lying on front and trying to bend the knee against resistance probably won’t produce much pain.

 

What can the athlete do?

Use a compression bandage or heat retainer until you feel no pain.

See a sports injury professional who can advise on rehabilitation and strengthening.

 

 

What can a Sports Injury Specialist or Doctor do?

Use sports massage techniques to speed up recovery (very important).

Use ultrasound and electrical stimulation

Prescribe a rehabilitation programme.

 

Grade 2: What does it feel like?

Probably cannot walk properly.

May get occasional sudden twinges of pain during activity.

May notice swelling.

Pressing in causes pain.

Bending the knee against resistance causes pain.

Might be unable to fully straighten the knee.

 

What can the athlete do?

Ice, compress, elevate, use crutches for 3 to 5 days.

See a sports injury specialist who can advise on rehabilitation.

 

What can a Sports Injury Specialist or Doctor do?

Use sports massage techniques to speed up recovery (very important).

Use ultrasound and electrical stimulation

Prescribe a rehabilitation programme including stretching and strengthening exercises.

 

Grade 3: What does it feel like?

Unable to walk properly without the aid of crutches.

In severe pain.

Bad swelling appear immediately.

A static contraction will be painful and might produce a bulge in the muscle.

Expect to be out of competition for 3 to twelve weeks or more.

 

What can the athlete do?

Seek medical attention immediately.

R.I.C.E. (Rest, Ice, Compress, Elevate.) Use crutches.

See a sports injury professional who can advise on rehabilitation and prevention.

 

What can a Sports Injury Specialist or Doctor do?

Use sports massage techniques to speed up recovery (very important).

Use ultrasound and electrical stimulation.

Prescribe a rehabilitation programme and monitor it.

Operate if needed.

 

 

Calf Strain

The calf muscles consist of the Gastrocnemius which is the big muscle at the back of the lower leg and the Soleus muscle which is a smaller muscle lower down in the leg and under the Gastrocnemius. Either of these two muscles can be strained (torn).

 

Symptoms include:

A sudden pain at the back of the leg.

Difficulty in contracting the muscle or standing on tip toe.

Pain and swelling or bruising in the calf muscle.

If the rupture is very bad you may feel a gap in the muscle

A sudden sharp pain in the calf muscle followed by difficulty using it usually a give away for a calf strain. The most common place to get this injury is at the muscle – tendon junction of the Gastrocnemius roughly half way between the knee and the heel. You can test for this by contracting the muscle against resistance with the legs straight. Pain is felt midway up the calf muscle.

If you have damaged the Soleus muscle you might get pain lower in the leg and also pain when you contract the muscle against resistance with the knee bent. The Gastrocnemius muscle originates above the knee and inserts via the Achilles tendon into the heal. The Soleus originates below the knee and also inserts via the Achilles tendon.

 

What can the athlete do?

R.I.C.E. (Rest, Ice, Compression, Elevation) is essential. The sooner you do this the better.

See a sports injury professional who can advise on treatment and rehabilitation.

Wear a heel pad to raise the heel and shorten the calf muscle hence taking some of the strain off it.

 

What could a sports injury specialist do?

Prescribe anti-inflammatory medication e.g. ibuprofen which is beneficial in the first few days after the injury.

Use ultrasound treatment.

Use a compression device.

Use sports massage techniques after the initial acute phase.

Prescribe a full rehabilitation programme.

 

Once the initial healing has taken place it is essential the lower leg is fully strengthened in order to reduce the likelihood that the injury will nor reoccur or have an adverse effect on future performances.

 

Plantar Fasciitis (Heel Spur)

Plantar Fasciitis is an injury causing heel pain and foot pain. The Plantar Fascia or arch ligament is a band that runs from under the heel to the front of the foot. A rupture can sometimes occur at the origin of the arch ligament and result in inflammation and heel pain. This is more common in sports where jumping is important.

What are the symptoms?

Heel pain at the origin of the arch ligament when weight is put on the foot, pain at this point if standing on tip toes, tenderness and swelling under the heel, numbness along the outside of the sole of the foot.

Pain is usually worse first thing in the morning. After a few minutes it eases as the foot gets warmed up, but can get worse again during the day especially if walking a lot.

If the athlete over pronates then they may be prone to this injury because as the foot rolls in, the arch ligament is stretched more, putting more strain on it.

 

What can the athlete do?

Rest until it is not painful. A good taping technique can help the foot get the rest it needs by supporting the plantar fascia.

 

What a Sports Injury Professional can do:

Prescribe anti-inflammatory medication such as ibuprofen.

Prescribe orthotics.

Tape the foot. This is an excellent way of allowing the foot to rest.

X ray to see if there is any bone growth (calcification)

Operate if there is calcification.

 

Achilles Tendonitis

The Achilles tendon is the piece of tendon that helps connect the calf muscle to the back of the heel bone.  Unlike an Achilles tendon rupture that is typically caused from a sudden explosive or forceful movement, Achilles tendonitis is typically caused over time.  There is not one direct cause of Achilles tendonitis, but it is believed that the injury can be caused due to inadequate rest, poor running form, bad shoes, and increase in activity and/or from running hills. Achilles tendonitis is commonly seen in the game of tennis, running, volleyball and hockey. It is important to begin following the R.I.C.E. treatment method in order to help expedite the recovery process.  Please note that injuries to the Achilles tendon do not heal as fast as other areas of the body, due to less blood supply in the area.

 

Medical Definition of Achilles Tendonitis

Disruption of the Achilles tendon usually occurs 5 to 7 cm proximal to the insertion of tendon into the calcaneus or heel bone. Achilles tendonitis presents as a swelling of the Achilles tendon of gradual onset but it may also occur as an acute episode.  The main change is a disruption of the ground substance which causes the tendon fibres to separate, leading to degeneration. Healing of the Achilles tendon is typically very slowly due to their being inadequate blood supply to that area of the body.

Synonyms

– Achilles tendinitis

– Achilles tendinopathy

 

What are the symptoms of Achilles Tendonitis?

– Gradual onset of Achilles tendon pain, over a period of a few weeks or months.

– Constant pain surrounding the Achilles tendon while exercising.

– Weakness will begin to occur in the lower leg.

– Pain tends to ease with rest.

– Sensitivity to touch in the area of the Achilles tendon.

– Achilles tendon may be very stiff and sore in the morning when waking up.

 

Related Injuries

Ankle Sprain

Achilles Tendon Rupture

Calf Strain

 

Treatment of Achilles Tendonitis

– Application of cold therapy to the site of the injury.

– Non-operative treatment consists of casting or bracing with foot in plantar flexion.

– Non-operative treatment is based on activity level, age, and condition.

Stretching and strengthening exercises emphasized during rehabilitation.

AC Joint Sprain

Also known as the acromioclavicular joint, an AC joint sprain is caused when the two bones that make up the shoulder joint separate from one another. These two bones are the outer portion of the collarbone and the acromion process of the scapula. The severity of an AC joint sprain can range from mild to severe, and it is important to understand the severity grade system that is utilized with this shoulder injury. The graded severity of an AC joint sprainis measured using the Rockwood scale and the scores on this system range from 1-6.

 

Medical Definition of an AC Joint Sprain

Disorders to the AC joint are commonly seen in the athletic population. Injuries to the AC joint are either classified as acute traumatic or chronic injuries. The chronic disorder may be atraumatic or post-traumatic, with the former being attributed to generalized osteoarthritis, inflammatory arthritis, or mechanical problems of the meniscus. The majority of acute traumatic injuries occur from a fall onto the shoulder with the arm adducted at the side. An AC joint sprain may be classified into six categories based on the direction and amount of displacement, with 1 being the least severe.

 

Synonyms

– Acromioclavicular Joint Sprain

Shoulder Separation

 

What are the symptoms of an AC Joint Sprain?

– Pain felt towards the end of the collar bone and throughout the shoulder

– Swelling of the shoulder

– Restricted range of motion due to the amount of pain felt when movement occurs

– Severe pain felt when attempting to lift arms above the head

 

Related Injuries

Frozen Shoulder

Shoulder Separation

Rotator Cuff Tear

 

Treatment of an AC Joint Sprain

– Rest can help alleviate some of the pain.

– Application of ice to help reduce the swelling.

– Proper usage of NSAIDS.

– Immobilize the shoulder with the proper brace or sling.

– Light stretching exercises for the shoulder when the pain subsides.

– Once pain has subsided you should begin shoulder strengthening exercises.

 

 

Related Anatomy

AC Joint

Collar Bone

Shoulder Blade

 

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