Volleyball is one of the most popular sports in the world with over 200 million players worldwide, and over 240 thousand players throughout Australia (Kilic, Maas, Verhagen, Zwerver., & Gouttebarge, 2017; Volleyball Australia, 2020).
The nature of volleyball places increased demands on the player’s musculoskeletal system, increasing the risk of injuries (Kilic, et al., 2017).
Overuse injuries due to incorrect technique and poor biomechanics, chronic repetitive overload and firm playing surfaces are prevalent amongst volleyball players. The three most common areas prone to overuse injuries in volleyball players include the shoulder, knee and low back (Bahr & Reeser, 2003).
The following is a set of 12 neuromuscular exercises (total of 12 mins) to target identified risk factors associated with such overuse injuries which can be incorporated within a warm-up or for individual use in an attempt to reduce rates of injury.
This exercise program has been created by physiotherapy students, with the understanding that user’s respect their own skill when executing the exercises. Before relying on the material in any important matter, users should carefully evaluate the accuracy and relevance of the information and should obtain appropriate professional advice relevant to their particular circumstances when applicable.
- Rotator cuff tendinitis, labral tears, shoulder impingement syndrome (internal) and glenohumeral joint instability are the most common shoulder injuries in volleyball. With key risk factors including: excessive ‘winding up’ mechanisms of the shoulder joint during serving, spiking and blocking, scapula dyskinesis, strength imbalances and glenohumeral joint internal rotation deficit (Challoumas, Stavrou & Dimitrakakis, 2017).
- Scapula motor control helps to isolate, recruit and strengthen the serratus anterior muscles which, primarily acts to stabilize the scapula against the thoracic rib region in movements where the arm is moving forwards (Challoumas, Stavrou & Dimitrakakis, 2017).
- The rotator cuff muscle group provides the shoulder joint with stability during its extreme range of motion demands. Exercises which target the rotator cuff muscle group, such as internal and external rotation, prepare the shoulder for the dynamic movements required in the sport (Ganderton et al., 2020).
- Movements that involve the key muscle groups surrounding the shoulder joint such as push ups, allow for optimal biomechanical movement patterns and neuromuscular control during dynamic active movements of the shoulder - repeatedly performed by the players (Eshghi, Zarei, Abbasi & Alizadeh, 2020).
- The knee is prone to force injuries from activities such as jumping and landing (Bahr & Reeser, 2003; Reitmayer, 2017).
- These exercises allow for the knee to prepare, in a controlled and safe environment, for the strenuous and continuous flexion/ extension and force generation (Acbenbach et al., 2018).
- Allows the knees to adapt to the ballistic/ fast movements, jumping/ propelling in different directions and maintaining balance to meet the demands of the game (Barendrecht et al., 2011).
- Aim is to increase strength, power, flexibility and stability in the lower limb musculature, tendons and ligaments surrounding the tibiofemoral (knee) joint (Vecchio, Daewoud & Green, 2018).
- Non-specific low back pain is extremely common; 86% elite volleyball players experienced LBP at least once in their career with key risk factors relating to reduced core stability and spinal immobility (Kulling et al., 2014).
- Core muscles divided into two groups deep muscles (local stabilising) and shallow muscles (global stabilising) have a primary role to maintain spinal stability for the prevention of injuries. The core muscles act as a natural brace, when they are strong and functioning well they can maintain segmental stability to protect the spine and reduce stress impacting on the lumbar vertebrae Chang, Lin and Lai (2015).
- These exercises aim to increase spinal stability via minimising load on spinal structures, improve endurance of the trunk muscular, improve balance, postural control and light co-contraction of the stabilising muscles of the lumbar spine, combined breathing with exercises to achieve a normal ROM of the spine (Taulaniemi, Kankaanpaa, Tokola, Parkkari, & Suni, 2019).
This set of resources was developed by Flinders University Physiotherapy students with contribution and assistance from Volleyball SA and South Australian Sports and Medicine Association.
Achenbach, L., Krutsch, V., Weber, J., Nerlich, M., Luig, P., Loose, O., ... & Krutsch, W. (2018). Neuromuscular exercises prevent severe knee injury in adolescent team handball players. Knee surgery, sports traumatology, arthroscopy, 26(7), 1901-1908.
Bahr, R., & Bahr, I. A. (1997). Incidence of acute volleyball injuries: a prospective cohort study of injury mechanisms and risk factors. Scandinavian journal of medicine & science in sports, 7(3), 166-171. Received from https://onlinelibrary-wiley-com.ezproxy.flinders.edu.au/doi/abs/10.1111/j.1600-0838.1997.tb00134.x
Barendrecht, M., Lezeman, H. C., Duysens, J., & Smits-Engelsman, B. C. (2011). Neuromuscular training improves knee kinematics, in particular in valgus aligned adolescent team handball players of both sexes. The Journal of Strength & Conditioning Research, 25(3), 575-584. Doi: 10.1519/JSC.0b013e3182023bc7
Challoumas, D., Stavrou, A., & Dimitrakakis, G. (2016). The volleyball athlete’s shoulder: biomechanical adaptations and injury associations. Sports Biomechanics, 16(2), 220-237. doi: 10.1080/14763141.2016.1222629
Chang, W., Lin, H., & Lai, P. (2015). Core strength training for patients with chronic low back pain. Journal of Physical Therapy Science, 27(3), 619-622. DOI: 10.1589/jpts.27.619
Eshghi, S., Zarei, M., Abbasi, H., & Alizadeh, S. (2020). The Effect of Shoulder Injury Prevention Program on Shoulder Isokinetic Strength in Young Male Volleyball Players. Research In Sports Medicine, 1-12. doi: 10.1080/15438627.2020.1860050
Ganderton, C., Kinsella, R., Watson, L., & Pizzari, T. (2019). Getting more from standard rotator cuff strengthening exercises. Shoulder & Elbow, 12(3), 203-211. doi: 10.1177/1758573219888829
Kilic, O., Maas, M., Verhagen, E., Zwerver, J., & Gouttebarge, V. (2017). Incidence, aetiology and prevention of musculoskeletal injuries in volleyball: A systematic review of the literature. Journal of Sport Science, 17(6). Doi: 10.1080/17461391.2017.1306114.
Kulling, F. A., Florianz, H., Reepschlager, B., Gasser, J., Jost, B., & Lajtai, G. (2014). High prevalence of disc degeneration and spondylolysis in the lumbar spine of professional beach volleyball players. The Orthopaedic Journal of Sports Medicine, 2(4).
Taulaniemi, A., Kankaanpaa, M., Tokola, K., Parkkari, J., & Suni, J. H. (2019). Neuromuscular exercise reduces low back pain intensity and improves physical functioning in nursing duties among female healthcare workers; secondary analysis of a randomised controlled trial. BMC Musculoskeletal Disorders, 20.
Vecchio, L. D., Daewoud, H., & Green, S. (2018). The health and performance benefits of the squat, deadlift. and bench press. MOJ Yoga & Physical Therapy, 3(2), 40-47. Doi: 10.15406/mojypt.2018.03.00042
Volleyball Australia (2020). Australian Sports Commission confirms volleyball is all the rage. Retrieved from, http://www.volleyballaustralia.org.au/post/australian-sports-commission-confirms-volleyball-is-all-the-rage