Knee, Low Back, and Shoulder Problems Among University and Professional Volleyball Players: Playing With Pain

Abstract

Context: The knee, low back, and shoulder account for most overuse injuries in volleyball. Previous researchers have used methodology that did not examine the extent of injury burden and effect on performance.

Objective: To develop a more accurate and complete understanding regarding the weekly prevalence and burden of knee, low back, and shoulder problems within the highest levels of men's volleyball, including the role that preseason complaints, match participation, player position, team, and age have on complaints.

Design: Descriptive epidemiology study.

Setting: Professional volleyball clubs and the National Collegiate Athletic Association Division I program.

Patients or other participants: A total of 75 male volleyball players, representing 4 teams playing in their country's respective premier league (Japan, Qatar, Turkey, and the United States), participated over a 3-season period.

Main outcome measure(s): Players completed a weekly questionnaire (Oslo Sports Trauma Research Centre Overuse Injury Questionnaire) reporting pain related to their sport and the extent to which knee, low back, and shoulder problems affected participation, training volume, and performance. Problems leading to moderate or severe reductions in training volume or performance or the inability to participate were considered substantial problems.

Results: The mean weekly prevalence of knee, low back, and shoulder problems based on 102 player-seasons was 31% (95% CI = 28%, 34%), 21% (95% CI = 18%, 23%), and 19% (95% CI = 18%, 21%), respectively. Most players (93%, 95/102 player-seasons) reported some level of knee (79%, n = 81/102 player-seasons), low back (71%, n = 72/102 player-seasons), or shoulder (67%, n = 68/102 player-seasons) complaints during the season. Most players (58%, n = 59/102 player-seasons) experienced at least 1 episode of substantial problems affecting the knee (33%, n = 34/102 player-seasons), low back (27%, n = 28/102 player-seasons), or shoulder (27%, n = 28/102 player-seasons). Players with preseason complaints had more in-season complaints than teammates without preseason problems (mean weekly prevalence: knee, 42% versus 8%, t49 = -18.726, P < .001; low back, 34% versus 6%, t32 = -12.025, P < .001; shoulder, 38% versus 8%, t30 = -10.650, P < .001).

Conclusion: Nearly all included elite male volleyball players experienced knee, low back, or shoulder problems, and most had at least 1 bout that substantially reduced training participation or sport performance. These findings suggest that knee, low back, and shoulder problems result in greater injury burden than previously reported.

Keywords: back pain; injury burden; injury prevalence; jumper’s knee; overuse injuries.

Figure 1

A–D, The cumulative and weekly prevalence of volleyball players who developed knee (A), low back (B), shoulder (C), and all (D) complaints throughout the season (N = 102 player-seasons, nonliberos). The shaded bar indicates the preseason. Week 0 indicates the start of the regular season.

Figure 2

A–C, Duration of the season that individual volleyball players reported knee (A), low back (B), and shoulder (C) complaints (N = 102 player-seasons, nonliberos). D, All complaints (knee, low back, and shoulder) combined. Category percentages are rounded to the nearest whole percentage.

Figure 3

The in-season weekly prevalence of knee, low back, and shoulder complaints for volleyball players with and those without preseason complaints. A, All complaints. B, Substantial complaints. The shaded bar indicates the preseason. Week 0 indicates the start of the regular season.