Volleyball Injuries – What You Need To Know

In competitive volleyball, many points are won or lost at “the net”. The area at and under the net is the most common part of the volleyball court to see injuries, some minor but some potentially catastrophic to the young athlete. Not only does playing at the net require jumping and elevation, but more importantly from an injury standpoint, it requires a safe landing. When making a play at the net, there is typically an offensive player, the hitter, and the defensive players, the blockers, all  fighting for the same ball and then landing in the same area of the court. Feet getting tangled up in the landing zone is probably where most ankle and knee injuries occur. The setter is also at risk, especially if a ball is played close to the net and a “joust” is required. During a joust, the setter oftentimes will have to make quick decisions and maneuver around the defensive players, again typically landing in the same dangerous real estate under the net. The most common injuries under the net are ankle sprains and ACL injuries due to awkward landing.

Sometimes injuries are unavoidable. Landing on someone else’s foot is occasionally the only option. However, when a player lands on the court, how the body reacts to the landing is what can really make or break that brief moment of instability. The science behind safe landing lies in part of the body’s sense of PROPRIOCEPTION. Some have described this as a human’s “sixth sense”. Proprioception is simply defined as the body’s understanding of where it is in space. An example is your ability to walk around a dark room, knowing you are upright. Or if you have your eyes closed and raise your hand to ask a question, your brain knows your hand is in the air. Proprioception is a very complex feedback mechanism that happens instantaneously. It is a balance between stretch receptors in the muscles and tendons surrounding joints and ligaments connecting the joints together. Proprioception is affected by the proper function of the muscle and the flexibility of the muscle and tendons. Joint stability, which is what proprioception is trying to protect, is dictated by the strength and integrity of the joint’s capsule and the ligaments protecting that joint. Joint stability is a delicate balance. You want the joints to be flexible, however you don’t want them to be too loose (which can happen after injury). The best way to maintain joint flexibility is a good warm up program throughout a natural range of motion.

The muscle and tendon proprioception can be trained. The most important time to perform this training is during the adolescent growth period, as the rapid lengthening of the skeletal system can sometimes affect the muscle and tendon’s ability to coordinate the body’s proprioception. The most important training occurs on a daily basis, with proper stretching of the muscles and tendons BEFORE and after activity to make sure the length of these tissues are ready to go for the sport activity. Using dynamic stretching before exercise and a foam roller to stretch the tissue around the muscle (called fascia) is an easy step.

Other methods of training proprioception include the use of exercises incorporating compound body movements (body squats, for example). Compound body movements help the body develop this system of biofeedback. An athlete should try the following progression in training: 1. Perform the compound body movement with amirror and a trainer, to make sure the motion is correct;  2. Remove the mirror and focus on the movement without the visual cue of watching your body. Finally, 3. Perform the movement with your eyes closed. Use the body weight squat in this progression and it will enhance the proprioception system over time. Exercise routines incorporating yoga are also extremely effective at enhancing proprioception.

At Elite Sports Medicine and Orthopaedic Center we understand your sport and what your body needs to safely compete at the highest level of competition. Your doctors at Elite offer the most cutting edge sports medicine and orthopaedic techniques and the physical therapists at Elite and MPOWER Performance Institute use the most current techniques for both the recovery of the healing athlete and to prevent further injury.

R. Chris Glattes, MD
Orthopaedic Surgeon at Elite Sports Medicine and Orthopaedic Center, Nashville and Franklin, TN
Team Physician to Lipscomb University Volleyball – Atlantic Sun Conference Champions
And– Volleyball Dad to 2 daughters 

Artificial Cervical Disc Replacement-

Pain and Disability due to disc disease in the neck is a serious problem and now there is a new and better option for some patients. There are approximately 1.1 Million patients each year in the U.S. that suffer from symptomatic cervical disc disease. Disc problems in the neck can lead to neck pain, arm pain, arm weakness and/or loss of function in the hands. This condition can significantly affect a person’s ability to sleep, work, drive, and many other critical functions of daily life.

Since the 1960’s the treatment of choice when conservative measures have failed has been neck fusion surgery- or cervical fusion.  However, thanks to new technology and rigorous clinical studies – patients now have another option and it is available in Nashville at Elite Sports Medicine and Orthopaedic Center. Dr. Chris Glattes and Dr. Colin Crosby at Elite are performing this new state of the art procedure: the artificial cervical disc replacement.

An artificial disc is designed to replace the damaged disc in the neck and maintain the normal biomechanics of the spine in the neck.  The artificial cervical disc has demonstrated certain clear advantages over fusion for certain patients. The advantages include a shorter surgery without any screws or hardware, a quicker recovery, and preservation of natural range of motion in the neck. One of the concerns with a spinal fusion is that when a spinal fusion is done the spinal levels adjacent to the fusion (IE- the level above and the level below the fusion) are eventually compromised. They become “over stressed” and we see joint degeneration after the fusion since there is no longer any movement the area above or below it. This leads to an increased risk of needing subsequent surgeries in the spine as time goes on. We do not have this issue with artificial cervical disc replacement since the spine is not fused and range of motion is maintained.

“Although there will still be patients that will need to have a cervical fusion I believe in maintaining the natural motion of the cervical spine with a disc replacement or other option whenever possible” said Dr. Crosby.

Dr. Crosby and Dr. Glattes at Elite are both using the only artificial cervical disc technology currently available that can be used on up to two levels in the cervical spine, and the only technology that maintains the natural multi-planar range of motion. The clinical data supports many positive outcomes with this surgery over a cervical fusion including that patients are able to maintain their neck motion, have less adjacent segment degeneration, less re-operations, and a faster recovery and return to activities when compared to a cervical fusion.

Dr. Glattes speaks to recovery time in saying, “the data shows that patients are able to return to work almost 3 weeks faster than a traditional fusion. And whether they are a serious athlete or just trying to return to the activities of daily life a quick recovery is so important for my patients.”

This and other advancements in orthopaedics and sports medicine are exciting and the physicians and staff at Elite Sports Medicine & Orthopaedic Center are committed tosetting the standard of care for spine and for all our other orthopaedic sub-specialties and sports medicine.

To Schedule an Appointment Please Call us at 615-324-1600.