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