Finger injury may be acute or induced.

Volleyball injuries can be caused by inadequate blocking technique, speed of a spiked ball, inadequate anatomic position in contact with the ball.

Prevention: proper technique of the block, preventive bandaged fingers. The thumb is the most common injury, so when bandaging it first you must bandaged thumb, and then starting from the wrist you need to bandage whole thumb.

The symptoms of thumb injury: pain when the thumb is moving, pain in the web of the thumb.

If they experience this kind of injury, volleyball players need to rest for a couple of weeks before they come back to training sections.

Tennis elbow

Tennis elbow is an inflammation of the tendon that connects the extensor muscles with external epikondilom. These are the long muscles on the outer side of the forearm that help to open up and correct the hand and wrist. The mechanism of injury is related to the muscles that are annexed to the lateral humeral epikondilus: m extensor carpi radialis longus and brevis, m. extensor carpi ulnaris, m. extensor digitorum, m. extensor digiti minimi, m. Supinator and m. Anconeus.

Throwers elbow

Throwers elbow injury occurs when there is damage to the bones, muscles, tendons and ligaments around the elbow joint and forearm. The structures on the medial side of the elbow to stretch because of the throwing movement, and at the same time compresses the structures on the lateral side of the elbow.

This injury can cause movements restrictions, pain, formation of scar tissue, bone spurs. If untreated, muscles and nerves can cut off the blood flow because of so much pressure that causes this injury and pinch the nerves responsible for controlling the muscles in the forearm.

Preventions

There are a number of preventative techniques that will help to prevent elbow injury. Some of them are correct warm up, flexible muscles and tendons, strengthening and conditioning the muscles of the forearm and wrist.

Symptoms: absence of extension, flexion and rotation.

Mechanisms: unbalanced technical jumps and drops, back muscle weakness, fatigue.

Prevention: mobility and stretching the thigh and knee, muscle strengthening, balance back and abdominal muscles, warming up.

1. Quality and adequate preparation:

- a medical examination before the start of season,

- testing 4-6 weeks before the start of season,

- various training,

- individual approach to the exercise selection,

- previous preparation and preventive care are obliged to exercise power,

- players have to warm up before training or matches and stretch after training or matches.

2. Good and quality technique as a preventive measure:

- structure of techniques should include good condition,

- satisfaction of requests for anatomical, dynamic and a different structure of each technique.

3. Secure areas, equipment and appropriate personal protection:

- elastic wood and synthetic surfaces are recommended, items that may cause injury should be removed from the court,

- the court must be dry and clean;

- players must wear volleyball kneepads,

- for training and match use volleyball sneakers;

- avoid hard surface landings, and do not do exercises that are not learned;

- if the pain appears, discontinue exercise,

- start the exercise slowly and concentrated.

4. Modify rules for children and beginners:

- reduce the number of volleyball players on the court,

- use only the techniques that are learned.

5. Tips for training:

- determine which parts of exercise may cause injury,

- removal plan for fatigue and rest,

- before each exercise keep in mind is volleyball player sufficiently strong and durable; properly executed technique,

- ensure the proper relationship between strength and endurance during training sessions.

With inclusion in the program of Olympic games, volleyball gets more important as a competitive sport with the increasing number of athletes in particular and the length of training. Therefore, the number of injuries are increasing. Many of these injuries can be avoided by good training organization.

Coaches and volleyball players are required to know the types of injuries, the main causes of injury, injury mechanisms and procedures after the injury, because they usually happen to them and they are the first who can help themselves and others.

Volleyball is a fun game where relaxation and imagination can lead to sudden movements, uncomfortable positions and downs that may cause injury. They call them volleyball injuries as they occurred in volleyball, but they are always associated with physical deformities and pain, and a consequence is difficulty in moving of volleyball players, lack of entertainment, threatened the life activity. Doctors are responsible for the treatment and rehabilitation.

The rotator cruff muscles

Without learned muscle control, any overhead activity, let alone just lifting the arm, would be impossible. The muscle group for this control is the rotator cuff (RC) muscles – the infraspinatus, supraspinatus, teres minor, and subscapularis muscles. The muscles primarily designed to position the scapula for overhead movement are the trapezius, and serratus anterior. The larger and more powerful muscles that generate movements of the arm are the deltoids, latissimus dorsi, and pectoralis major.

The shoulder is at risk for injury in many sports. The rotator cuff can be injured through overuse or through trauma. Rotator cuff tendinitis is common in volleyball. Rotator cuff tears can occur if the tendons are overloaded in weight lifting or football. There are ligaments which hold the shoulder bone in its socket. The shoulder has a very large range of motion, and needs some flexibility of the ligaments to allow for that range. But if the ligaments become stretched or torn, this can lead to instability. A mild amount of instability will allow the shoulder to slip part way out of socket, called a subluxation. When the shoulder comes completely out of its socket this is called a dislocation.

Prevention

Shoulder injuries can be diminished by careful warmup, stretching, and strengthening of the shoulder muscles.

• Flexibility

The purpose of flexibility varies for the different muscles around the shoulder. For the major power muscles, it is important that flexibility allows freedom of movement for the pelvis, trunk, scapula, and humerus. Too much flexibility at the expense of strength and control can be dangerous because of the excessive shear forces causing wear and tear in the joint. Too much flexibility at the expense of muscle control puts strains on the soft tissues and causes injuries.

• Stretching

Stretching to increase flexibility should never be done prior to training or competition, but instead done during ‘down’ times in the week. This is because of the suppression of the ‘stretch reflex’ that takes place during sustained passive stretching of muscle tissue (ie, repeated holds of 20-30 seconds). If one were to do rapid forceful movements such as throwing straight after such passive stretching, there would be an increased chance of muscle and tendon tears.

• Warm-up

Before stretcing the shoulder should be warmed up thoroughly with gradually increasing movements – big circles, across body movements, trunk twists, shoulder blade rolls and forward and backward squeezes. The purpose of this is to increase blood flow and temperature, thereby increasing the elasticity and ‘give’ in the soft tissues.

Symptoms

Rotator cuff injury symptoms may include:

• pain and tenderness in your shoulder, especially when reaching overhead, reaching behind your back, lifting, pulling or sleeping on the affected side
• shoulder weakness
• loss of shoulder range of motion
• inclination to keep your shoulder inactive

The most common symptom is pain. You may experience it when you reach up to comb your hair, bend your arm back to put on a jacket or carry something heavy. Lying on the affected shoulder also can be painful. If you have a severe injury, such as a large tear, you may experience continuous pain and muscle weakness.

Tests and diagnosis

If your injury appears to be severe or your doctor can’t determine the cause of your pain through physical examination, he or she may recommend diagnostic imaging tests to better delineate your shoulder joint, muscles and tendons. These may include:

• X-rays
• a magnetic resonance imaging (MRI) scan
• an ultrasound scan

Treatments

Most of the time, treatment for rotator cuff injuries involves exercise therapy. Your doctor or a physical therapist will talk with you about specific exercises designed to help heal your injury, improve the flexibility of your rotator cuff and shoulder muscles, and provide balanced shoulder muscle strength. Depending on the severity of your injury, physical therapy may take from three weeks to several months.

Other rotator cuff injury treatments may include:
Steroid injections. Depending on the severity of your pain, your doctor may use a corticosteroid injection to relieve inflammation and pain.
Surgery. If you have a large tear in your rotator cuff, you may need surgery to repair the tear. Sometimes during this kind of surgery doctors may remove a bone spur or calcium deposits. The surgery may be performed as an open repair through a 2 1/2- to 4-inch (6- to 10-centimeter) incision, as a mini-open repair through a 1 1/4- to 2-inch (3- to 5-centimeter) incision, or as an arthroscopic repair with the aid of a small camera inserted through a smaller incision.

Arthroplasty. Some long-standing rotator cuff tears over time may contribute to the development of rotator cuff arthropathy, which can include severe arthritis. In such cases, your doctor may discuss with you more extensive surgical options, including partial shoulder replacement (hemiarthroplasty) or total shoulder replacement (prosthetic arthroplasty).

How it happenes

Ankle sprains happen when the foot twists, rolls or turns beyond its normal motions. A great force is transmitted upon landing. You can sprain your ankle if the foot is planted unevenly on a surface, beyond the normal force of stepping. This causes the ligaments to stretch beyond their normal range in an abnormal position.

If there is a severe in-turning or out-turning of the foot relative to the ankle, the forces cause the ligaments to stretch beyond their normal length. If the force is too strong, the ligaments can tear. You may lose your balance when your foot is placed unevenly on the ground. You may fall and be unable to stand on that foot. When excessive force is applied to the ankle’s soft tissue structures, you may even hear a “pop”. Pain and swelling result.

Grade 1 sprain:

Slight stretching and some damage to the fibers (fibrils) of the ligament.

Grade 2 sprain:

Partial tearing of the ligament. If the ankle joint is examined and moved in certain ways, abnormal looseness (laxity) of the ankle joint occurs.

Grade 3 sprain:

Complete tear of the ligament. If the examiner pulls or pushes on the ankle joint in certain movements, gross instability occurs.

Diagnosis

Diagnosis of the injury is determined by examination of the location of the bruising (ecchymosis), swelling, and tenderness. It is also necessary to perform stress testing of the ligaments to determine whether the ligament has been torn. Stress testing of the ligaments is done by pushing on the ankle and attempting to determine if there is any abnormal motion at the joint which would indicate that a ligament has been torn. In addition, x-rays are often performed to check for the possibility of a chipped bone or fracture.

When performing a stress test of the ligaments, a posteriorly directed force is applied to the front of the tibia (shin bone). If the ankle ligaments are completely torn, the tibia will visibly shift backwards at the ankle joint. When the force is removed, the tibia will snap back into its proper position at the ankle joint. When this abnormal motion occurs, the anterior talo-fibular ligament (ATFL) has been torn.

Most ankle sprains need only a period of protection to heal. The healing process takes about four weeks to six weeks. The doctor may tell you to incorporate motion early in the healing process to prevent stiffness. Motion may also aid in being able to sense position, location, orientation and movement of the ankle (proprioception). Even a complete ligament tear can heal without surgical repair if it is immobilized appropriately. Even if an ankle has a chronic tear, it can still be highly functional because overlying tendons help with stability and motion.

For a Grade 1 sprain, use R.I.C.E (rest, ice, compression and elevation):
Rest your ankle by not walking on it.
Ice should be immediately applied. It keeps the swelling down. It can be used for 20 minutes to 30 minutes, three or four times daily. Combine ice with wrapping to decrease swelling, pain and dysfunction.
Compression dressings, bandages or ace-wraps immobilize and support the injured ankle.
Elevate your ankle above your heart level for 48 hours.

For a Grade 2 sprain, the RICE guidelines can also be used. Allow more time for healing to occur. The doctor may also use a device to immobilize or splint the ankle.

A Grade 3 sprain can be associated with permanent instability. Surgery is rarely needed. A short leg cast or a cast-brace may be used for two weeks to three weeks.

All ankle sprains recover through three phases:

• Phase 1 includes resting, protecting the ankle and reducing the swelling (one week).
• Phase 2 includes restoring range of motion, strength and flexibility (one week to two weeks).
• Phase 3 includes gradually returning to activities that do not require turning or twisting the ankle and doing maintenance exercises. This will be followed later by being able to do activities that require sharp, sudden turns (cutting activities) such as tennis, basketball or football (weeks to months).

What is the best way to use ice?
Putting ice on your ankle can be very helpful, but you also need to be careful. The cold can damage nerves if the ice is left in place too long.

Ice can be left on your ankle for up to 20 minutes at a time. When your skin feels numb, it’s time to remove the ice. Use ice treatments every 2 to 4 hours for the first 3 days after your injury. Ice treatments can consist of ice packs, ice slush baths or ice massages.

To use ice packs, partly fill a plastic bag with crushed ice. Wrap a thin, wet cloth around your injury. Place the ice pack over this and then wrap an elastic bandage around the ice pack to hold it in place.

For ice slush baths, fill a large bucket with water and ice. Place your ankle in the bucket until the skin gets numb.

Ice massages can work well for small areas. Freeze water in 4- to 8-ounce styrofoam (coffee) cups. Tear the top part of the cup away from the ice. Hold the covered end and slowly rub the ice over the sprained area with a circular motion. Don’t hold the ice on one spot for more than 30 seconds.

Rehabilitation

Adequate rehabilitation is often overlooked by the athlete and subsequently places them at increased risk for re-injury. The overall goals of rehabilitation for an ankle sprain are: decrease swelling, decrease pain, increase range of motion, return to normal gait and function and regain lost strength. Modalities commonly used by athletic trainers in the initial care of ankle sprains include ice, cold whirlpool and electric stimulation. As symptoms improve, athletic trainers will include the use of ultrasound, moist hot packs and warm whirlpool. The use of these modalities is an important factor in the high performance athlete returning to play faster than the recreational athlete. To regain strength and motion, athletic trainers often add stretching activities such as calf stretching and range of motion exercises. Calf raises, rubber tubing exercises and balancing are other forms of exercise one would commonly see in an ankle sprain rehabilitation program. The athlete may be able to return to practice and competition prior to a complete recovery. If this is the case, continuing to strength the muscles surrounding the ankle while improving balance are essential tasks to avoid re-injury.

Prevention

The best way to prevent ankle sprains is to maintain good strength, muscle balance and flexibility.

• Warm-up before doing exercises and vigorous activities
• Pay attention to walking, running or working surfaces
• Wear good shoes
• Pay attention to your body’s warning signs to slow down when you feel pain or fatigue

The knee is the most frequent site of injury in volleyball players. More than 40% of high level players suffer overuse injuries during this activity; this particularly painful syndrome is caused by the amount of jumping typical in volleyball play, and in its training which aims at strengthening the quadriceps muscle. In volleyball players the extensor apparatus is subject to continuously high stress and the bone tendon junction, being the weakest point, is susceptible to lesion.

More severe injuries include bone bruises or damage to the cartilage or ligaments. There are two types of cartilage in the knee. One is the meniscus, a crescent-shaped disc that absorbs shock between the thigh (femur) and lower leg bones (tibia and fibula). The other is a surface-coating (or articular) cartilage. It covers the ends of the bones where they meet, allowing them to glide against one another.

Knee injuries can result from a blow to or twist of the knee; from improper landing after a jump; or from running too hard, too much, or without proper warmup.

Although volleyball is a sport without contact between players, traumatic acute injuries are more frequent and more serious than would be expected. It is therefore important to emphasise that volleyball must be considered among the high risk sports that expose the knee not only to twisting, but also to contact with other players. Generally, the lesions are caused by frequent jumps with loss of balance and a consequent ‘one-footed’ landing.

How to train muscles that support the knee

All strength exercises that aim to develop muscle power and volume should be performed slowly and in a controlled
manner in concentric mode for one to two seconds and in eccentric mode for three to four seconds. The exercise should be performed with 8 RM for three sets to achieve muscle hypertrophy and increased strength. The injured leg must initially be trained separately from the non-injured. Quadriceps muscle strength can be trained with leg press, squats or leg extension manoeuvres. The vastus medialis muscles require special attention after patella (kneecap) dislocation or in mal-tracking conditions that cause anterior knee pain. If the patella is subluxated or out of place and knee extensions cause pain, a soft knee brace can be useful and give very good results. The quadriceps muscles are essential for knee stability in activities such as jumping, sprinting, twisting and turning.

Hamstring muscle strength is trained with knee flexion and hip extension exercises, standing or sitting, using wires with weights or specific machines allowing a hamstring curl.

What should you do if you have knee injury

• Stay off your feet for 24 hours. After that, you can gradually increase the amount you use your injured knee when walking, as long as it doesn’t hurt too much.

• Use crutches or a cane until it is no longer painful to put weight on the knee when you stand.
• Put ice on the injury for 15 to 20 minutes each hour for the first 1 to 2 days. Place the ice in a plastic bag and place a towel between the bag of ice and your skin.
• To rest your knee and allow it to heal, wear your splint or elastic bandage (ace wrap) as directed by your doctor.
• You may take over-the-counter medications to relieve the pain. If the doctor prescribes any medicine, take it exactly as directed.

Call a doctor if…

• the bruising, pain, or swelling grows worse,
• the skin on your lower leg turns white or blue and feels cool to the touch.

Although virtually any part of your body can be injured during sports or exercise, the term is usually reserved for injuries that involve the musculoskeletal system, which includes the muscles, bones, and associated tissues like cartilage. Traumatic brain and spinal cord injuries, (relatively rare during sports or exercise) and bruises are considered briefly in the Appendix.

Regardless of the specific structure affected, sports injuries can generally be classified in one of two ways: acute or chronic.

Acute Injuries

Acute injuries, such as a sprained ankle, strained back, or fractured hand, occur suddenly during activity. Signs of an acute injury include the following:

• Sudden, severe pain
• Swelling
• Inability to place weight on a lower limb
• Extreme tenderness in an upper limb
• Inability to move a joint through its full range of motion
• Extreme limb weakness
• Visible dislocation or break of a bone

Chronic Injuries

Chronic injuries usually result from overusing one area of the body while playing a sport or exercising over a long period. The following are signs of a chronic injury:

• Pain when performing an activity

• A dull ache when at rest
• Swelling