Volleyball injuries fall into two categories: traumatic or overuse. Traumatic injuries may result from a sudden force or impact and overuse injuries result due to repetitive movements over a length of time.
Rotator Cuff injuries
The rotator cuff is a group of four muscles and their tendons that help in the movement and stability of the shoulder. In volleyball, the shoulder elevation required to play can lead to rotator cuff problems. Rotator cuff overuse injuries are known as rotator cuff tendinopathies and they cause shoulder pain and weakness and overhead arm movement can sometimes be severely limited. Pain is often worse at night. Rotator cuff tear can result from a longstanding tendinopathy that is left untreated or an acute tear may occur without a pre-disposing tendinopathy. Symptoms of a rotator cuff tear are the same as that of a tendinopathy but usually more severe. A scan can distinguish between these two injuries.
Surgical repair of the torn rotator cuff can be done with arthroscopy (a minimally invasive operation) and the patient usually goes home the same or following day. Following this, physical therapy will help with pain management, restoring range-of-motion and will help you regain muscular strength. Physical therapy alone, with no surgical intervention, is often enough to help you overcome a rotator cuff tendinopathy and return to volleyball sooner without the re-injury.
A sudden impact to the shoulder during play can cause a dislocation of the shoulder. When this happens, there is an extreme rotation of the upper arm bone (humerus) and the head of the humerus pops out of the socket in a forwards or downwards direction. Symptoms are immediate shoulder pain, weakness, numbness and swelling. Once a fracture is ruled out via x-ray, a health professional will relocate the bone through a procedure called a closed reduction. The arm is then immobilized in a sling for several weeks, during which gentle passive range of motion exercises will be done (the physical therapist moves the arm). After the sling is removed, a full rehabilitation program of stretching and strengthening exercises will begin. Return to volleyball can happen anywhere between eight to twelve weeks.
Shoulder tendinopathy, bursitis and impingement syndrome
These are volleyball injuries that may result from overuse: Tendinopathy is an injury to a tendon; bursitis is inflammation of the bursa - the fluid-filled sacs between the tendon and bone. Tendinopathy and bursitis can both lead to an impingement syndrome if the tendons or bursae become inflamed and swollen. This swelling leads a lack of space in the shoulder joint during movement which causes pain and restriction of movement with accompanying weakness of the muscles. Repetitive overhead arm motions may irritate the muscles, tendons and other soft tissues such as the bursae over time leading to inflammation and impingement.
Symptoms of this condition are slow onset of pain and shoulder or upper arm pain at night when lying on the affected side. Pain may also be felt with abduction of the arm (moving the arm out to the side) or raising the arm overhead. Shoulder pain at the front or the side is also common and may radiate down to the elbow and forearm.
Treatment involves rest, icing and the use of anti-inflammatory medications and topical creams. Physical therapy treatment is for the return of flexibility and strength in the affected shoulder and is also beneficial for pain relief. Physical therapy rehabilitation for any chronic shoulder problem is essential to help return to volleyball. Please see us for an evaluation if you are experiencing any shoulder pain.
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