Oslo Sports Trauma Research Center

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Information about project titled 'Ankle injuries in volleyball: A retrospective cohort study'

Ankle injuries in volleyball: A retrospective cohort study

Details about the project - category Details about the project - value
Project status: Published
Project manager: Roald Bahr
Coworker(s): Rune Øvrebø, Ragnhild Karlsen


Volleyball is among the most popular sports in the world with more than 200 member countries in the Fédération Internationale de Volley-Ball (FIVB) and about 150 million players. In spite of this, there are surprisingly few reports of volleyball injuries in the medical literature. Studies show that ankle sprains account for 1/4 to 1/2 of all acute injuries. It is known that volleyball injuries are most common in the net zone and when blocking or attacking, but more information is necessary to document the exact mechanisms of injury and suggest possible prevention strategies.
In volleyball the opposing players are separated by the net and the center line, and this should reduce the risk of contact injuries compared to other team sports. But according to FIVB rules, players from both teams are allowed to step on the 5 cm wide center line and into the half-court of the opponent, provided that some part of the penetrating foot/feet remains either in contact with or directly above the center line. Thus, there is a zone of about 50 cm width under the net where players from opposing teams may come into conflict when landing after attacking or blocking. Also, players from the same team usually try to form a block of two or even three players jumping simultaneously to stop the opponent attack.

We would therefore expect many of the ankle injuries to stem from landing on the foot of an opponent or teammate.


The purpose of the present study was to examine the incidence and mechanisms of ankle inversion injuries in a well trained and skilled population of volleyball players.

The study was designed as a retrospective cohort study, where coaches and players in the top two divisions of the Norwegian Volleyball Federation were interviewed after the 1991-1992 season about ankle inversion injuries that had occurred.
The study was limited to acute ankle inversion injuries that caused an absence of one or more days from training or match play.

Results: A total of 63 injuries were found among 318 players during 60612 hours of training and 928 matches. The total injury rate was 0.9 ± 0.12 per 1000 player hours: 0.7 ± 0.11 during training and 2.6 +/- 0.56 during match play. The relative risk of injury during match play versus training was 3.9 (p<0.001). Women had an injury rate of 1.1 ± 0.18, whereas that of men was 0.7 ± 0.15 (relative risk = 1.47; not significant). Most of the players (78%) had suffered at least one previous injury of the affected ankle. Most injuries were mild to moderate. The majority of the injuries (86%) occurred at the net, mainly when landing after blocking (63%) or attacking (29%).

The results suggest that simple measures such as rule changes, technical training, and prophylactic taping or bracing may lead to a significant reduction in the incidence and severity of such injuries.


Conclusion: Acute ankle inversion injuries are common in volleyball, especially during competition. We suggest rule changes, technical training and prophylactic taping/bracing as possible prevention strategies.