Playing with pain: knee, low back, and shoulder problems rampant among university and professional volleyball players.

CONTEXT: The knee, low back, and shoulder account for the majority of overuse injuries in volleyball; unfortunately, previous studies utilized methodology that failed to examine the extent of their injury burden and impact on performance.

OBJECTIVE: To develop a more accurate and complete understanding regarding the weekly prevalence and burden of knee, low back, and shoulder problems within the highest levels of men's volleyball - including the role that preseason complaints, match participation, player position, team, and age have on complaints.

DESIGN: Descriptive epidemiology study.

SETTING: Professional volleyball clubs and NCAA Division I program.

PATIENTS OR OTHER PARTICIPANTS: Seventy-five male volleyball players, representing four teams playing in their country's respective premier league (Japan, Qatar, Turkey, United States) participated over a 3-season period.

MAIN OUTCOME MEASURE(S): Players completed a weekly questionnaire (Oslo Sports Trauma Research Center Overuse Injury Questionnaire; OSTRC-O) reporting pain related to their sport and the extent to which knee, low back, and shoulder problems affected participation, training volume, and performance. Problems leading to moderate or severe reductions in training volume or performance, or the inability to participate were defined as substantial problems.

RESULTS: The average weekly prevalence of knee, low back, and shoulder problems, based on 102 player-seasons, was: knee - 31% (95% CI, 28-34%), low back - 21% (18-23%), and shoulder - 19% (18-21%). Most players (93%) reported some level of knee, low back, and/or shoulder complaints during the season (knee: 79%; low back: 71%; shoulder: 67%) and 58% experienced at least one episode of substantial problems (knee: 33%; low back: 27%; shoulder: 27%). Players with preseason complaints continued to have more in-season complaints than teammates without preseason problems (average weekly prevalence - knee: 42% vs. 8%, P <.001; low back: 34% vs. 6%, P <.001; shoulder: 38% vs. 8%, P <.001).

CONCLUSION: Nearly all included elite male volleyball players experienced knee, low back, or shoulder problems - and the majority had at least one bout that substantially reduced training participation or sports performance. These findings suggest that knee, low back, and shoulder problems result in greater injury burden than previously reported.