Injuries: How coaches can reduce risks

The NCAA a while back put out what I think is an interesting infographic about injuries in women’s college volleyball. It features data from the 2004-05 to 2008-09 seasons. Admittedly, the figures are a bit dated at this point, but they are informative nevertheless.

Preseason is a problem

Here’s something that really stands out for me:

Preseason has the highest overall injury rate (6.5 per 1,000 athlete exposures), while the postseason has the lowest (2.4 per 1,000 athlete exposures) as compared to the in-season injury rate of 3.6 injuries per 1,000 athlete exposures.

No surprise that preseason has a much higher injury rates than the other phases (over 80% more risk). Consider the normal situation. You have a bunch of players who might be in good shape, but they aren’t in full volleyball condition. No matter how good the workout program, it’s not the same as actually training and/or playing every day.

On top of this, not only do we put them into a daily routine, preseason usually features two or more sessions per day. That means not just increasing their workload, but doing so significantly. It’s that sharp change which increases risk of injury (I should note that big decreases in intensity also raise injury risk.)

When do injuries happen?

There’s more detail to the report worth considering. Since preseason is almost all about practice rather than competition, these following figures are worth knowing.

The majority of practice-related injuries occurred during team drills (60.0 percent), followed by individual drills (10.0 percent) and conditioning (6.4 percent).

It’s pretty easy to come up with why so many more injuries happen during team drills. There are a lot more moving parts, and intensity levels tend to be higher. That means generally more exertion, plus more opportunity for collision. On top of that, game play tends to feature most in the latter phase of practice – especially 6 v 6. This can mean a fatigue factor.

Interestingly, though, fatigue doesn’t look to be at play when it comes to injuries during matches. The NCAA figures show roughly even odds of injury between warm-ups and each set.

I think it’s reasonable to suggest, however, that many matches are not as physically demanding as practice – in particular in terms of between-play recovery. I’ve yet to see a second or third wash style ball tossed in at the end of a rally in a match. 🙂

Why fewer injuries during playoffs?

One of the interesting bits from what I shared above is that the injury rate during the post-season is much lower than during the regular season. Why would this be? After all, to the extent that cumulative factors play a part, you would expect them to most show up in the numbers at this time of year.

The first explanation that comes to mind for me is what we could call survivorship bias. By that I mean that by the time we get to post-season the players most at risk for injury have already had them. Thus, those still playing are inherently players with lower injury risk.

Also, by this time of season teams have been working together a lot longer. That means there should be better coordination during play, thus fewer contact-based injuries.

Of course, since only the better teams make post-season, there’s one other simple possible reason. Those teams have better-prepared athletes and are more coordinated in their actions.

What can we do?

Some injuries are ones we can’t do much about. They are the result of an unfortunate circumstance. We as coaches can do things to reduce injury risk, though. Here are a few of those ways, beyond the physical work.

Ramp things up in preseason, or any time the players have been at a lower intensity. You probably won’t these days have to start at 0 fitness, but even going from 50 straight to 100 puts the players at risk. The Coaching Conversation I did on Key strategies for building athlete work capacity for return to play is a good starting point to think about this. It has COVID-19 as a context, but the principles apply broadly.

Monitor workload and risk factors. This can include objective things like jump counts and landing force measures. It can also be more subjective, such as the Rated Perceived Exertion (RPE). These topics come up in my Conversation on Player Performance Accountability Utilizing Match Data.

Focus on teamwork. Two players trying to occupy the same space leads to a collision, which can lead to injury. Players who understand their positional roles and responsibilities reduce the odds of impact. How you set up seam decisions, structure your defense, and generally decide who takes a given ball all play a part here.

Develop physical control. Players who are not in control of their bodies are collisions risks. Young players often simply lack coordination. Older, but inexperienced, ones haven’t sharpened their movements yet. It’s our job to train those things.

Teach good decision-making. Sometimes impacts – with others or with objects – happen because players make poor choices. We can avoid unnecessary risks in practice by discouraging things like hitters taking big broad jumps to try to reach tight sets, thereby jeopardizing themselves and the blocker(s) on the other side.

Make safety a priority. Teammates should look out for each other. That means keeping balls from rolling into dangerous area, preventing each other from running into chairs, not leaving clothing near the court, etc. This should be a feature of your team culture.

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John Forman

John is currently the Strategic Manager for Talent (oversees the national teams) and Indoor Performance Director for Volleyball England. His 20+ years of volleyball coaching experience includes all three NCAA divisions, plus Junior College, in the US; university and club teams in the UK; professional coaching in Sweden; and both coaching and club management at the Juniors level. He's also been a visiting coach at national team, professional club, and juniors programs in several countries.

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