Spikes, Sets, and Sore Shoulders: Injury Prevention for Young Volleyball Players
Part 5 of our Fall Sports Safety Series
Volleyball doesn't get talked about as often as football or soccer when it comes to youth injury risk, but between constant jumping, overhead hitting, and explosive landings, it puts unique and often underestimated stress on young shoulders and knees. Here's what the research shows for the volleyball families in our practice.
The Injuries Unique to Volleyball
Unlike sports built around running and cutting, volleyball's injury pattern centers on repetitive overhead motion and jumping. The two most common problem areas are the shoulder and the knee.
Shoulder overuse develops from the repeated overhead motion of serving and hitting. Studies of youth overhead athletes, a category that includes volleyball alongside baseball and handball; show these injuries build gradually from poor mechanics, muscular imbalance, or inadequate shoulder and scapular strength rather than a single traumatic event. One study of adolescent female volleyball players found that roughly 40% reported shoulder pain that wasn't tied to any specific traumatic injury, an indication of just how common cumulative overuse is in this age group, and outside hitters who take on a large share of a team's attacking load are especially susceptible to related elbow and shoulder strain.
Knee injuries stem from the sheer volume of jumping and landing volleyball demands. Patellar tendinopathy, commonly called "jumper's knee," is the most frequent overuse injury at the knee, with research estimating it affects roughly a quarter of volleyball athletes at some point. More seriously, ACL injuries in volleyball are overwhelmingly non-contact, and recent research has found the majority occur specifically during the landing after a spike a single-leg, asymmetric landing that's fairly unique to volleyball compared to other jumping sports. Female athletes face notably higher ACL injury rates than male athletes in this sport, and high schoolers show higher rates than collegiate players, which researchers suspect reflects less developed landing mechanics and strength in younger athletes.
Ankle sprains and finger or wrist injuries round out the list, often from landing on another player's foot at the net or from blocking, setting, and digging.
What Actually Reduces Risk
Encouragingly, volleyball-specific research is starting to catch up to what soccer has known for years: generic multi-sport warm-up programs don't fully address volleyball's unique demands, particularly the single-leg spike landing tied to most ACL injuries. Volleyball-specific neuromuscular training programs built around the sport's actual landing patterns rather than a one-size-fits-all warm-up shows stronger evidence for reducing both knee and shoulder injury risk.
On the shoulder side, structured overuse-prevention programs targeting rotator cuff and scapular strength have been developed specifically for youth overhead athletes and are showing promising early results for reducing shoulder and elbow overuse injuries in adolescent volleyball players.
Prevention Tips for Parents
1. Ask about spike-landing-specific training, not just a general warm-up. A generic dynamic warm-up is a good start, but the evidence increasingly points to single-leg landing drills as the more important piece for volleyball specifically.
2. Build rotator cuff and scapular strength proactively. This isn't just for kids already dealing with shoulder pain, strengthening these stabilizing muscles before symptoms appear is the more effective prevention strategy, especially for hitters and servers carrying a heavy overhead load.
3. Don't dismiss shoulder soreness as "normal." Given how common pain-without-injury is in young volleyball players, recurring shoulder discomfort is worth a professional look rather than being treated as an unavoidable part of the sport.
4. Brace or tape after a prior ankle or knee injury. For athletes who've already sprained an ankle or dealt with knee pain, a brace or athletic tape provides extra support and has been shown to reduce re-injury risk.
5. Take "jumper's knee" pain seriously early. Pain below the kneecap that worsens with continued play, rather than improving, is a sign to scale back jumping volume and get it evaluated before it becomes chronic.
6. Prioritize an annual sports physical. Because so much of volleyball's injury risk is cumulative rather than sudden, a preseason physical and movement baseline is one of the most useful tools for catching small issues early.
When to Bring in a Sports Medicine Provider
If your young hitter or setter has recurring shoulder soreness, knee pain that lingers after practice, or a landing that looks asymmetric or unstable, a movement evaluation before it turns into a season-ending injury is worth the visit. At Patel Peak Performance, our Kinetisense 3D motion analysis can assess the shoulder mechanics and single-leg landing patterns research has tied directly to volleyball injury risk, and we coordinate preseason physicals with our partners at Beyond Performance Medicine to make sure your athlete is cleared and ready before tryouts.
Resources
"Dual Benefits of Neuromuscular Training in Adolescent Volleyball Players: Knee Injury Prevention and Athletic Performance Share a Common Mechanistic Foundation." Frontiers in Sports and Active Living, 2026. PMC13341738.
Lau, R., & Mukherjee, S. "Prevalence of Shoulder and Elbow Overuse Injuries Among Competitive Overhead Youth Athletes in Singapore." Orthopaedic Journal of Sports Medicine, 2023;11(3).
Lau, R., & Mukherjee, S. "Effectiveness of Overuse Injury Prevention Programs on Upper Extremity Performance in Overhead Youth Athletes: A Systematic Review." Sports Medicine and Health Science, 2023. DOI: 10.1016/j.smhs.2023.03.001.
Lau, R., & Mukherjee, S. "Developing the Singapore Youth Shoulder Overuse Injury Prevention Program." Physical Therapy in Sport, 2024;65:30–37.
"Preventing Musculoskeletal Injuries Among Recreational Adult Volleyball Players: Design of a Randomised Prospective Controlled Trial." PMC5541696.
Goebel, S., MD. "Preventing Injuries for Volleyball Players." OrthoNebraska.
"Volleyball Safety for Youths and Teens." Children's Health.
"Dynamic Volleyball Warm-ups & Injury Prevention Guide." Therapeutic Associates.
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