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With any style of repetitive movements, our bodies adapt in several ways both structurally (i.e. muscular strength) and functionally (i.e. neuromuscular coordination) to carry out a specific task. The major adaptations seen that are linked to injury and long term performance decline are:

  • sport-specific adaptations

  • alterations in strength

  • flexibility

  • posture (in the glenohumeral joint, and also in other links of the kinetic chain)

When the body adapts in these ways, the integrity of the body system is compromised if it is not properly stabilized with mindful practice and appropriate training.


Of the overhead athlete group, volleyball skills are unique in the demands of the shoulder. Particularly, in the higher shoulder abduction and horizontal adduction at ball contact.  This presents a slight difference in the range of strength needed for high performance as well as the subsequent injuries observed.  Most of the reported shoulder injuries are strains, implicating a process over time, with chronic overload leading to injury. Chronic shoulder pain in volleyball players is often attributed to the previously mentioned adaptations.

These alterations change biomechanics and movement strategies during serving and striking that can lead to overload injuries at the shoulder. An important thing to understand is that our body is one big kinetic chain and thus it functions as a whole system in every movement.  An injury on one end could come from an imbalance on the opposite.  The most common imbalances seen in shoulder injuries are:

  • glenohumeral internal-rotation deficit (GIRD)

  • rotator cuff strength imbalance

  • scapular dyskinesis

  • thoracic spine stiffness

  • hyperkyphosis

  • lumbar core instability

  • hip range of motion

  • strength deficits

  • structural predispositions

Dysfunction somewhere along the kinetic chain is typically a result of repetitive, vigorous activities in athletes of all ages. In order to understand and prevent recurrent injuries in volleyball athletes, four steps need to be undertaken:

  • Establish the risk factors for injury and re-injury
  • Utilize these risk factors as part of a return-to-play criteria
  • Measure these variables using reliable, valid assessment tools and procedures
    1. 3D Motion Capture and Force Plate are the most reliable and valid tools available
    2. Functional analysis during the sport-specific movement will produce the most accurate information
  • Design and implement training programs to prevent re-injury, increase longevity, and enhance performance.
    1. To restore flexibility of the surrounding soft tissue of the scapula (pectoralis minor, levator scapulae, rhomboid, and posterior shoulder structures)
    2. To increase scapular muscle performance around the scapula, focusing on control and coordination and balance


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