Background Knee injuries were common in volleyball players, and ACL injury is a serious injury for athletes.

Objective The purpose of this study was to investigate the mechanism of ACL injury in volleyball players using a questionnaire.

Design Research study using a questionnaire.

Setting Volleyball players who had ACL reconstruction at our institution.

Patients Twenty-five females and 1 male (mean age; 24.6±11.0 years-old) volleyball players who ruptured their ACL during volleyball and underwent ACL reconstruction.

Assessment of Risk Factors They were asked about their position, dominant hand defined as the spiking hand, side of injury, event during which the injury occurred (game or practice), the circumstance of injury (the situation in which the injury occurred, the specific motion at the time of injury) and player position and court location where the injury occurred.

Results There were 19 wing spikers (left 13, right 6). Twenty-four players were right-handed and 2 players were left-handed, and 23 players injured the knees opposite to dominant hand. The 65.4% of injuries were prevalent during game. Twenty players (76.9%) were injured during spiking. Twenty-one players (80.8%) receive injured during landing, and 16 of them injured with single-leg landing after spiking. Most of ACL injuries (84.6%) occurred in front of the attack line near the net.

Conclusions Single leg landing after spiking close to the net was the most common cause of injury, and most of wing spikers injured the knee opposite to their dominant hand. It suggests that wing spikers need to consider prevention strategies focusing on spiking movement.