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Landing-related ankle injuries do not occur in plantarflexion as once thought: a systematic video analysis of ankle injuries in world-class volleyball
  1. Christopher Skazalski1,
  2. Jacek Kruczynski2,3,
  3. Martin Aase Bahr4,
  4. Tone Bere1,4,
  5. Rod Whiteley1,
  6. Roald Bahr1,3,4
  1. 1 Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  2. 2 Department of General Orthopaedics, Oncology and Traumatology, Poznan University of Medical Sciences, Poznan, Poland
  3. 3 Fédération Internationale de Volleyball, Lausanne, Switzerland
  4. 4 Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
  1. Correspondence to Christopher Skazalski, Aspetar Orthopaedic and Sports Medicine Hospital, Sport City Street, P.O. Box 29222, Doha, Qatar; Christopher.Skazalski{at}


Background Ankle injuries are prevalent in elite volleyball and suggested to result from player contact at the net. Traditionally, ankle sprains are thought to happen in a plantarflexed position, but case studies suggest plantarflexion may not be involved.

Aim Describe the injury situations and mechanisms of ankle injuries in world-class volleyball based on systematic video analysis of injuries reported through the Fédération Internationale de Volleyball (FIVB) Injury Surveillance System.

Methods Videos of 24 injuries from major FIVB tournaments were included for analysis (14 men, 10 women). Five analysts reviewed the videos to determine specific situations and mechanisms leading to injuries.

Results The majority of injuries occurred during two volleyball situations, blocking (n=15) and attacking (n=6). Injuries to blockers were the result of landing on an opponent (n=11) or teammate (n=4). Attacking injuries most frequently occurred when a back-row player landed on a front-row teammate (n=4 of 6). When landing on an opponent under the net, the attacker landed into the opponent’s court in 11 of 12 situations but without violating the centre line rule. Injuries mostly resulted from rapid inversion without any substantial plantarflexion.

Conclusions The majority of injuries occur while blocking, often landing on an opponent. The attacker is overwhelmingly to blame for injuries at the net secondary to crossing the centre line. Injuries while attacking often result from a back-row player landing on a front-row teammate. Landing-related injuries mostly result from rapid inversion with the absence of plantarflexion.

  • ankle
  • sprain
  • risk factor
  • volleyball
  • injury prevention

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  • Contributors CS, TB, RW and RB contributed to project planning and data collection. CS, JK, MAB, RW and RB performed data analysis. CS, RW and RB analysed and interpreted the data and wrote the first draft of the paper. All authors reviewed and approved the manuscript.

  • Funding The FIVB ISS has been established based on financial support from the FIVB. The Oslo Sports Trauma Research Center has been established at the Norwegian School of Sport Sciences through generous grants from the Royal Norwegian Ministry of Culture, the South-Eastern Norway Regional Health Authority, the International Olympic Committee, the Norwegian Olympic Committee & Confederation of Sport, and Norsk Tipping AS.

  • Competing interests None declared.

  • Ethics approval Regional Ethics Committee Midt-Norge.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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