Lower Extremity Youth Volleyball Injuries Predominantly Impact Female Athletes: A Sex-specific Analysis of National Injury Data from 2013 to 2022

Research Objectives: To evaluate current youth volleyball player lower extremity (LE) injury trends and sex-specific differences in the United States.

Design: Statistical analysis of the National Electronic Injury Surveillance System (NEISS) database.

Setting: All emergency departments across the United States.

Participants: Patients ≤18 years old who visited the emergency department for a LE volleyball injury from January 1, 2013 to December 31, 2022.

Interventions: Not applicable.

Main Outcome Measures: Body part injured, diagnosis, mechanism of injury, age, gender, annual trends in injury, and disposition (national estimates were calculated using the hospitals’ corresponding statistical sample weights).

Results: A total of 134,785 (raw cases = 3,957) LE recreational and/or competitive indoor volleyball-related injuries were included. Average age was 14.8±2.0 years. Females made up 80.6% of patients. The most common body parts injured were ankles (78,315, 58.1%), knees (36,202, 26.9%), and feet (11,419, 8.5%). The most common identifiable mechanisms of injury were twisting (73,314, 54.4%), impact with the floor (17,283, 12.8%), and impact with another player (9,916, 7.4%). Most common diagnoses were strain/sprain (87,473, 64.9%), other/not stated (21,950, 16.3%), and fractures (10,675, 7.9%). During the study period excluding 2020, there was a significant annual increase in overall injuries (129, p=0.004, CI: 42 to 216). A greater proportion of females sustained strains/sprains (66.8% vs. 61.6%, p< 0.001) and contusions/abrasions (5.9% vs. 5.6%, p=0.046), while a greater proportion of males sustained fractures (12.5% vs. 7.0%, p< 0.001) and dislocations (5.5% vs. 3.5%, p< 0.001).

Conclusions: LE injuries in volleyball have been increasing since 2013, mostly affecting the ankles and female youth players. Strain/sprains, pain and swelling, and fractures are the most common diagnoses, with females experiencing more strains/sprains and contusions/abrasions, and males experiencing more fractures and dislocations. The increase in LE volleyball injuries may be due to increased popularity of the sport and more athletes playing without ankle braces and/or less participation in plyometric training/ankle-strength conditioning involving jumping and landing safely.

Author(s) Disclosures: No disclosures to report.