Boyd W. Haynes III, MD
At the time of this writing, we’re all quarantined in our houses, awaiting the end of the COVID-19 pandemic. Those of us who love sports are eager to return to playing with our teammates. You may not know this about me, but I’ve played beach & indoor volleyball for decades and still do. That\’s me in the photo, wearing a green shirt, playing the net. As I’m an Orthopaedic Sports Medicine physician, I also serve as my beach volleyball team’s physician, so I’m qualified to discuss this topic.
Volleyball Shoulder is a unique type of condition that affects volleyball players because of the type of ways that they hit the volleyball over the net, like serving and spiking. This issue causes abnormal function of the shoulder blade and is often visibly noticeable when looking at the scapula (aka shoulder blade) of their hitting side. At first glance, when looking at a player’s upper back, the scapula of their hitting side looks like it is further away from their spine than the scapula on their non-hitting side. When their arms are raised above their head and they do a full rotation of their arms, you can often see a deep recess in their scapular muscle wall during movement and their scapula is much more pronounced.
Symptoms are the visible changes and players may experience pain, muscle loss and weakness, however not all players have pain. There may also be less accuracy and power when serving or hitting the volleyball. Volleyball shoulder can occur on the non-hitting side due to blocking and diving for the ball, but the vast majority of cases occur on the hitting side. You need to play a lot of volleyball for this condition to develop or be an elite competitor. Playing once a year when your family goes to the beach for a week is not going to cause this condition.
If I see a volleyball player who is complaining of pain or issues with playing, I will order diagnostic imaging studies and do a complete physical exam. I will look closely at their upper back and ask them to fully rotate their hitting and non-hitting arm for comparison. I will ask a lot of questions about how often they play, what their work out routine is and how long they have had symptoms.
Treatment often involves relative rest – a reduction in the number of hits or swings of the arm – if I allow the patient to play. I may request that they fully rest and only do Physical Therapy for a number of weeks. Physical Therapy is very important in treating this type of condition and focuses on stretching tight muscles in the chest and shoulder and strengthening the muscles that support the scapula. Naproxen Sodium is a good anti-inflammatory to use for pain relief.
If we don’t see an improvement in the symptoms, I may order an MRI or nerve conduction study to see if there is a more serious underlying condition or another contributing issue that may hinder recovery. The good news is that Volleyball Shoulder can be treated successfully. If the patient adheres to the rest and physical therapy regimen I prescribe and works with me to carefully and slowly increase activity, I’ll get them back on the beach or indoor playing volleyball safely.