Overuse, specialization, club? High volume of injuries in college alarming

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“Is it because kids aren’t running around? Have we gone past the free-range-chicken type of kid that will just leave the house after breakfast in the morning and just play? Just ride their bikes, get into games, run through the woods, go to the park, whatever situations we had when we were growing up. They don’t start playing unless it’s organized and rarely are things that are organized a daily activity.”
— Penn State men’s coach Mark Pavlik

 

I’m not a doctor and I’m not going to try to play one on a website.

But I know this: More and more college volleyball players are showing up on campus already broken or they break down once they arrive.

“I think it’s probably a near 50-50 split between how many are coming in a little broken or battered or how many are breaking down on our watch,” Akron coach Tom Hanna said.

The prevailing topic in conversations I have with women’s college coaches is about dealing with injuries. Volleyball may not be a contact sport, but it’s all about ankles, knees, shoulders, backs, feet, and, well, it hurts just to think about it.

Literally as I was typing the previous sentence North Carolina coach Joe Sagula returned a call to talk about his Tar Heels for another story.

“I love this team, but I haven’t seen them all be together yet because we’ve had some injuries, unfortunately,” Sagula said with remarkable journalistic timing. “We haven’t had our full roster practice yet.”

And it’s not just the women. Men’s teams get decimated. And look at beach volleyball, where players are using so much kinesiology tape they look like mummies.

“Essentially it’s going to be difficult in the future to find someone who comes in completely healthy,” Texas A&M coach Laurie Corbelli said sadly.

With the college season beginning Friday, I assure you the busiest people in volleyball programs throughout the land are the trainers.

This is not a medical report, nor am I citing studies. If they exist, hopefully they’ll be pointed out to me because of this story.

“I don’t know the numbers, but from my eye I’m concerned about it,” Georgia coach Tom Black said.

Simply put, I visited with a lot of coaches over the past few months to collect their thoughts and throw it out there for the volleyball world to ponder.

“We’ve had both, but broken before they get there is the bigger issue in terms of the playing volume. And playing on a one-inch piece of plastic over concrete,” Hanna said while we were standing on a one-inch piece of plastic over concrete at AAU Nationals in Orlando.

The surface came up quite often.

“I think a lot of people will say playing on cement all the way through is a problem,” Wisconsin coach Kelly Sheffield said. “It is a problem and with kids starting younger and younger, and there are some positives, but there’s also a cumulative effect of playing on bad surfaces all the time.

“I won’t say that’s a reason for all of it, but I think it’s one of a lot of different things.”

Sagula, starting his 28th year at Carolina, wouldn’t argue.

“The college level has become such a more physical sport and at times I don’t think we’re prepared for that because they come in a little bit beaten up,” Sagula said. “I think college kids play less volleyball than junior volleyball kids.

“The kids who play junior volleyball are just getting worn out playing on those Sport Courts in those convention centers. playing Friday-Saturday-Sunday, three days in a row, and they get to college and play one match on a Friday and one match on a Saturday. They play less. It’s higher quality but when I talk to our players and they think back to how much they played they can’t believe it. Ask them to play three matches on a weekend now, forget it.”

Tennessee coach Rob Patrick concurred.

“It’s all overuse. We have kids coming in and they’ve had zero break,” Patrick said, adding the familiar refrain of going from high school to club and back again with no rest. “The first break they get is Christmas break in college. It’s too much and the bodies can’t handle it.”

“Here’s what I do know: Kids aren’t having time off like they used to,” Sheffield said. “Colleges used to be able to train more and longer 30 years ago. But the elite players in high school are playing way more than they’ve ever played. When I coached club, we got started in January. Well, right now you have qualifiers happening in January for the 18s. So they are starting right after high school is done with no break. And high schools are starting right after nationals. So you don’t have the two-month break you used to have right after the high school season. I’m not a fan of that.”

Sheffield pointed out, too, that some of the best are playing not only club and high school, but also on the USA level.

It’s doubtful any trainer has been more knee deep on the front lines than Erin Boyette of Texas A&M. The Aggies had four offseason surgeries before the 2016 season and at times last year were seemingly kept together with tape and glue.

“It’s an almost like an epidemic and they’re coming in more and more injured,” Boyette said. “We’re getting girls with thick medical files before they even get here, which didn’t used to be like that years ago.

“A lot of it is the specialization and it’s not just volleyball. We’re seeing it talking to other athletic trainers that work different sports. Kids are specializing younger and younger and they’re sticking to one sport and even more so they’re sticking to just one position in one sport. So they’re getting repetitive training of the same exact motion over and over and the body’s going to break down because of that.”

Boyette called the resulting problems a “chronic wear and tear on the body.”

She said A&M does a lot of movement screening when athletes first arrive, assess their strengths and weaknesses, “and we try to balance all of that with a lot of shoulder maintenance, core maintenance, shoulder mobility, hip mobility, stuff like that counterbalances what they do in the weight room and what they do in the gym.

“But it’s like playing catch-up to a game you’re never going to catch up to.”

That’s a sobering thought.

“We’ve been relatively healthy so I don’t know if that’s luck or what, but it’s a hot topic amongst coaches that players are arriving hurt or that they’re playing too much or on the wrong surfaces,” Washington coach Keegan Cook said. “But everyone has a responsibility to take care of the players and nobody wants to be the person to give the kids rest, not the high school coaches, the club coaches, the college coaches. The problem is not going to be solved until everyone takes a joint responsibility in giving the players the rest they need. Everyone wants to complain, but everyone’s equally responsible.”

Kevin Hambly, starting his first season at Stanford after eight years at Illinois, sounded a familiar refrain.

“A lot of it has to do with overuse injuries. Kids are playing way more club, there are way more tournaments, way less training time,” Hambly said. “It is what it is. I don’t know how we change it. Kids don’t play as many sports and they become imbalanced and how you handle those imbalances when they come into your program determines how injured the kids are going to be during their time.

“And you have to approach them as broken.”

Hambly cited some examples.

“A lot of them are quad-heavy, their hamstrings need development, a lot of them don’t have good ankle flexibility, probably because they’re just pounding and pounding and pounding. But it’s still going to take two to three years to get through that. I think you have to slow play it the whole way and figure it out and not really start loading them up until they get to the point where they’re ready to handle that.

“For me for a lot of years we didn’t do a good job of that, we didn’t do a good job of understanding what their issues were and addressing those quickly and taking our time to working on power and strength.”

Anne Kordes is back to her roots at the Louisville club KIVA. But she was a longtime head college coach, both at Saint Louis and for the past six years at Louisville.

“You’re going to have all different answers because you have individual bodies and individual training and that goes for club and colleges. Preseasons are very different for some colleges and club seasons are very different, but we talk a lot about maintenance of your body at KIVA, whether it’s physical therapy or chiropractic care, or making sure you’re working your core. Eating right is important. And for example after a long weekend if you come back in the gym on Monday, Tuesday we have no-jumping practices. Little things like that can make a difference. But every individual body can react differently to different training situations.”

Hanna said Akron uses VERT to monitor jumping and making sure his players don’t over-jump.

“My theory is if you break them you can’t use them, so I’ve always been a little conservative,” Hanna said. “So if something is ailing you we’ll just shut you down completely or really limit you.”

Wisconsin trainer Kristin Walker also bemoaned specialization.

“I mean, we’ve got kids on 11s teams that are just doing volleyball now,” she said.

Walker, who played basketball at UC Irvine, has a 4-month old, so she’s not cross-training yet.

“But she will be,” Walker said with a laugh. “I want her playing every sport.”

Walker said athletes train more than ever before and “they’re training the same motor patterns over and over and over. There’s not as much recovery time and there’s not as much general athletic training, just getting away from the sports-specific components. And that’s everywhere.“

A&M’s Boyette agreed.

“It sounds simple enough, but play more than one sport,” said Boyette, who played both volleyball and softball in high school. “And I would counter that with play a different sport that focuses on different body parts.”

A perfect example is Michigan middle blocker Claire Kieffer-Wright. She won the Big Ten high jump championship this past spring, and except for a foot injury early in her career, Kieffer-Wright has avoided injuries.

“I think cross training is really important, especially for younger kids,” Kieffer-Wright said. “It so good for your body to be doing something different.

“When you play multiple sports I feel personally that injuries don’t happen as often because your body is being worked out in different ways, not the same way every time. I never had a problem with my shoulders in high school because I wasn’t just all volleyball all the time.

“I understand playing one sport, but you should play as many sports as you want to play.”

Walker noted that a lot of coaches are seeking out multi-sports athletes. To wit, a recent story in the Wall Street Journal where Michigan football coach Jim Harbaugh said he wanted guys who had played soccer.

If they’ve played multiple sports, Walker said, “they’re health longevity is better. And it doesn’t do you any good to recruit kids you are not actually going to play.”

Added Sagula, “We play too much volleyball at the junior level. Only volleyball. What I mean by that is I would rather recruit a kid who is playing some basketball, some softball, track and field, or maybe soccer, because I think we overuse the same muscle groups in that one sport. So if you’re only playing volleyball you’re wearing out the shoulders and the knees. In basketball, you have some different things and you’re running. In soccer you’re doing more cutting moves.”

There’s no doubt the players are bigger and stronger, so the game is more physical. The sport continues to grow, especially on the club level, so Boyette’s “catch up” line might be inevitable.

“There’s great stuff going on in our sport,” Sheffield said. “There’s great stuff.

“But there’s also a price and one of the prices is maybe there are some health consequences for playing that long on these surfaces, without time off and with kids a lot more into one sport.

“The play has never been better. We’ve never been more physical. The sport has never been healthier. But, yeah, without any reading any research, yeah, there are probably more injuries.”

Or more unknown injuries.

“I always worry about when the kids come in the first day of preseason and they go see the athletic trainers and they get a screening and they go through their history of injuries,” UNC’s Sagula said. “And the kids come to you and you ask how they’re feeling and they’re like, ‘I’m doing great coach.’ And they leave the athletic trainer and the trainer comes to you with a list, ‘This kid has this issue, this issue, this issue and this issue. And she can’t sprint. This one shouldn’t do as many jumps, this one shouldn’t take this many swings.’ They’re just worn out.

“And you don’t know that stuff (ahead of time) and it’s not stuff you can even ask and don’t even expect. You watch these kids play and they seem fine but they’re hurting inside. Who knows, kids have had concussions, kids have had shoulder problems, they’ve had tendinitis. And the other thing is we’ve got bigger kids, taller kids. Those 6-foot-3 kids who are freshmen in high school, they’re dealing with knee issues and bone-growth issues and all kinds of stuff like that.”

Corbelli knows that well.

“What do you do?” she asked while we sat and watched a match at a big tournament last spring. “Well, our staff has been talking a lot about getting any doctor’s reports sooner if we can, especially with backs. Find out what’s going on with it, it could be growth, it could be scoliosis, but it also could be the discs, just trying to be more cautious in who we recruit.”

She shook her head.

“I just heard that two kids we want to recruit and watch today may not be playing very much because one has a bad shoulder and one has a bad back. So we won’t really get to evaluate them. I don’t know what to do. I think a lot of coaches are still trying to figure that out.”

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