Most sports have a spread of injuries. Volleyball has one that dominates.
A prospective study of 272 players in the top two divisions of Norwegian volleyball, covering more than 51,000 player hours, found the ankle accounted for 54 percent of all injuries.
Lower back was next at 11 percent. Then knee at 8, shoulder at 8, and fingers at 7.
More than half of everything, in one joint.
And the reason it stays that way is a second finding in the same study that should change how every program handles it.
The Number That Explains the Problem
Of those ankle injuries, 79 percent were recurrences.
Roughly four out of five were not new injuries. They were the same ankle again.
The relative risk of injury was 3.8 times higher for previously injured ankles compared with ankles that had never been sprained.
And the window matters enormously. Among 50 ankles that had been sprained within the previous six months, 21 were reinjured, which is 42 percent, with a risk ratio of 9.8 compared with uninjured ankles.
Nearly ten times the risk in the six months after a sprain.
A separate study reached a compatible conclusion, finding that 75 percent of players who sustained an ankle sprain reported a previous sprain, and concluding that prevention programs should focus specifically on players with a history.
So the volleyball ankle problem is not really a sprain problem. It is a reinjury problem.
Why It Happens at the Net
The mechanism is specific and it is worth understanding, because it explains why this is a volleyball problem rather than a general landing problem.
Indoor ankle sprains occur most often at the net, as a result of contact between the attacker and the opposing blocker across the center line.
You land on somebody else’s foot.
Not a bad landing. Not a wobble. A foot that was not supposed to be there, under yours, on the way down.
Which is why the center line rule appears in the injury literature as a risk factor, and why net play is the highest risk moment in the sport.
It also explains why the usual landing mechanics advice only goes so far here. You can land perfectly and still roll an ankle if there is a foot underneath it.
What That Means for Prevention
Three things follow, and they are not what most teams do.
One: External Support, for Longer Than You Think
The Norwegian study’s conclusion was direct. External supports should be worn for six to twelve months after an ankle sprain.
Six to twelve months. Not until it stops hurting. Not for the rest of the season.
Taping and bracing appear in the volleyball literature as modifiable risk factors, meaning the evidence supports them in this sport specifically.
And the practical reality is that most players wear a brace for a few weeks, feel fine, and stop. Given the 42 percent reinjury rate within six months, that timing is unfortunate.
A reasonable position: if you have sprained an ankle this season, you should be braced or taped for the rest of it, and probably into the next one.
Two: Rehabilitate It Properly, Not Just Until It Stops Hurting
Pain settles well before function returns.
A sprain damages ligaments, and it also degrades proprioception, meaning the feedback from the joint telling your brain where it is and how fast it is moving. That feedback loop is what fires the protective muscular response within milliseconds.
Damage it and your ankle does not know it is rolling until it already has.
And that deficit does not resolve on its own. Walking and jumping normally does not restore it. It requires specific balance and proprioceptive training.
Which is why so many players return at three weeks feeling fine and roll it again in November.
Three: Screen the Players With a History
Given that previous injury is the leading risk factor, the highest value thing a program can do is identify who has one.
Ask the squad. Who has sprained an ankle, which side, and when.
Those players are your priority group for balance work, bracing and proper assessment.
And a systematic review found that preventive measures had a significant effect, with ankle injuries reduced from 0.9 to 0.5 injuries per 1000 player hours. That is a substantial reduction from measures that are neither expensive nor time consuming.
What a Program Should Include
Balance and proprioceptive training, progressed deliberately. Single leg stance, then eyes closed, then on an unstable surface, then with a ball, then with reaching and head turns, then landing from a jump onto one leg.
Five to ten minutes most days beats one long session weekly, because this is skill training.
Strength work, particularly the muscles on the outside of the lower leg that resist an inward roll, plus calf and hip strength.
Landing and reactive work, including landing under slightly unpredictable conditions, which is closer to what actually happens at the net.
And court specific exposure, since balance on a flat gym floor is not the same as balance after a hard approach jump in the third set.
A Note on Who Is Affected
Worth including because the assumption runs the other way.
The volleyball literature notes there is no compelling evidence that sex is a significant risk factor for acute ankle injuries in this sport.
Which differs from the picture for knee injuries, where differences between male and female athletes are well documented.
So ankle prevention applies across the squad, not to one group.
If You Roll One Mid Season
Assess before continuing. Can you bear weight? Is there immediate swelling? Is there bony tenderness over the ankle bones or the midfoot?
Inability to bear weight for four steps, or bony tenderness at those specific points, warrants medical assessment to rule out a fracture. Those are the standard criteria clinicians use.
Then rehabilitate it properly, which means through to restored balance and strength rather than to the absence of pain.
And brace it when you return, for considerably longer than feels necessary.
Seek Medical Assessment For
Inability to bear weight after the injury.
Bony tenderness over the ankle bones or the midfoot.
Significant immediate swelling.
An ankle that repeatedly gives way.
Persistent swelling months after an injury.
An ankle that locks or catches.
Numbness or tingling in the foot.
And any ankle that has been sprained three or more times, which warrants a proper assessment rather than another few weeks of tape.
Build the Ankle That Does Not Keep Going
More than half of volleyball injuries happen at one joint, and four out of five of those are repeats of an injury that was never fully rehabilitated.
Sports Physical Therapy offers a free discovery visit at no cost and no obligation. You will get a thorough assessment of your ankle strength, balance and control with side to side comparison, a clear picture of what is still missing, and a program that closes the gap.
If your presentation suggests imaging is warranted, we will tell you plainly and help you get there.