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The Landing Impact Crisis: Understanding Volleyball’s Knee Injury Epidemic
Volleyball generates substantial knee injuries in volleyball affecting knee structures through repetitive jumping, explosive landing forces, and sustained playing demands, creating an epidemic affecting recreational players, amateur competitors, and elite professional volleyball athletes across all competitive levels from youth leagues through professional competitions. A volleyball player lands from a powerful spike attempt, the knee experiences valgus stress with inward deviation, and the ACL tears from the extreme rotational forces during single-leg landing. A competitive player performs hundreds of jumps during training sessions creating cumulative patellar tendon loading, chronic patellar tendinopathy develops affecting jumping capability, and jumper’s knee progresses limiting volleyball performance. A professional volleyball athlete performs thousands of explosive jumps and landings during training and games combined with high-impact forces on hard court surfaces, the knee structures experience extraordinary stress, and chronic knee dysfunction affects career longevity substantially. These diverse mechanisms—landing mechanisms dominating volleyball knee injuries more than any other sport, combined with explosive jumping creating patellar tendon overload—create knee injuries in volleyball affecting 15-20 percent of competitive volleyball players annually with ACL injuries accounting for 26.3-60.2 percent of all volleyball knee injuries and patellar tendinopathy affecting up to 45 percent of elite volleyball athletes where volleyball knee injury prevention sometimes proves inadequate affecting volleyball injury prevention success.
The distinctive injury epidemiology reflects volleyball’s unique characteristics combining explosive vertical jumping with repetitive landing throughout prolonged training sessions and matches. Research demonstrates that ACL injuries are prevalent in volleyball accounting for 26.3-60.2 percent of all knee injuries, with landing following take-off representing the primary non-contact mechanism causing ACL injuries particularly in women’s volleyball. Studies reveal that 80.8 percent of volleyball ACL injuries occur during landing with 76.9 percent occurring during spiking, and 84.6 percent of ACL injuries occurring in front of the attack line near the net where single-leg landing after spiking represents the most common cause of ACL injury. This combination creates injury patterns dominated by anterior cruciate ligament tears from valgus-rotational loading during landing affecting female volleyball players at rates 4-6 times higher than males, patellar tendinopathy (jumper’s knee) from repetitive jumping overload affecting 45 percent of elite volleyball athletes, meniscus tears from rotational stress during landing and directional changes, and sometimes collateral ligament injuries from landing mechanics affecting functional capacity and volleyball performance.
Position-specific vulnerability creates dramatic variation in knee injury risk across volleyball despite the sport’s relatively unified playing environment. Outside hitters (wing spikers) experience knee injuries in volleyball at rates 2-3 times higher than setters, reflecting hitters’ emphasis on explosive jumping and landing during attacking creating substantial knee loading, high spike volume throughout matches creating cumulative stress, and single-leg landing vulnerability during approach mechanics. Research demonstrates that 73.1 percent of volleyball ACL injuries occur in wing spikers (left outside hitters 50 percent, right outside hitters 23.1 percent), with 88.5 percent of injured athletes landing on the knee opposite their dominant hand during spiking approach and landing mechanics. Middle blockers experience elevated rates through sustained blocking volume requiring repeated jumping and landing cycles. Opposite hitters experience elevated rates similar to outside hitters through equivalent attacking demands. Setters experience moderate rates through jumping setting mechanics despite reduced maximum jump heights compared to attacking positions. These position-specific variations underscore that volleyball injury prevention requires understanding position-specific jumping and landing demands rather than applying universal protocols affecting volleyball knee injury prevention strategies throughout careers.
Knee Architecture: Why Volleyball Creates Extraordinary Knee Vulnerability
The knee joint represents volleyball’s most vulnerable lower-extremity articulation for non-contact injury mechanisms, sacrificing some stability for functional mobility allowing explosive jumping and rapid directional changes. Understanding knee anatomy explains why volleyball’s repetitive landing mechanics create such substantial knee injury burden affecting elite and recreational players alike across the competitive spectrum of volleyball.
The knee joint comprises the distal femur (thighbone end), proximal tibia (shinbone top), and patella (kneecap) articulating through multiple ligaments, menisci, and supporting musculature. The anterior cruciate ligament (ACL) prevents anterior tibial translation and controls rotational knee stability through its distinctive fiber arrangement providing multi-directional stability during landing and pivoting movements. Research demonstrates that non-contact ACL injuries occur primarily in youth healthy individuals as a result of sudden changes in direction or speed during physical activities, with this type of knee joint injury being the most common injury in volleyball requiring medical intervention. Peak ACL loading during volleyball landing approaches 2,000-3,000 Newtons substantially exceeding static loads, with valgus knee positioning (inward knee deviation) during landing creating the highest risk factor for ACL injuries in volleyball populations.
The patellar tendon connects the patella (kneecap) to the tibia (shinbone) transmitting forces during knee extension allowing leg straightening and absorbing force during jumping and landing. This tendon plays a key role in knee extension allowing volleyball athletes to straighten legs and absorb force during jumping and landing movements. During volleyball jumping and landing, the patellar tendon experiences tensile loading sometimes exceeding 6,000-8,000 Newtons during maximum-effort jumps and landings. Research demonstrates that when repetitive impact overloads the patellar tendon through repeated jumping activities, it can lead to microtears, inflammation, and chronic pain creating patellar tendinopathy (jumper’s knee) especially common in high-impact sports like volleyball.
The collateral ligaments (MCL medially and LCL laterally) provide medial and lateral stability resisting valgus (inward) and varus (outward) forces. The menisci (medial and lateral fibrocartilage structures) function as shock absorbers and load distributors between femoral and tibial articular surfaces. During volleyball jumping, landing, and directional changes, knee structures experience combined loading combining rotational stress, valgus stress during landing particularly single-leg landing, and compression loading affecting knee injury susceptibility in volleyball.
Proprioceptive pathways in knee ligaments and capsular structures provide critical feedback regarding knee position and movement velocity during dynamic landing movements. Knee ligaments contain mechanoreceptors providing sensory information allowing neuromuscular stabilization during rapid landings. Research demonstrates that most young volleyball athletes probably have little or no awareness that knees and toes should point in the same direction or how this relates to knee injury risk, highlighting the importance of coaching and training addressing proper landing mechanics. Proper volleyball knee injury prevention and knee injury recovery must address proprioceptive restoration and neuromuscular training not just structural healing for complete functional recovery in volleyball athletes.
Landing Mechanics: Understanding Volleyball Knee Loading Patterns
Volleyball landing mechanics involve distinctive phases creating specific knee loading patterns affecting knee injury susceptibility in volleyball players. Understanding proper landing mechanics guides both volleyball injury prevention strategies and rehabilitation protocols addressing jump-landing-specific demands during volleyball competition.
Jump phase involves explosive vertical movement generating upward velocity through coordinated lower-extremity extension. During jumping, the quadriceps contracts concentrically extending knee while gluteal muscles contract generating vertical force. Peak vertical velocities during maximum-effort volleyball spikes sometimes exceed 3-4 meters per second creating substantial upward acceleration requiring explosive knee extension power. Approach mechanics for spiking involve running toward net followed by explosive two-foot or single-leg takeoff creating various landing vulnerability patterns based on approach style.
Landing phase involves impact with ground surface creating sudden deceleration and force transfer through knee structures. Research demonstrates that 80.8 percent of volleyball ACL injuries occur during landing with 76.9 percent occurring during spiking, and single-leg landing after spiking close to the net representing the most common cause of ACL injury in volleyball. During landing, peak deceleration forces sometimes exceed 2,500-3,000 Newtons during maximum-effort jumps. Studies reveal that the highest valgus moment (considered a risk factor for ACL injuries) occurs during run-back type landing following blocking, with run-back landing also showing highest vertical reaction forces.
Single-leg landing creates particular knee vulnerability compared to bilateral landing because single-leg contact concentrates all landing forces through one knee. Research demonstrates that 16 of 21 volleyball athletes sustaining ACL injuries during landing were injured with single-leg landing after spiking, representing 76.2 percent of landing-related ACL injuries. Single-leg landings occur frequently during volleyball through spiking approach mechanics where attacking approach creates single-leg landing vulnerability, particularly when landing on the leg opposite the dominant arm during cross-body spiking mechanics.
Valgus knee positioning during landing represents the primary biomechanical risk factor for ACL injuries in volleyball. Research demonstrates that when landing in a valgus (knee abduction) stance, the propensity for medial laxity and lateral tension allow for greater internal rotation of the femur placing undue stress on the ACL. Studies reveal common landing positions for female volleyball players show knees moving forwards (increasing knee joint load) while hip joints haven’t bent much nor has pelvis moved backwards (which would reduce knee load by spreading forces over gluteal muscles, hamstrings, and calves). This valgus-dominant landing pattern combined with inadequate hip and knee flexion creates the highest ACL injury risk during volleyball landing mechanics.
ACL Injuries: The Career-Threatening Volleyball Knee Injury
ACL tears represent the most severe knee injury in volleyball, affecting career trajectory substantially despite relatively lower annual incidence rates compared to overuse injuries. Research demonstrates that ACL injuries account for 26.3-60.2 percent of all volleyball knee injuries, with landing following take-off representing the primary non-contact mechanism.
Volleyball-specific ACL injury mechanisms involve landing from spiking where single-leg contact combined with valgus knee positioning creates combined valgus-rotational stress exceeding ACL capacity. Research reveals that 80.8 percent of volleyball ACL injuries occur during landing with 76.9 percent occurring during spiking, and single-leg landing after spiking close to the net representing the most common ACL injury cause. Studies demonstrate that 84.6 percent of ACL injuries occur in front of the attack line near the net where spike landing creates maximum vulnerability, with 73.1 percent of injuries occurring in wing spikers (outside hitters).
Female volleyball players demonstrate substantially higher ACL injury rates compared to male counterparts, with incidence many times more common among females than males reflecting biomechanical differences in lower-extremity mechanics, possible hormonal influences on ligament properties, and differences in neuromuscular control affecting female-specific volleyball knee injury prevention requirements. Landing following take-off has been identified as the primary non-contact mechanism causing ACL injuries in women’s volleyball, with the largest number of ACL injuries occurring during the second decade of life.
ACL injury presentation includes immediate severe knee pain, audible pop sensation reported by 70 percent of ACL-injured athletes, immediate swelling from intraarticular bleeding within hours, and functional instability creating sensation of knee “giving way” during volleyball movement. Research demonstrates that 88.5 percent of volleyball ACL injuries affect the knee opposite the dominant hand, suggesting that wing spikers need prevention strategies focusing on spiking movement patterns and landing mechanics on the non-dominant side.
ACL injury treatment requires comprehensive evaluation confirming diagnosis through clinical examination (Lachman test, anterior drawer test) and MRI imaging. Most ACL ruptures require surgical reconstruction for competitive volleyball return, though rehabilitation-focused approaches sometimes prove adequate for recreational athletes. Studies demonstrate that female collegiate volleyball players return to play following ACL injury at high rates (93.1 percent) and maintain pre-injury performance levels, though recovery requires 9-12 months comprehensive rehabilitation before competitive return. Given the prolonged recovery and substantial decrease in chances of full return to sports after surgical ACL repair, prevention efforts including gait training, muscle strengthening, and awareness substantially decrease injury rates.
Patellar Tendinopathy (Jumper’s Knee): The Overuse Volleyball Injury
Patellar tendinopathy (jumper’s knee) represents the most common overuse knee injury in volleyball, affecting up to 45 percent of elite volleyball athletes throughout their careers through mechanisms creating patellar tendon degeneration from repetitive jumping overload. Research demonstrates that jumper’s knee is a form of overuse injury affecting the patellar tendon where repetitive impact overloads the tendon leading to microtears, inflammation, and chronic pain especially common in high-impact sports like volleyball.
Volleyball-specific patellar tendinopathy develops through cumulative patellar tendon loading from repetitive jumping and landing throughout training sessions and competitions. Patellar tendinitis is a repetitive strain injury where overusing knee and putting too much repeated stress on patellar tendon causes it, with repeated wear and tear like jumping a lot making tiny tears in the tendon. During volleyball jumping, the patellar tendon experiences tensile loading during knee extension generating vertical force, then eccentric loading during landing absorbing impact energy. If athletes keep using knees for intense physical volleyball activities, tears don’t have time to heal, and eventually extra stress makes tendons weak and sore creating chronic patellar tendinopathy.
Patellar tendinopathy presentation includes pain directly below the kneecap worse with jumping activities, stiffness or discomfort after volleyball activity, swelling or tenderness at the front of the knee below patella, and difficulty jumping or squatting affecting volleyball performance. Symptoms typically worsen progressively through volleyball seasons if loading continues without modification, initially causing pain only after training advancing toward pain during activity eventually creating constant pain limiting volleyball participation.
Patellar tendinopathy risk factors include high training volumes with excessive jumping frequency, inadequate recovery between volleyball sessions, weak quadriceps or gluteal musculature creating compensatory patellar tendon loading, tight quadriceps or hamstring muscles limiting shock absorption during landing, and sometimes biomechanical factors including altered landing mechanics or inadequate hip control. Research identifies frequent jumping as primary jumper’s knee risk factor alongside sudden changes in direction on hard playing surfaces and minimal recovery time.
Patellar tendinopathy treatment depends on severity and duration. Most patellar tendinopathy responds to conservative management through activity modification reducing jumping volume, eccentric quadriceps strengthening (declined squats representing most effective intervention), patellar tendon loading progressions, and ice application managing symptoms. Rest, over-the-counter pain relievers, and physical therapy represent the most common treatments. Severe chronic patellar tendinopathy sometimes requires extended time away from volleyball (3-6 months) or occasionally surgical intervention when conservative management proves inadequate affecting volleyball career trajectory.
Landing Technique: Biomechanical Risk Factors and Correction
Proper landing technique represents the most modifiable risk factor for volleyball knee injuries, particularly ACL injuries. Research demonstrates that most young volleyball athletes have little awareness that knees and toes should point in the same direction or how this relates to knee injury risk, making coaching responsibility to identify errant landing patterns and provide corrective exercises.
Valgus knee collapse during landing represents the primary biomechanical risk factor requiring correction. Common landing positions for female volleyball players show knees moving inward (valgus position) creating medial knee stress and lateral tension allowing greater internal femoral rotation placing undue stress on ACL. Ideally, athletes should train to have the knee (kneecap) and toes pointing in the same direction as they jump and land, preventing dangerous valgus positioning during landing mechanics.
Inadequate hip and knee flexion during landing creates excessive anterior knee loading. Research demonstrates common landing positions show knees moving forwards (increasing knee joint load) unfortunately with hip joints not bending much nor pelvis moving backwards, which would reduce knee load by spreading forces over gluteal muscles, hamstrings, and calves. Teaching athletes to move pelvis and butt backwards as they land helps engage hamstrings eccentrically, representing one of the common movement-related injury prevention strategies reducing ACL load.
Proper landing mechanics involve bending ankles, knees, and hips during landing creating good biomechanical outcomes. Without getting too deep into anatomy and physiology, if athletes will simply bend ankles, knees, and hips as they land, this engages many leg muscles which work to reduce forces on knee joint and better control forward movement of lower leg dramatically decreasing ACL injury risk.
Landing type variations affect knee loading substantially. Research demonstrates highest valgus moment occurs during run-back landing following blocking with run-back also showing highest vertical reaction forces, while step-back landing creates reduced knee stress making it desirable if players have enough time after unsuccessful blocks. Teaching players landing variations based on game situations reduces knee injury exposure during volleyball competition.
Acute Match Assessment and Volleyball Knee Injury Recognition
Appropriate assessment during volleyball matches determines whether injured players receive appropriate acute care or experience inappropriate management perpetuating complications. Volleyball’s structured match format with timeouts and between-set intervals provides assessment opportunities yet proper recognition proves crucial for player safety and volleyball knee injury prevention.
Immediate injury recognition during volleyball involves identifying mechanism (landing creating knee injury particularly single-leg landing during spiking, blocking creating landing vulnerability, sudden directional change creating rotational stress), pain severity and location, functional capacity preservation, and swelling development. Sudden severe knee pain during landing with audible pop sensation typically indicates ACL rupture requiring immediate removal from play and urgent medical evaluation. Gradual knee pain development below kneecap during matches suggests patellar tendinopathy progression from cumulative loading.
The Lachman test (assessing anterior tibial translation with knee flexed 20-30 degrees) provides reliable sideline ACL assessment demonstrating 85-90 percent sensitivity when performed by experienced examiners. Anterior drawer test assesses ACL integrity through anterior tibial displacement. Immediate knee swelling within minutes indicates significant intra-articular injury typically ACL rupture from intraarticular bleeding.
Weight-bearing assessment establishes baseline knee function. Inability to bear weight immediately suggests significant knee injury warranting removal from play. Ability to bear weight with substantial pain suggests moderate injury potentially allowing limited participation though conservative approach recommends removal for player safety. Patellar tendon palpation identifying tenderness directly below patella suggests patellar tendinopathy affecting volleyball participation capability.
Conservative Management: The Foundation of Knee Recovery
Most volleyball knee injuries respond to conservative management emphasizing appropriate immobilization initially for acute injuries, progressive mobilization, neuromuscular training, and graduated activity progression supporting complete volleyball knee injury recovery. Understanding conservative knee injury recovery protocols proves essential for effective volleyball athlete management.
Early knee injury recovery phases (Days 0-3 for strains, Weeks 0-3 post-surgery for ACL reconstruction) emphasize pain management, swelling control, and basic range-of-motion restoration. ACL reconstruction requires comprehensive rehabilitation protocol spanning 9-12 months before competitive volleyball return. Patellar tendinopathy requires activity modification reducing jumping volume 40-60 percent during acute phases allowing tendon healing.
Intermediate knee injury recovery phases emphasize progressive range-of-motion restoration, quadriceps and hamstring strengthening, and proprioceptive development. Quadriceps activation exercises (straight leg raises, quad sets) reactivate quadriceps muscles overcoming arthrogenic muscle inhibition. Eccentric quadriceps strengthening through declined squats represents most effective intervention for patellar tendinopathy treatment and prevention. Hamstring strengthening develops posterior knee support reducing ACL loading during landing. Proprioceptive training through single-leg balance activities progressing toward dynamic balance develops neuromuscular control supporting safe landing mechanics.
Advanced knee injury recovery phases incorporate volleyball-specific movement patterns and graduated activity progression. Progressive jumping and landing mechanics training at controlled intensities allows volleyball-specific knee loading while maintaining recovery focus. Landing mechanics coaching emphasizing proper technique (knee and toe alignment, adequate hip and knee flexion, avoiding valgus collapse) reduces re-injury risk. Plyometric training develops explosive knee capability with proper mechanics.
Return-to-sport phases involve graduated volleyball participation from controlled practice advancing toward match participation. Studies demonstrate female collegiate volleyball players return to play following ACL injury at high rates (93.1 percent) maintaining pre-injury performance levels with comprehensive rehabilitation. Initial return involves non-jumping drills progressing toward controlled jumping practice, eventually advancing toward full match participation.
Prevention Excellence: Building Resilient Knees for Volleyball Demands
Comprehensive volleyball knee injury prevention requires addressing neuromuscular training, proper landing mechanics coaching, hip and core strengthening, and appropriate training load management throughout volleyball seasons. Understanding volleyball knee injury prevention proves essential for reducing volleyball knee injury burden given that ACL injuries account for 26.3-60.2 percent of volleyball knee injuries.
Neuromuscular training represents the single most effective volleyball knee injury prevention intervention. Landing mechanics coaching addressing proper technique proves essential given that most young athletes lack awareness of proper knee-toe alignment and injury risk relationships. Training emphasizing knee-toe alignment (knees and toes pointing same direction), adequate hip and knee flexion during landing (bending ankles, knees, hips), and avoiding valgus knee collapse substantially reduces ACL injury risk. Research demonstrates prevention efforts including gait training, muscle strengthening, and awareness substantially decrease injury rates.
Hip strengthening provides proximal stability supporting knee function during all volleyball movements. Weak hip abductors and external rotators create compensatory valgus knee loading during landing. Placing resistance band around thighs (just above knees) helps activate and strengthen select hip muscles providing lateral stability of knees when jumping and landing, with band pulling knees together forcing athlete to engage correct hip muscles keeping knees apart during jumping and landing movements. Progressive hip strengthening substantially reduces knee injury risk through proximal stability development.
Core stability training provides foundational support affecting lower-extremity function and knee loading patterns. Weak core forces compensatory lower-extremity loading affecting knee structures during volleyball activities. Progressive core training supports optimal knee loading during all volleyball movements.
Patellar tendon load management prevents overuse patellar tendinopathy clustering during high-volume training periods. Careful monitoring of jumping volume, training intensity progression, and adequate recovery between volleyball sessions prevents excessive patellar tendon loading. Research demonstrates proper warm-ups, gradual activity progression, and sufficient recovery time prove essential for jumper’s knee prevention.
Landing type coaching teaches athletes landing variations based on game situations. Research demonstrates step-back landing should be used when players have time after unsuccessful blocks rather than run-back landing which creates highest valgus moment and vertical reaction forces. Teaching landing variations reduces dangerous loading exposures during volleyball competition.
Frequently Asked Questions
What’s the realistic timeline for returning to volleyball after ACL tear?
Recovery timelines for ACL reconstruction require 9-12 months comprehensive rehabilitation before competitive volleyball return. Research demonstrates female collegiate volleyball players return to play following ACL injury at high rates (93.1 percent) and maintain pre-injury performance levels with proper rehabilitation. Early-phase rehabilitation (Weeks 0-6) emphasizes swelling control and basic function restoration. Intermediate rehabilitation (Weeks 6-12) develops strength and proprioception. Advanced rehabilitation (Weeks 12-26) incorporates volleyball-specific training. Return-to-sport (Weeks 26-52) involves graduated volleyball participation. Individual variation spans 9-18 months based on rehabilitation quality, position demands, and psychological readiness. Return should follow objective functional criteria including strength symmetry achievement, proper landing mechanics restoration, and sport-specific testing clearance rather than arbitrary timelines.
Can volleyball players prevent knee injuries through training?
Yes, comprehensive volleyball knee injury prevention programs incorporating neuromuscular training, proper landing mechanics coaching, hip strengthening, and appropriate training load management substantially reduce volleyball knee injuries. Research demonstrates prevention efforts including gait training, muscle strengthening, and awareness substantially decrease injury rates. Landing mechanics coaching addressing knee-toe alignment, adequate hip and knee flexion, and avoiding valgus collapse proves essential given that 80.8 percent of volleyball ACL injuries occur during landing. Given that ACL injuries account for 26.3-60.2 percent of volleyball knee injuries and patellar tendinopathy affects 45 percent of elite athletes, prevention proves essential for volleyball injury prevention success throughout careers.
How do volleyball knee injuries differ from basketball knee injuries?
Volleyball knee injuries predominantly result from landing mechanics following explosive vertical jumping with single-leg landing creating highest ACL vulnerability, with 80.8 percent of ACL injuries occurring during landing and 76.9 percent during spiking. Basketball injuries result from combined landing and cutting mechanisms with more varied directional demands. Research shows 84.6 percent of volleyball ACL injuries occur near net during attacking, while basketball shows more distributed court locations. Volleyball demonstrates higher patellar tendinopathy rates (45 percent of elite athletes) compared to basketball. Prevention strategies differ: volleyball emphasizing landing mechanics and spike approach technique; basketball emphasizing multidirectional movement control affecting sport-specific volleyball knee injury prevention development.
What prevention exercises reduce volleyball knee injury risk?
Effective prevention emphasizes neuromuscular training including landing mechanics drills (knee-toe alignment practice, hip and knee flexion emphasis during landing), hip strengthening using resistance bands above knees during jumping and landing movements, eccentric quadriceps strengthening (declined squats for patellar tendinopathy prevention), hamstring strengthening providing posterior knee support, and core stabilization. Programs incorporating 25-35 minutes, 3-4 times weekly demonstrate substantial injury reduction. Research demonstrates bending ankles, knees, and hips during landing engages leg muscles reducing knee joint forces and dramatically decreasing ACL injury risk. Given that 88.5 percent of volleyball ACL injuries affect knee opposite dominant hand, bilateral training proves essential for volleyball knee injury prevention success.
What’s the re-injury rate for volleyball knee injuries?
ACL re-injury rates in volleyball populations show variable outcomes with studies demonstrating 93.1 percent return-to-play rates and maintained performance levels suggesting good outcomes with comprehensive rehabilitation. However, the substantial decrease in chances of full return to sports after surgical ACL repair highlights ongoing vulnerability. Patellar tendinopathy demonstrates substantial recurrence vulnerability with chronic symptoms affecting up to 45 percent of elite volleyball athletes. Comprehensive rehabilitation emphasizing neuromuscular control restoration, proper landing mechanics, progressive strength development, and appropriate training load management substantially reduces re-injury risk. Given that prevention efforts substantially decrease injury rates, implementing comprehensive prevention protocols throughout careers proves essential for volleyball knee injury prevention success.
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