To Brace or not to Brace?: That is the Question

‘Ankle braces will weaken your ankles mate, don’t stay on them too long’. I don’t know when or how this myth started, but guys, it ain’t true. We play Volleyball. We jump at the net, surrounded by many other people, land from crazy heights, into even more dangerous positions, feet are everywhere, uncoordinated idiots jumping under the net…please, protect your ankles.

What is Proprioception?

Proprioception is an important sense in the body. Unlike, sight, touch, hearing taste and smell, it focuses on only internal feedback from the body. Proprioception is the process by which you body can vary muscles contraction in immediate response to incoming information about your body in space. It is basically a sensory feedback for muscle control and posture.

Proprioception occurs by utilizing proprioceptors (little sensory things- Golgi tendon organs and Muscle spindle) in your muscles to monitor length, tension and pressure.

So why don’t they weaken your ankles?

OK, I get the reasoning behind everyone’s assumption that long-term ankle brace usage will cause ankle weakness. I hear a lot that it is doing the work for your ankle, so your ankle becomes detrained and won’t perform the proprioception itself. I get it, yeah, but it’s wrong. Let me try and explain.

Most people reading this would have worn an ankle brace at some stage in their career. Firstly you simply cannot take away your body’s proprioception. When you move in an ankle brace, your ankle still has to do a lot of work. You haven’t surrounded your ankle with a new joint and voila, no more ankle activation. When you land, or move, your ankle still must correct itself, and your proprioception is still very much hard at work. Your ankle will move a fair bit in the brace, and lots of forces will be applied, so in a healthy ankle the muscle spindles and Golgi tendons will be getting a fair workout. The fact of the matter is, that bracing will actually work to enhance your proprioceptive input, not override it.

All ankle braces are doing for you, is stopping you ripping the crap out of your ankle, shattering every bone, snapping all the ligaments and ending your career. OK, over dramatic, but you get the point? An ankle brace will not dull your senses; it will simply prevent a real disaster occurring. If you are going to go over your ankle badly, you probably will in an ankle brace anyway, it just means that the severity of the injury is a lot less.

Don’t believe me? Fair enough. I get that. But there are numerous studies supporting me.

Mitchell et.al (2000) did a study on the effects long-term ankle bracing has on the Peroneus Longus (muscle around the ankle) during sudden inversion in normal subjects. They did the study because

“ankle bracing in a healthy ankle over a sustained period has been scrutinized due to possible neuromuscular adaptations resulting in diminished dynamic support offered by the peroneus longus muscle. Although this claim is anecdotal in nature, we sought to investigate the effects of long-term ankle bracing using 2 commonly available appliances on Peroneus Longus latency (edit: time delay between and effect on the muscle and a reaction to that effect) in normal subjects. Our second purpose was to evaluate the effects of ankle bracing on Peroneus Longus latency before a period of extended use”

Their results? Ankle bracing had no effect on the latency of the Peroneus muscle. Short term or long term. Nothing at all.

“The duration of the Peroneus Longus stretch reflex (latency) is neither facilitated nor inhibited with extended use of an external ankle support. Proprioceptive input provided by the muscle spindles within the Peroneus Longus does not appear to be compromised with the long-term use of ankle braces.”

Feuerbach et.al (1994) also did a study looking at the effect of ankle orthosis (bracing) on ankle joint proprioception. The found that using an ankle brace would actually increase the feedback from your internal receptors, and will lead to an improved ankle joint position sense.

Nishikawa and Grabiner (1999) did a very similar study. They also found that application of the ankle brace excited the receptors, most likely those that are to do with the skin. Meaning bracing led to better proprioception and joint sense; helping make the candidates more aware. They also showed that Peroneus Longus latency was not affected at all by ankle brace use. They noted that this is very important for rehabilitation purposes, as an injured ankle needs to work on proprioception, and bracing may help to excite and stimulate that.

Sorry for the the technical crap, but now you have some evidence.

There has got to be some negatives to bracing…

Speaking recently to Aussie Libero Phill DeSalvo and my roommate with vastly improving hip mobility, Sarah, both have a different view on the ankle brace. A very very high percentage of ankle sprains in Volleyball occur at the net. Now, if you are a libero and you are jumping to spike or block at the net, then you don’t know what you are doing, are in violation of a lot of rules, and should hand your different coloured shirt in. The point is, ankle injuries occur when jumping and landing, Liberos rarely jump or land. In fact, some feel that they maybe limit their range of motion a little. There is no evidence to support this, but it is a feeling held by quite a few liberos. As you try to get into a deep side lunge, the ankle brace can inhibit that slightly as your ankle obviously doesn’t have as much range. Some players also find that they don’t fit well with their shoe, or are simply uncomfortable. Try taping! Just a little food for thought on the negative aspect of bracing.

Some very good reasons to wear braces

Prevention

You jump. A lot. Surrounded by a few people. You land in the same environment. Yes, in elite Volleyball there are much less uncoordinated players unable to halt their momentum and jump under the net, but at even slightly lower level, it does become a little dangerous!

To put it simply, there are very little reasons not to wear an ankle brace. You won’t weaken your ankles, just won’t happen. So you can take that out of your mind when making your decision. I know as a coach, if one of my players did their ankle and wasn’t in a brace, my sympathy would be waning. The nature of the sport is one in which ankle sprains are common. Let’s try and prevent them a little hey, seems a stupid reason to miss games.

Rehabilitation

When you sprain your ankle, you lose some of your proprioceptive ability and muscle control. You have to retrain it with proprioception exercises to get it back to full functioning. This is a pretty tough gig and a lot of people don’t do it so well. We will have a post in the future on ankle proprioception exercises that can help you get back to full functionality.

Anyway, the point is, when you are returning to play, your ankle proprioception is still a little wayward, even though you are nearly back to full strength. Ankle brace or taping is imperative at this stage, as you are much more likely to do your ankle. In fact, for other sports, its recommended after an ankle injury that some sort of protection be worn for up to 6 months whilst you are trying to regain full or near to full proprioception.

Keep in mind that the best way to rehab a bad ankle is to do stuff without braces. When doing your fitness work, and proprioception training there is no need for them. You aren’t landing amongst people and have no need to wear them, a similar principle and argument for a libero not needing to wear them. Since they have very little effect on the proprioception of a joint, other than to create more awareness in certain situations, and there is no risk involved when doing balance training, lowering exercises and general ankle strengthening work outside of Volleyball play, keep them off.

So…

Bracing is very much an individual choice. However quite a lot of teams, especially at higher levels do require that braces are worn by everyone during games and trainings, as they simply don’t want to lose players. When factoring in your decision to wear a brace or not, please remember that you aren’t going to detrain your ankles, just help prevent a serious injury.

Ouch, check this out…(nope she wasn’t wearing a brace!) Don’t forget to vote on our poll in the sidebar!

Injury Stats in Volleyball


Pic: hugovk

Injuries happen in every sport, and we get a fair share of them. A study was done in Australia by Monash University in 2001 on Injury rates and severity amongst Volleyball participants. There is really no comprehensive source of injury data in Australia. This study used insurance claims, and hospital admissions. They also took lots of data from previous studies. This means there are big limitations with these stats, but hey, its all we have and we are going to share them. We have summarised the massive report just a little for you, hopefully provides some interesting stats.

It should be noted that this study isn’t as accurate as it could be. It was very hard for them to document the overuse injuries that occur in volleyball. It’s obvious, and well known that shoulder and knee overuse injuries are very common. However in relation to gathering stats for it, it’s virtually impossible. They got their info from hospital visits and insurance claims, most of this stuff happens directly after an acute injury. Chronic injuries take time to arise and are not as well documented. So most of the statistics we are talking about in this post are from acute injuries (sprains etc).

Who Gets Injured Most?

Here they have quoted some statistics from other recent studies. Amongst kids, when compared to other 37 other sports, Volleyball had much lower injury rates. It ranked 30, and they were much less severe injuries. With less than 8% being treated in hospital. Thats right parents, it’s a safe sport, so get involved.

An interesting one was the comparison from indoor to beach. For all ages, the injury rate for indoor was 4.2/1000 hours, whereas the rate for beach was 4.9/1000 hours. I knew indoor was safer. There was less ankle and finger injuries in beach. It can be assumed this is because there is only one blocker, less likely to have accidents when landing. It also applies to the finger injuries, less blocking, and less forceful hits to rip a finger off with. There were more shoulder injuries in beach. This can be attributed to the fact that you serve and spike a lot more in beach, and having to adjust more often (from wind or a wet ball) resulting in weird shoulder movements.

The level of play seems to be another indicating factor. There was significantly less injuries amongst the elite level. Overall there was more injuries, but simply because they play more, however the rate was much lower. One can assume this is because they are more skilled, better coordination patterns, less likely to jump through the net, can land more efficiently, and more importantly have access to some important resources that the average recreational player doesn’t!

Another conclusion form this study was that you are more likely to get injured at the net. Not so surprising there. You are more likely to get injured blocking and attacking.

What Kind Of Injuries Occur?

Well of all reviewed studies, within the Monash report, the most injured parts of the body were the ankle (17-61%), finger (8-45%), knee (6-59%), shoulder (2-24%), and back (9-18%). Note that there were many different study designed, definitions of injury, participant numbers and source of data. That accounts for the large ranges in percentages I have just shown you!

The most common types of injuries were strains and sprains (64-81%). Following closely behind were fractures and dislocations and overuse injuries. As I mentioned earlier the overuse injuries aren’t well documented in terms of pure stats, and end up being largely under estimated.

If you are interested you can check out the full Monash University Report here, but be warned, it’s 107 pages. It does have some interesting reading further down on prevention and rehabilitation of injuries. We will cover all these in later posts!

Body Types: What Do We Know?


Pic: MightyFastPig

We all know that setters are clearly the smartest and best-looking players in a Volleyball team, and generally the most talented. But what else do we know?

Let’s do a little bit of background work to start. Somatotype refers to the kind of body shape you have, what your body is inclined to look like, what your physique is. You heard in the interview with Phill DeSalvo, that he referred to himself as an Ecto. What he meant was an Ectomorph, here is a small explanation of each type.

• Endomorphic body type is characterized by an increased amount of fat storage. There is a higher number of fat cells, and a larger proportion of digestive tissue. Endomorphs generally have a wide waist and a large bone structure.
• Ectomorphic body type is characterized by long limbs, narrow shoulders, and supposedly more nervous tissue. Their muscles are long and thin, they have very low fat storage and are usually skinny.
• Mesomorphic body type is characterized by a large amount of muscle growth, and more muscle tissue. They have a large bone structure, but very little fat storage. They often have wide shoulders and a narrow waist.

What has this got to do with anything?

Not much really, but its kind of interesting. Different positions in Volleyball call for different athletic abilities, and therefore you would think, different body types are more suited to certain positions.

In 2001 a study was conducted called ‘Somatotype, role and performance in elite volleyball players’. The work done in this study was with senior Italian players and was investigating the different body types amongst different positions in Volleyball. They found that setters tended to have the highest endomorphic and mesomorphic characteristics (fat and muscly), whilst middles have the lowest endomorphic and the highest ectomorphic characteristics (skinny…just really skinny). And funnily enough, outside hitters and opposites were somewhere between the two. You could have guessed all that right? Well me too, but there was more interesting stuff in another recent study.

An English study done in 2006 called ‘Anthropometric and Physiological characteristicsof junior elite volleyball players’ looked at the same thing, but in some younger kids. The results differed. Here it showed that setters were classed as endomorphic ectomorphs (fattish but kind of skinny), hitters and opposites were balanced ectomorphs (skinny) and middles were ectomorphic mesomorphs (skinny but muscly).

So…?

Theres not that much to take from these studies. It’s fairly obvious when you watch a match of Volleyball that each position carries different responsibilities, which means there is a need for different kinds of athletes. You aren’t going to see a short and chunky dude running the middle anywhere at a high level. Therefore the kind of body type you have will affect your ability to play Volleyball, at least determine which position is best for you. When doing talent ID, that’s got to be kept in mind, and that’s the main reason someone decided this would be a good idea to investigate.

It seems hitters and middles have the same characteristics from junior level through to senior. Interestingly though the setters differed somewhat. Perhaps in England they like their setters a little fatter?

Recovery: Don’t Ignore It


Stretching is great for your recovery… Pic: Tom@HK

You finish your game, you lost, the coach is mad, you are mad, some idiot tells you to stretch and have something to eat…you get even angrier, grab your bag and storm off to your car and get home as quick as possible. Sound familiar? It’s happened to me numerous times and I always regret it. Recovery is something many Volleyballers, and athletes in general neglect. What they don’t realise is that recovery techniques have many more benefits for athletes than simply rehabilitation and recuperation. This article is a bit of an overview on recovery and not so much specific to Volleyball, but we’ll start with it and do some more detailed posts later.

What is it and why do I need to do it?

Good question eh. The main idea behind recovery is to help athletes adapt faster to training by reducing their fatigue. This means they can be back earlier and stronger for the next session, allowing you to train harder, and thus get more out of it. Both the training and recovery are important parts a training programme. Check out this graph…(yes I made it and it’s a bit rough but you get the picture!)

overcompensation.jpg

So, you do the work, which is the training or game stimulus. Your body gets fatigued, performance and physical capabilities drop. As you recover you body gets back to its normal state (there are many different kinds of fatigue, these will be covered in a separate post) and with recovery you will get an adaptation. Which means you are getting gains from training. If you recover well, these gains will come earlier, and you will be ready to train earlier. Recovery can allow you to actually get more gains from that single training stimulus and also train harder and get more gains by simply having done more work.

It also should be noted that by not recovering, and having a reasonably high training load, you don’t even get back to your previous state and never get the gains. If this happens repeatedly, overtraining can occur. Basically you do not get your gain from training, because you did not give your body enough time to recover and regenerate. Again, this will be covered in a later post but is just another factor emphasising the importance of recovery.

Recovery Techniques

Here I’m going to give you an overview of techniques. Each one will be discussed in much more detail in later posts. Recovery is not just immediately after the game, it occurs for days after. This is simply just a list of techniques; timelines and more detail will be discussed later.

Nutrition

Eating is simple, but your body needs to replace what it lost and to refuel the muscles. It is recommended that you consume some food, preferably high carbohydrate food with a high glycemic index within 30 minutes after a session or game. This is the optimal time for the body to uptake the fuel and will promote better recovery. By not giving your body immediate fuel, you will slow the rate and quality of recovery. In the hours after the session or game food consumed should also be high carbohydrate. Care needs to be taken to rehydrate. Replacing fluid and electrolyte losses will speed up your recovery and needs to be immediately addressed.

Stretching

Stretching, the simplest form of recovery…yet many of us fail to achieve it. Just do it! After a game, after training, have a stretch. It relaxes your muscles, lengthens them and helps get them back to where they were before you killed them.

Hot/Cold Shower

Can be done right after trainings or games. The theory around it was to cause vasodilation and vasoconstriction (opening and closing your blood vessels) hoping to flush out the crap from your muscles. Also to stimulate your nervous system, reduce post exercise swelling and basically increase blood flow to the muscles. There is still debate on the mechanism, but it is a popular technique and does leave you feeling refreshed.

Ice Bath

A good idea. Get in one. They hurt, they are uncomfortable, but you will feel better. Same principles as above. We’ll discuss the theory around it in a later post. It can also be done alternating with a hot shower.

Active Recovery

Ride a bike, go for a walk, go for a swim (pool recovery), have a stretch. Active recovery is doing stuff. Simple. If you do stuff, you are moving your muscles, helping blood circulate and push through all the crap that’s built up in your muscles. Regain mobility and movement, increase blood flow to your muscles, promote recovery…and feel better. Can be done in the days after the session.

Compression

Wearing Skins or something similar is a popular recovery technique these days. The theory is similar to the above means, aids blood flow through the muscles, hence recovery.

Massage

Getting a massage helps to relax your muscles, and flush out all the toxins. Its basically a deep stretch and is a very good recovery means in the days after your session.

Sleep

Very underrated as a recovery means. Lack of sleep messes with your hormones big time. Sleep promotes recovery, as it promotes normal body functions. Growth hormone is released during sleep. Growth Hormone, promotes muscle growth, bone formation and much more stuff you need to recover. Growth Hormone release is diminished when you don’t sleep. A lack of sleep will hinder your recovery. This is one of the easiest things to do right…so go to bed.