30 May Volleyball Shoulder: Don’t Let it Ruin Your Game

Volleyball players can have unique appearances to their shoulder blade on the hitting side- let’s call it volleyball shoulder.

What does volleyball shoulder look like?

Take a close look at this video of a left-handed elite volleyball hitter. Pay special attention to the her left shoulder blade. Don’t be afraid to watch it several times if needed.

Video Courtesy of USA Volleyball Sports Medicine

Volleyball Shoulder: What did you see?

Notice what happens to the shoulder blade when she raises her arms as reaching to block.

The resting position against the chest wall is lower and farther from the spine than the right shoulder blade.

Once motion starts, it appears to “jump” or come off of the chest wall.

Coming down, the lower and inside part of the shoulder blade really comes off the chest wall.

Now when raising her arms up and away, really look at that inside border of the shoulder blade.

Seems that there is quite a lesser bit of muscle control on the left side.

It may even appear that the muscles in the middle of the left shoulder blade seem smaller.

This is volleyball shoulder- pretty impressive video, right?

Before you get real concerned for this athlete (or maybe for yourself), read the following sentence.

These changes might cause pain and poor performance- or they all might be normal and not as big a deal.

Volleyball Shoulder- What is it?

Those of us who work with volleyball players- school-age to USA Volleyball Olympians– see these flavors of volleyball shoulder:

• Hitting-side shoulder blade (aka scapula) that is lower than on the non-hitting side
• That same hitting-side shoulder blade is positioned further away from the spine
• Lower and inside border of the hitting side shoulder blade tends to come off the chest wall
• Less smooth motion of the shoulder blade with hitting, blocking, and serving motions
• In some cases, there is less muscle bulk in the middle of the shoulder blade on the hitting side

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Of course, pain and shoulder problems don’t just occur on the hitting side.

Blocking, diving, and ball release to serve can all cause problems with the non-hitting shoulder.

However, these majority of these volleyball shoulder problems tend to affect the hitting shoulder.

Volleyball Shoulder- When is it a problem?

With elite volleyball, poor scapular mechanics and even muscle loss are actually fairly common (especially in beach/sand players).

Muscle loss around the right shoulder blade in elite hitter who continued to star on the court

For higher-level players, the above findings are a problem when they cause problems on the court.

Those problems often include pain or reduced accuracy and strength with hitting and serving.

In younger players (school age including collegiate players in my opinion), any of these findings should immediately be considered a problem.

Now, this doesn’t mean that these issues can be blown off or assumed to be “normal”.

In any case of volleyball shoulder, no matter the level of player, a full medical evaluation should take place.

This can include a solid history, full physical exam, and imaging that might include x-rays and Magnetic Resonance Imaging (MRI) studies and occasionally nerve studies.

Findings from these exams could include trapping or pinching of the suprascapular nerve that might need surgical care in some cases.

Volleyball Shoulder: How do we like to treat the pain or poor performance?

• Limits in swings or hits
• Focused exercises to build up the strength and function of the muscles that support the shoulder blade
• Stretch the muscles in front of the chest (pectoralis minor and short head of biceps) that attach to the shoulder blade. Tightness in these muscles pulls on the shoulder blade and can help create inefficient and poor positioning.
• Stretch muscles in back of the shoulder ball and socket joint
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The younger the player, the more aggressive with limitations and early, aggressive therapy. Best to avoid long-term problems or more future issues due to weakness or poor shoulder blade function.

With more experienced or elite players, again, pain and performance level often determine ability to play.

In the above video case, our player has pain in her left shoulder. Thus, her hitting repetitions will be monitored and she perform corrective exercises for her shoulder blade and front of her chest.

However, there are several Olympic-level volleyball players with big-time muscle loss and even weakness with muscle testing.

Yet watching them on the court, they (almost shockingly) can continually bring heat with accurate spikes and serves without any pain.

In those players,  yes, every attempt will be made to correct weakness and poor movement. But if they can continue to dominate on the court, they will continue to play.

Volleyball Shoulder: How about if there is no pain

Some may ask: do you look for signs of volleyball shoulder in players who don’t have pain?

I tend to evaluate the hitting side shoulder when ever I get a chance.

That might mean during sports physicals, or even when a player comes in with an illness.

I do this in hopes of catching abnormal shoulder blade function early, making suggestions, and not having to deal as much with future problems.

This again is most important in younger players who are still growing and developing their hitting techniques.

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