Volleyball was invented in the city of Holyoke, Massachusetts, USA in 1895 by a YMCA instructor by the name of William G. Morgan. Since then, the sport has enjoyed exceptional growth. Concomitant with volleyball's increasing popularity, sport scientists have demonstrated a growing interest in researching the fundamental questions relevant to the sport. This is perhaps best reflected by the growing number of volleyball-related papers published annually in the peer-reviewed literature. Science and medicine have played and will continue to play a significant role in the evolution of sport. Over time, through experience and the cooperative efforts of clinicians and scientists, our understanding of the pathophysiology and biomechanics of sports traumatology has improved. Among the current "hot topics" on the sports medicine research agenda is the optimization of physiological recovery from intensive exercise.

The wheel chair games evolved into the Paralympic Games, which were first held in 1960 in conjunction with the Rome Olympics. Since then, the Paralympic movement has grown to include athletes with many types of physical impairment and disability. Sitting volleyball has subsequently grown into the most popular form of adapted volleyball for individuals with physical impairment. A "standing" version of adapted volleyball for athletes with physical impairments has also gained considerable popularity around the world. With the growing popularity of the beach game, an effort has been made to adapt sand volleyball to provide persons with physical impairments the opportunity to enjoy the sport and compete on the beach. Only three studies have been published that investigate the injury history of disabled volleyball athletes. The data indicate that players who remained healthy were more likely to have a congenital impairment or have learned to play volleyball prior to their disability.

BACKGROUND:There is a relative paucity of research examining the sport-specific injury epidemiology of high school and collegiate volleyball athletes. Moreover, differences in study methodology frequently limit our ability to compare and contrast injury data collected from selected populations.HYPOTHESIS:There are differences between the injury patterns characteristic of high school and collegiate female volleyball athletes.STUDY DESIGN:Retrospective clinical review.LEVEL OF EVIDENCE:Level 3.METHODS:We statistically analyzed injury incidence and outcome data collected over a 4-year interval (2005-2006 to 2008-2009) by 2 similar injury surveillance systems, the National Collegiate Athletic Association's Injury Surveillance System (NCAA ISS) and the High School Reporting Injuries Online (HS RIO). We compared diagnoses, anatomic distribution of injuries, mechanisms of injury, and time lost from training or competition between high school and collegiate volleyball athletes.RESULTS:The overall volleyball-related injury rate was significantly greater among collegiate athletes than among high school athletes during both competition (injury rate ratio, 2.9; 95% CI, 2.5-3.4) and practice (injury rate ratio, 3.5; 95% CI, 3.1-3.9). Collegiate athletes had a higher rate of ankle sprain, knee injury, and shoulder injury. Concussions represented a relatively high percentage of injuries in both populations (5.0% of total NCAA ISS injuries vs 4.8% of total HS RIO injuries, respectively).CONCLUSION:The data suggest that although similar, there were distinct differences between the injury patterns of the 2 populations. Compared with high school volleyball players, collegiate athletes have a higher rate of acute time loss injury as well as overuse time loss injury (particularly patellar tendinosis). Concussions represented a significant and worrisome component of the injury pattern for both study populations.CLINICAL RELEVANCE:The injury data suggest that important differences exist in the injury patterns of female high school compared with collegiate volleyball athletes. Consideration of the specific injury patterns may be helpful in future prevention efforts.

Objective Infraspinatus syndrome (IS) results from injury to the suprascapular nerve. For reasons that are poorly understood, volleyball players are at greater risk of developing IS than are athletes who compete in other overhead sports. Differences between the shoulder kinematics of volleyball-related overhead skills and those skills demanded by other overhead sports might explain the pronounced prevalence of IS among volleyball athletes.Design Observational, laboratory-based, cross-sectional study.Setting The American Sports Medicine Institute.Participants Fourteen healthy female Division 1 collegiate volleyball athletes.Methods Upper limb biomechanics of 14 healthy female Division 1 collegiate volleyball athletes while spiking and serving were quantified, then compared to the results from data previously obtained from female baseball pitchers and tennis players.Results Although the general movement pattern at the shoulder girdle is qualitatively similar for the upper limb skills required by a variety of overhead sports, volleyball spiking and serving result in greater shoulder abduction and horizontal adduction at the moment of ball contact/release than do baseball pitching or tennis serving.Conclusion The authors suggest that the unique scapular mechanics which permit the extreme shoulder abduction and horizontal adduction that characterise volleyball spiking and serving place anatomically predisposed volleyball athletes at increased risk for developing cumulative traction-related injury to the suprascapular nerve at the level of the spinoglenoid notch.

Background There seems to be a discrepancy between the available heat stress guidelines and the actual risk of heat-related illness among professional beach volleyball players competing under hot and humid conditions. Objective To monitor heat stress and record cases of heat-related medical forfeits on the Swatch FIVB Beach Volleyball World Tour. Methods The FIVB Heat Stress Monitoring Protocol covered events on the FIVB Beach Volleyball World Tour and FIVB Beach Volleyball World Championships during the 2009, 2010 and 2011 seasons (51 events, most of these double gender). The protocol consisted of (1) measuring the Wet Bulb Globe Temperature (WBGT) on centre court prior to the start of every match, and (2) recording any heat-related medical forfeits during the tournament. Results Data were collected during 48 of 51 events. There were nine events where the peak WBGT exceeded the US Navy Black flag conditions of >32.3°C and an additional two events where the peak WBGT exceeded 31°C, (meeting Red flag conditions.) In two events, the average WBGT equalled at least 31°C. One case of a medical forfeit related to heat stress was recorded over the 3-year surveillance period: an athlete whose fluid balance was compromised from a 3-day bout of acute gastroenteritis. Conclusion The incidence of significant heat illness among athletes competing on the FIVB Beach Volleyball World Tour appears to be quite low, even though weather conditions frequently result in a WBGT index >32°C. Currently available guidelines appear to be inadequate to fully assess the risk of heat stress and too conservative to inform safety decisions in professional beach volleyball.

The Personalized Medicine Research Project (PMRP) is a population-based biobank with more than 20,000 adult participants in central Wisconsin. A Community Advisory Group (CAG) and Ethics and Security Advisory Board (ESAB) provide ongoing feedback. In addition, the study newsletter is used as a two-way communication tool with study participants. The aim of this study was to assess and compare feedback received from these communication/consultation strategies with results from focus group discussions in relation to protocol changes. In summer 2009, enrollee focus groups were held addressing these topics: newsletter format, readability, and content of three articles written to solicit PMRP subject feedback. The CAG and ESAB jointly reviewed focus group results, discussed protocol changes to access residual blood samples, and made recommendations about the general communication approach. Nearly everyone in three focus groups stated that they wanted more information about PMRP. No focus group participant said that accessing stored samples would have changed their enrollment decision. Most said they wanted to be informed directly about changes affecting their original consent. For minimal-risk PMRP protocol changes, the community, CAG, and ESAB were comfortable with an opt-out model because of the initial broad consent. The planned duration of the biobank extends for decades; therefore regular, ongoing communication to enrollees is necessary to maintain awareness and trust, especially relating to protocol changes reflecting evolving science. The multi-faceted approach to communication including newsletters, external advisory boards, and focus group discussions has been successful for the PMRP biobank and may be a model for others to consider. © 2011 Wiley-Liss, Inc.

ObjectiveTo determine whether the apolipoprotein E4 (Apo E4) allele may be a genetic risk factor for fibromyalgia syndrome (FMS).DesignA retrospective assessment of associations between Apo E4 genotype and selected environmental exposures among a cohort diagnosed with FMS compared with control subjects.SettingMarshfield Clinic Research Foundation's Personalized Medicine Research Project (PMRP) biobank.ParticipantsOne hundred fifty-one case subjects with fibromyalgia and 300 age- and gender-matched control subjects.MethodsFibromyalgia case subjects were identified according to a strict phenotypic definition from among the nearly 20,000 subjects enrolled in the PMRP. Age- and gender-matched control subjects also were identified from the PMRP in a 2:1 control/case ratio. Apo E4 genotype was determined by single nucleotide polymorphism analysis for both case subjects with fibromyalgia and control subjects. Case subjects with fibromyalgia and control subjects were asked to assess their level of function and stress by completing the Short Form-36 and the Perceived Stress Scale.Main Outcome MeasuresStatistical associations between the Apo E4 genotype and phenotypic criteria (diagnosis of FMS) as well as historical environmental exposures as documented in the electronic medical record were assessed.ResultsApproximately one quarter of both case subjects with fibromyalgia and control subjects were found to carry at least one Apo E4 allele. The odds ratio (OR) for case subjects with fibromyalgia who had ever been in a motor vehicle accident and subsequently had been diagnosed with FMS was increased among those with at least one copy of the Apo E4 allele (OR 7.04) compared with those without an Apo E4 allele (OR 1.90). The presence of an Apo E4 allele did not influence the degree of pain or level of function among those with FMS.ConclusionsThese data suggest that specific interactions between genetically susceptible individuals (eg, those with at least one copy of the Apo E4 allele) and the environment (eg, involvement in a motor vehicle accident) may contribute to the risk of being diagnosed with FMS, although Apo E4 allele status does not appear to modulate perceived FMS severity.

BACKGROUND:The shoulder is the third-most commonly injured body part in volleyball, with the majority of shoulder problems resulting from chronic overuse.HYPOTHESIS:Significant kinetic differences exist among specific types of volleyball serves and spikes.STUDY DESIGN:Controlled laboratory study.METHODS:Fourteen healthy female collegiate volleyball players performed 5 successful trials of 4 skills: 2 directional spikes, an off-speed roll shot, and the float serve. Volunteers who were competent in jump serves (n, 5) performed 5 trials of that skill. A 240-Hz 3-dimensional automatic digitizing system captured each trial. Multivariate analysis of variance and post hoc paired t tests were used to compare kinetic parameters for the shoulder and elbow across all the skills (except the jump serve). A similar statistical analysis was performed for upper extremity kinematics.RESULTS:Forces, torques, and angular velocities at the shoulder and elbow were lowest for the roll shot and second-lowest for the float serve. No differences were detected between the cross-body and straight-ahead spikes. Although there was an insufficient number of participants to statistically analyze the jump serve, the data for it appear similar to those of the cross-body and straight-ahead spikes. Shoulder abduction at the instant of ball contact was approximately 130° for all skills, which is substantially greater than that previously reported for female athletes performing tennis serves or baseball pitches.CONCLUSION:Because shoulder kinetics were greatest during spiking, the volleyball player with symptoms of shoulder overuse may wish to reduce the number of repetitions performed during practice. Limiting the number of jump serves may also reduce the athlete's risk of overuse-related shoulder dysfunction.CLINICAL RELEVANCE:Volleyball-specific overhead skills, such as the spike and serve, produce considerable upper extremity force and torque, which may contribute to the risk of shoulder injury.

American Journal of Human BiologyVolume 22, Issue 2 p. 224-224 Book Review Book review: Bodies in Doubt: An American History of Intersex Jonathan Reeser, Jonathan Reeser Marshfield Clinic Research Foundation, Office of Research Integrity and Protections, Marshfield, WisconsinSearch for more papers by this author Jonathan Reeser, Jonathan Reeser Marshfield Clinic Research Foundation, Office of Research Integrity and Protections, Marshfield, WisconsinSearch for more papers by this author First published: 11 January 2010 https://doi.org/10.1002/ajhb.21029AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume22, Issue2March/April 2010Pages 224-224 RelatedInformation

Injuries are, regrettably, an unavoidable hazard of sports participation. Although volleyball and beach volleyball are by most estimates relatively safe sports – particularly in comparison to other sports such as football (soccer) – epidemiologic research has revealed that volleyball athletes are at risk for certain types of injuries. Serious injuries which interfere with the athlete’s ability to participate have obvious immediate consequences (time lost from training and competition) and may have long term implications as well (chronic disability and functional limitation). Coaches and trainers should therefore have an understanding of the most common volleyballrelated injuries in order to appreciate the potential impact injuries may have on the both on the athlete and the team.

Objective To identify risk factors for volleyball‐related shoulder pain and dysfunction. Design Cross‐sectional, observational. Setting National championship sporting event. Participants Competitors at the 2006 National Intramural & Recreational Sports Association Collegiate Club Volleyball Championship competition were invited to volunteer for the study. A total of 422 athletes returned questionnaires, of whom 276 also underwent a structured physical examination. Assessment of Risk Factors Study participants provided information on any history of volleyball‐related shoulder pain or dysfunction. The simple shoulder test (SST) and a visual analog scale permitted subjects to quantify the extent of their perceived functional limitation. Subjects also were invited to undergo a physical examination in which dynamic scapular positioning, glenohumeral range of motion, shoulder girdle strength, and core stability were assessed. Main Outcome Measurements Standard statistical methods of comparison and tests of association were used to identify risk factors for shoulder pain among participating volleyball athletes. Results Approximately 60% of participants reported a history of shoulder problems. Attackers and “jump” servers were more likely to have shoulder problems than setters, defensive specialists, and “float” servers. Nearly half of the athletes who reported shoulder problems perceived some associated functional limitation, with female athletes providing lower SST scores than male athletes (9.0 versus 10.1, P = .001). Athletes reporting shoulder pain and dysfunction were more likely to have SICK scapula scores of 3 or greater ( P = .010). Participants who demonstrated core instability also had greater SICK scapula scores (3.9 versus 2.9, P = .038), and were more likely to report a history of shoulder problems (χ 2 = 8.83, P = .032). Although the authors observed a significant mean left‐right difference of 8.9° in available glenohumeral internal rotation among participating athletes, this deficit was not associated with shoulder problems. However, there was an association between asymmetric coracoid tightness /pectoral shortening and shoulder pain ( P = .030), as well as for restricted shoulder flexion in the sagittal plane and shoulder problems ( P = .015). Conclusions Although most risk factors for volleyball‐related shoulder problems are similar to those identified for other overhead sports, there appear to be additional volleyball‐specific risk factors that may reflect the biomechanical demands of the sport. An understanding of modifiable risk factors is critical to providing optimal care for overuse injuries and may facilitate future efforts to prevent shoulder problems among volleyball athletes.

The fibromyalgia syndrome (FMS) is an incompletely understood musculoskeletal pain condition that affects 2-6% of the population. Patients with FMS complain of widespread muscular pain and tenderness, in addition to fatigue, disordered sleep, headache, depression, irritable bowel and bladder, and temporomandibular joint discomfort. Clinically, FMS shares many phenotypic traits with post-concussive syndrome. FMS has been shown to have a genetic component, but does not follow simple Mendelian inheritance patterns. PURPOSE: To determine whether the Apolipoprotein E4 allele may be a genetic risk factor for FMS. METHODS: 150 cases of fibromyalgia were identified according to a strict phenotypic definition from among the nearly 20,000 subjects enrolled in the Marshfield Clinic Research Foundation's Personalized Medicine Research Project (PMRP) - the largest population-based biobank in the United States. Age and gender matched controls were identified from the PMRP in a 2:1 control:case ratio. The ApoE genotype for cases and controls was determined by single nucleotide polymorphism (SNP) analysis using SNPs rs7412 and rs429358. Relevant historical data were abstracted from the Clinic's electronic medical record. RESULTS: Approximately one quarter of the cases and controls were found to carry at least one ApoE4 allele. However, the prevalence of the ApoE4 allele was significantly greater among those cases who had ever been in a motor vehicle accident (MVA) (28% vs 14% of controls, p<0.001), and among those cases who had ever smoked (41% vs 25% of controls, p<0.001). CONCLUSION: These data strongly suggest that specific interactions between genetically susceptible individuals (e.g. those with at least one copy of the ApoE4 allele) and the environment (e.g. a history of MVA, or of ever smoking) may contribute to the risk of developing FMS.

Page 1. FORTHCOMING IN JUNE Including Articles that Cover Such Topics as: IN THIS ISSUE Protecting the Vulnerable: Who Are They? Opinions of IRB Members and Chairs Regarding Investigators' Relationships with Industry IRB Member Judgments of Decisional Capacity, Coercion, and Risk in Medical and Psychiatric Studies Investigating Perceived Institutional Review Board Quality and Function Using the IRB Researcher Assessment Tool Perceived Benefits in Trauma Research: Examining Methodological and Individual Difference Factors in Responses to Research Participation Children's Perception of Research Participation: Examining Trauma Exposure and Distress The Effects of Trauma-Focused Research on Pregnant Female Participants Administrators' Perspectives on Ethical Issues in Long-Term Care Research …