Here Comes the Boom: The Real Facts on Concussions and 4 Ways to Minimize Head Injuries in Your Gym


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Concussions in volleyball are an all too common occurrence. According to a 2015 study in PT in Motion News, volleyball players report a rate of 3.57 concussions per 10,000 exposures. An exposure is equivalent to one practice or one match. This number may seem small, but if your daughter or son plays both high school and club volleyball, your player will have a combined 200+ practices and matches per year; or an approximate 7% likelihood of receiving a concussion for each year played.

Statistics are good to know, but it's the personal stories of these young athletes that drive home the need for concussion management. I have two daughters that play both club volleyball at the highest level and high school volleyball for a large, 6A school in Texas. At this level, the speed of the game and the power of the hits are intense, significantly increasing the likelihood of concussion-related injury.

Last April, my oldest daughter was concussed during a rapidly paced practice drill involving two balls in play at the same time. She went up to set a ball on her side of the net, the middle on the opposing side hit around a block and pounded a ball into the left side of her forehead. She was stunned and shaken but managed to sit out a few minutes, finish practice and drive home. Although she was clearly upset that night, we chalked it up to exhaustion and nerves over the "near miss."

Unfortunately, things were not looking up the next morning as she prepared for school, complained of a headache, and inexplicably started to cry. The following several days were a miserable blur of emotions and headaches that required dark and quiet and left her barely able to leave her room. After that, she spent two weeks in a supervised "return to school" protocol followed by an additional two weeks in a "return to play" protocol. During those weeks of recovery, she missed two AP Exams and a Volleyball Qualifier that likely cost her club team a bid to USAV Nationals, further adding to the stress of the situation.

Without a doubt, there is strong internal pressure to return to play and help your team win. As a result, I suspect many athletes return to play too quickly, putting themselves at greater risk of re-injury or delayed recovery. Over the last six years, we have witnessed over a dozen concussions; all but two occurred during practices. Sadly, we know three girls who have had to retire from the sport due to concussions at the ages 14, 15, and 16 respectively. Several of these girls struggled with the recovery process. As a result, we were very cautious with our own daughter.

Our high school had performed baseline concussion testing of all athletes at the beginning of the school season. Shortly after her injury, our pediatrician administered a follow up "concussion" test from a well-known company. Despite being highly symptomatic, she managed to score higher than her baseline test. When we asked her how she managed to do this, she said she concentrated as hard as she could for 40 minutes. She then announced she had a headache and was going to lie down. She slept through the rest of the day! We later learned the particular test administered has several issues with "repeatability" and numerous papers debating its effectiveness have been written. 

We were fortunate. Our daughter recovered in a relatively short amount of time. Since that injury, we have heightened concern for her lifelong brain health. Every volleyball player knows that with all the warm-up and practice balls flying around, there are a lot of little hits that occur on an almost daily basis. Because of this, we have chosen to monitor our daughters over time using the ClearEdge Brain Health Toolkit. It records symptoms, measures cognitive abilities and assesses balance. It gives us peace of mind to see results immediately and track how they change over time. And while no test is 100% accurate, we know this assessment is conducted by a healthcare professional in a controlled environment, unlike many baseline tests administered in busy high school gyms.

In addition, we have become advocates for safer protocols in volleyball practices. Our younger daughter's Coach Corrine Atchison, has experienced multiple concussions and witnessed many more. Coach Atchison, who coaches at Texas Advantage Volleyball, a national known JVA member club in Dallas, Texas, has developed a few simple precautions to minimize the occurrence of head injuries for her teams.

Apply these 4 precautions below to help prevent head injuries from occurring in your gym:

Atchison's 4 Rules:

  1. Don't run under the net with your back to the server or hitter: No matter the drill, we always hit in the same direction when putting balls across the net. My servers all serve and my hitters all hit from the same side of the net until we run out of balls. Then, we all shag at the same time. If we don't have enough balls to go around, we'll have one serving group and one shagging group. No one is allowed to run under the net and risk having her back to a server or hitter.

  2. No unsupervised "play": Very rarely do I let my athletes "play" before practice without coaching supervision. If they arrive early, they are instructed to go through their prescribed warm-up routine. By the time they are ready to play, coaches are there to supervise.

  3. Always face your opponent's servers and hitters during warm-ups: During tournaments, my team always shags for the opposing team. This eliminates an opposing player's need to run under the net to shag and reduces her risk of being hit. It also ensures my team is facing our opponent's servers and hitters during warm-ups. Prior to instituting this precaution, you would have likely seen my team in a huddle by our bench, exposing our backs to our opponent's servers and hitters and increasing our risk of being hit from behind.

  4. Have defenders shag for hitters: During our hitting warm-ups, our defenders shag for our hitters so they don't have to run under the net to retrieve their balls. When we add in the setters or defenders, we put them all on the same side of the net, with the "off" hitting line ready to shag in case the opposing team doesn't offer.

For more on Corinne Atchison's story click HERE

Paul Goodlett, M.D., a Family Practice Physician and team physician for Collins High School in Shelbyville added, "We know a lot more about brain health today than we used to. It's important to establish a baseline so that we can have more data to evaluate patients and be able to comfortably and safely get them back into activity."

Volleyball is a wonderful sport. The teamwork, discipline and leadership lessons learned have been invaluable for our family, and we want to make the sport safer for everyone. ClearEdge assessments allowing for a safer return to play are an important step in the right direction.

For related reading for volleyball coaches click HERE. For related reading for Club Directors click HERE.

About the Author

Felicia Giambalvo graduated with a degree in Economics from Cornell University and an MBA from the University of Michigan. She is the founder and CEO of Scott Alan Enterprises providing interim CEO and fractional Chief Commercialization Officer services for medical device and health IT companies since 2006. Felicia is also the proud mother of two daughters, age 15 and 17; both have won USAV National Championships.



Corinne Atchison is an accomplished Club and High School coach in the North Texas Region (NTR) with over eighteen years of experience. In the last five years, she has led three TAV teams to National Championships in USAV (2013 USA, 2015 Open & 2016 Open). Prior to coaching, Corinne played in the NTR for six years and competed as a Collegiate Athlete for another four. Volleyball has always been her passion. She coaches to share her love of the game.




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