The High Price of Greatness: How the Elite Sports Culture Across All Disciplines Drives Injury Rates and Psychological Strain in High School Athletes and Challenges High School Coaches to Redefine Training Strategies

BY JACOB THOMPSON LEANDER ROUSE HS - HEAD VOLLEYBALL COACH

High school volleyball: A sport traditionally celebrated for its athleticism, teamwork, and strategic depth is being adversely affected by a relentless pursuit of elite status that is fueled by the pressures of specialized club programs and college recruitment. Our young athletes are being deceived and pressured to sacrifice their long-term physical health in the name of ambition. This culture and increased injury incidence then forces the high school coaches to scramble to adjust their practices, offseason structures and schedules for the safety of the athlete.

You could simply remove the word “volleyball” from this article and substitute it with any sport played at the high school level. I say this from personal experience, as I also work as a college recruiting director for a major select organization. I’m not suggesting that club and select sports should be eliminated entirely—they’re a necessary evil, no doubt—but I am firmly asserting that the system needs restructuring. Even football, which once lacked a select organization, is now overwhelmed by the rise of 7-on-7. When will we finally prioritize the athletes’ best interests? It’s obvious that select organizations won’t take the lead on this, since doing so would cut into their profits.

The Culture Exploitation of Young Athletes:

Over the last decade there has been an explosion of year-round, often exorbitantly priced club programs. USA Volleyball (USAV) has experienced consistent revenue growth with a notable increase from $27.6 million in 2014 to $42.7 million in 2023. This growth can be attributed to factors such as increased participation, sponsorships, and successful events. These programs create significant financial commitments from families while simultaneously pushing young athletes into a strenuous hyper-focused environment. Players face relentless training schedules and a constant barrage of tournaments, leaving virtually no time for the crucial rest and recovery necessary for healthy body maintenance, growth, and adolescent development. The pressure to excel in these profit-driven clubs is immense, far exceeding the demands of competitive high school programs. While the focus of the high school program typically centers on both the physical and emotional development of the athlete, club programs are frequently incentivized by the prestige of winning teams and face competing for the same revenue, personnel, and athletes. This can lead to a “win at all cost mentality” and causes clubs to use the allure of college scholarships and winning to overload a players’ training volume, which neglects their physical well-being with insufficient rest and recovery while maximizing the clubs' own success. This shifts focus from the athlete’s long-term health and development to short-term gains for the club and club coaches. Unfortunately, this then leaves the high school coaches in the difficult position of countering the whirlwind of year-round competition with their own program culture. While club programs and schedules relentlessly push athletes, high school coaches are often then solely responsible to provide crucial breaks and allow for recovery, attempting to mitigate the damage caused by the club system’s overemphasis on volume and short-term gains.

Over the past decade, club volleyball has seen a dramatic increase in training demands. Teams are now holding more practices per week, for longer durations, and incorporate “optional” sessions and extra workouts before or after regular practices. This “keeping up with the Joneses” mentality, combined with high school training schedules, creates a spiraling effect on athletes. What was once a standard of two 2-hour practices per week in club volleyball has, in some areas, escalated to three 2-hour practices and even a single 3-hour session. The driving force behind this escalation is tied to the fear of losing athletes to other clubs with more intensive training programs.

The Physical Demands and Vulnerability of Young Athletes in Volleyball: The repetitive jumping, spiking, serving, and quick directional changes required in volleyball can place an immense stress on athletes’ still growing joints and muscular systems. Because they are still growing and developing, they are more vulnerable to injury from the high volume and cumulative impact of repetitive stressors. Without adequate recovery time between demands (both for activity and growing), the athletes’ susceptibility to injury increases. The importance of recovery time is frequently overlooked in club environments when it comes to driving athletic success, occasionally leading to devastating outcomes. High school coaches must balance the desire for competitive off-seasons with the athletes’ best interests, tailoring expectations to protect their developing bodies.

Common Injuries in High School Volleyball Associated with Overtraining: With the demand that growth and volleyball put on the body, coupled with increases in volume and less and less down or recovery time, can lead to numerous injuries such as the following.

Patellar Tendinitis/Achilles Tendonitis/Plantar Fasciitis: These tendons become inflamed with growth spurts, and the repetitive jumping and landing exacerbates this inflammation. Lack of recovery time leads to maladaptation and injury.

Osgood-Schlatter Disease: An inflammation of the tibial tuberosity where the patellar tendon attaches to the lower leg, becomes inflamed as tension leads to a bony growth at the attachment sight. This condition is particularly prevalent in adolescents experiencing rapid growth spurts and exacerbated by the repetitive jumping demanded in volleyball

Anterior Cruciate Ligament (ACL) Tears: While traditionally associated with contact, fatiguing stabilizing muscles (glutes, hamstring, quad), and the need for repeated stabilization with jumping increase the risk of non-contact ACL injury.

Rotator Cuff Strain and Tear: Repetitive overhead motions, coupled with fatiguing of scapular stabilizing muscles involved in spiking and serving, can lead to inflammation and tears in the rotator cuff muscles of the shoulder.

Subacromial Pain Syndrome: Commonly called “Impingement”, there are multiple forms of this injury. In volleyball it is common to see when the scap stabilizers are weakened or fatigued and pecs are tight. This throws off how the joint rotates and can pinch down on the rotator cuff (fraying it) and inflame the bursa in the shoulder. Remaining untreated or ignored with a “push through” mentality, can lead to rotator cuff tears.

Stress Fractures: Repetitive motions without allowing recovery time for the body to adapt to the demand can lead to weakening and thinning in bones, particularly in the feet and shins but is also being seen in the low back and vertebrae.

Spinal Injuries: As the body fatigues, good form will suffer. This coupled with repetitive impacts and spinal twisting can lead to herniated discs or pars fractures.

High school coaches statewide have had to rethink their off-season training strategies. They are now incorporating more rest periods to balance athletes’ training loads. This change has significantly impacted team dynamics. Increasingly, teams seem to struggle with selfishness and a lack of team culture. Off-season training, once a crucial time for team bonding, now requires coaches to find innovative ways to foster camaraderie and reduce self-centeredness.

The Psychological Toll: The relentless pressure to perform, coupled with the risk of injury, can have significant psychological consequences for young athletes. Fear of injury, the pressure to maintain a high level of play, and the intense competition can lead to anxiety, depression, and burnout. The dedication, requiring hours of training and travel, can negatively impact academic performance and social relationships. The constant pressure to succeed can overshadow the enjoyment of the sport itself, transforming a passion into a source of stress and anxiety.

The Role of Coaches and Parents: Coaches and parents play a critical role in mitigating the risk of overuse injuries. By the time a female volleyball player finishes her sophomore year of high school, she will likely have already competed in more matches than she will during her entire four-year college career. Coaches should prioritize proper training techniques, emphasize adequate rest and recovery, and encourage a balanced approach to athletic development. They must be educated about the risks of overuse and understand the limitations of adolescent athletes. Parents should prioritize their child’s well-being over the pursuit of athletic accolades. They need to encourage open communication about pain and discomfort, advocate for appropriate rest and recovery, and support their child’s overall well-being beyond the volleyball court.

The Need for Systemic Change: Solving the overuse injury problem in high school volleyball requires a fundamental shift in the elite sports culture. The disparity between the high school and club seasons is a prime example of the issue. With a 16-week high school season and a 32-week club season, it’s difficult to justify why club volleyball needs to occupy twice as much of the year. This includes: Promoting a Balanced Approach to Training: Emphasis should be placed on quality over quantity, incorporating rest and recovery into training programs.

Implementing Age-Appropriate Training Guidelines: Training programs should be tailored to the developmental stage of the athlete, considering the vulnerabilities of the adolescent musculoskeletal system.

Example 1: Early Adolescence (Ages 11-14, Pre-Peak Height Velocity)

Developmental Stage: Pre-growth spurt, with developing coordination, limited strength, and vulnerable growth plates.

Training Program:

● Skill Development:

○ Focus: Fundamental techniques like passing, serving, and setting with controlled, low-impact drills.

○ Example Drill: Partner passing (10-15 reps) focusing on proper forearm platform and footwork to build coordination without excessive strain.

○ Modification: Use lighter volleyballs (e.g., Volley Lite balls) to reduce shoulder and wrist stress during serving practice.

● Strength Training:

○ Focus: Build foundational strength and stability using bodyweight exercises to protect joints.

○ Example Exercise: Bodyweight squats (3 sets of 12 reps) to strengthen quads and glutes for basic movement patterns.

○ Example Core Work: Plank holds (3 sets of 20-30 seconds) to stabilize the spine without overloading it.

● Injury Prevention Consideration: Avoid repetitive jumping or heavy loads to protect growth plates in the knees and ankles.

○ Example Adjustment: Replace jump serves with standing float serves to minimize impact.

Rationale: Skills focus on technique and coordination, while strength builds a base without risking overuse injuries like Osgood-Schlatter disease (knee growth plate irritation).

Example 2: Mid-Adolescence (Ages 14-16, During Peak Height Velocity)

Developmental Stage: Growth spurt phase, with rapid bone lengthening, muscle tightness, and increased injury risk due to imbalances. Training Program:

● Skill Development:

○ Focus: Refine volleyball-specific movements (e.g., approach for spiking, defensive shuffles) with emphasis on mechanics.

○ Example Drill: Approach and arm swing practice (10 reps per side) using a wall or low net to perfect timing and reduce landing stress.

○ Modification: Limit jump attempts to 20-30 per session, focusing on form rather than power.

● Strength Training:

○ Focus: Introduce light resistance to address muscle imbalances and improve stability for volleyball actions.

○ Example Exercise: Resistance band lateral walks (3 sets of 10 steps each direction) to strengthen hips for lateral movement.

○ Example Plyometric: Controlled squat jumps (2 sets of 8 reps) with emphasis on soft landings to build power safely.

● Flexibility Component: Add stretching to counter tightness from growth.

○ Example Routine: Hamstring and quad stretches (20-30 seconds each, post-practice) to maintain range of motion.

Rationale: Skills progress to sport-specific actions, while strength training supports growing muscles and joints, minimizing risks like patellar tendinitis (jumper’s knee) from rapid growth.

Example 3: Late Adolescence (Ages 16-19, Post-Peak Height Velocity)

Developmental Stage: Growth plates mostly closed, with greater muscle mass and strength capacity, though overuse injuries remain a concern.

Training Program:

● Skill Development:

○ Focus: Advanced techniques like jump serving, blocking, and explosive spiking with full gamelike intensity.

○ Example Drill: Jump serve practice (15-20 serves) targeting specific zones, integrating power and accuracy.

○ Example Team Drill: 3-on-3 block and dig scenarios (10 minutes) to simulate match conditions and refine timing.

● Strength Training:

○ Focus: Build power and endurance with moderate weights and sport-specific plyometrics.

○ Example Exercise: Barbell squats (3 sets of 8 reps at 60-70% 1RM) to enhance jumping ability for blocking and spiking.

○ Example Plyometric: Depth jumps (3 sets of 6 reps) from a 12-inch box to train explosive takeoffs and landings.

● Injury Mitigation: Strengthen supporting muscles to handle volleyball’s demands.

○ Example Routine: Rotator cuff exercises with light dumbbells (3 sets of 12 reps) to protect shoulders from spiking strain.

Rationale: Skills and strength training ramp up to match the physical maturity of the athlete, focusing on performance while preventing overuse injuries like shoulder impingement or stress fractures.

Key Considerations Across Stages:

• Skill-Strength Integration: Pair skill drills with complementary strength exercises (e.g., passing drills with lateral band walks to reinforce hip stability).

• Volume Control: Limit high-impact reps (e.g., jumps or serves) based on stage—20-30 for early, 30-50 for mid, 50-75 for late adolescence—to avoid overloading the musculoskeletal system.

• Monitoring Growth: Adjust programs based on individual growth markers (e.g., height changes, flexibility loss) rather than age alone.

• Recovery Emphasis: Include rest days and sleep (8-10 hours) to support bone and muscle repair, especially during growth spurts.

Reducing the Number of Games and Tournaments: Reducing the number of matches and tournaments played throughout the year can significantly lower the risk of overuse injuries. Beyond simply decreasing the volume of competition, USAV and clubs nationwide should reconsider the duration of the club season. It’s difficult to understand why anyone believes it’s beneficial for athletes to compete 46 out of 52 weeks a year.

Educating Coaches and Parents: Education programs should be implemented to raise awareness about the risks of overuse injuries and promote best practices in training and injury prevention.

Encouraging Open Communication: Open communication between athletes, coaches, and parents is crucial for identifying and addressing potential problems early on.

Prioritizing Player Well-being: A shift in focus from winning at all costs to prioritizing the long-term health and well-being of young athletes is essential.

The issue of overuse injuries in high school volleyball is a complex problem with serious consequences. The relentless pressure to achieve athletic excellence, fueled by a hyper-competitive environment and the pursuit of college scholarships, is placing young athletes at significant risk. Addressing this crisis requires a collective effort from coaches, parents, athletic organizations, and medical professionals. By promoting a balanced approach to training, emphasizing adequate rest and recovery, and prioritizing the long-term well-being of young athletes, we can help ensure that the passion for volleyball remains a source of joy and fulfillment, rather than a pathway to injury and long-term health problems. The future of these young athletes, their physical and mental health, demand nothing less. Let’s not lose sight of what truly matters. Playing for a high school team means representing the team, friends, faculty, staff, family, and a community that values the name on the jersey. Club sports, on the other hand, often prioritize individual advancement and achievement.

In conclusion, the escalating demands of elite sports culture have left an indelible mark on high school athletes, with overuse injuries becoming an all-too-common consequence of a system that often prioritizes profit and prestige over well-being. The passion that drives young athletes to excel should not come at the cost of their physical and mental health, yet the current structure of year-round club programs and intensified training schedules has forced high school coaches to adapt in unprecedented ways—rethinking off-season plans, enforcing critical rest periods, and striving to rebuild team unity in the face of growing individualism. It’s time for a reckoning in how we approach youth sports, not just in volleyball but across all disciplines. By fostering a culture that values balance, embraces age-appropriate training, and places the athlete’s long-term development above short-term glory, we can reclaim the true spirit of high school athletics—a spirit rooted in community, growth, and the joy of the game. The stakes are high, and the health of our young athletes hangs in the balance; it’s up to all of us—coaches, parents, and organizations—to champion the change they deserve.