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ObjectiveTo assess the incidence of concussions among adolescent volleyball players in Canada.DesignCross sectional survey.SettingOnline survey.ParticipantsIn total, 663 registered Volleyball Canada members completed a national survey, with a response rate of 13.0%; web-based survey response rates rarely exceed 5%. The 452 (68.2%) female and 211 (31.8%) male responders had a mean age of 16.2 (95% CI: 16.1to 16.4) years with a range from 14 to 19 years.Assessment of risk factorsThe type of environment: controlled non-competitive environment (practice or warm-up) versus competitive game play environment.Outcome measuresWhether the athletes sustained a concussion as defined by the 2012 Zurich Consensus. Main resultsA total of 86 concussions were reported, of which 52 were in the previous 12 months, yielding a one-year cumulative incidence per 100 athletes of 7.1 (95% CI: 4.3 to 11.4) and 7.5 (95% CI: 5.4 to 10.3) for males and females, respectively. In total, 57.1% (95% CI: 46.2 to 67.5) of all concussions involved ball-to-head contact. Player-to-player contact and head-to-floor contact were less prevalent at 20.2% (95% CI: 12.8 to 30.4) and 15.5% (95% CI: 9.1 to 25.1) respectively. Practice environment accounted for 46.5% of all concussions while 38.4% occurred in game play. The remaining 15.1% occurred in warm-up. In total, 61.6% (95% CI: 50.2 to 71.7) of concussions occurred outside of free-flow competitive game play, in a more structured environment.ConclusionsThere is a significant margin for injury prevention as a substantial proportion (61.6%) of concussions happening in a noncompetitive, controlled environment that may be amenable to change that would reduce the potential for such injury.Competing interestsThe authors have no competing interest to state.

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Objective:To evaluate injury incidence rates, types, mechanisms, and potential risk factors in youth volleyball.Design:Prospective cohort.Setting:2018 Canadian Youth National Volleyball Tournament.Participants:Thousand eight hundred seventy-six players [466 males, 1391 females, mean age 16.2 years (±1.26)] consented to participate (19.5%).Assessment of Risk Factors:Sex (male/female), age group, position, and underage players.Main Outcome Measures:Players completed a questionnaire (demographic information, injury, and concussion history). Medical attention injuries were recorded by tournament medical personnel through an injury report form (eg, mechanism and type). Injury was defined as any physical complaint seeking onsite medical attention. Concussion was defined using the fifth International Consensus. Injury rates adjusted for cluster by team were calculated by sex. Exploratory multivariable Poisson regression was used to analyze potential risk factors (eg, sex, age group, position, and underage players) for injury, adjusted for cluster by team and offset by athlete exposures (AEs).Results:There were 101 injuries in the 7-day tournament {IRFemale = 6.78 injuries/1000 AEs [95% confidence interval (CI), 5.27-8.72]; IRMale = 4.30 injuries/1000 AEs (95% CI, 2.55-7.24)}. Joint sprain (n = 29, 28.71%) and concussion (n = 26, 25.74%) were the most common. Most concussions were associated with ball-to-head contact (61.5%). There was no statistically significant difference in injury rate by sex (IRRF/M: 1.47; 95% CI, 0.80-2.69). The rates of injury in U14 were higher than U18 (IRRU14: 2.57; 95% CI, 1.11-5.98).Conclusions:Injury rates are high in youth volleyball tournament play, with the highest rates in U14. More research is needed to inform the development of volleyball-specific injury prevention strategies.