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We have twin girls on a college volleyball team. The coach wants them to learn some better techniques for their drop jump landings. I confess I was their high school volleyball coach, so I'm feeling a little guilty that I might have taught them some wrong techniques. What's the latest thinking on this landing?

Volleyball has become a very popular sport for men and women. The ability to jump and land is very crucial for this game. And the most common injury is the jump landing sequence. In fact, acute injuries of the ligaments, tendons, and muscles among volleyball players are equal to those reported in ice hockey and soccer. Players must be able to jump up high in the air, land safely, and immediately be ready to spike, block, or return the ball across the net. They are encouraged to control their vertical jumps keeping to a height that will place the top of their heads below the top of the net. Spiking or blocking the ball requires vertical jumps and jump-landing sequences. The player must complete this series of movements with energy and force but dissipate the kinetic energy generated during the jump upon landing. Injury is more likely if the force of the impact on landing is not reduced or balanced. Foot placement on landing is important. Most players use both feet to propel themselves up into the air. The landing may be with both feet at the same time but usually one-foot lands first and in front of the other. Research shows fewer injuries when players consistently use a two-footed landing. Landing on one foot means that all the force generated by two feet going up is now dissipated through one leg upon landing. The risk of losing balance and/or incurring an injury is much greater with a unilateral landing pattern. And it's much easier to get into a position of no return when landing on one foot. This means the feet are spread so far apart that the player either loses balance and falls or a musculoskeletal injury occurs. It's not entirely clear what is the best strategy for preventing lower extremity injuries from jump landings. A program of strengthening and physical training seems the most practical and likely to be effective. Practicing safe landing techniques on both feet is advised. The knees should be slightly flexed and toes pointed so that the landing occurs from toe-to-heel. Using a toe-heel contact pattern with more knee flexion whenever possible has been shown to reduce injuries. This technique requires greater muscular strength and coordination. The player must use just the right amount of knee flexion to complete a safe landing but not so much that they can't execute the next move quickly. For now, it looks like strength-training, conditioning, and modifying jump-landing techniques is the best way to prevent knee injuries.

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