Prevalence and associated factors of non-traumatic knee pain in high school volleyball players: a cross-sectional study

ABSTRACT

Objectives

This study aimed to determine the prevalence of knee pain among high school volleyball attackers, identify associated factors, and explore the relationship between knee pain and lower back pain (LBP).

Methods

A cross-sectional study involving 82 high school volleyball attackers (15–17 years) used questionnaires, interviews, and field-based assessments to collect data on demographics, volleyball-specific factors, flexibility, and jumping ability. Logistic regression analysis was used to identify factors associated with knee pain.

Results

The prevalence of knee pain was 19.5%. Factors significantly associated with knee pain were a history of LBP (OR, 4.64; 95% CI, 1.28 to 16.8; p = 0.019) and flexibility determined by the absolute difference in heel-buttock distance (OR, 1.37; 95% CI, 1.02 to 1.83; p = 0.037). Participants with knee pain had more volleyball experience and a higher proportion of players who competed as starters in the previous year. Both groups reported approximately 18 hours of practice per week during the school year and around 27 hours during school holidays, with no significant difference observed.

Conclusion

Factors associated with knee pain include a history of LBP and reduced flexibility on the heel-buttock distance test. The study highlights the need for a comprehensive approach, considering the coexistence of LBP and focusing on improving anterior thigh flexibility.

KEYWORDS:

• Volleyball
• adolescent
• high school
• knee pain
• low back pain
• muscle flexibility
• training volume
• injury prevention

Acknowledgment

We would like to thank the coaches and players of the high school volleyball clubs in Saitama, Japan, for their valuable cooperation.

Disclosure statement

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript. The manuscript submitted does not contain information about medical device (s)/drug(s).

Author’s contributions

Conceptualization: Y.M, K.S, K.A; Data curation: Y.M, K.A; Formal analysis: Y.M, T.H, K.A; Investigation: Y.M, K.S, N.S, H.N; Methodology: Y.M, K.S, K.A; Supervision: K.A; Validation: T.H; Visualization: Y.M; Writing – original draft: Y.M; Writing – review & editing: K.S, N.S, H.N, T.H, K.A

Clinical trial registry name and registration number

This study has been registered as a clinical trial with the Universal Medical Information Network (UMIN) under the registration number UMIN000027554.

Data availability statement

The data that support the findings of this study are available on request from the authors.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Ethics Committee at the Faculty of Health and Medical Care, Saitama Medical University (Approval No. M-73) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from teams, players, and parents. High school principals and coaches received detailed explanations, granting written consent. Participants and parents were similarly informed, providing written consent.

Social media handles

Twitter, Yasuaki Mizoguchi, @Mizo_yasu; Toby Hall, @DrTobyHall; Kiyokazu Akasaka, @akasaka0829; Instagram, Yasuaki Mizoguchi, @yasu_volley_pt

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.