Decoding injury risk: Exploring the impact of asymptomatic hypermobility on lower limb injury risk factors in young female volleyball players

Abstract

Generalized hypermobility is associated with higher rates of musculoskeletal injuries, a trend also observed in volleyball. We aimed to investigate how asymptomatic hypermobility affects other suggested lower limb injury risk factors. Fifty female volleyball players (22 hypermobile, 28 non-hypermobile) were assessed using Beighton scores (BS) and lower limb injury risk factors based on the Landing Error Scoring System, single-leg dynamic balance, and Limb Symmetry Index (LSI) for single-leg hop and triple hop for distance. Spearman’s correlations assessed relationships between BS and the risk factors, and t-tests or Mann-Whitney U tests compared risk factors between non-hypermobile and asymptomatic hypermobile groups. No significant associations were found between BS and most risk factors, except for a negative correlation with the centre of pressure range of motion in the medio-lateral direction during dynamic balance on the non-dominant leg (ρ = -0.332; p = 0.015). The only significant group difference was in the LSI for single-leg hop distance, where the hypermobile group showed greater symmetry (r = 0.28, p = 0.041). The association between BS and dynamic balance was weak, with no clear difference in injury risk factors were observed between groups, suggesting hypermobile players may not need specialized training programs.