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Beachvolleyball: Risiken im weichen Sand

Beachvolleyball: Risiken im weichen Sand

Sehr geehrte Damen und Herren,

endlich Sommer: Die Beachvolleyballer ziehen von Strand zu Strand und  haben bei angenehmen Temperaturen jetzt beste Bedingungen und Voraussetzungen für ihren Sport, der den „California lifestyle“ wohl wie kein anderer vermittelt. Wind, Regen und Kälte hatten den Start in die Saison verdorben und die Gefahr von Verletzungen zusätzlich ansteigen lassen. Warum das Risiko im weichen Sand ohnehin hoch ist, warum es im Beachvolleyball ganz besondere Verletzungen gibt und was ein „Sand toe“ ist, erklärt  Dr. Antonius Kass in unserem aktuellen Newsletter zum Thema: „Beachvolleyball: Risiken im weichen Sand.“

Wenige Tage nach dem erfolgreichen Kongress in Basel mit spannenden Vorträgen, Symposien und Diskussionen geht der Fokus schon wieder in Richtung 31. GOTS-Jahreskongress. Dazu lädt Sie Kongresspräsident Prof. Dr.  Romain Seil vom 17. – 18. Juni 2016 nach München ein. Wir werden Sie auch an dieser Stelle kontinuierlich über die Vorbereitungen und das Programm informieren. Den Flyer zum 31. Jahreskongress finden Sie hier:

GOTS-Kongress_2016

Mit freundlichen Grüßen
Ihr Andreas Bellinger, presse@gots.org

Beachvolleyball: Risiken im weichen Sand

Wie kaum eine andere Sportart verkörpert Beachvolleyball den „California lifestyle“ von Sport, Strand und Sonne. Fast an jedem Strand Europas und Amerikas findet sich eine Anlage und die Zahl der Spielplätze – Outdoor wie Indoor – steigt stetig. Seit 1996 in Atlanta ist die Sportart olympisch und war auch bei den darauffolgenden Spielen in Sydney (am Bondi Beach), Athen, Peking und London eine der Attraktionen. Nun beginnt die deutsche „Smart Beach Tour“. Diese  professionellen Turnierserien tragen zur steigenden Popularität bei – wie auch die olympische Berichterstattung und nicht zuletzt der Olympiasieg von Julius Brink und Jonas Reckermann.

Beachvolleyball wurde 1920 erstmals in Santa Monica, Kalifornien gespielt, verbreitete sich zunächst an amerikanischen Stränden und in den 1950er und 1960er Jahren mehr und mehr auch in Europa und Asien. Zuerst bestand eine Mannschaft noch aus sechs Spielern, während sich danach die „Zwei gegen Zwei“-Spielform durchsetzte. Die Zahl originärer Beachvolleyball-Spieler – also ohne Wurzeln im Indoorbereich – steigt stetig. Barfuss auf Sand  spielen zwei Mannschaften mit je zwei Spielern auf zwei 8 × 8 m großen Spielfeldern, die durch ein Netz getrennt sind. Das Spielfeld  ist kleiner als im Hallenvolleyball, die Netzhöhe jedoch identisch. Die mittlere effektive Spieldauer beträgt 45 min, in Turnieren sind oft mehrere Spiele pro Tag üblich. Für Frauen bestand bis 2012 Bikinipflicht.

Besonderheiten beim Beachvolleyball:

Akute Verletzungen:
Akute Verletzungen sind vergleichsweise selten und betreffen überwiegend Knie-, Schulter- und Sprunggelenk. Kniegelenksdistorsionen entstehen häufig durch Verdrehen im Kniegelenk auf unebenem Sand in der Absprung- und Landephase und können Bänder- und Meniskusverletzungen nach sich ziehen. Sprunggelenkverletzungen sind weniger häufig als im Hallenvolleyball, sind aber durch Umknicken oft ebenfalls durch unebenem Sand bedingt. Schulterverletzungen und teilweise auch Luxationen entstehen durch Verdrehen des Armes bei der Ballabwehr. Nicht selten kommt es auch zu Schnittverletzungen durch Verunreinigungen im Sand sowie Sonnenbrand.

Chronische Verletzungen – Überlastungsschäden:

Überlastungsschäden spielen in der sportmedizinischen Betreuung beim Beachvolleyball eine größere Rolle und lassen sich auf die hohe zeitliche, koordinative und repetitive sportartspezifische Belastung zurückführen. Besonders die hohe Frequenz der Sprünge am Netz – teilweise als Angriff- oder als Blockaktionen – führt zu chronischen Verletzungen. Die häufigsten Überlastungssyndrome der Beachvolleyball-Spieler im Bereich des Kniegelenkes sind das Patellasehnen- und Quadrizepssehnensyndrom („Patellaspitzensyndrom“). Bis zu 34% der Spieler sind betroffen. Chronische Entzündungen führen nicht selten zu strukturellen Veränderungen im Bereich dieser Sehnen.

Sehr häufig sind auch Wirbelsäulensyndrome zu finden. Wind, Sonne und unebener Sand führen dazu, dass die Position des Körpers zum Ball im Moment des Angriffsschlages oft nicht optimal ist. Den Ball dennoch zu treffen und platziert zu schlagen erfordert Ausgleichsbewegungen in Rumpf und Schultergelenk. Hierbei kommt es zu einer vermehrten Belastung der kleinen Wirbelgelenke durch eine vermehrte Drehung und Lordose besonders im Übergang von Brust- und Lendenwirbelsäule. Der gleiche Mechanismus führt zu einer hohen Belastung der Schulter. Bis zu 35% der Spieler zeigen entzündliche Veränderungen der Rotatorenmannschette, des subakromialen Schleimbeutels und des Schultereckgelenkes.

Bei dem sog. „Sand-toe“ handelt es sich um einen Überlastungsschaden im Großzehengrundgelenk durch das wiederholte Abknicken der Großzehe nach unten. In einer Studie an US-Professionals zeigten 100% der Spieler Bewegungseinschränkungen und 42% Dauerbeschwerden.
Spezielle Rolle des betreuenden Arztes:

Wie bei jeder anderen Sportart auch ist die Kenntnis der sportartspezifischen Belastung und der Bewegungsabläufe Voraussetzung für eine Betreuung. Neben der Versorgung der Verletzung hat die  Zusammenarbeit mit dem Trainer und den Therapeuten – und selbstverständlich auch die Prävention – den höchsten Stellenwert. Hierbei sollten frühzeitig Dysbalancen, Blockierungen und Verspannungen erkannt und beseitigt werden, und im Verletzungsfall die Trainingsbelastung angepasst werden. Allgemeinmedizinisch, internistisch muss das Hauptaugenmerk auf Infektprophylaxe und Schutz gegen Sonne und Dehydratation gelegt werden.
Prävention:

Bei einer derart belastungsintensiven Sportart wie Beachvolleyball hat die Prävention einen herausragenden Stellenwert. Besonders wertvoll ist in diesem Zusammenhang ein senso-motorisches Trainingsprogramm für Schulter und Beinachsen sowie die segmentale Stabilisierung der Wirbelsäulenabschnitte.


Über den Autor:
Dr. med. Antonius Kass ist Facharzt für Orthopädie und Unfallchirurgie sowie Sportmedizin, Chirotherapie und Akupunktur in Düsseldorf. Als Olympiaarzt war er in Sydney, Athen und London im Einsatz (Volleyball/2000 und 2004 – Beachvolleyball/2000 – Tischtennis/2012) und war betreuender Arzt der Olympiasieger Julius Brink/Jonas Reckermann. Zudem ist er Leitender Verbandsarzt des DTTB und Mitglied der  der Anti-Doping-Kommission des DVV.

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