Spike! But Not Too Hard

Digital ischemia possibility in elite volleyball players is turning fingers cold and blue

(RxWiki News) Bump, set, spike! With those power moves as volleyball season gets underway, so come the stinging injuries with the slap of the ball.

With each hit, volleyball players are getting tiny blood clots in their hands, which are causing other problems as they practice and compete.

A high percentage of volleyball players are reporting symptoms stemming from these clots in their dominant hand, a new study has found.

"Back off play if your fingers hurt."

Sacs forming in the blood vessels of the hands are causing the problems. The vessels widen and close abnormally, causing sacs to form.

In volleyball, these clots are forming in the fingers and in the posterior circumflex humeral artery (PCHA).

The study, led by Mario Maas, MD, PhD, a professor in the Department of Radiology at the University of Amsterdam, looked at 99 male elite volleyball players from 10 Dutch national and beach volleyball teams.

The athletes averaged 24 years of age and about 6'4".

Researchers gave the players a questionnaire asking about their symptoms from the minor blood blockages in their hands.

More than half reported they had no history of cardiovascular disease in their families, 29 percent had a history of the disease, and 20 percent did not know.

Researchers found that the volleyball players had cold, blue or pale fingers in their dominant hand during or immediately after practice or competition 11 to 27 percent of the time.

Cold fingers occurred 27 percent of the time. Within this group, 41 percent had no cardiovascular disease in their families while another 41 percent did, so it's unclear whether family history affected the results.

Players had blue fingers during and immediately after practice 18 percent of the time, and after competition 11 percent of the time.

Pale fingers occurred 20 percent and 12 percent respectively.

The participants reported having some combination of cold and discolored fingers 12 percent of the time.

The authors say that the "number of volleyball players seen with symptoms of digital ischemia potentially as a result of pathological lesions with digital emboli represents only a fraction of the number of volleyball players who suffer" from the same conditions.

"Because symptoms mostly occur during practice or competition, surveillance might be most relevant after periods with increased physical activity, such as a few weeks after the start of the training season and a few weeks after the winter recess," the authors said in their study.

"Players might be more vulnerable in these periods."

The authors said volleyball players are potentially at risk of lowering blood flow to their hands, but more research on digital ischemia needs to be done.

"I think the condition itself is rare, and for that reason it's not...a condition players at a recreational level are going to experience," said Dr. Jonathan Reeser to Reuters, the physician director in the department of Physical Medicine and Rehabilitation at Marshfield Clinic in Marshfield, Wisconsin, who was not involved in the study.

"That said, it does happen, and usually it happens in the more competitive athletes, and so for that reason you really don't want to miss it."

Dan Clearfield, DO, a primary care sports medicine physician, has covered USA Volleyball and hasn't seen any injuries of this kind.

"This is exceedingly rare, and this type of injury in this type of sport is very unlikely," Dr. Clearfield said.

The authors declare they have no conflicts of interest in authorship and publication.

The study was published online Aug. 27 in the American Journal of Sports Medicine

Review Date: 
September 9, 2012