Purpose Overuse shoulder injuries are common in youth handball, but research is limited. The purpose of this study was to identify pre‐season risk factors associated with overuse shoulder injuries in this population. Methods One‐hundred and thirty‐eight (70 boys and 68 girls) youth elite players (age 14.1 ± 0.8 years, height 175.2 ± 8.2 cm, weight 64.0 ± 9.6 kg) completed a pre‐season screening protocol. Passive glenohumeral range of motion and maximum external (ER) and internal rotation (IR) strength were measured with a manual goniometer and a hand‐held dynamometer. Scapular dyskinesia and maximum throwing velocity were also assessed. Players completed standardised questionnaires over the 2017–2018 season and reported any overuse shoulder symptoms. Results Decreased isometric and eccentric ER strength was identified as a risk factor for overuse shoulder injury, both for absolute (OR 10.70, 95% CI 1.2–95.6, p = 0.034) and normalised ER strength (OR 1.2, 95% CI 1.0–1.4, p = 0.015) and the ER:IR strength ratio (OR 1.2, 95% CI 1.1–1.5, p = 0.012). ER gain of more than 7.5° (p = 0.025) and GIRD of more than 7.5° (p = 0.014) were identified as risk factors for overuse shoulder injury in girls. Scapular dyskinesia (OR 1.1, n.s.) and maximum throwing velocity did not seem to contribute to injury risk. The average response rate was 63%. Conclusion In elite youth handball, deficits in ER strength is a risk factor for overuse shoulder injury for both sexes; ER gain and GIRD are only risk factors for girls. Focused pre‐season assessments may aid the identification of risk factors for shoulder overuse injuries and the application of specific programmes to reduce risk. Level of evidence II.

Frequent neuromuscular exercises prevent severe knee injury in adolescent team handball players and should thus be included in the practical routine as well as in the education of team coaches.

The basic knowledge of prevention and injuries is sufficient in elite football, but the transfer from theoretical knowledge to practical routine is suboptimal. The study also shows possibilities to improve the prevention process and communication between players, coaches, doctors, and physiotherapists, while there is no consent between players and coaches regarding return to play decision.

III.

AimWe aimed to identify patterns and mechanisms of injury situations in men’s professional handball by means of video match analysis.MethodsModerate and severe injuries (absence of >7 days) sustained in competition in one of six seasons (2010 to 2013 and 2014 to 2017) in men’s professional handball were prospectively analysed with a newly developed standardised observation form. Season 2013 to 2014 was excluded because of missing video material.Results580 injuries were identified: 298 (51.4%) contact injuries, 151 (26.0%) indirect contact injuries and 131 (22.6%) non-contact injuries. Head (87.5%), hand (83.8%), shoulder (70.2%) and ankle (62.9%) injuries were mainly sustained during direct contact. Typical contact injuries included collision with an opponent’s upper extremity or torso, and ankle injuries mainly consisted of foot-to-foot collisions. A large proportion (41.7%) of knee injuries were caused by indirect contact, whereas thigh injuries mainly occurred (56.4%) through non-contact mechanism. Wing (56.9%) and pivot (58.4%) players had the highest proportion of contact injuries, whereas backcourt players had a high proportion of indirect contact injuries (31.5%) and goalkeepers of non-contact injuries (48.9%). The injury proportion of foul play was 28.4%. Most injuries occurred in the central zone between the 6-metre and 9-metre lines (26.1%) and during the last 10 min of each match half (OR 1.71, p=0.016).ConclusionsIn men’s professional handball in a league setting, contact — but not foul play — was the most common mechanism associated with moderate and severe injuries. Head, hand, shoulder and ankle injury were mainly sustained during direct contact.

Purpose Injury data of professional soccer players obtained from media reports are frequently used in scientific research, but the accuracy of such data is still unclear. Patients and Methods Injuries of professional soccer players of the German first and second league were documented by continuously screening media reports over one season (2015–2016). After the season, the validity of media-reported injuries was anonymously analyzed by the team physicians of 8 different soccer clubs. Results A total of 255 injuries of 240 players of 8 professional soccer teams had been published online, of which 146 were confirmed by the team doctors as correct, yielding a rate of 57.3% of confirmed media-reported injuries. In addition, 92 injuries without media registration were detected and added to the online statistics, resulting in 347 injuries and an overall weak validity of media-based data of 42.1%. Statistical analysis showed that the validity of media-reported injury data depended on both the individual soccer club and the body site affected by injury: publications on knee injuries (78.2%) had a higher validity than those on foot injuries (46.2%), and publications on severe injuries had a higher validity (joint dislocation: 100%; ligament rupture: 82.9%; fracture: 73.3%) than those on minor injuries. Publications on specific severe soccer injuries, such as anterior cruciate ligament (ACL) injuries, had a validity of 100%. Conclusion Media-based injury data were only valid for a few severe injury types such as ACL injuries. In daily soccer routine and scientific research, media-based data should thus only be used in combination with specific criteria or verification processes.

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ACL stump trephination and concomitant intra-ligamentary application of ACP revealed promising results at mid-term follow-up to treat partial ACL lesions.