Reduced glenohumeral rotation, external rotation weakness and scapular dyskinesis are risk factors for shoulder injuries among elite male handball players: a prospective cohort study

Objective: To investigate shoulder-rotator strength, internalrotation (IR) and external-rotation (ER) range of motion (ROM), and acromiohumeral distance (AHD) in asymptomatic adolescent volleyball attackers to determine if they have risk factors for injury.Design: Cross-sectional study. Setting: University laboratory. Participants: Thirty-nine adolescent high school-aged volleyball attackers (22 boys, 17 girls; age ¼ 16.0 6 1.4 years, height ¼ 179.2 6 9.0 cm, mass ¼ 67.1 6 10.9 kg, body mass index ¼ 20.7 6 2.6 kg/m 2 ). Main Outcome Measure(s): Shoulder IR and ER ROM, total-rotation ROM, glenohumeral IR deficit, AHD, and concentric and eccentric strength of the shoulder internal and external rotators were tested bilaterally.Results: External-rotation ROM was greater (t 38 ¼ 4.92, P , .001), but IR ROM (t 38 ¼ À8.61, P , .001) and total ROM (t 38 ¼ À3.55, P ¼ .01) were less in the dominant shoulder, and 15 athletes had a glenohumeral IR deficit (IR ROM loss . 188). We observed greater concentric internal-rotator (t 38 ¼ 2.89, P ¼ .006) and eccentric external-rotator (t 38 ¼ 2.65, P ¼ .01) strength in the dominant than in the nondominant shoulder. The AHD was less in the dominant shoulder (t 38 ¼ À3.60, P , .001).Conclusions: Adolescent volleyball attackers demonstrated decreased IR ROM, total ROM, and AHD and increased ER ROM in their dominant shoulder. Therefore, routine screening of adolescent athletes and designing training programs for hazardous adaptive changes could be important in preventing shoulder injuries.Key Words: ultrasonography, sports, glenohumeral joint, muscle strength Key PointsAsymptomatic adolescent volleyball attackers demonstrated less internal-rotation range of motion (ROM), total ROM, and acromiohumeral distance and more external-rotation ROM in the dominant than in the nondominant shoulder, which might put them at risk for shoulder injuries. Routinely screening adolescent athletes and designing training programs to address hazardous adaptive changes could help prevent shoulder injuries.

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“…12,32 Clarsen et al 9 reported that decreased total ROM was related to increased shoulder pain in handball players.…”

Section: Glenohumeral-rotation Motionmentioning

confidence: 99%

“…9,11 Reduced shoulder IR is defined as a glenohumeral IR deficit (GIRD). 12 Individuals with more than 188 of IR ROM loss and 58 difference in total-rotation ROM between the dominant and nondominant shoulders are at risk for shoulder injury.…”

Section: à11mentioning

confidence: 99%

Shoulder-Rotator Strength, Range of Motion, and Acromiohumeral Distance in Asymptomatic Adolescent Volleyball Attackers

Harput

Guney

Toprak

et al. 2016

Journal of Athletic Training

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“…Results indicate that for a population of adolescent athletes with an amateur sports level, the dyskinesis prevalence is high; however, it is not associated with pain and does not seem to affect measures of upper limb function. Although some studies support the relationship between pain/ lesion and scapular dyskinesis 2,[7][8][9][10][11] , more than half of the current sample (56.7%) presented changes in scapular movement without, however, being associated with shoulder pain. The results of this study corroborate those of Oliveira et al 28 who analyzed amateur male athletes with shoulder injury syndrome and observed no association between dyskinesis and shoulder pain.…”

Section: Discussionmentioning

confidence: 89%

“…Specifically, the modification in the scapula positioning, called scapular dyskinesis, has been studied because it presents possible relations with the presence of pain and shoulder injuries in athletes 2,[6][7][8] . Most of the studies state the relation between shoulder pain/ injury and scapular dyskinesis 2,7,[9][10][11] . Such research ensures that ORIGINAL ARTICLE DOI 10.5935/2595-0118.20180009 changes in scapular kinematics may result in structural and functional changes in the glenohumeral and acromioclavicular joints, decreased subacromial space, changes in the scapular muscles activation and, consequently, leading to dysfunctions such as shoulder-rotator cuff syndrome, rotator cuff tendinopathies, glenohumeral instability, and other conditions.…”

Section: Introductionmentioning

confidence: 99%

Scapular dyskinesis was not associated with pain and function in male adolescent athletes

Oliveira¹,

Silva²,

Pitangui³

et al. 2018

Brazilian Journal of Pain

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BACKGROUND AND OBJECTIVES: Scapular dyskinesis has been associated to shoulder injuries and pain. However, this relationship with adolescent athletes is not well established. The objective of this study was to evaluate scapular dyskinesis in young athletes and its association with pain or shoulder function. METHODS: 178 male adolescent athletes (14.58±2.16 years) were evaluated. The subjects completed the Quick Disability Arm Shoulder Hand questionnaire. Body mass, height, shoulder internal rotation and Closed Kinetic Chain Upper Extremity Stability test were measured. A dynamic visual method was applied to assess dyskinesis. Binary logistic regression was applied to analyze the association between dyskinesis and other variables. The comparison between groups with and without dyskinesis was made by the Mann-Whitney and t-test, accepting a statistical significance of p<0.05. RESULTS: The dyskinesis prevalence was 56.7% and this condition was not associated with shoulder pain. Younger athletes are 159% more likely to have dyskinesis, while those who practice more than one hour a day for three times a week are 77% more likely to have the same outcome. No difference in shoulder function was found. CONCLUSION: Scapular dyskinesis is not associated with pain and does not affect shoulder function in adolescent athletes. Sports modality, age and training volume seem to induce changes in scapula movement. Keywords: Adolescents, Athletes, Athletic performance, Pain, Shoulder. Scapular dyskinesis was not associated with pain and function in male adolescent athletes RESUMO JUSTIFICATIVA E OBJETIVOS:A discinese escapular tem sido associada a lesões e dor no ombro, no entanto essa relação em adolescentes atletas ainda não é bem definida. O objetivo deste estudo foi avaliar a prevalência de discinese escapular em adolescentes atletas amadores e sua associação com a dor e medidas de função no ombro. MÉTODOS: 178 adolescentes do sexo masculino (14,58±2,16 anos) participaram do estudo. Os sujeitos responderam ao questionário Quick Disability Arm Shoulder Hand. Também foram avaliados massa corporal, estatura, rotação interna do ombro e Closed Kinetic Chain Upper Extremity Stability. Para avaliação da discinese escapular, utilizou-se o método visual dinâmico. A regressão logística binária foi utilizada para analisar a associação entre discinese e as demais variáveis. A comparação entre os grupos com e sem discinese foi feita pelo teste t e Mann-Whitney, sendo aceito significância estatística quando p<0,05. RESULTADOS: A prevalência de discinese foi de 56,7% e essa condição não teve associação com dor no ombro. Atletas mais jovens têm 159% mais chances de apresentar discinese, enquanto aqueles que treinam mais de uma hora por dia, durante três vezes por semana, têm 77% mais chances de ter o mesmo desfecho. Nenhuma diferença na função do ombro foi encontrada. CONCLUSÃO: A discinese escapular não está associada à dor e não altera medidas de função no ombro em adolescentes atletas. Modalidade, idade e volume de treinamento pa...

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“…Shoulder pain is a common injury in elite handball players with the average weekly prevalence being approximately 28% during the season (Clarsen, Bahr, Andersson, Munk, & Myklebust, 2014). This condition is also highly prevalent in other throwing and overhead sports such as baseball (Amin et al, 2015).…”

Section: Commentarymentioning

confidence: 99%

Engagement in exercise for people with Parkinson’s: What is meaningful?

Mulligan¹,

Armstrong²,

Francis³

et al. 2018

NZJP

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Whilst it is suggested that exercise is integral in the management of Parkinson’s, there is minimal literature exploring this population’s perceptions about exercise, and how these perceptions relate to standardised physical outcome measures. This mixed method study explored participants’ views on an exercise programme which was offered as part of an intervention in a randomised controlled trial for people with Parkinson’s. Participants in the intervention group (n = 21) received an exercise programme and a cognitive enrichment programme while the control group (n = 20) continued with usual care. Semi-structured, face to face, audio-recorded individual or group interviews were undertaken with the intervention group and data analysed thematically. Quantitative data extracted from the clinical trial included the 6 Minute Walk Test and the mini-Balance Evaluation Systems Test (mini-BESTest). The themes: ‘Having trust in professional guidance’, and ‘An understanding and supportive environment’ contributed to the overarching theme of ‘A sense of individual empowerment’. Together the themes demonstrated meaningful holistic benefits gained by participants, which differed from the non-statistically significant quantitative results from the clinical trial. Small group tailored exercise effectively addressed multiple cornerstones of health in people with Parkinson’s, creating an overall sense of individual empowerment. This study also suggests that research may overemphasise reporting of standardised physical outcomes to the detriment of what participants perceive as meaningful outcomes.

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Reduced glenohumeral rotation, external rotation weakness and scapular dyskinesis are risk factors for shoulder injuries among elite male handball players: a prospective cohort study

Abstract: Injury prevention programmes should incorporate interventions aimed at improving glenohumeral rotational range of motion, external rotation strength and scapular control.

Cited by 272 publications

References 41 publications

Shoulder-Rotator Strength, Range of Motion, and Acromiohumeral Distance in Asymptomatic Adolescent Volleyball Attackers

Shoulder-Rotator Strength, Range of Motion, and Acromiohumeral Distance in Asymptomatic Adolescent Volleyball Attackers

Scapular dyskinesis was not associated with pain and function in male adolescent athletes

Engagement in exercise for people with Parkinson’s: What is meaningful?

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