Abstract
Purpose
Glenohumeral range of motion adaptations may affect throwing athletes and contribute to shoulder injury. The purpose of this study was to evaluate shoulder rotation deficits among elite professional handball players and its correlation to the presence of shoulder pain and morphological changes.
Methods
Eighty-seven elite professional handball players and 41 healthy non-athlete volunteers participated in the study. Evaluations included measurement of range of internal and external rotation, total arch of motion, identification of shoulder pain and ultrasound scan for diagnosis of rotator cuff tears and internal impingement.
Results
Glenohumeral rotational deficits (>20–25°) were found among 11 players group (13%). The throwing shoulders in the players group showed a decrease in internal rotation and an increase in external rotation with significantly larger ranges among players compared to the non-athlete group. Internal rotation deficit >20° was associated with higher incidence of shoulder pain among players. Both internal rotation deficits (>25°) and total arch of motion deficit (>20°) co-existed with higher incidence of internal impingement. Shoulder pain was common (36/97–41%) and was associated with decreased external rotation and total arch of motion. Internal impingement (found in 13/87–15%) correlated with decreased rotation ranges and a greater deficit in total arch of motion, whereas higher gain in external rotation correlated with a partial rotator cuff tear (found in 12/87–14%).
Conclusions
Shoulder pathologies and problems commonly affected the group of handball players. Greater glenohumeral rotational deficits in throwing shoulders of handball players correlate with shoulder pain and internal impingement, while increased external rotation with partial rotator cuff tears. Such deficits affect 13% of the athlete population. Major clinical relevance of the study is to monitor handball players’ shoulders both clinically and by proper imaging. Evaluation of range of rotation seems to identify shoulders at risk of the pathology.
Level of evidence
Cross-Sectional study with control group, Level II.
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Abbreviations
- GIRD:
-
Glenohumeral internal rotation deficit
- ER:
-
External rotation
- ERG:
-
External rotation gain
- D:
-
Dominant
- IR:
-
Internal rotation
- MRI:
-
Magnetic resonance imaging
- ND:
-
Non-dominant
- RCT:
-
Rotator cuff tear
- ROM:
-
Range of motion
- SD:
-
Standard deviation
- SLAP:
-
Superior labral anterior to posterior tear
- TAM:
-
Total arch of motion
- TAMD:
-
Total arch of motion deficit
- TAMG:
-
Total arch of motion gain
- US:
-
Ultrasound scan
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Acknowledgments
The work was supported by the National Science Center under Grant DEC-2011/01/B/NZ7/03596.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards
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Informed consent was obtained from all individual participants included in the study.
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Lubiatowski, P., Kaczmarek, P., Cisowski, P. et al. Rotational glenohumeral adaptations are associated with shoulder pathology in professional male handball players. Knee Surg Sports Traumatol Arthrosc 26, 67–75 (2018). https://doi.org/10.1007/s00167-017-4426-9
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DOI: https://doi.org/10.1007/s00167-017-4426-9