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A Biomechanical Perspective on Rehabilitation of ACL Injuries in Handball

  • I. Setuain
  • J. Bencke
  • J. Alfaro-Adrián
  • M. Izquierdo
Chapter

Abstract

Handball sport is a good example of a highly strenuous body-contact team sport with a strong emphasis on running speed, jumping, abrupt changes in direction and throwing in which enormous forces are developed around the knee joint. Due to handball’s intrinsic need for abrupt changes in direction and unplanned action management, as well as the high game intensity, anterior cruciate ligament (ACL) rupture is one of the most frequent devastating injuries among handball players. Moreover, an incomplete or insufficient rehabilitation program following an ACL injury may increase the risk of both re-injury and injury of the unaffected contra lateral knee. Thus, the identification of functional, biomechanical and neuromuscular deficits before discharging these patients from rehabilitation appears to be crucial for ACL re-injury prevention in this population. However, the scientific literature has still several concerns that despite previous conscientious scientific efforts made, remains sparse and to be clarified yet. This cornerstones are: the optimums rehabilitation type for successful ACL injury recovery, and the gold standard for an evidence based, objective and clinically feasible criteria for a save and competitive return to play after the suffering of this knee injury. Through a biomechanical approach to ACL injury management this chapter aims to help the clinician to understand the main biomechanical and functional aspects to deal when treating with an ACL injured handball player.

References

  1. 1.
    Langevoort G, Myklebust G, Dvorak J, Junge A. Handball injuries during major international tournaments. Scand J Med Sci Sports. 2007;17:400–7.PubMedGoogle Scholar
  2. 2.
    Seil R, Rupp S, Tempelhof S, Kohn D. Sports injuries in team handball. A one-year prospective study of sixteen men’s senior teams of a superior nonprofessional level. Am J Sports Med. 1998;26:681–7.CrossRefGoogle Scholar
  3. 3.
    Ardern CL, Taylor NF, Feller JA, Webster KE. Return-to-sport outcomes at 2 to 7 years after anterior cruciate ligament reconstruction surgery. Am J Sports Med. 2012;40:41–8.CrossRefGoogle Scholar
  4. 4.
    Myklebust G, Bahr R. Return to play guidelines after anterior cruciate ligament surgery. Br J Sports Med. 2005;39:127–31.CrossRefGoogle Scholar
  5. 5.
    Grassi A, Zaffagnini S, Marcheggiani Muccioli GM, Neri MP, Della VS, Marcacci M. After revision anterior cruciate ligament reconstruction, who returns to sport? A systematic review and meta-analysis. Br J Sports Med. 2015;49:1295–304.CrossRefGoogle Scholar
  6. 6.
    Ernst GP, Saliba E, Diduch DR, Hurwitz SR, Ball DW. Lower extremity compensations following anterior cruciate ligament reconstruction. Phys Ther. 2000;80:251–60.PubMedGoogle Scholar
  7. 7.
    Hewett TE, Myer GD, Ford KR, et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med. 2005;33:492–501.CrossRefGoogle Scholar
  8. 8.
    Horita T, Komi PV, Nicol C, Kyrolainen H. Interaction between pre-landing activities and stiffness regulation of the knee joint musculoskeletal system in the drop jump: implications to performance. Eur J Appl Physiol. 2002;88:76–84.CrossRefGoogle Scholar
  9. 9.
    Paterno MV, Ford KR, Myer GD, Heyl R, Hewett TE. Limb asymmetries in landing and jumping 2 years following anterior cruciate ligament reconstruction. Clin J Sport Med. 2007;17:258–62.CrossRefGoogle Scholar
  10. 10.
    Gokeler A, Hof AL, Arnold MP, Dijkstra PU, Postema K, Otten E. Abnormal landing strategies after ACL reconstruction. Scand J Med Sci Sports. 2010;20:e12-e19.CrossRefGoogle Scholar
  11. 11.
    Hewett TE, Myer GD, Ford KR. Anterior cruciate ligament injuries in female athletes: part 1, mechanisms and risk factors. Am J Sports Med. 2006;34:299–311.CrossRefGoogle Scholar
  12. 12.
    Myer GD, Paterno MV, Ford KR, Quatman CE, Hewett TE. Rehabilitation after anterior cruciate ligament reconstruction: criteria-based progression through the return-to-sport phase. J Orthop Sports Phys Ther. 2006;36:385–402.CrossRefGoogle Scholar
  13. 13.
    Setuain I, Izquierdo M, Idoate F, et al. Differential effects of two rehabilitation programs following anterior cruciate ligament reconstruction. J Sport Rehabil. 2017;26(6):544–55.CrossRefGoogle Scholar
  14. 14.
    Olsen OE, Myklebust G, Engebretsen L, Holme I, Bahr R. Relationship between floor type and risk of ACL injury in team handball. Scand J Med Sci Sports. 2003;13:299–304.CrossRefGoogle Scholar
  15. 15.
    Quatman CE, Kiapour AM, Demetropoulos CK, et al. Preferential loading of the ACL compared with the MCL during landing: a novel in sim approach yields the multiplanar mechanism of dynamic valgus during ACL injuries. Am J Sports Med. 2014;42:177–86.CrossRefGoogle Scholar
  16. 16.
    Ramirez-Campillo R, Gallardo F, Henriquez-Olguin C, et al. Effect of vertical, horizontal, and combines plyometrics training on explosive, balance and endurance performance of young soccer players. J Strength Cond Res. 2015;29(7):1784–95.CrossRefGoogle Scholar
  17. 17.
    Gorostiaga EM, Asiain X, Izquierdo M, et al. Vertical jump performance and blood ammonia and lactate levels during typical training sessions in elite 400-m runners. J Strength Cond Res. 2010;24:1138–49.CrossRefGoogle Scholar
  18. 18.
    Izquierdo M, Aguado X, Gonzalez R, Lopez JL, Hakkinen K. Maximal and explosive force production capacity and balance performance in men of different ages. Eur J Appl Physiol Occup Physiol. 1999;79:260–7.CrossRefGoogle Scholar
  19. 19.
    Bobbert MF, Huijing PA, van Ingen Schenau GJ. Drop jumping. I. The influence of jumping technique on the biomechanics of jumping. Med Sci Sports Exerc. 1987;19:332-338.Google Scholar
  20. 20.
    Markovic G. Does plyometric training improve vertical jump height? A meta-analytical review. Br J Sports Med. 2007;41:349–55.CrossRefGoogle Scholar
  21. 21.
    Devita P, Skelly WA. Effect of landing stiffness on joint kinetics and energetics in the lower extremity. Med Sci Sports Exerc. 1992;24:108-115.Google Scholar
  22. 22.
    Paterno MV, Schmitt LC, Ford KR, Rauh MJ, Myer GD, Hewett TE. Effects of sex on compensatory landing strategies upon return to sport after anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther. 2011;41:553–9.CrossRefGoogle Scholar
  23. 23.
    Bonnet V, Mazza C, Cappozzo A. Real-time estimate of body kinematics during a planar squat task using a single inertial measurement unit. IEEE Transactions in Biomedical Engineering. 2013;60:1920–6.CrossRefGoogle Scholar
  24. 24.
    Requena B, García I, Requena F, Saez-Saez de Villarreal E, Pääsuke M. Reliability and validity of a wireless microelectromechanicals based system (Keimove™) for measuring vertical jumping performance. J Sports Sci Med. 2012;11:115–22.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Bosco C, Luhtanen P, Komi PV. A simple method for measurement of mechanical power in jumping. Eur J Appl Physiol Occup Physiol. 1983;50:273–82.CrossRefGoogle Scholar
  26. 26.
    Glatthorn JF, Gouge S, Nussbaumer S, Stauffacher S, Impellizzeri FM, Maffiuletti NA. Validity and reliability of Optojump photoelectric cells for estimating vertical jump height. J Strength Cond Res. 2011;25:556–60.CrossRefGoogle Scholar
  27. 27.
    Cormie P, McBride JM, McCaulley GO. Power-time, force-time, and velocity-time curve analysis of the countermovement jump: impact of training. J Strength Cond Res. 2009;23:177–86.CrossRefGoogle Scholar
  28. 28.
    Linthorne NP. Analysis of standing vertical jumps using a force platform. Am J Phys. 2001;69:1198–204.CrossRefGoogle Scholar
  29. 29.
    Hatze H. Validity and reliability of methods for testing vertical jumping performance. J Appl Biomech. 1998;14:127–40.CrossRefGoogle Scholar
  30. 30.
    Gorostiaga EM, Granados C, Ibanez J, Gonzalez-Badillo JJ, Izquierdo M. Effects of an entire season on physical fitness changes in elite male handball players. Med Sci Sports Exerc. 2006;38:357–66.CrossRefGoogle Scholar
  31. 31.
    Marques MC, Izquierdo M. Kinetic and kinematic associations between vertical jump performance and 10-m sprint time. J Strength Cond Res. 2014;28:2366–71.CrossRefGoogle Scholar
  32. 32.
    Noyes FR, Barber-Westin SD, Fleckenstein C, Walsh C, West J. The drop-jump screening test: difference in lower limb control by gender and effect of neuromuscular training in female athletes. Am J Sports Med. 2005;33:197–207.CrossRefGoogle Scholar
  33. 33.
    Oberlander KD, Bruggemann GP, Hoher J, Karamanidis K. Altered landing mechanics in ACL-reconstructed patients. Med Sci Sports Exerc. 2013;45:506–13.CrossRefGoogle Scholar
  34. 34.
    Myer GD, Schmitt LC, Brent JL, et al. Utilization of modified NFL combine testing to identify functional deficits in athletes following ACL reconstruction. J Orthop Sports Phys Ther. 2011;41:377–87.CrossRefGoogle Scholar
  35. 35.
    Eitzen I, Moksnes H, Snyder-Mackler L, Engebretsen L, Risberg MA. Functional tests should be accentuated more in the decision for ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2010;18:1517–25.CrossRefGoogle Scholar
  36. 36.
    Bonnet V, Mazza C, Fraisse P, Cappozzo A. Real-time estimate of body kinematics during a planar squat task using a single inertial measurement unit. IEEE Trans Biomed Eng. 2013;60:1920–6.CrossRefGoogle Scholar
  37. 37.
    Patterson MR, Delahunt E. A diagonal landing task to assess dynamic postural stability in ACL reconstructed females. Knee. 2013;20:532–6.CrossRefGoogle Scholar
  38. 38.
    Dowling AV, Favre J, Andriacchi TP. A wearable system to assess risk for anterior cruciate ligament injury during jump landing: measurements of temporal events, jump height, and sagittal plane kinematics. J Biomech Eng. 2011;133:071008.CrossRefGoogle Scholar
  39. 39.
    Kristianslund E, Faul O, Bahr R, Myklebust G, Krosshaug T. Sidestep cutting technique and knee abduction loading: implications for ACL prevention exercises. Br J Sports Med. 2014;48:779–83.CrossRefGoogle Scholar
  40. 40.
    Zebis MK, Andersen LL, Bencke J, Kjaer M, Aagaard P. Identification of athletes at future risk of anterior cruciate ligament ruptures by neuromuscular screening. Am J Sports Med. 2009;37:1967–73.CrossRefGoogle Scholar
  41. 41.
    Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM. Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc. 2004;36:926–34.CrossRefGoogle Scholar
  42. 42.
    Khayambashi K, Ghoddosi N, Straub RK, Powers CM. Hip muscle strength predicts noncontact anterior cruciate ligament injury in male and female athletes: a prospective study. Am J Sports Med. 2016;44:355–61.CrossRefGoogle Scholar
  43. 43.
    Zebis MK, Andersen LL, Brandt M, et al. Effects of evidence-based prevention training on neuromuscular and biomechanical risk factors for ACL injury in adolescent female athletes: a randomised controlled trial. Br J Sports Med. 2016;50:552–7.CrossRefGoogle Scholar
  44. 44.
    Prodromos CC, Han Y, Rogowski J, Joyce B, Shi K. A meta-analysis of the incidence of anterior cruciate ligament tears as a function of gender, sport, and a knee injury-reduction regimen. Arthroscopy. 2007;23:1320–5.CrossRefGoogle Scholar
  45. 45.
    Hewett TE, Ford KR, Hoogenboom BJ, Myer GD. Understanding and preventing ACL injuries: current biomechanical and epidemiologic considerations—update 2010. N Am J Sports Phys Ther. 2010;5:234–51.PubMedPubMedCentralGoogle Scholar
  46. 46.
    Myklebust G, Holm I, Maehlum S, Engebretsen L, Bahr R. Clinical, functional, and radiologic outcome in team handball players 6 to 11 years after anterior cruciate ligament injury: a follow-up study. Am J Sports Med. 2003;31:981–9.CrossRefGoogle Scholar
  47. 47.
    Setuain I, Millor N, Gonzalez-Izal M, et al. Biomechanical jumping differences among elite female handball players with and without previous anterior cruciate ligament reconstruction: a novel inertial sensor unit study. Sports Biomech. 2015;14:323–39.CrossRefGoogle Scholar
  48. 48.
    Rowlands AV, Stiles VH. Accelerometer counts and raw acceleration output in relation to mechanical loading. J Biomech. 2012;45:448–54.CrossRefGoogle Scholar
  49. 49.
    Kulas AS, Hortobagyi T, Devita P. The interaction of trunk-load and trunk-position adaptations on knee anterior shear and hamstrings muscle forces during landing. J Athl Train. 2010;45:5–15.CrossRefGoogle Scholar
  50. 50.
    Busfield BT, Kharrazi FD, Starkey C, Lombardo SJ, Seegmiller J. Performance outcomes of anterior cruciate ligament reconstruction in the National Basketball Association. Arthroscopy. 2009;25:825–30.CrossRefGoogle Scholar
  51. 51.
    Setuain I, Gonzalez-Izal M, Alfaro J, Gorostiaga E, Izquierdo M. Acceleration and orientation jumping performance differences among elite professional male handball players with or without previous ACL reconstruction: an inertial sensor unit-based study. PM R. 2015;7:1243–53.CrossRefGoogle Scholar
  52. 52.
    Brophy RH, Schmitz L, Wright RW, et al. Return to play and future ACL injury risk after ACL reconstruction in soccer athletes from the Multicenter orthopaedic outcomes network (MOON) group. Am J Sports Med. 2012;40:2517–22.CrossRefGoogle Scholar
  53. 53.
    Hewett TE, Stroupe AL, Nance TA, Noyes FR. Plyometric training in female athletes. Decreased impact forces and increased hamstring torques. Am J Sports Med. 1996;24:765–73.CrossRefGoogle Scholar
  54. 54.
    Bencke J, Curtis D, Krogshede C, Jensen LK, Bandholm T, Zebis MK. Biomechanical evaluation of the side-cutting manoeuvre associated with ACL injury in young female handball players. Knee Surg Sports Traumatol Arthrosc. 2013;21:1876–81.CrossRefGoogle Scholar
  55. 55.
    Alentorn-Geli E, Mendiguchia J, Samuelsson K, et al. Prevention of anterior cruciate ligament injuries in sports. Part I: systematic review of risk factors in male athletes. Knee Surg Sports Traumatol Arthrosc. 2014;22:3–15.CrossRefGoogle Scholar
  56. 56.
    Quatman CE, Hewett TE. The anterior cruciate ligament injury controversy: is “valgus collapse” a sex-specific mechanism? Br J Sports Med. 2009;43:328–35.CrossRefGoogle Scholar
  57. 57.
    Gomes JL, de Castro JV, Becker R. Decreased hip range of motion and noncontact injuries of the anterior cruciate ligament. Arthroscopy. 2008;24:1034–7.CrossRefGoogle Scholar
  58. 58.
    Rotterud JH, Sivertsen EA, Forssblad M, Engebretsen L, Aroen A. Effect of gender and sports on the risk of full-thickness articular cartilage lesions in anterior cruciate ligament-injured knees: a nationwide cohort study from Sweden and Norway of 15 783 patients. Am J Sports Med. 2011;39:1387–94.CrossRefGoogle Scholar
  59. 59.
    Ageberg E, Forssblad M, Herbertsson P, Roos EM. Sex differences in patient-reported outcomes after anterior cruciate ligament reconstruction: data from the Swedish knee ligament register. Am J Sports Med. 2010;38:1334–42.CrossRefGoogle Scholar

Copyright information

© ESSKA 2018

Authors and Affiliations

  • I. Setuain
    • 1
    • 2
  • J. Bencke
    • 3
  • J. Alfaro-Adrián
    • 2
  • M. Izquierdo
    • 1
  1. 1.Department of Health SciencesPublic University of NavarraNavarraSpain
  2. 2.Clinical Research DepartmentAdvanced Rehabilitation Center, TDNPamplonaSpain
  3. 3.Department of Orthopedics, Human Movement Analysis LaboratoryCopenhagen University Hospital HvidovreHvidovreDenmark

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