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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2018

15.02.2017 | Shoulder

Rotational glenohumeral adaptations are associated with shoulder pathology in professional male handball players

verfasst von: Przemyslaw Lubiatowski, Piotr Kaczmarek, Pawel Cisowski, Ewa Breborowicz, Monika Grygorowicz, Marcin Dzianach, Tomasz Krupecki, Lior Laver, Leszek Romanowski

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 1/2018

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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.
Literatur
1.
Zurück zum Zitat Almeida GP, Silveira PF, Rosseto NP, Barbosa G, Ejnisman B, Cohen M (2014) Glenohumeral range of motion in handball players with and without throwing-related shoulder pain. J Shoulder Elbow Surg 22:602–607CrossRef Almeida GP, Silveira PF, Rosseto NP, Barbosa G, Ejnisman B, Cohen M (2014) Glenohumeral range of motion in handball players with and without throwing-related shoulder pain. J Shoulder Elbow Surg 22:602–607CrossRef
2.
Zurück zum Zitat Burkhart SS, Morgan CD, Kibler WB (2003) The disabled throwing shoulder: spectrum of pathology Part I: pathoanatomy and biomechanics. Arthroscopy 19:404–420CrossRefPubMed Burkhart SS, Morgan CD, Kibler WB (2003) The disabled throwing shoulder: spectrum of pathology Part I: pathoanatomy and biomechanics. Arthroscopy 19:404–420CrossRefPubMed
3.
Zurück zum Zitat Burkhart SS, Morgan CD, Kibler WB (2003) The disabled throwing shoulder: spectrum of pathology. Part II: evaluation and treatment of SLAP lesions in throwers. Arthroscopy 19(5):531–539CrossRefPubMed Burkhart SS, Morgan CD, Kibler WB (2003) The disabled throwing shoulder: spectrum of pathology. Part II: evaluation and treatment of SLAP lesions in throwers. Arthroscopy 19(5):531–539CrossRefPubMed
4.
Zurück zum Zitat Casáis L, Martínez M (2012) Intervention strategies in the prevention of sports injuries from physical activity; In: KR Zaslav (ed) An International Perspective on Topics in Sports Medicine and Sports Injury. InTech, Rijeka, pp 355–378 Casáis L, Martínez M (2012) Intervention strategies in the prevention of sports injuries from physical activity; In: KR Zaslav (ed) An International Perspective on Topics in Sports Medicine and Sports Injury. InTech, Rijeka, pp 355–378
5.
Zurück zum Zitat Clarsen B, Bahr R, Andersson SH, Munk R, Myklebust G (2014) Reduced glenohumeral rotation, external rotation weakness and scapular dyskinesis are risk factors for shoulder injuries among elite male handball players: a prospective cohort study. Br J Sports Med 48(17):1327–1333CrossRefPubMed Clarsen B, Bahr R, Andersson SH, Munk R, Myklebust G (2014) Reduced glenohumeral rotation, external rotation weakness and scapular dyskinesis are risk factors for shoulder injuries among elite male handball players: a prospective cohort study. Br J Sports Med 48(17):1327–1333CrossRefPubMed
6.
Zurück zum Zitat de Jesus JO, Parker L, Frangos AJ, Nazarian LN (2009) Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a meta-analysis. Am J Roentgenol 192:1701–1707CrossRef de Jesus JO, Parker L, Frangos AJ, Nazarian LN (2009) Accuracy of MRI, MR arthrography, and ultrasound in the diagnosis of rotator cuff tears: a meta-analysis. Am J Roentgenol 192:1701–1707CrossRef
7.
Zurück zum Zitat Dwelly PM, Tripp BL, Tripp PA, Eberman LE, Gorin S (2009) Glenohumeral rotational range of motion in collegiate overhead-throwing athletes during an athletic season. J Athl Train 44:611–616CrossRefPubMedPubMedCentral Dwelly PM, Tripp BL, Tripp PA, Eberman LE, Gorin S (2009) Glenohumeral rotational range of motion in collegiate overhead-throwing athletes during an athletic season. J Athl Train 44:611–616CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Ellenbecker TS, Roetert EP, Bailie DS, Davies GJ, Brown SW (2002) Glenohumeral joint total rotation range of motion in elite tennis players and baseball pitchers. Med Sci Sports Exerc 34(12):2052–2056CrossRefPubMed Ellenbecker TS, Roetert EP, Bailie DS, Davies GJ, Brown SW (2002) Glenohumeral joint total rotation range of motion in elite tennis players and baseball pitchers. Med Sci Sports Exerc 34(12):2052–2056CrossRefPubMed
9.
Zurück zum Zitat Halbrecht JL, Tirman P, Atkin D (1999) Internal impingement of the shoulder: comparison of findings between the throwing and nonthrowing shoulders of college baseball players. Arthroscopy 15:253–258CrossRefPubMed Halbrecht JL, Tirman P, Atkin D (1999) Internal impingement of the shoulder: comparison of findings between the throwing and nonthrowing shoulders of college baseball players. Arthroscopy 15:253–258CrossRefPubMed
10.
Zurück zum Zitat Hoeberigs J, van Galen W, Philipsen H (1986) Pattern of injury in handball and comparison of injured versus noninjured handball players. Int J Sport Med 7:333–337CrossRef Hoeberigs J, van Galen W, Philipsen H (1986) Pattern of injury in handball and comparison of injured versus noninjured handball players. Int J Sport Med 7:333–337CrossRef
11.
Zurück zum Zitat Jost B, Zumstein M, Pfirrmann CW, Zanetti M, Gerber C (2005) MRI findings in throwing shoulders: abnormalities in professional handball players. Clin Orthop Relat Res 434:130–137CrossRef Jost B, Zumstein M, Pfirrmann CW, Zanetti M, Gerber C (2005) MRI findings in throwing shoulders: abnormalities in professional handball players. Clin Orthop Relat Res 434:130–137CrossRef
12.
Zurück zum Zitat Kaczmarek P, Lubiatowski P, Cisowski P, Grygorowicz M, Łepski M, Długosz, J, Romanowski L (2014) Shoulder problems in overhead sports. Part I—biomechanics of throwing. Pol Orthop Traumatol 15(79): 50–58 Kaczmarek P, Lubiatowski P, Cisowski P, Grygorowicz M, Łepski M, Długosz, J, Romanowski L (2014) Shoulder problems in overhead sports. Part I—biomechanics of throwing. Pol Orthop Traumatol 15(79): 50–58
13.
Zurück zum Zitat Kaplan KM, Elattrache NS, Jobe FW et al (2011) Comparison of shoulder range of motion, strength, and playing time in uninjured high school baseball pitchers who reside in warm- and cold-weather climates. Am J Sports Med 39:320–328CrossRefPubMed Kaplan KM, Elattrache NS, Jobe FW et al (2011) Comparison of shoulder range of motion, strength, and playing time in uninjured high school baseball pitchers who reside in warm- and cold-weather climates. Am J Sports Med 39:320–328CrossRefPubMed
14.
Zurück zum Zitat Kibler WB, Kuhn JE, Wilk K, Sciascia A, Moore S, Laudner K, Uhl T (2013) The disabled throwing shoulder: spectrum of pathology-10-year update. Arthroscopy 29:141–161CrossRefPubMed Kibler WB, Kuhn JE, Wilk K, Sciascia A, Moore S, Laudner K, Uhl T (2013) The disabled throwing shoulder: spectrum of pathology-10-year update. Arthroscopy 29:141–161CrossRefPubMed
15.
Zurück zum Zitat Kibler WB, Sciascia A, Thomas SJ (2012) Glenohumeral internal rotation deficit: pathogenesis and response to acute throwing. Sports Med Arthrosc 20:34–38CrossRefPubMed Kibler WB, Sciascia A, Thomas SJ (2012) Glenohumeral internal rotation deficit: pathogenesis and response to acute throwing. Sports Med Arthrosc 20:34–38CrossRefPubMed
17.
Zurück zum Zitat Lintner D, Mayol M, Uzodinma O, Jones R, Labossiere D (2007) Glenohumeral internal rotation deficits in professional pitchers enrolled in an internal rotation stretching program. Am J Sports Med 35:617–621CrossRefPubMed Lintner D, Mayol M, Uzodinma O, Jones R, Labossiere D (2007) Glenohumeral internal rotation deficits in professional pitchers enrolled in an internal rotation stretching program. Am J Sports Med 35:617–621CrossRefPubMed
18.
Zurück zum Zitat Lintner D, Noonan TJ, Kibler WB (2008) Injury patterns and biomechanics of the athlete’s shoulder. Clin Sports Med 27:527–551CrossRefPubMed Lintner D, Noonan TJ, Kibler WB (2008) Injury patterns and biomechanics of the athlete’s shoulder. Clin Sports Med 27:527–551CrossRefPubMed
19.
Zurück zum Zitat Lubiatowski P, Kaczmarek P, Dzianach M, Ogrodowicz P, Bręborowicz M, Długosz JD, Romanowski L (2013) Clinical and biomechanical performance of patients with failed rotator cuff repair. Int Orthop 37:2395–2401CrossRefPubMedPubMedCentral Lubiatowski P, Kaczmarek P, Dzianach M, Ogrodowicz P, Bręborowicz M, Długosz JD, Romanowski L (2013) Clinical and biomechanical performance of patients with failed rotator cuff repair. Int Orthop 37:2395–2401CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Lubiatowski P, Kaczmarek PK, Ślęzak M, Długosz J, Bręborowicz M, Dudziński W, Romanowski L (2014) Problems of the glenohumeral joint in overhead sports—literature review. Part II—pathology and pathophysiology. Pol Orthop Traumatol 23: 59–66 Lubiatowski P, Kaczmarek PK, Ślęzak M, Długosz J, Bręborowicz M, Dudziński W, Romanowski L (2014) Problems of the glenohumeral joint in overhead sports—literature review. Part II—pathology and pathophysiology. Pol Orthop Traumatol 23: 59–66
21.
Zurück zum Zitat McConnell J, Donnelly C, Hamner S, Dunne J, Besier T (2012) Passive and dynamic shoulder rotation range in uninjured and previously injured overhead throwing athletes and the effect of shoulder taping. PM R 4:111–116CrossRefPubMed McConnell J, Donnelly C, Hamner S, Dunne J, Besier T (2012) Passive and dynamic shoulder rotation range in uninjured and previously injured overhead throwing athletes and the effect of shoulder taping. PM R 4:111–116CrossRefPubMed
22.
Zurück zum Zitat Myers JB, Laudner KG, Pasquale MR, Bradley JP, Lephart SM (2006) Glenohumeral range of motion deficits and posterior shoulder tightness in throwers with pathologic internal impingement. Am J Sports Med 34:385–391CrossRefPubMed Myers JB, Laudner KG, Pasquale MR, Bradley JP, Lephart SM (2006) Glenohumeral range of motion deficits and posterior shoulder tightness in throwers with pathologic internal impingement. Am J Sports Med 34:385–391CrossRefPubMed
23.
Zurück zum Zitat Myklebust G, Hasslan L, Bahr R, Steffen K (2013) High prevalence of shoulder pain among elite Norwegian female handball players. Scand J Med Sci Sports 23:288–294CrossRefPubMed Myklebust G, Hasslan L, Bahr R, Steffen K (2013) High prevalence of shoulder pain among elite Norwegian female handball players. Scand J Med Sci Sports 23:288–294CrossRefPubMed
24.
Zurück zum Zitat Nakamizo H, Nakamura Y, Nobuhara K, Yamamoto T (2008) Loss of glenohumeral internal rotation in little league pitchers: a biomechanical study. J Shoulder Elbow Surg 17:795–801CrossRefPubMed Nakamizo H, Nakamura Y, Nobuhara K, Yamamoto T (2008) Loss of glenohumeral internal rotation in little league pitchers: a biomechanical study. J Shoulder Elbow Surg 17:795–801CrossRefPubMed
25.
Zurück zum Zitat Ruotolo C, Price E, Panchal A (2006) Loss of total arc of motion in collegiate baseball players. J Shoulder Elbow Surg 15:67–71CrossRefPubMed Ruotolo C, Price E, Panchal A (2006) Loss of total arc of motion in collegiate baseball players. J Shoulder Elbow Surg 15:67–71CrossRefPubMed
26.
Zurück zum Zitat Shanley E, Thigpen CA, Clark JC, Wyland DJ, Hawkins RJ, Noonan TJ, Kissenberth MJ (2012) Changes in passive range of motion and development of glenohumeral internal rotation deficit (GIRD) in the professional pitching shoulder between spring training in two consecutive years. J Shoulder Elbow Surg 21:1605–1612.CrossRefPubMed Shanley E, Thigpen CA, Clark JC, Wyland DJ, Hawkins RJ, Noonan TJ, Kissenberth MJ (2012) Changes in passive range of motion and development of glenohumeral internal rotation deficit (GIRD) in the professional pitching shoulder between spring training in two consecutive years. J Shoulder Elbow Surg 21:1605–1612.CrossRefPubMed
27.
Zurück zum Zitat Tehranzadeh AD, Fronek J, Resnick D (2007) Posterior capsular fibrosis in professional baseball pitchers: case series of MR arthrographic findings in six patients with glenohumeral internal rotational deficit. Clin Imaging 31:343–348CrossRefPubMed Tehranzadeh AD, Fronek J, Resnick D (2007) Posterior capsular fibrosis in professional baseball pitchers: case series of MR arthrographic findings in six patients with glenohumeral internal rotational deficit. Clin Imaging 31:343–348CrossRefPubMed
28.
Zurück zum Zitat Torres RR, Gomes JL (2009) Measurement of glenohumeral internal rotation in asymptomatic tennis players and swimmers. Am J Sports Med 37(5):1017–1023CrossRefPubMed Torres RR, Gomes JL (2009) Measurement of glenohumeral internal rotation in asymptomatic tennis players and swimmers. Am J Sports Med 37(5):1017–1023CrossRefPubMed
29.
Zurück zum Zitat Trakis JE, McHugh MP, Caracciolo PA, Busciacco L, Mullaney M, Nicholas SJ (2008) Muscle strength and range of motion in adolescent pitchers with throwing-related pain: implications for injury prevention. Am J Sports Med 36:2173–2178CrossRefPubMed Trakis JE, McHugh MP, Caracciolo PA, Busciacco L, Mullaney M, Nicholas SJ (2008) Muscle strength and range of motion in adolescent pitchers with throwing-related pain: implications for injury prevention. Am J Sports Med 36:2173–2178CrossRefPubMed
30.
Zurück zum Zitat Wagner H, Pfusterschmied J, von Duvillard SP, Müller E (2011) Performance and kinematics of various throwing techniques in team-handball. J Sports Sci Med 10:73–80PubMedPubMedCentral Wagner H, Pfusterschmied J, von Duvillard SP, Müller E (2011) Performance and kinematics of various throwing techniques in team-handball. J Sports Sci Med 10:73–80PubMedPubMedCentral
31.
Zurück zum Zitat Wilk KE, Macrina LC, Fleisig GS, Porterfield R, Simpson CD, Harker P, Andrews JR (2011) Correlation of glenohumeral internal rotation deficit and total rotational motion to shoulder injuries in professional baseball pitchers. Am J Sports Med 39:329–335CrossRefPubMed Wilk KE, Macrina LC, Fleisig GS, Porterfield R, Simpson CD, Harker P, Andrews JR (2011) Correlation of glenohumeral internal rotation deficit and total rotational motion to shoulder injuries in professional baseball pitchers. Am J Sports Med 39:329–335CrossRefPubMed
32.
Zurück zum Zitat Wilk KE, Reinold MM, Macrina LC, Porterfield R, Devine KM, Suarez K, Andrews JR (2009) Glenohumeral internal rotation measurements differ depending on stabilization techniques. Sports Health (London) 1:131–136CrossRef Wilk KE, Reinold MM, Macrina LC, Porterfield R, Devine KM, Suarez K, Andrews JR (2009) Glenohumeral internal rotation measurements differ depending on stabilization techniques. Sports Health (London) 1:131–136CrossRef
33.
Zurück zum Zitat Yamaguchi K, Sher JS, Andersen WK, Garretson R, Uribe JW, Hechtman K, Neviaser RJ (2000) Glenohumeral motion in patients with rotator cuff tears: a comparison of asymptomatic and symptomatic shoulders. J Shoulder Elbow Surg 9:6–11CrossRefPubMed Yamaguchi K, Sher JS, Andersen WK, Garretson R, Uribe JW, Hechtman K, Neviaser RJ (2000) Glenohumeral motion in patients with rotator cuff tears: a comparison of asymptomatic and symptomatic shoulders. J Shoulder Elbow Surg 9:6–11CrossRefPubMed
Metadaten
Titel
Rotational glenohumeral adaptations are associated with shoulder pathology in professional male handball players
verfasst von
Przemyslaw Lubiatowski
Piotr Kaczmarek
Pawel Cisowski
Ewa Breborowicz
Monika Grygorowicz
Marcin Dzianach
Tomasz Krupecki
Lior Laver
Leszek Romanowski
Publikationsdatum
15.02.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 1/2018
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-017-4426-9

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