Format

Send to

Choose Destination
Br J Sports Med. 2017 Feb;51(4):231-237. doi: 10.1136/bjsports-2016-096927. Epub 2017 Jan 19.

Handball load and shoulder injury rate: a 31-week cohort study of 679 elite youth handball players.

Author information

1
Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark.
2
Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.
3
Sports medicine clinic, Orthopedic dep., Hospital of Lillebaelt Vejle-Middelfart, Institute of Regional Health Research and Center for Research in Childhood Health, University of Southern Denmark, Odense, Denmark.
4
Division of Sports Traumatology, Aarhus University Hospital, Aarhus, Denmark.
5
Oslo Sports Trauma Research Centre, Norwegian School of Sport Sciences, Oslo, Norway.

Abstract

BACKGROUND:

Knowledge of injury patterns, an essential step towards injury prevention, is lacking in youth handball.

AIM:

To investigate if an increase in handball load is associated with increased shoulder injury rates compared with a minor increase or decrease, and if an association is influenced by scapular control, isometric shoulder strength or glenohumeral range of motion (ROM).

METHODS:

679 players (14-18 years) provided weekly reports on shoulder injury and handball load (training and competition hours) over 31 weeks using the SMS, phone and medical examination system. Handball load in a given week was categorised into (1) <20% increase or decrease (reference), (2) increase between 20% and 60% and (3) increase >60% relative to the weekly average amount of handball load the preceding 4 weeks. Assessment of shoulder isometric rotational and abduction strength, ROM and scapular control was performed at baseline and midseason.

RESULTS:

An increase in handball load by >60% was associated with greater shoulder injury rate (HR 1.91; 95% CI 1.00 to 3.70, p=0.05) compared with the reference group. The effect of an increase in handball load between 20% and 60% was exacerbated among players with reduced external rotational strength (HR 4.0; 95% CI 1.1 to 15.2, p=0.04) or scapular dyskinesis (HR 4.8; 95% CI 1.3 to 18.3, p=0.02). Reduced external rotational strength exacerbated the effect of an increase above 60% (HR 4.2; 95% CI 1.4 to 12.8, p=0.01).

CONCLUSIONS:

A large increase in weekly handball load increases the shoulder injury rate in elite youth handball players; particularly, in the presence of reduced external rotational strength or scapular dyskinesis.

KEYWORDS:

Adolescent; Epidemiology; Load; Risk factor; Scapula

PMID:
28104592
DOI:
10.1136/bjsports-2016-096927
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center