Female adolescent elite handball players are more susceptible to shoulder problems than their male counterparts

Martin Asker,Eva Skillgate,Markus Waldén,Henrik Källberg,Lena W Holm

doi:10.1007/s00167-018-4857-y

Abstract

PurposeShoulder problems are frequent among senior elite handball players. The objective of this study was to assess the prevalence of shoulder problems among adolescent elite handball players and to investigate potential differences in gender, school grade, playing position and playing level.MethodsDuring the 2014 and 2015 pre-season periods, 471 players (age 15–18 years, 54% female) completed a comprehensive baseline questionnaire regarding history of any shoulder pain and shoulder problems experienced during the past season. The players were monitored weekly for one competition season (September–April) regarding shoulder problems and the amount of match and training. Generalised linear models with a binomial link function were used to calculate a prevalence ratio (PR) with 95% confidence interval (CI) to compare the subgroups of players.ResultsIn total, 110 players (23%) reported having substantial shoulder problems (defined as moderate/severe reduction in training volume, or moderate/severe reduction in performance, or complete inability to participate) at some point during the follow-up season, of which almost half reported complete inability to participate. Of those players reporting substantial problems, 43% (95% CI 39–48) did so for at least 3 consecutive weeks during the season. The prevalence was significantly higher in female players (PR 1.46, 95% 1.04–2.06) and in backcourt players (PR 1.58, 95% CI 1.08–2.32), but no differences were found for school grade (PR 1.21 95% CI 0.88–1.67) or playing level (PR 1.09 95% CI 0.76–1.56).ConclusionsThe prevalence of substantial shoulder problems in adolescent elite handball players is high, especially among females, and this warrants further studies on risk factors for shoulder injury and the development of prevention strategies in handball players already before the age of 15. These findings also highlight the importance of introducing a clinical monitoring programme on a routine basis and improving the medical support, taking gender-related aspects into consideration, at handball-profiled secondary schools.Level of evidenceII.

Highlights

Handball is a physically challenging sport that includes throwing, jumping, running and side-cutting movements as well as direct and indirect contact with opponents, which leads to a high injury rate [5]
81 players did not consent to participate in the study and another 26 players did not finish the follow-up, mainly due to quitting their studies at the handball-profiled school (Fig. 1)
The weekly prevalence of any shoulder problems and substantial shoulder problems, respectively, was 25% and 6%

Summary

Introduction

Handball is a physically challenging sport that includes throwing, jumping, running and side-cutting movements as well as direct and indirect contact with opponents, which leads to a high injury rate [5]. High prevalence of shoulder problems has been reported in both senior male and female elite players [1, 6, 16]. There is no study that has investigated the prevalence of shoulder problems among adolescent elite handball players, including potential associations with gender, school grade, playing position and playing level. The objective of this study was to assess the prevalence of shoulder problems, and especially substantial problems, in adolescent elite handball players and to investigate potential differences in gender, school grade, playing position, and playing level.

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Discussion

Conclusion