Abstract
A glenohumeral internal rotation deficit (GIRD) of the shoulder, is associated with an increased risk of shoulder injuries in tennis athletes. The aim of the present study was to reveal the impact of 1) age, sex, specific training data (i.e. training volume, years of tennis practice, years of competitive play) and 2) upper extremity injuries on GIRD in youth competitive tennis athletes.A cross-sectional retrospective study design was adopted. Youth tennis players (n = 27, 12.6 ± 1.80 yrs., 18 male) belonging to an elite tennis squad were included. After documenting the independent variables (anthropometric data, tennis specific data and history of injury), the players were tested for internal (IR) and external (ER) shoulder rotation range of motion (RoM, [°]). From these raw values, the GIRD parameters ER/IR ratio and side differences and TRoM side differences were calculated. Pearson’s correlation analyses were performed to find potential associations of the independent variables with the GIRD outcomes.A significant positive linear correlation between the years of tennis training and IR side asymmetry occurred (p < .05). A significant negative linear relation between the years of tennis training and the ratio of ER to IR range of motion (RoM) in the dominant side (p < .05) was found. The analysis of covariance showed a significant influence of the history of injuries on IR RoM (p < .05).Injury and training history but not age or training volume may impact on glenohumeral internal rotation deficit in youth tennis athletes. We showed that GIRD in the dominant side in youth tennis players is progressive with increasing years of tennis practice and independent of years of practice associated with the history of injuries. Early detection of decreased glenohumeral RoM (specifically IR), as well as injury prevention training programs, may be useful to reduce GIRD and its negative consequences.
Highlights
Shoulder injuries are the most common upper limb injuries in professional tennis athletes [1]
Two players had a history of upper extremity injuries at their dominant side, one athlete showed an injury in the non-dominant arm (1x bursitis, 1x fracture of collarbone, 1x impingement) and three showed bilateral orthopedic abnormalities in their shoulder girdle (2x misalignment of the shoulders, 1x Scapula alata) prior to those 3 months
Hypothesis testing and comparison with existing evidence The results showed an increase in side-to-side shoulder internal rotation (IR) range of motion (RoM) difference and a decrease in the External rotation (ER)/IR RoM ratio with increasing years of tennis training but not with age, years of competitive play, or training volume
Summary
Shoulder injuries are the most common upper limb injuries in professional tennis athletes [1]. A permanent tightness of the posterior rotator cuff, muscles and tendons, lead to alterations in scapular and humeral kinematics and in a stable change in shoulder motion of tennis athletes [5,6,7] More precise, these physiological adaptations often result in a decreased internal rotation (IR) range of motion (RoM) of the shoulder joint. Kalo et al BMC Musculoskeletal Disorders (2020) 21:553 combined with a decreased total range of motion (TRoM) of the dominant compared to the nondominant limb [8] This glenohumeral internal rotation deficit (GIRD), is associated with an increased risk for shoulder injuries [9,10,11,12,13] and might have an impact on the performance of youth tennis players [14]. Rose and Noonan [16] defined a pathological GIRD as the loss of glenohumeral IR combined with a loss in TRoM greater than 5 degrees
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