Risk Factors For Shoulder Injuries Research Articles

Shoulder Check: Investigating Shoulder Injury Rates, Types, Severity, Mechanisms, and Risk Factors in Canadian Youth Ice Hockey.

To describe shoulder-related injury rates (IRs), types, severity, mechanisms, and risk factors in youth ice hockey players during games and practices. Secondary analysis of data from a 5-year prospective cohort study, Safe-to-Play (2013-2018). Canadian youth ice hockey. Overall, 6584 player-seasons (representing 4417 individual players) participated. During this period, 118 shoulder-related games and 12 practice injuries were reported. An exploratory multivariable mixed-effects Poisson regression model examined the risk factors of body checking policy, weight, biological sex, history of injury in the past 12 months, and level of play. Injury surveillance data were collected from 2013 to 2018. Injury rates with 95% confidence interval (CI) were estimated using Poisson regression. The shoulder IR was 0.35 injuries/1000 game-hours (95% CI, 0.24-0.49). Two-thirds of game injuries (n = 80, 70%) resulted in >8 days of time-loss, and more than one-third (n = 44, 39%) resulted in >28 days of time-loss. An 83% lower rate of shoulder injury was associated with policy prohibiting body checking compared with leagues allowing body checking (incidence rate ratio [IRR], 0.17; 95% CI, 0.09-0.33). A higher shoulder IR was observed for those who reported any injury in the last 12-months compared with those with no history (IRR, 2.00; 95% CI, 1.33-3.01). Most shoulder injuries resulted in more than 1 week of time-loss. Risk factors for shoulder injury included participation in a body-checking league and recent history of injury. Further study of prevention strategies specific to the shoulder may merit further consideration in ice hockey.

Shoulder muscle imbalance as a risk factor for shoulder injury in elite badminton players: A prospective study

ObjectivesTo assess the impact of preseason shoulder testing on the risk of significant shoulder injury (SSI) in elite badminton players. DesignProspective cohort study. SettingSecondary care, academic medical center. ParticipantsNineteen elite badminton players (19.37 ± 4.79 years, n = 13 males). Main outcome measuresAt preseason, they had shoulder examination tests including the table-to-acromion distance and the glenohumeral rotation range of motion. The glenohumeral internal rotation deficit (GIRD) was calculated. Isokinetic internal and external rotator shoulder muscle strength was tested at 60°/s (concentric and eccentric modes) and 240°/s (concentric mode). Bilateral strength ratio (non-dominant:dominant) and unilateral agonist:antagonist conventional and functional ratios (FR: eccentric-to-concentric) were calculated. ResultsDuring the follow-up time of 38 weeks, SSIs were assessed by an experienced sport physician and 42% of the participants sustained at least one SSI at their dominant side. The preseason GIRD and FR at 240°/s (FR240) were independently associated with SSIs (G2 = 6.28, p = .012 and G2 = 6.23, p = .013, respectively). FR240 < 0.69 (odds ratio = 28.0) and GIRD> 14° (odds ratio = 36.14) were predictors for SSIs. ConclusionsLower functional deceleration ratio and greater GIRD are associated with a higher risk of SSI at the dominant side in elite badminton players.

Risk factors for shoulder injuries in handball: systematic review

BackgroundHandball is a sport with a high number of severe injuries. The shoulder is one of the most commonly injured joints, with an average prevalence of 17–41%.ObjectiveThe primary aim is to identify the most significant risk factors related to shoulder injuries in handball. The secondary aim is to propose recommendations based on the available evidence concerning potential injury prevention strategies.MethodsSystematic searches of PubMed, MEDLINE, CINAHL, Proquest, SPORTDiscus, Web of Science, EMBASE, and Scopus were undertaken for peer reviewed articles published between 15 July 1995 and 15 July 2019. The same search strategy was repeated on 24 April 2022. Prospective cohort studies, written in English and published in a journal with a peer-review process aiming to investigate at least one modifiable or/and a non-modifiable potential risk factor for shoulder injuries, specifically in handball players, were included. Only papers published after 1995 were included. The methodological quality of the eligible studies was assessed using the modified version of the Downs and Black Checklist. The Best Evidence Synthesis (BES) approach was used for synthesizing and reporting the results.Results1849 studies were identified, of which 8 were included. A total of 2536 (males = 1354, females = 1182) participants of which 2522 were handball athletes, were included. Four of the eight studies were rated as high methodological quality studies (> 85%) while the rest were rated as medium (50–85%). The risk factors for shoulder injuries in handball identified in the studies were strength imbalances (n = 6), glenohumeral range of motion (ROM) imbalances (n = 5), scapular dyskinesis (n = 5), incorrect dosage of training load (n = 2), previous injury (n = 1), sex (n = 2), player’s position, school grade, playing level (n = 1), altered shoulder joint position sense (n = 1).ConclusionOverall, from all the risk factors evaluated, there was strong evidence that the weakness of the shoulder external rotator muscles and the female sex increase the probability of shoulder injury in handball athletes. Nevertheless, the evidence for the other risk factors was moderate due to the methodological quality and the limited number of studies.Protocol registration: PROSPERO ID: CRD42020138233.

The Epidemiology of Youth Sport-Related Shoulder Injuries: A Systematic Review.

Youth around the globe place their shoulders at risk for injury when participating in sports. Shoulder injuries may vary in severity, produce the potential for time-loss from sport, and result in functional disability. We sought to explore sport-related shoulder injuries in youth by identifying injury rates, risk factors, injury mechanisms, and injury prevention strategies. All relevant full-text articles were identified by searching MEDLINE, EMBASE, CINAHL, Sport Discus, and the Cochrane Controlled Trials Registry. No date restrictions were used. All full-text studies reporting original research describing sport-related shoulder injury among female and/or male youth from 5 to 18 years old were included. Of 3,889 studies screened, 97 described shoulder injury in youth sports. Shoulder injuries were identified in 24 unique sports. The median seasonal prevalence of shoulder injury was 10.9% (range 1.2-28.2%). The most common injury mechanisms identified were contacted with another player, contact with the playing environment, and falling to the ground. Risk factors for shoulder injury identified were side-to-side strength imbalances, weak external rotator muscles, and scapular dyskinesia. One study evaluated a successful training strategy to prevent shoulder injuries, but two other interventions demonstrated no effect. Sport-related shoulder injuries are prevalent among youth athletes. Injury risk factors identified included modifiable intrinsic factors such as strength, range of motion, and training load. The most common injury mechanism was direct contact with either another person or an object in the playing environment. Innovative shoulder-specific strategies are needed to reduce shoulder injuries in this population. Trial Registration: PROSPERO ID: CRD42020189142.

Isokinetic strength testing of shoulder rotators in collegiate throw ball players

Background and Objectives: Throwball involves repetitive shoulder rotations leading to the overuse of shoulder rotators causing several internal risk factors for shoulder problems. Reduction in the range and strength of shoulder rotators is major risk or cause for shoulder injuries. Hence, the primary objective of the study is to determining isokinetic strength of shoulder rotators in collegiate throwball payers. The secondary objectives are to determine the rotator strength on shoulder rotators in non-players and compare the strength between the two groups. Methods: Sample size was estimated to be 60 females between 18-25years, 30players (20.05+1.39) and 30 nonplayers (19.96+1.33); height (157.36+5.92 players; 158.18+5.38 non-players); weight (59.66+14.60 players; 63.24+12.63 non-players) participated in this cross-sectional study. Concentric and concentric peak torque of internal and external rotator ROM and strength was assessed. Three speeds of 1800/s, 1200/s and 600/s was used. Results: The dominant side presented higher mean values for peak torque for IR in players at all three speeds; the non-dominant side presented higher mean peak for in ER in both the groups at all three speeds. In the non-players group, the dominant limb presented higher mean peak torque values in IR at 1800/s and 600/s whereas the non-dominant limb presented higher peak for IR at 1200/s. However, only the mean peak torque of IR at 600/s had significant difference (15.65+3.23 for players; 13.2+3.54 for non-players) with p=0.02 and t-value=2.32. Interpretation and Conclusion: There was no significant difference between the players and non-players which implies that the players need to be trained for rotator strengthening especially external rotators as muscle strength imbalance between the agonist and antagonist is one of the major risk factors for shoulder injuries. The values obtained for the strength of the players can be used as reference for further studies for population-specific isokinetic data profile for both rehabilitation and prevention.

Are Rotator Muscle Performance and Posterior Shoulder Capsule Tightness Related to Glenohumeral Internal Rotation Deficit in Male College Baseball Players?

Posterior inferior capsule (PIC) tightness in the shoulder joint, a known risk factor for shoulder injury, can be assessed using shear-wave ultrasound elastography (SWE). However, to date, the correlation between PIC elasticity and shoulder rotator muscle performance in college baseball players with glenohumeral internal rotation deficit (GIRD) has not been reported. This study aimed to analyze the differences in PIC elasticity measured using SWE and shoulder rotator muscle performance between male college baseball players with and without GIRD. Twenty-four male college baseball players participated in this study: 10 with GIRD (G group) vs. 14 without GIRD (NG group). PIC elasticity was measured using SWE in the lateral decubitus position. Shoulder rotator muscle performance tests were performed for the internal rotators (IRs) and external rotators (ERs) at an angular velocity of 180°/sec with 90° shoulder abduction using an isokinetic test device. Mean PIC elasticity was significantly greater in the throwing shoulders of the G group than in those of the NG group (4.8 ± 1.2 kPa vs. 3.7 ± 1.2 kPa, p = 0.036). In the throwing shoulders of the G group, compared with those of the NG-group, the ER/IR ratio was significantly lower (35.7% ± 5.0% vs. 55.5% ± 6.2%, p < 0.001) and IR muscle strength was significantly greater (75.0 ± 7.6 Nm kg-1 × 100 vs. 55.7 ± 6.4 Nm kg-1 × 100, p = 0.002). The mean elasticity of the PIC showed a significant negative correlation with the ER/IR ratio in the throwing shoulders of the G group (r = -0.640, p = 0.046). Among the male college baseball players with GIRD, SWE could quantitatively assess PIC tightness, and an imbalance in shoulder rotator muscle strength was found in these baseball players. Therefore, clinicians and therapists need to focus on the restoration of shoulder rotator muscle imbalance in addition to improving internal rotation in these players.

Risk Factors of Shoulder and Elbow Injuries in Baseball: A Scoping Review of 3 Types of Evidence.

Background:Shoulder and elbow overuse injuries are the most common problems in baseball players. No scoping review has compared the findings from different types of evidence.Purpose:To map the broad evidence from 3 types of evidence (epidemiological, biomechanical, and narrative) on potential risk factors for shoulder and elbow injuries in baseball and identify gaps in the existing literature to guide future research.Study Design:Scoping review.Methods:Eight electronic databases were searched from inception to May 14, 2020. Any peer-reviewed papers that investigated or discussed potential risk factors for shoulder and elbow injuries in baseball were included.Results:A total of 302 studies (107 epidemiological studies, 85 biomechanical studies, and 110 narrative reviews) were included. Risk factors were categorized into 9 domains: sports profiles, physical characteristics/functions, pitching mechanics, performance, behavioral, psychosocial, biological and developmental, injury/sports profiles, and environmental factors. Studies were consistent in supporting limited shoulder range of motion (ROM) and player positions (pitchers or catchers) as risk factors for shoulder injuries. For elbow injuries, the majority of the included studies suggested that being pitchers or catchers and working with higher ball velocity can be risk factors.Conclusion:Findings were consistent in some risk factors, such as limited shoulder ROM and positions. However, findings were inconsistent or limited for most factors, and substantial research gaps were identified. Research assessing those factors with inconsistent or limited evidence in the current literature were recognized to be priorities for future studies.

Risk Factors for Shoulder Injuries in Water Polo: a Cohort Study.

BackgroundVery limited investigations have been conducted exploring risk factors for injury in water polo players. A gap remains in the literature regarding identification of variables that should be considered as part of player screening evaluations.PurposeTo estimate whether previous injury, changes in strength, range of motion (ROM) or upward scapular rotation (UR) are related to shoulder injuries in water polo players.Study DesignDescriptive cohort studyMethodsThirty-nine international-level players participated (19 males). Shoulder internal (IR) and external rotation (ER) peak torque was measured using an isokinetic device (CONtrex MJ). Shoulder ROM was measured passively using standard goniometry. Scapular UR was measured using a laser digital inclinometer. At baseline players were divided into groups: those with and without previous shoulder injuries. Independent t-tests and Mann-Whitney U tests were used to compare the study variables between groups. After nine months, a second analysis compared the same athletes, who were then grouped by those who had or had not sustained new injuries. Effect sizes were calculated with a Hedge’s g. Chi squared analysis compared proportion of injured players with and without previous injury.ResultsEighteen participants (46%) had previous injuries at baseline. Players with a previous injury showed higher peak torques for IR (0.62±0.15 vs 0.54±0.13N/kg, p=0.04, g=0.60); larger loss of IR ROM (9.9±9.1 vs 4.1±7.5°, p=0.04, g=0.68), but no statistical difference in UR (p=0.70). After nine months, there were no statistical strength differences between groups. Loss of IR ROM was significantly higher in the injured group (9.8±9.8 vs 4.0±6.7°, p=0.04, g=0.68), as well as UR (13.0±3.0 vs 10.4±3.3°, p=0.01, g=0.81). History of previous injury was significantly related to developing a new injury (OR 6.5, p=0.02). Logistic regression found previous injury and UR most important contributors to injury risk.ConclusionsPrevious injury, changes in IR ROM and UR are related to new shoulder injuries in water polo, but further variables such as rest, training load, or psychosocial factors may explain the incidence of new injuries.Level of EvidenceLevel 3

Are muscle weakness and stiffness risk factors of the development of rotator cuff tendinopathy in overhead athletes: a systematic review.

Background:Underlying muscle weakness and stiffness may increase the risk of developing rotator cuff tendinopathy. This systematic review aims to assess existing prospective studies to summarize whether muscle weakness and stiffness are risk factors for the development of rotator cuff tendinopathy in overhead athletes.Methods:A systematic search was performed using PRISMA guidelines. Prospective studies measuring muscle strength or stiffness and the incidence of rotator cuff tendinopathy were included. Quality assessment was performed with the Newcastle-Ottawa quality assessment scale.Results:The search yielded six studies, with a total of 523 trained overhead athletes followed up for one season. External rotation (ER) and internal rotation (IR) strength were described as protective factors against the development of rotator cuff tendinopathy. Athletes who did not sustain shoulder injuries had statistically stronger eccentric IR (p < 0.01) and ER (p < 0.05) strength in the pre-season assessment. Muscle stiffness indicated by limited range of motion of <106° for shoulder ER was described as a risk factor with an odds ratio of 1.12 (p < 0.001). Imbalance between ER and IR strength was reported as risk factors for shoulder injuries in two studies, with a relative risk of 2.57 (p < 0.05) reported in one study. Supraspinatus weakness was also reported as a risk factor for shoulder injuries in one study.Conclusion:Limited evidence support ER, IR weakness, limited ER range of motion, and very limited evidence support imbalance in ER/IR strength, and supraspinatus weakness as risk factors for rotator cuff tendinopathy in overhead athletes. No existing studies investigated the general population on this topic. Future cohort studies may improve on existing evidence with investigations on the general public, a longer follow-up time, clearly documented injury history, and a stringent diagnosis to rotator cuff tendinopathy.

Preseason shoulder rotational isokinetic strength and shoulder injuries in volleyball players

BACKGROUND: Rotator cuff weakness is considered an important risk factor for shoulder injuries in volleyball. OBJECTIVE: To evaluate association of shoulder preseason strength status with shoulder injury occurrence in subsequent season. METHODS: Volleyball players (N= 181; 99 men) from Slovenian 1st and 2nd national league volunteered to participate in this prospective cohort study. Preseason isokinetic testing of the shoulder was conducted at 60∘/s in the concentric mode of contraction over a RoM of 60∘ with five repetitions of internal (IR) and external (ER) rotation. During the subsequent season the players reported shoulders injuries through a weekly questionnaire. RESULTS: During the season we have registered 14 (7.7%) shoulder injuries (10 in men). All injuries affected the dominant shoulder. There was significant preseason weakness of ER and lower ER/IR strength ratio in players with shoulder injury. Normal strength ratio ER/IR was a significant protective factor (Exp (B) = 0.217, 95% C.I. 0.058–0.811) for shoulder injury occurrence when controlled for sex and previous injury. CONCLUSIONS: The inclusion of systematic strengthening of the external rotators of the shoulder is necessary, especially for male volleyball players, as part of preventive measures for the prevention of shoulder injuries.

Scapular Dyskinesis Is Not an Isolated Risk Factor for Shoulder Injury in Athletes: A Systematic Review and Meta-analysis

Background: Scapular dyskinesis has been considered a risk factor for athletic shoulder injury; however, findings in the prospective literature have demonstrated mixed results. Purpose: To determine if scapular dyskinesis increases the risk of shoulder injury in athletes. Study Design: Meta-analysis. Methods: A systematic search was conducted on the MEDLINE, CINAHL Plus, SPORTDiscus, and Embase databases to identify prospective studies examining scapular dyskinesis and shoulder injury risk in athletes. Studies were included if they assessed participants using a dynamic scapular assessment at baseline and monitored for the development of shoulder injury. Data from the studies were subject to meta-analysis using the Mantel-Haenszel method to produce a pooled risk ratio. Results: Seven studies were eligible for inclusion, resulting in 212 shoulder injuries observed across 923 athletes. Scapular dyskinesis was present in 46% of participants, and these athletes had an injury rate of 25%. The presence of scapular dyskinesis displayed a trend to increase the risk of shoulder injury, but this was not statistically significant (risk ratio, 1.07; 95% CI, 0.85-1.34; P = .59). Conclusion: Scapular dyskinesis was not significantly associated with the development of shoulder injury in athletes. Registration: CRD42019133089 (PROSPERO).

Correlation of glenohumeral internal rotation deficit with shear wave ultrasound elastography findings for the posterior inferior shoulder capsule in college baseball players

The glenohumeral internal rotation deficit (GIRD), primarily caused by the tightness of the posterior capsule, is a major risk factor for shoulder injuries in overhead throwing athletes. Quantitative evaluation of posterior capsular thickness and tightness can help determine the relationship between the posterior inferior capsule and GIRD. One previous study has assessed posterior capsule tightness using shear wave elastography (SWE), in college baseball players; however, it did not address the cutoff value of capsular elasticity that could be considered as abnormal capsular tightness. We aimed to re-evaluate effectiveness of SWE in quantifying posterior shoulder capsule tightness in college baseball players and determine the cutoff value of abnormal capsular elasticity that can predict impending throwing-related shoulder injuries associated with GIRD. Twenty-four college baseball players were enrolled in this study. External and internal rotation of the shoulder joint was assessed. The participants were classified into the GIRD group if their throwing shoulder showed >20° of internal rotation loss compared with their nonthrowing shoulder. In a longitudinal ultrasonographic scan of the posterior inferior capsule, shear wave (SW) velocity and thickness were measured at the point nearest to the labrum on both shoulders. Of the 24 subjects, 6 had a GIRD. The mean value of the SW velocity in the throwing shoulder was greater in the GIRD group than in the non-GIRD group (P = .006). The SW velocity difference between the throwing and nonthrowing shoulder was also greater in the GIRD group than in the non-GIRD group (P < .001). There was no significant difference in the thickness of the posterior inferior capsule between both groups. In correlation analysis, the difference in the SW velocity was more strongly correlated with the GIRD than with the SW velocity in the throwing shoulder. When we assume that a 20° GIRD is indicative of a shoulder at risk, the cutoff SW velocity in the throwing shoulder is 4.81 m/s and the SW velocity difference is 0.77 m/s. The SW velocity is closely associated with posterior shoulder capsular tightness and may be of quantitative value in baseball players.

Efficacy of throwing exercise with TheraBand in male volleyball players with shoulder internal rotation deficit: a randomized controlled trial

BackgroundThe Glenohumeral internal-rotation deficit (GIRD) is related to the altered eccentric external-rotator (ER), the concentric internal-rotator (IR), muscle strength, and the ER: IR ratio. GIRD has been documented as a risk factor for shoulder injuries. However, few studies have investigated the effect of an exercise training on these parameters in athletes with GIRD. Therefore, the purpose of this study was to evaluate the effects of an 8-week throwing exercise with a TheraBand for retraining the rotator cuff on Electromyography (EMG) activity of selected muscles, rotator cuff muscle strength, the glenohumeral (GH) joint IR range of motion (ROM) and GH joint position sense in asymptomatic male volleyball players with GIRD.MethodsSixty male volleyball players with GIRD were randomized into either a training group or a control group. The experimental group underwent an 8-week throwing exercise with a TheraBand including 5 sessions of stretching and 3 sessions of strengthening exercises per week. The control group received an active self-exercise program. EMG (onset time and muscle activation), shoulder range of motion (ROMs), strength and GH joint position sense were all assessed pre and post trainings.ResultsThere were statistically significant within-group differences in the EMG activity of the anterior deltoid (p = 0.005), middle deltoid (p = 0.007), posterior deltoid (p = 0.004), infraspinatus (p = 0.001) and supraspinatus (p = 0.001) muscles, IR ROM (p = 0.001), rotator cuff muscle strength ratio (p = 0.001), and GH joint position sense (p = 0.033) in the experimental group. A 2 × 2 analysis of variance with a mixed model design and independent and paired t-tests were used for statistical analysis.ConclusionsThrowing exercise with a TheraBand improved shoulder muscle activation, IR ROM, rotator cuff muscle strength ratio and GH joint position sense in participants with GIRD. These findings may improve the treatment of GIRD in a clinical setting. Although the results are significant, further studies should follow up the long-term effects of the Throwing exercise with a TheraBand on GIRD.Trial registrationCurrent Controlled Trials using the UMIN-RCT website with ID number of, UMIN000038416 “Retrospectively registered” at 2019/10/29.

The Self-Assessment Corner for Shoulder Strength: Reliability, Validity, and Correlations With Upper Extremity Physical Performance Tests.

Rotator cuff weakness and rotation ratio imbalances are possible risk factors for shoulder injury among overhead athletes. In consensus statements, organizations have highlighted the importance of a screening examination to identify athletes at risk of injury. The screening should be portable and designed to be feasible in many different environments and contexts. To evaluate the reliability and validity of the Self-Assessment Corner (SAC) for self-assessing shoulder isometric rotational strength and examining whether performance on 2 physical performance tests was correlated with isometric shoulder rotational strength using the SAC in handball players. Cross-sectional study. Sport setting. A first sample of 42 participants (18 men, 24 women) was recruited to determine the reliability and validity of the SAC. In a second sample of 34 handball players (18 men, 16 women), we examined correlations between physical performance tests and the SAC. The SAC was used to measure isometric rotational strength with the upper extremity at 90° of abduction in the frontal plane and 90° of external rotation and the elbow flexed to 90° with neutral rotation of the forearm. The SAC findings were compared with those from manual testing. Results from the seated medicine ball throw (SMBT) and closed kinetic chain upper extremity stability test (CKCUEST) were used to establish relationships with the SAC. We calculated intraclass correlation coefficients to determine relative reliability and used standard error of measurement and minimal detectable change to quantify absolute reliability. Relationships among the different strength-testing procedures and with the physical performance tests were determined using the Pearson product moment correlation coefficient (r) or Spearman rank correlation coefficient (rs). We observed good to excellent reliability (intraclass correlation coefficient [2,k] range = 0.89 to 0.92). The standard error of measurement varied from 3.45 to 3.48 N. The minimal detectable change with 95% confidence intervals ranged from 8.06 to 8.13 N. Strong correlations were present among strength procedures (r = 0.824, rs range = 0.754-0.816). We observed moderate to strong correlations between the CKCUEST findings and rotational strength (r range = 0.570-0.767). Moderate correlations were found between rotational strength and SMBT (r range = 0.573-0.626). The SAC is a clinically applicable and standardized protocol for self-assessing rotational strength in young healthy adults without pathologic conditions. Performance on the SMBT and CKCUEST may be valuable as a screening tool to further assess shoulder strength.

Kinesiotaping for scapular dyskinesis: The influence on scapular kinematics and on the activity of scapular stabilizing muscles

Scapular dyskinesis is observed in 61% of overhead athletes (Burn et al., 2016). For most of them, it remains asymptomatic. However, scapular dyskinesis is considered a risk factor for shoulder injury by some authors (Clarsen et al., 2014). The aim of this study is to explore the effectiveness of kinesiotaping in modifying scapular kinematics and peri-scapular muscle activity in dyskinetic athletes. The 3-dimensional position and orientation of the scapula as well as the activation of upper trapezius, lower trapezius and serratus anterior were recorded in twenty asymptomatic athletes during shoulder movements (flexion and abduction), in loaded and unloaded conditions and in three circumstances (standard, kinesiotaping 1, kinesiotaping 2). A significant decrease between 9 and 12% in upper trapezius activity was observed with kinesiotaping 1 and 2. Lower trapezius activity was slightly increased with kinesiotaping 1 while it was significantly decreased about 15–20% with kinesiotaping 2. No change was observed in serratus anterior activity, for either kinesiotaping 1 or 2. Considering scapular kinematics, both kinesiotaping 1 and 2 significantly increased posterior tilt and upward rotation. External rotation was decreased with kinesiotaping 2, in comparison to standard condition. Kinesiotaping, and especially taping 1, seems to be an effective method for changing periscapular muscle activity and scapular kinematics.

Reduced shoulder strength and change in range of motion are risk factors for shoulder injury in water polo players

ObjectiveTo determine whether pre-season shoulder ROM and strength can be used to identify athletes at risk of future shoulder injury. DesignProspective cohort. SettingHigh performance sports institute. Participants76 sub-elite water polo players. Main outcome measuresMean pre-season shoulder internal (IR) and external rotation (ER) ROM and strength values compared by gender, dominance and prospective injury status. Results14-dominant shoulder injuries were recorded. There was a significant difference (p = 0.05) in total ROM difference (TROM) between the prospectively injured and no injury groups (−17.2°(30.4);-0.8°(13.3)), and dominant side ER strength (11.7%(2.4) vs 14.5%(2.8), p = 0.03) and IR strength (16.5%(3.0) vs 21.6%(4.9) as a percentage body weight (PBW) were also significantly different (p ≤ 0.03). Separate significant associations were found between future episodes of shoulder injury and; dominant shoulder TROM difference of ≥7.5°(OR 3.6,95%CI 0.8–16.0), ER strength as a PBW≤12.5%(OR 5.2,95%CI 1.0–27.9), and IR strength as a PBW≤16.8%(OR 13.8,95%CI 2.2–88.0). ConclusionPre-season dominant TROM difference, and reduced shoulder IR and ER strength relative to body weight were significant predictors for future shoulder injury. Although further investigation with a larger sample size is required, achieving optimal values on these measures may reduce future episodes of shoulder injury in water polo players.

Evaluation of Shoulder Strength and Kinematics as Risk Factors for Shoulder Injury in United States Special Forces Personnel.

Background:Musculoskeletal injuries at the shoulder are highly prevalent and place a large burden on United States Special Forces personnel. Literature is lacking regarding the risk factors for these types of injuries.Purpose/Hypothesis:The purpose of this study was to evaluate the association of shoulder strength and kinematic characteristics, which have shown retrospective associations with shoulder conditions/injuries, with prospectively collected shoulder injuries. We hypothesized that lower strength and abnormal kinematics would be predictive of future shoulder injury.Study Design:Case-control study; Level of evidence, 3.Methods:A total of 140 male Special Forces operators underwent a musculoskeletal evaluation of the shoulder that included a scapular kinematic assessment during a humeral elevation task and isokinetic strength testing of the scapular protractors/retractors, external/internal rotators, and elevators of the shoulder. From strength assessments, ipsilateral strength ratios and bilateral strength asymmetries were also calculated. Musculoskeletal injuries of the shoulder were collected prospectively by use of medical chart reviews at 365 days following the evaluation. Separate generalized estimating equations (GEEs) and simple logistic regressions were used to analyze the association between baseline predictors and development of shoulder injury.Results:Results of the GEEs showed no significant prediction of shoulder injury by shoulder strength (odds ratio [OR], 1.00-1.03), ipsilateral strength ratios (OR, 0.43-2.12), or scapular kinematics (OR, 0.99-1.01). Logistic regression indicated that none of the bilateral asymmetries were significantly predictive of shoulder injury (OR, 1.00-1.04).Conclusion:The results indicate that shoulder strength and kinematic characteristics are not risk factors for shoulder injury in the Special Forces population. These findings are in opposition to the general findings of previous research using a retrospective analysis.

Asymmetry of dominant and non-dominant shoulders in university level men and women volleyball players

PurposeVolleyball involves repetitive forceful actions predominantly of one arm, which could eventually lead to an injury or shoulder pathology. The aim of the study was to compare the range of motion and strength in the dominant and non-dominant shoulders of university level volleyball players, with the objective of examining any differences between sexes.MethodsA total of 19 university level volleyball players (9 men: 81.3 ± 8.0 kg, 21 ± 1 years; 10 women: 66.0 ± 8.2 kg, 19 ± 1 years) participated. The passive internal and external range of motion of the dominant and non-dominant spiking shoulders were measured with a goniometer. The shoulder strength tests were performed on an isokinetic dynamometer at the speed of 60°/s in the concentric mode of contraction. Shoulder internal and external rotator concentric strength, range of motion, and internal/external rotation strength ratios were tested between arm dominance and sex with the use of 2-way mixed design ANOVA.ResultsInternal and external rotation strength was asymmetrical in both men and women, in favour of the dominant side (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Both men and women displayed asymmetrical external/internal ratios (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), with greater ratios present in the non-dominant side.ConclusionsUniversity level men and women volleyball players exhibit similar levels of significant asymmetry in the internal/external rotation strength between dominant and non-dominant spiking arms. Furthermore, subject-specific responses in strength asymmetries suggest further investigation at the individual level. Isokinetic shoulder screening could be used to reveal information about possible risk factors for shoulder injuries.

Reduced shoulder strength and change in range of motion are risk factors for shoulder injuries in sub-elite water polo players

Reduced shoulder strength and change in range of motion are risk factors for shoulder injuries in sub-elite water polo players

Risk Factors for Elbow and Shoulder Injuries in Adolescent Baseball Players: A Systematic Review

Background: The incidence of shoulder and elbow injuries among adolescent baseball players is on the rise. These injuries may lead to surgery or retirement at a young age. Purpose: To identify independent risk factors for elbow and shoulder injuries in adolescent baseball players. A secondary aim was to determine whether the literature supports the Major League Baseball and USA Baseball Pitch Smart guidelines. Study Design: Systematic review. Methods: A systematic review was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines utilizing MEDLINE, SPORTDiscus, and Web of Science. Because of study heterogeneity, a quantitative synthesis was not performed. A qualitative review was performed on 19 independent risk factors for elbow and shoulder injuries in adolescent baseball players. Level of evidence was assigned per the Oxford Centre for Evidence-Based Medicine Working Group, and risk of bias was graded per the Newcastle-Ottawa Scale. Results: Twenty-two articles met criteria for inclusion. Of the 19 independent variables that were analyzed, age, height, playing for multiple teams, pitch velocity, and arm fatigue were found to be independent risk factors for throwing arm injuries. Pitches per game appears to be a risk factor for shoulder injuries. Seven independent variables (innings pitched per game, showcase participation, games per year, training days per week, pitch type, shoulder external rotation, and shoulder total range of motion) do not appear to be significant risk factors. The data were inconclusive for the remaining 6 variables (weight, months of pitching per year, innings or pitches per year, catching, shoulder horizontal adduction, and glenohumeral internal rotation deficit). Conclusion: The results from this study demonstrate that age, height, playing for multiple teams, pitch velocity, and arm fatigue are clear risk factors for throwing arm injuries in adolescent baseball players. Pitches per game appears to be a risk factor for shoulder injuries. Other variables are either inconclusive or do not appear to be specific risk factors for injuries.