Incidence Of Shoulder Injuries Research Articles

Shoulder Injury Incidence and Epidemiology in Youth, High School, and Collegiate Fastpitch Softball Players: A Systematic Review and Future Research Perspectives.

Fastpitch softball is one of the most popular sports in the United States among young female athletes. Softball players regularly subject their shoulders to extreme range of motion and high velocity movements. To date, no systematic review has reported on the epidemiology and incidence of shoulder injuries in softball players. To describe the incidence and epidemiology of softball-related shoulder injuries in youth, high school, and collegiate female softball players. PubMed, Web of Science, and Embase were searched for relevant English language articles from 1980 to 2023. Studies selected based on predefined inclusion criteria. Studies were required to be available full text, in English. Systematic review. Level 4. A preliminary screening was performed based on study title and abstract. In the subsequent screening, the full text versions of the remaining articles were evaluated by 2 reviewers for the fulfillment of the inclusion criteria. A total of 7 articles met criteria for inclusion. All studies evaluated injuries among softball players for at least 1 season. In total, there were 1107 softball-related shoulder injuries reported in the 7 studies included in this systematic review. Of the 3 studies that included a shoulder injury rate, a mean rate of 4.01 shoulder injuries per 10,000 athlete-exposures was calculated. The 2 most common shoulder injuries were shoulder muscle-tendon strains (297) and shoulder/biceps tendinitis (220). High-level prospective studies reporting injury incidence and risk factors among female softball players are extremely limited. Only 2 studies eligible for inclusion in this systematic review were prospective in nature, with neither of these reporting the specific injury rate for shoulder injuries among softball players.

Effectiveness of a twelve-week manual therapy intervention for shoulder injury prevention and management in female volleyball players

Purpose: This study aimed to assess the efficacy of a twelve-week manual therapy intervention in preventing and managing shoulder injuries among female volleyball players through a randomized controlled trial. Material and Methods: Forty college female volleyball players aged 18-25 years with a history of shoulder pain or dysfunction were recruited and randomly assigned to either a manual therapy intervention group or a control group. The intervention group received a comprehensive manual therapy program, including soft tissue mobilization, joint mobilization, and tailored exercise therapy, administered by a licensed physical therapist. Outcome measures, including shoulder range of motion, strength, pain levels, functional performance, and incidence of shoulder injuries, were assessed at baseline, post-intervention (twelve weeks), and follow-up (three months post-intervention). Statistical analysis was conducted using Paired t-tests and Wilcoxon Signed-Rank Tests. Results: Significant improvements were observed in shoulder range of motion, strength, and functional performance in the intervention group compared to the control group at post-intervention and follow-up assessments. Specifically, the intervention group exhibited notable enhancements in shoulder range of motion and strength. Moreover, a significant reduction in baseline pain levels was observed among participants in the intervention group. Conclusions: The findings suggest that a comprehensive twelve-week manual therapy program holds promise in effectively addressing shoulder injuries among female volleyball players. Manual therapy techniques, including soft tissue and joint mobilization, alongside tailored exercise therapy, may serve as valuable adjuncts to traditional preventive strategies in sports injury management.

Increased Elbow and Olecranon Injury History in Professional Pitchers With Increased Elbow Flexion at Ball Release

Background: Elbow flexion at late portions of the pitch has been associated with increased elbow varus torque, a kinetic surrogate associated with injury risk. Direct examinations of injury incidence with elbow flexion angles have not been conducted in professional pitchers. Purpose: To compare elbow and shoulder injury incidence among professional baseball players stratified by degree of elbow flexion at ball release (BR). Study Design: Descriptive laboratory study. Methods: Professional pitchers (N = 314) were instructed to pitch between 8 and 12 fastballs while being evaluated using motion capture technology. Upper extremity injury incidence was recorded upon interview. Pitchers were subsequently subdivided into 3 groups based on increasing elbow flexion at BR. Analysis of variance was used to compare participant characteristics and kinematic and peak kinetic variables. An odds ratio (OR) was calculated to determine the risk of having a previous upper extremity injury based on the degree of elbow flexion at BR. Results: A total of 116 pitchers (132 documented injuries) had a previous upper extremity injury, with elbow injury (76 injuries; 57.6%) being the most common. Evaluation of kinetic values showed that pitchers with the smallest elbow flexion at BR had significantly less peak elbow flexion torque than did those with greatest elbow flexion at BR (3.8 ± 0.5 vs 4.1 ± 0.6 %weight × height; P = .003). Pitchers who demonstrated a greater than average degree of elbow flexion at BR when pitching were more likely to have a history of elbow injury (OR, 1.97; 95% CI, 1.14-3.40; P = .015) and olecranon spur formation or stress fracture (OR, 5.79; 95% CI, 1.25-26.85; P = .025). Conclusion: Pitchers with greater elbow flexion at BR had significantly higher odds of previous injury of the elbow and olecranon. Increasing elbow flexion has been shown to place the medial elbow in a position to carry a greater amount of load, which may be exacerbated during the final moments of the pitching motion. Professional pitchers can consider decreasing elbow flexion at BR as a potential, modifiable risk factor for elbow injury, in particular for olecranon spur formation and fracture. Clinical Relevance: This study attempts to associate injury incidence with a modifiable, kinematic variable for an at-risk population.

Epidemiology of Shoulder Injuries in Schoolboy Rugby Union in Ireland.

Background:The shoulder has been reported as a frequent location of injury in adult professional and amateur rugby, with match injury incidence rates ranging from 1.8 to 3 per 1000 player-hours (h). An increased understanding of the incidence and mechanism of shoulder injuries in school rugby players is vital to establish effective injury preventive strategies and advise on appropriate rehabilitation.Purpose:To describe the incidence, nature, and severity of shoulder injuries in schoolboy rugby in Ireland.Study Design:Descriptive epidemiology study.Methods:Injury surveillance was carried out for Senior Cup teams across two seasons (N = 665 players aged 17-19 years) in Ireland from 2018 to 2020. Match and training injury data were recorded using an online system by trained nominated injury recorders. Match exposure was also recorded.Results:Shoulder match injury incidence was 12.2 per 1000 h (95% CI, 9.1-16.2), with a mean severity of 47 days’ time loss and an overall burden of 573 days per 1000 h. In total, 47 match and 5 training shoulder injuries were recorded. The most common injuries were shoulder dislocations/subluxations (34%), followed by acromioclavicular joint sprains (30%). Shoulder dislocations/subluxations represented the most burdensome injury (280 days per 1000 h). The tackle accounted for the majority (81%) of shoulder injuries. Forwards sustained a significantly higher incidence of shoulder injuries (8.3/1000 h) in comparison with backs (3.9/1000 h), with a rate ratio of 2.13 (95% CI, 1.15-3.94; P = .015).Conclusion:We found a notably higher injury incidence rate in schoolboy rugby as compared with the adult amateur and professional game. Shoulder injuries were responsible for more days lost than any other injury, and shoulder dislocations were the most severe. This is of particular concern so early in a player’s career and warrants further investigation into potential risk factors and mechanisms associated with shoulder injuries in school-age players.

Predicting Shoulder Joint Reaction Forces From 3D Body Kinematics: A Convolutional Neural Network Approach

This study aimed to develop a convolutional neural network (CNN) model to predict shoulder joint reaction forces from 3D body kinematics. Results showed a good convergence between CNN model prediction and musculoskeletal model estimation for six novel tasks. Therefore, a CNN-based deep learning model can be used as a simple and relatively less time- and labor-intensive method to identify unsafe shoulder exertions in order to prevent the incidence of shoulder injuries or pathologies in occupational settings.

Correlation of scapulothoracic muscle strength and functional activity in volleyball players

<p class="abstract"><strong>Background:</strong> Volleyball is the game in which upper extremities are mostly involved. This game needs repeated forceful high-speed upper limb activities required during training sessions and matches; which are reported to high incidence of shoulder injuries. This study is to correlate scapulothoracic muscle strength and functional activity in volleyball players.</p><p class="abstract"><strong>Methods:</strong> Study is cross sectional; correlational study was done with convenient sampling. Sample size was 55. Subjects were selected from all over Pune. Scapulothoracic muscles strength was measured (using the handheld dynamometer) in volleyball players which fitted in the inclusion and exclusion criteria and filled disabilities of the arm, shoulder and hand (DASH) scale by every participant included in study. Correlated evaluated data using spearman rho method.</p><p class="abstract"><strong>Results: </strong>Study shows that all muscle carry good strength. Statistical analysis shows no significance, p value for all tested muscle is (p>0.05). Also DASH scale shows lesser score which indicates lesser difficulty to do functional activities.</p><p class="abstract"><strong>Conclusions: </strong>This study proves that there is no correlation between scapulothoracic muscle strength and functional activity in volleyball players.</p>

Comparing major joint injuries, interventions and late sequelae inelite male handball players with an age-matched control group.

Handball is a contact sport which involves throwing and jumping, exposing players to serious physical stress. There is a high risk of injuries leading to possible long-term sequelae. The aim of this study was to assess the incidence of musculoskeletal injuries in elite male handball players compared with an age-matched control group. Former elite handball players, who had played on the Swiss national team between 1980 and 1985, answered a questionnaire about injuries, surgical interventions and their current health status. A total of 34 athletes were compared with 58 age-matched volunteers, who only engaged in recreational sports or no sports at all. The mean age of the athletes was 58.4 years (range 52-68 years) and did not differ significantly from the mean age of the control group of 58.7 years (range 53-69 years). In the control group, 70 % engaged in recreational sports. There was no statistical difference regarding the life-long incidence of shoulder injuries and surgical interventions, sequelae or persistent shoulder pain. Athletes had more interventions after elbow injuries (0.09 vs. 0, p = 0.047), but the difference with respect to chronic pain or late sequelae was not statistically significant. For knee injuries, there were no significant differences regarding the incidence of injuries or interventions, the prevalence of secondary consequences or persistent pain. Concerning the foot and ankle, there was a significantly higher incidence of injuries (0.5 vs. 0.03, p < 0.001) and interventions (0.5 vs. 0.09, p < 0.001) in athletes, but no statistical difference regarding sequelae or persistent pain. Overall quality of life had identical ratings in both groups (athletes mean 85.9 %, controls mean 85.8 %). Top handball players did not sustain more shoulder or knee injuries than the age-matched control group. The elbow was more at risk in these top athletes, but long-term consequences appeared to be less severe. The most distinctive difference was seen in foot and ankle injuries. A career as an elite handball player had no adverse effect on the overall quality of life of elite handball players 25 to 30 years after retiring from professional sports.

The cricketer's shoulder and injury: Asymmetries in range of movement and muscle length.

BackgroundShoulder injuries in cricket are often undetected and untreated.ObjectivesTo determine whether there are associations between shoulder internal and external rotation range of movement (ROM), throwing arc (TA) ROM, glenohumeral internal rotation deficit (GIRD), external rotation gain (ERG), pectoralis minor muscle length and the incidence of shoulder injury during the first 3 months of a cricket season amongst provincial and club cricketers.MethodMale, actively participating, provincial and club cricketers were included in this prospective longitudinal cohort study. The independent variables included shoulder pain, which did not limit participation in cricket training and matches; shoulder external and internal rotation (ROM, TA ROM, GIRD and ERG) and pectoralis minor muscle length. Time-loss dominant shoulder injury was recorded for 3 months.ResultsNine of the 32 participants sustained dominant shoulder injuries. Initial non-time-loss shoulder pain during baseline testing was associated with time-loss in-season shoulder injury (p = 0.007). Statistically significant side-to-side differences were found for all of the independent variables (internal rotation ROM, TA ROM and pectoralis minor muscle length distance), with the exception of external rotation ROM, amongst the uninjured players.ConclusionNon-time-loss-defined shoulder pain in actively participating cricketers seems to be a precursor to time-loss shoulder injury. Asymmetries in ROM and pectoralis minor muscle length in uninjured cricketers may have a protective role to play in the case of shoulder injury.Clinical implicationsThe presence of shoulder pain and asymmetries in ROM should be investigated during the pre-season screening procedures, and early intervention should be implemented where appropriate.

Effect of an 8-week Indian clubbell strengthening programme on Handball players’ shoulder muscle strength and range of motion

Introduction: Overhead throwing sports players like cricketers and handball athletes undergo thousands of repeated shoulder rotations each playing season, predisposing their shoulders to heightened injury risk. Shoulder rotational range of motion and muscle strength maintenance have been advocated to prevent shoulder injury incidence. Indian clubbells are used as exercise equipment to improve shoulder range of motion and muscle strength. The physical dimensions of the Indian clubbells are advantageous as it permits the shoulder to be exercised in multiple planes of movement. Therefore the current study was aimed at investigating the effectiveness of an 8–week Indian clubbell exercise programme on shoulder rotational range of motion and muscle strength.

Sports-related acute shoulder injuries in an urban population

ObjectivesMore than a third of sports injuries involve the upper extremity. The primary aim was to quantify and describe sports-related shoulder injuries in a general population cohort. A secondary aim...

Shoulder injuries from birth to old age: A 1-year prospective study of 3031 shoulder injuries in an urban population

IntroductionShoulder injuries are commonly encountered in emergency departments. In spite of this, the epidemiology is only partly known, and soft tissue injuries in particular remain unclear. The aim of this study was to obtain an overview of shoulder injuries in a general population cohort, and to estimate the relative proportion of the main injury categories soft tissue injuries, fractures and dislocations, as well as their variation with age and gender. Patients and MethodsWe registered prospectively all patients admitted with a suspected shoulder injury at a combined casualty and primary health care facility during one year. The facility serves all hospitals and all citizens of Oslo. The patient-reported questionnaires, electronic patient records and radiology reports were examined. Results3031 shoulder injuries were registered from May 2013 through April 2014. The median age was 37 years (range 14 days–102 years), 51 years in women and 31 years in men (p < 0.001), 60% were male. The male/female shoulder injury incidence rate ratio in the 20–34 years age group was 3.6 (95%CI, 3.0 to 4.3; p < 0.001). Contrary, the female/male rate ratio above 75 years was 2.1 (95%CI, 1.6–2.8; p < 0.001). Almost half of the injuries were soft tissue injuries, 35% were fractures and 17% were dislocations. The age-stratified incidence rates differed substantially in men and women. Fractures dominated in children up to 10 years and in adults over 60 years, soft tissue injuries in the ages between. The highest dislocation incidence rates were found in young males. A rotator cuff tear was diagnosed in 4% of the injuries. ConclusionWhich shoulder structures that are affected by injury vary substantially with age and gender. The shoulder injury incidence rates of young men and the elderly are high. The findings are important for the understanding of the shoulder and the diagnostic process in A&Es.

Incidence of Shoulder Injury in Elite Wheelchair Athletes Differ Between Sports: A Critically Appraised Topic.

Clinical Scenario: Until recently, injury epidemiology data on elite Paralympic athletes were limited. Current data suggest high rates of shoulder injury in wheelchair athletes. Differences in shoulder injury rates between sports have not been reported in this population. Clinical Question: Is the incidence of shoulder injury in elite wheelchair athletes different between sports? Summary of Key Findings: Shoulder injury rates are high in elite wheelchair athletes, particularly in sports such as field events and fencing that require a stable base (eg,trunk, core control) from which to perform. Wheelchair racing requires repetitive motions that contribute to shoulder injuries, but rates are lower than field sports and fencing. Wheelchair curling and sledge hockey have low shoulder injury risk. Clinical Bottom Line: Shoulder injury rates vary based on sport in elite wheelchair athletes. In addition to incorporating shoulder complex specific rehabilitation for overuse shoulder injuries, clinicians should focus on core and trunk stabilization in elite wheelchair athletes competing in sports, such as field events and fencing. Strength of Recommendation: Grade C evidence exists that reports shoulder injury rates among elite wheelchair athletes differ based on sport participation.

An Investigation of Potential Factors Leading to Shoulder Injury in Adolescent Rugby Union Players: A Retrospective Cohort Study

Objectives: To investigate the association between potential factors that may lead to shoulder injury in adolescent male rugby union players. Methods: A self-administered questionnaire consisting of 10 standardised questions was used to investigate the incidence of shoulder injury in adolescent male rugby union players. Participants had previously partaken in a study by Rowland and colleagues in 2014 investigating shoulder range of motion, strength and generalised joint hypermobility. Data from the previous and current study was correlated in order to determine the relationship between the aforementioned variables and shoulder stability. Results: Twenty three (23) participants completed the questionnaire with 9 participants (39%) reporting a shoulder injury. No statistically significant association was found between shoulder injury and generalised joint hypermobility (p=0.32), average shoulder range of motion (p=0.38), body mass index (p=0.60) or hand dominance (p=0.53). A statistically significant association was observed between shoulder injury and shoulder muscle strength (p=0.04). Similarly, a statistically significant association was found between left shoulder flexion strength (p=0.03), right shoulder flexion (p=0.03), left shoulder abduction (p=0.03) and right shoulderinternal rotation at 90 degrees abduction (p=0.008). Conclusions: Reduced strength of the shoulder musculature appears to be associated with an increased risk of sustaining a shoulder injury in adolescent male rugby union players. However, it is inconclusive if overall generalised joint hypermobility along with increased active shoulder ranges of motion are associated withshoulder injury. Further investigations are required to determine if muscle strengthening programs are effective in reducing shoulder injuries.

A prospective cohort study identifying risk factors for shoulder injuries in adolescent elite handball players: the Karolinska Handball Study (KHAST) study protocol

BackgroundHandball is a physical contact sport that includes frequent overhead throwing, and this combination leads to a high rate of shoulder injuries. Several factors have been associated with shoulder injuries in overhead athletes, but strong scientific evidence is lacking for most suggested risk factors. We therefore designed the Karolinska Handball Study (KHAST) with the aim to identify risk factors for shoulder injuries in adolescent male and female elite handball players studying at handball-profiled secondary schools in Sweden. Secondary objectives are to investigate whether shoulder function changes during the competition season and whether the physical profile of the players changes during their time in secondary school.MethodsPlayers aged 15 to 19 years were included during the pre-season period of the 2014–2015 and the 2015–2016 seasons. At inclusion, players signed informed consent and filled in a questionnaire regarding playing position, playing level, previous handball experience, history of shoulder problems and athletic identity. Players also completed a detailed test battery at baseline evaluating the shoulder, neck and trunk. Players were then prospectively monitored weekly during the 2014–2015 and/or 2015–2016 competitive seasons regarding injuries and training/match workload. Results from the annual routine physical tests in the secondary school curriculum including bench press, deep squat, hand grip strength, clean lifts, squat jumps, counter movement jumps, <30 m sprints, chins, dips and Cooper’s test will be collected until the end of the competitive season 2017–2018. The primary outcome is the incidence of shoulder injuries and shoulder problems. The secondary outcome is the prevalence of shoulder injuries and shoulder problems.DiscussionShoulder problems are frequent among handball players and a reduction of these injuries is therefore warranted. However, in order to introduce appropriate preventive measures, a detailed understanding of the underlying risk factors is needed. Our study has a high potential to identify important risk factors for shoulder injuries in adolescent elite handball players owing to a large study sample, a high response rate, data collection during consecutive seasons, and recording of potential confounding factors.

Design of 3D knitted structures for impact absorption in sportswear

&lt;p&gt;Some sports involve frequent collisions between the players, and between a player and the playing surface, leading to injuries such as muscular strains, dislocations, sprains, lacerations, fractures and soft tissue injuries. In several instances, these injuries are so severe that they may cause bone fracture or dislocation of joints. In recent years, researchers are focusing on reducing these injuries by using protective gears and protective clothing to cover the torso, head, hands and legs. For rugby uniforms, shoulder pads are integrated to reduce the incidence of shoulder injury during the making or receiving of front-on tackles. Although some shoulder pads such as closed cell foams are commercially available, they are often discarded by the players due to their stiffness and discomfort. Hence, in this research an attempt was made to explore the potential of using flexible textile structures to replace the currently used commercial foam. Three flexible textile structures (A, B and C) were designed in three dimensional (3D) structure using Shima Seiki flatbed machine. Each fabric consisted of 3 layers, 2 external (face and back) and one internal layer. Fabric A consisted of mercerized cotton (space dyed) and Elastane external layers, whereas ballistic nylon internal layer. Fabrics B and C were prepared using Dyneema (untwisted) and Elastane external layers and Dyneema (untwisted) internal layer, but with different structures. These textile structures were analysed for their collision protection using the technique of ‘drop test’. The test was based on principle of energy absorption by the textile structure due to the impact of a hard surface with them. It was assumed that the higher is the energy absorbed by the textile structure, the smaller will be the impact to the wearer. It was found that the 3D structures can provide equivalent amount of impact protection as the commercial foam (Sample D). The flexible structures recover easily with the body movement, and provide a high level of comfort. The methods of drop-test including the results are discussed in this paper. The findings of this study suggested that an equivalent level of protection can be achieved with the use of 3D textile structures and higher amount of comfort for the rugby players. Hence, the 3D textile structures can be used as an alternative material to replace the commercial closed foam currently in use in the shoulder pad to achieve similar protection and improved thermal comfort.&lt;/p&gt;

EPIDEMIOLOGY OF INJURIES IN ENGLISH COMMUNITY LEVEL RUGBY UNION USING SMS PLAYER SELF-REPORTED DATA

BackgroundThe reporting of non-time loss injuries in community sport can be challenging due to infrequent contact between players and team medical staff. Text messaging or short messaging service (SMS) is...

Shoulder Injuries in Men’s Collegiate Lacrosse, 2004-2009

Background: Men’s lacrosse has been one of the fastest growing team sports in the United States, at both the collegiate and high school levels. Uniquely, it combines both continuous overhead and contact activity. Thus, an understanding of its injury epidemiology and mechanisms is vital. Shoulder injuries have been shown to be common in the sport, but thus far there has been no dedicated analysis of these injuries with which to better inform injury prevention strategies. Study Design: Descriptive epidemiology study. Methods: All athlete exposures (AEs) and shoulder injuries reported to the National Collegiate Athletic Association (NCAA) Injury Surveillance System for intercollegiate men’s lacrosse athletes from 2004-2005 through 2008-2009 were collected. Type of injury was documented and the injury incidence per 1000 AEs was calculated. Event type, injury mechanism, specific injury, outcome, and time lost were recorded. Statistical analysis was performed using 95% CIs, calculated based on a normal approximation to Poisson distribution. Results: There were a total of 124 observed shoulder injuries during 229,591 monitored AEs. With weights, this estimates 1707 shoulder injuries over 2,873,973 AEs, for an incidence of 0.59 per 1000 AEs (95% CI, 0.56-0.62). The incidence of shoulder injury during competition was 1.89 per 1000 AEs (95% CI, 1.76-2.02), compared with 0.35 per 1000 AEs (95% CI, 0.33-0.38) during practice. Acromioclavicular joint injuries were most common (0.29 per 1000 AEs; 95% CI, 0.27-0.31). Labral injuries and instability events were also frequent (0.11 per 1000 AEs; 95% CI, 0.10-0.13). Player-to-player contact caused 57% of all shoulder injuries, with 25% due to contact with the playing surface. The average time lost was 11.0 days, with 41.9% of all shoulder injuries requiring ≥10 days. Clavicle fractures and posterior shoulder dislocation were particularly severe, with no athletes returning to play during the same season. Conclusion: Shoulder injuries are common in NCAA men’s lacrosse and are an important source of lost playing time. Acromioclavicular injuries were the most frequent injury in this series, but labral and instability injuries were also common. In this increasingly popular contact sport, an understanding of the epidemiology and mechanism of shoulder injuries may be used to improve protective equipment and develop injury prevention.

Shoulder Injuries in English Community Rugby Union.

The aim of this study was to describe the incidence, severity and type of shoulder injuries resulting from match play in adult community rugby union between 2009-2013. A total of 254 time-loss shoulder injuries were reported, an overall incidence of 2.2 per 1 000 h (95% CI: 1.9 to 2.4), and a mean injury severity of 9.5 weeks missed (95% CI: 8.2 to 10.8). The semi-professional group had an incidence of 2.8 injuries per 1 000 h (95% CI: 2.2 to 3.5), which was higher than the recreational group at 1.8 injuries per 1 000 h (95% CI: 1.4 to 2.2, p=0.004). The incidence of acromioclavicular joint injury for semi-professional players was 1.2 per 1 000 h (95% CI: 0.8 to 1.6); which was significantly higher than the incidence of this injury type in recreational players (0.5 per 1 000 h 95% CI: 0.3 to 0.7, p=0.002). Overall, back row players sustained the highest incidence of all shoulder injuries for a given playing position, 2.9 injuries per 1 000 h (95% CI: 2.2 to 3.6). The tackle was the main event associated with injury. Injury prevention programs and coaching strategies that consider tackle technique and physical conditioning of the shoulder region are therefore considered important.

Reliability and Validity of EN-TreeM Dynamometer for Measurement of Shoulder Rotator Strength in Volleyball Players.

Volleyball involves repeated forceful arm actions that produce a high incidence of shoulder injury. Shoulder rotator strength ratio is an important predictor of the likelihood of shoulder injury, especially, secondary shoulder impingement and instability. Therefore, assessment of muscle strength of external and internal rotators of shoulder is imperative to establish the profiles of shoulder rotator performance, strength ratios, and shoulder mobility of volleyball players. To establish reliability and validity of EN-TreeM dynamometer for the measurement of shoulder rotators strength in volleyball players. Thirty male volleyball players aged 18-24 years, mean height 1.7m, weight 69.8 Kg and BMI 23.1 participated in the study. They performed 1RM (one repetition maximum) estimation protocols using EN-TreeM dynamometer and free weights for shoulder rotators, to investigate its concurrent validity. A retest using the same protocol was performed 48 hours later to assess test-retest reliability of the EN-TreeM dynamometer. The results yielded excellent test-retest reliability (ICC0.96) and internal consistency (Cronbach's alpha0.98) for both internal and external rotators. The concurrent validity was established using Pearson correlation coefficient (internal rotator r=0.45, p=0.01;External rotator r=0.38, p=0.03). The findings establish the reliability and concurrent validity of EN-TreeM dynamometer for the quantification of shoulder rotators strength. Based on these findings in volleyball players, EN-TreeM dynamometer can be used with confidence as an instrument for assessing muscle performance (strength). Additionally, it may also be used for monitoring changes due to rehabilitation interventions in shoulder injuries.

Shoulder injuries in elite rugby union football matches: Epidemiology and mechanisms.

Shoulder injuries in rugby union football have been the focus of few in-depth studies, despite their frequency and severity. The study's objective was to describe the incidence, patterns and mechanisms of shoulder injuries in rugby. Prospective cohort study of shoulder injury incidence and retrospective case-series study of shoulder injury mechanisms. Data were collected from Super Rugby matches from 2005 to 2010 involving elite level adult male rugby players. 7920 player participation hours and 100 shoulder injuries were recorded during 397 Super Rugby matches. The shoulder injury incidence rate was 13 per 1000 player hours (95% confidence interval 10-16). The mean number of days unavailable for selection due to these injuries was 37 (95% confidence interval 25-54). Tacklers sustained shoulder injuries at a higher rate than ball carriers (Rate Ratio=1.7 (95% confidence interval 0.5-5.3)). The most frequently reported injuries were those to the acromio-clavicular joint; dislocations resulted in the greatest amount of missed play. Using video analysis, 47 of the 100 shoulder injury events were successfully identified and analyzed. The main mechanisms of shoulder injury were contact with the ground with the shoulder/arm in horizontal adduction, flexion, and internal rotation; and impact to the lateral aspect of the shoulder with the elbow flexed and arm at the side. Direct impact to the shoulder, either through player-to-player contact or contact with the ground, is the main cause of shoulder injury. Methods to reduce injury risk, such as shoulder pads and tackle skills, require consideration.