Shoulder Pain Research Articles

ANALYZING THE EFFECTIVENESS OF PROGRAMS ON SHOULDER FUNCTION IN PATIENTS WITH KINESIOPHOBIA.

Background: Involvement of overhead activities is present in many of the games. In volleyball it’s very important. In a competitive atmosphere the collegiate players tend to get injuries, because of that they are developing apprehension. They are becoming kinesiophobia, there are very less studies are available related to this domain, Objective: This study analyzed the effectiveness of SINEX (Shoulder instability neuromuscular exercises) program on shoulder function in patients with kinesiophobia compared to HOMEX (Home based standard care exercise) program. Methods: This is an experimental study; participants were volleyball players who is kinesiophobic. Study setting was KG Campus, study duration is 6 months, and Treatment duration is 12 weeks. Total sample size was 22. By using random sampling method, the population divided into two groups. SINEX was given for Group A and HOMEX for Group B. The outcome measures were SPADI (shoulder pain and disability index) and Spiking velocity. Results: The study assessed the Shoulder function, after the training program, the player improved as well as the player was able to perform the game as well. Both SPADI and spiking velocity show positive improvement. T values of SPADI and Spiking velocity is 11.731 and 2.765 at p<0.05. Conclusion: SINEX (Shoulder instability neuromuscular exercises) program shows better improvement on shoulder function in patients with kinesiophobia compared to HOMEX (Home based standard care exercise) program.

BIOMECHANICAL ASSESSMENT OF SCAPULAR PLANE ELEVATION EXERCISE WITH DIFFERENT MODES OF RESISTANCE IN SUBJECTS WITH AND WITHOUT IMPINGEMENT SYNDROME.

Background: Strengthening the rotator cuff and scapular stabilizers is usually prescribed for subjects with shoulder pain and is done either using dumbbells or TheraBand. The resistance offered by elastic Theraband increases with increase in change from initial length and therefore the resistance offered by TheraBand, and dumbbell differs across the range of motion. Objectives: The purpose of the study is to evaluate the scapular kinematics and activity of prime mover (Anterior Deltoid) while using two different modes of resistance (TheraBand v/s dumbbell) in subjects with and without impingement syndrome. Methods: Twenty-two asymptomatic subjects and 12 subjects with impingement syndrome were included. 3D motion sensors were attached over the humerus, scapulae and trunk to capture movements of the shoulders as the subject performed scapular elevation without load, with yellow Theraband or 2 Kg Dumbbell. Simultaneous electromyography (EMG) activity of anterior Deltoid was measured and analyzed as percentage of maximum voluntary contraction. Results: During arm elevation, scapular Upward rotation was significantly greater at 90° with TheraBand® as compared to unloaded. It was also greater at 120° as compared to unloaded and dumbbell conditions (p<0.001) during elevation and lowering phase. Scapula upward rotation was significantly lesser at 30° with TheraBand® as compared to other conditions. Conclusion: This study found significant downward rotation and anterior tilt of scapula with TheraBand during lowering phase of exercise as compared to dumbbell and unloaded. The alterations of kinematics may help therapists make informed decisions while making exercise prescriptions.

Post-procedural Brachial Neuritis: Clinical, Electrodiagnostic and Neuroimaging features.

Brachial neuritis is a monophasic condition affecting the brachial plexus and its branches, manifesting as acute shoulder and upper arm pain, followed by weakness and paresthesias. It can be triggered by antecedent events, including procedures such as surgery. Misdiagnosis and delay in diagnosis is common. Imaging is important to confirm the diagnosis of post-procedural brachial neuritis and exclude other etiologies. Clinical, electrodiagnostic, and neuroimaging features of patients with post-procedural brachial neuritis from a single quaternary care institution were identified and analyzed. Six (2 female) patients were identified with median age 62 (range 49-70) years. Antecedent procedures included 4 cervical spine surgeries, 1 rotator cuff repair, and 1 central venous catheter placement. Time to symptom onset ranged from 1-day to 2-weeks. The initial symptom for 5/6 patients was severe upper extremity pain followed by weakness. All patients had electrodiagnostic tests and MR neurography consistent with brachial neuritis. MR neurogram showed plexus and/or terminal branch abnormalities with associated muscular denervation edema. The C5 or C6 root, and/or upper trunk were always involved. The most common branches affected were the suprascapular, long thoracic, and axillary nerves. Hourglass constrictions of these nerves were seen in 3/6 patients. The average time to diagnosis was 3.4 (range 1.5-5) months. Post-procedural brachial neuritis is an underrecognized cause of acute upper extremity pain and weakness. MR neurography can exclude iatrogenic causes and document the presence of hourglass constrictions in affected nerves. Diagnostic neuroradiologists should be aware of this clinical entity and associated neuroimaging findings. HGC = hourglass constriction; EDX = electrodiagnostic; IRB = Institutional Review Board; ACDF = anterior cervical discectomy and fusion; NRS = Numerical Rating Scale; MUAP = motor unit action potential.

Costs of physician and diagnostic imaging services for shoulder, knee, and low back pain conditions: A population-based study in Alberta, Canada

Objectives To 1) estimate the utilization and costs of physician and diagnostic imaging (DI) services for shoulder, knee, and low-back pain (LBP) conditions; and 2) examine determinants of the utilization and costs of these services. Methods All patients visiting a physician for shoulder, knee, or LBP conditions (identified by the ICD-9 codes) in Alberta, Canada, in fiscal year (FY) 2022/2023 were included. Interested outcomes included numbers and costs of physician visits and DI exams stratified by condition, physician specialty, DI modality, and patients’ sex and age. Multivariate regressions were used to examine determinants of the outcomes. Results In FY 2022/2023, 10.4%, 7.0%, and 6.7% of the population saw physicians for shoulder, knee, and LBP conditions, respectively. This costs Alberta $307.04 million ($67.93 per capita), of which shoulder accounted for 41%, knee 28%, and LBP 31%. In the same FY, 17,734 computed tomography (CT), 43,939 magnetic resonance imaging (MRI), 686 ultrasound (US), and 170,936 X-ray exams related to shoulder/knee/LBP conditions were ordered for these patients, costing another $29.07 million, of which CT accounted for 14%, MRI 48%, US 0%, and X-ray 37%. Female, older age, comorbidity scores, and capital zone used physician services more frequently. Patients with a higher comorbidity index scores or more physician visits were more likely being referred for CT or MRI. Conclusion Musculoskeletal conditions are common and result in patients seeking healthcare services. Visits to family physicians, specialists, and the ordering of DI contribute to extensive utilization of health services, contributing to considerable health system costs.

Determinants of Between-Person Variation in Shoulder Pain in Individuals With Spinal Cord Injury: A Population-Based Cohort Study.

The aim of the study was to evaluate determinants of between-person variation in shoulder pain ("yes"/"no") in individuals with spinal cord injury living in Switzerland. This longitudinal study used data from the Swiss Spinal Cord Injury Cohort community surveys 2012, 2017, and 2022. Logistic regression analyses were used to identify determinants of between-person variability in shoulder pain while controlling for within-person variability. The prevalence of shoulder pain was 34.4% (95% CI = 33.0-35.9) when studying 4393 completed questionnaires. Significant determinants for between-subject variability revealed higher likelihoods for shoulder pain in females as compared with males (odds ratio: 1.57; 95% CI = 1.21-2.05), and when spasticity (1.49; 1.14-1.95), contractures (2.77; 2.21-3.48), and depression (1.39; 1.02-3.48) were present. In addition, shoulder pain presented highest likelihoods in individuals with incomplete tetraplegia (1.81; 1.32-2.48) versus incomplete paraplegia, in individuals over 26 yrs since injury (1.65; 1.15-2.37) versus up to 5 yrs since injury, and in individuals using a manual (2.17; 1.53-3.08) or electrical (2.16; 1.41-3.31) wheelchair versus no aids. There were significant interaction effects for gender with time since injury, contractures, and depression. Determinants of between-subject variability in shoulder pain were female gender, lesion severity, time since injury, specific health conditions, and wheelchair use.

Adherence to Physical Activity Guidelines in Manual Wheelchair Users With Spinal Cord Injury and the Association With Shoulder Pain.

The aim of the study is to investigate the association between adherence to spinal cord injury-specific physical activity guidelines in manual wheelchair users with spinal cord injury and shoulder pain prevalence. This is a cross-sectional analysis of the SwiSCI Community Survey 2022 data, assessing aerobic activity and muscle strength training adherence in manual wheelchair users with spinal cord injury and shoulder pain prevalence. Logistic regression analysis was used to identify the association between meeting the physical activity guidelines and shoulder pain. Low adherence to aerobic activity and strength training guidelines are observed, with 46% and 64% of the study sample not meeting the respective guidelines. The low adherence to physical activity guidelines contrasts with the general Swiss population from which around 75% is physically active for more than 2.5 hrs a week. Manual wheelchair users present a high prevalence of shoulder pain (40%) and nonadherence to aerobic guidelines in the study sample correlates with 1.55-1.97 higher odds of having shoulder pain. Aerobic activity adherence is associated with lower shoulder pain prevalence, emphasizing its potential for injury prevention. Overall, the presented findings necessitate further longitudinal studies and interventions for a comprehensive understanding and effective management of shoulder pain in manual wheelchair users with spinal cord injury.

Obese Patients With Polymyalgia Rheumatica Experience More Pain And Disability At Disease Onset And Require Higher Doses Of Glucocorticoids.

polymyalgia rheumatica (PMR) is an inflammatory disorder of the elderly characterized by girdle pain and stiffness. Obesity has an influence on disease activity and outcome in rheumatic diseases like osteoarthritis and rheumatoid arthritis, but its relationship to the severity and outcome of PMR is unknown. In a post-hoc analysis, 83 patients with recent-onset PMR were studied over six months with clinical examination, laboratory evaluation, and girdle ultrasound. MHAQ, Short Form 36 (SF36), and PMR-VAS, as well as prednisone (PDN) therapy were recorded. Patients were divided according to their body mass index (BMI). at baseline, the 12 obese patients had significantly more shoulder pain (p=0.03), global pain (p=0.03), PMR VAS (p<0.01), and fatigue (p=0.03), higher MHAQ (p=0.01), and lower physical component summary on SF36 (p=0.048), SF36 social functioning index (p=0.05) and SF36 pain index (p<0.001). The mean initial PDN dose was similar among groups, but obese patients received a lower dose per kg weight (1.9±0.7 mg vs. 2.2±0.7 mg; p<0.01). At six months, obese patients were being treated with higher mean daily PDN doses (8.5±3.2 mg/day vs. 6.2±5.2 mg/day, p=0.02); 40% of them were receiving higher daily PDN dose than per-protocol, vs. 14% non-obese patients (p=0.048). Clinical features, laboratory and ultrasound results were similar. obesity affects both symptoms severity and PDN utilization in patients with PMR. The reason thereof may relate to different subjective pain perception rather than increased inflammation in obese patients. BMI should be considered when interpreting symptoms in PMR patients and deciding their PDN doses.

A Shoulder Care Pathway Reduces Claim Duration Among Workers With Shoulder Injuries: A Cohort Study

A Shoulder Care Pathway Reduces Claim Duration Among Workers With Shoulder Injuries: A Cohort Study

Beyond the Surgery: The Impact of Coping Strategies on Persistent Pain After Rotator Cuff Repair

Background: Rotator cuff repair is widely recognized as one of the most painful orthopedic surgeries, yet postoperative pain management in these patients is often underexplored. This study aimed to explore the relationship between pain outcomes and functional recovery six months after arthroscopic rotator cuff repair (ARCR), with a focus on the role of different pain coping mechanisms as mediators. Methods: This study included 83 patients that underwent rotator cuff repair. Pain levels were assessed using the Brief Pain Inventory (BPI-SF), while shoulder function was evaluated using the Oxford Shoulder Score (OSS). Coping strategies, including self-statements, ignoring pain, distraction, and praying, were examined in relation to pain severity and interference and were assessed with the Coping Strategies Questionnaire-Revised (CSQ-R). Simple and parallel mediation analyses were performed using the PROCESS macro to assess the mediating effects of coping mechanisms on the relationship between pain intensity, pain interference, and postoperative OSS. Results: Post-surgery, patients showed a significant improvement in OSS (from 29 ± 9 to 42 ± 6). At six months, 24% of patients reported chronic postsurgical pain (CPSP), defined as a pain severity score of 3 or higher. Correlation analyses revealed that OSS was negatively associated with pain catastrophizing (r = −0.35, p &lt; 0.01) and praying (r = −0.28, p &lt; 0.01). OSS was significantly negatively associated with pain severity (r = −0.54; p &lt; 0.01) and pain interference (r = −0.51, p &lt; 0.01). Mediation analysis demonstrated that coping self-statements significantly mediated the relationship between pain interference and shoulder function (a*b = 0.5266 (BootSE = 0.2691, 95% CI [0.1010, 1.1470]), emphasizing the important role of cognitive strategies in supporting recovery outcomes. Conclusions: Patients engaging in adaptive coping strategies, particularly coping self-statements, reported better functional outcomes. The findings underscore the importance of targeted interventions focusing on effective pain coping mechanisms to improve recovery post-ARCR.

Anterior Rotator Interval Lesion (ARIL), its association with glenoid labrum pathology in patients with anterior shoulder pain and surgical outcome of Arthroscopic Rotator Interval Closure

Anterior Rotator Interval Lesion (ARIL), its association with glenoid labrum pathology in patients with anterior shoulder pain and surgical outcome of Arthroscopic Rotator Interval Closure

Muscle energy technique versus Maitland’s mobilization on shoulder pain and disability after neck dissection surgeries

Background. A substantial number of patients who undergo various neck dissection procedures experience shoulder dysfunction and pain, which can significantly complicate or disrupt daily routines, social engagements, and overall Quality of Life (QOL). Muscle Energy Techniques (MET) and mobilization have been demonstrated to effectively reduce shoulder pain and disability. Objective. The objective of this study was to examine the therapeutic benefits of MET and mobilization in improving shoulder pain and disability following neck dissection surgeries and compare these two techniques’ efficacies. Design. The present study employed a randomized, single-blind, controlled trial Methods. Thirty patients between the ages of 25 and 70 (13 men and 17 women) with shoulder dysfunction following six months’ post-neck dissection surgeries were enrolled in the study. Patients were equally randomized into two groups of 15per each: Group A received the Muscle Energy Technique (MET), and Group B underwent Maitland’s Mobilization. Both groups participated in identical conventional physiotherapy regimens. Both interventions were administered at a frequency of three sessions per week over four weeks. Visual Analogue Scale (VAS) for pain assessment, Shoulder Pain, and Disability Index (SPADI), in addition to shoulder range of motion (flexion, abduction, and lateral rotation), were measured before and after four weeks of intervention. Results. Following four weeks of intervention, both groups exhibited significant improvements in VAS, SPADI, and shoulder flexion, abduction, and lateral rotation, with p values ≤ 0.001. A comparison between the groups showed a statistically significant difference in all measured outcomes, favoring Group A, with p-values &lt; 0.001. Conclusion. The Muscle Energy Technique (MET) and Maitland’s Mobilization were effective therapeutic strategies for alleviating shoulder pain and disability following neck dissection surgeries. However, the results showed that MET outperformed Maitland’s Mobilization strategies.

Effect of scapular and shoulder strengthening exercises on prevention of upper limb lymphedema – a pilot study

Background. The most frequent type of cancer among women is breast cancer. According to the report published by Indian Council for Medical Research (ICMR, 2019), there are 1.5 lakh new instances of breast cancer nationwide and around 70,000 people in India die from breast cancer each year. Secondary lymphedema (SL) following breast cancer surgery can occur due to the removal of lymph nodes during breast cancer surgery. Objective. This pilot study was done with the objectives to improve the strength of scapular and shoulder muscles, increase the shoulder range of motion, prevent the development of upper limb lymphedema, to reduce shoulder pain and disability and to improve the quality of life among women who underwent breast cancer surgery. Methodology. Ten patients with a mean age of 49.9 ± 8.6 and mean Body mass index (BMI) of 28.4 ± 3.9 were included according to the inclusion and exclusion criteria. They were randomized into interventional group (Group A n = 5) and conventional group (Group B n = 5). The interventional group performed the routine exercises prescribed along with the scapular and shoulder muscle strengthening exercises, while the conventional group performed only the routine exercises for 12 weeks. Result. The mean change score values of the outcome variables of both the groups were analyzed using Independent ‘t’ test. Discussion. Arm circumference measurement, shoulder pain, disability and quality of life measures showed significant difference between groups at p &lt; 0.05. Shoulder range of motion, muscle strength and arm volumetry did not show much difference between groups indicating the need for long term continuation of the exercises to produce improvement in those parameters. Conclusion. Long term effect of strengthening exercises will have an effect on improvement of shoulder range of motion, arm volume and muscle strength among the women following breast cancer surgery. Strengthening exercises should be recommended as a part of breast cancer rehabilitation protocol to prevent secondary lymphedema and other postsurgical complications.

Effectiveness of Maitland Mobilizations Along with Kinesio Taping on Reducing Pain and Disability in Subjects with Periarthritis Shoulder

Background: Frozen shoulder is a condition in which insidious and progressive pain and loss of active and passive mobility are manifested in the glenohumeral joint, presumably due to capsular contracture. Diabetes mellitus patients are more affected. Various methods were effective in treating frozen shoulder. The present study was done in frozen shoulder patients to determine the additional effect of Kinesio taping and Maitland mobilization in managing frozen shoulder. Frozen shoulder tends to develop in three phases, coming on slowly. Each stage may last several months. Method: The present study included 30 subjects with frozen shoulder. The individuals were randomly divided into 2 groups. GROUP A-experimental group, which received Maitland mobilization and Kinesiotaping treatment, while GROUP B is the control group that received only Maitland mobilization. Both groups first received hot moist packs for 20 minutes and an ultrasound for 5 minutes. Exercises were advised. Subjects received 4 weeks of intervention for 3 days/week. Before and after the intervention, SPADI outcome measures were measured. Result: There was a significant difference showing improvement in the mean of shoulder pain and disability index scale SPADI before and within the groups with p&lt;0.0001. There was a statistical difference when post-intervention means were compared between the groups. Conclusion: Maitland mobilization with Kinesiotaping reduces pain and disability in subjects with peri-arthritis shoulder. KEYWORDS: Frozen shoulder, Maitland mobilization, Kinesiotaping, Shoulder pain and disability index scale (SPADI).

Relationship between training volume and overuse injuries in female volleyball players

Problems and Purpose. Overuse injuries are a result of repetitive stress without sufficient recovery, and female volleyball players are known to have high risk of overuse injuries due to the cumulative impact of these repetitive actions. Overuse injuries can occur due to high training volume, which is important for skill development. This raises the potential for overuse injuries. For this reason, the study was conducted to evaluate the correlation between training volume and the incidence of overuse injuries in female volleyball players. Materials and methods. This study used a cohort research design to evaluate the correlation between training volume and the incidence of overuse injuries in female volleyball players, using a questionnaire to collect demographic data such as age, weight, height, exercise history, and previous injury history and OSTRC to collect data regarding the incidence, severity, and impact of overuse injuries on sport participation and daily activities. The sample consisted of 48 female volleyball players of Yusso Yogyakarta club. Results. Out of 48 respondents, 42 athletes had experienced injuries. Based on the OSTRC measurement there were 22 athletes had no injuries on their knees, while 12 athletes had mild injuries to their knees, 8 athletes had moderate injuries to their knees, 6 people had severe injuries to their knees and none. For lower back injuries, 12 athletes did not suffer any, 30 experienced mild injuries, 6 experienced moderate injuries, 6 experienced severe injuries, and 2 experienced very severe injuries. And for the shoulder area, there were 18 athletes were not injuried, 12 athletes had mild injuries, 14 athletes had moderate injuries, 2 athletes had severe injuries, and 2 others had suffered very severe injuries. The correlation between training volume and the incidence of overuse injuries in female volleyball players was tested using the Spearman test. It was found that the amount of training per week influence knee overuse injury with a significant value of 0.001. The amount of exercise per week also correlates with the incidents of low back overuse injury (significance value of 0.043) and overuse injuries in the shoulder area (significance value of 0.034). Conclusion. This study found that high volume training increases the risk of injury excess in female volleyball players, such as shoulder, knee and wrist injuries. Therefore, It is important to develop a balanced excercise program that includes rest periods and recovery to prevent injury.

A Case of Intractable Shoulder Pain with Deltoid Muscle Atrophy- A Presentation of Parsonage Turner Syndrome

A Case of Intractable Shoulder Pain with Deltoid Muscle Atrophy- A Presentation of Parsonage Turner Syndrome

Effects of adding core stability training to conventional rehabilitation protocol on shoulder function after rotator cuff repair

Background. Rotator cuff tear (RCT) is a prevalent cause leading to shoulder disability and is widely recognized as one of the primary causes of pain as well as dysfunction in the shoulder. The core stabilization exercise program improved the strength of the shoulder muscles. The core stability training (CST) may be utilized during the early phases of shoulder rehabilitation. Purpose. To assess the impacts of adding CST to the conventional rehabilitation protocol on function, proprioception, as well as range of motion (ROM) of shoulder joint following rotator cuff repair (RCR). Methods. Fifty-two participants after RCR were assigned to two groups in a random manner; group I (n = 26) and group II (n = 26). Participants in groups I and II were engaged in a conventional rehabilitation protocol for 12 weeks after RCR. Group II additionally performed CST after the 8th week until the 12th week of RCR. Outcome measures were shoulder function using the Arabic shoulder pain and disability index (SPADI), shoulder joint position sense (JPS) (proprioception accuracy through detecting absolute angle of error) using digital inclinometer, ROM in shoulder flexion, abduction, internal rotation, as well as external rotation using the digital inclinometer. Unpaired t-test, chi square, and MANOVA test were implemented for data analysis. Results. Compared to the pre-treatment condition, the post treatment results revealed that there were statistical substantial improvements (p &lt; 0.05) in SPADI score, absolute angle of error, and ROM flexion, abduction, external rotation and internal rotation) in both groups, even though there were substantial differences among both groups at all post-treatment measures (p &lt; 0.05) in favor of group II. Conclusion. Incorporating CST into the conventional rehabilitation protocol after RCR leads to notable enhancements in shoulder joint function, proprioception, and ROM for flexion, abduction, internal rotation, as well as external rotation.

Prevention of Overhead Shoulder Injuries in Throwing Athletes: A Systematic Review

(1) Background: Shoulder pathologies are mostly found in overhead sports. Many risk factors have been identified, in particular a deficit in the kinetic chain. The aim of this review was to find out whether prevention by strengthening the kinetic chain can have an impact on the rate of shoulder injury in overhead pitching athletes. (2) Methods: A systematic review of the literature was carried out, including studies on the role of the kinetic chain in the prevention of overhead athletes. The studies used were works published over the last 10 years searched on PubMed, Cochrane Library, PEDro and Science Direct. They were also analyzed by methodological quality scales: the PEDro scale and the Newcastle–Ottawa scale. (3) Results: Eight studies met the inclusion criteria. The studies analyzed revealed a significant correlation between the use of the kinetic chain and the prevention of shoulder injuries, associating factors such as muscle strength, physical performance in tests (CMJ, FMS), static and dynamic balance and the ability to transfer energy from the lower to the upper body. (4) Conclusions: It is important to integrate core stability work and lower limb strengthening to minimize excessive stress on the shoulder complex, while optimizing force production and performance.

Transarterial Embolization for Musculoskeletal Pain Management: AJR Expert Panel Narrative Review.

Musculoskeletal embolization has emerged in recent years as a treatment for chronic joint pain, as the inflammatory cascade responsible for such pain has become better understood. Studies have demonstrated a complex interplay between joint inflammation and synovial hypervascularity that causes growth of new unmyelinated nerve fibers responsible for pain. Embolization targets joint hypervascularity, to disrupt the inflammatory cycle and provide pain relief. The standard treatment algorithm for chronic joint pain is well-established and entails escalating therapeutic options that include exercise, self-management programs, analgesic medications, intra-articular injections, and finally surgical replacement or release. Genicular artery embolization (GAE), targeting abnormal vasculature around the knee joint, is the most heavily studied musucloskeletal embolization procedure, reflecting the high worldwide prevalence and increasing incidence of knee osteoarthritis. GAE is now supported by multiple prospective studies, including randomized control trials comparing GAE versus sham treatment. Embolization has also extended outside of the knee joint to include the shoulder (treatment of adhesive capsulitis or secondary stiff shoulder), elbow (medial/lateral epicondylitis), hip (osteoarthritis, great trochanteric pain syndrome), and ankle (plantar fasciitis). This AJR Expert Panel Narrative Review discusses the current status of transarterial embolization for musculoskeletal pain management, focusing on treatment of knee osteoarthritis and chronic shoulder pain.

Health problems and injury management in adolescent handball: the Safeplay one-season cohort study of 679 players

ObjectivesTo assess (1) the 1-year prevalence of previous shoulder, knee and ankle injuries; (2) the in-season prevalence proportion (prevalence) of injuries and illnesses, injury incidence rate (ir) and injury burden (product of ir and weeks with injuries); (3) initial injury management strategies.MethodsWe conducted a cohort study of 679 highest-division Danish handball players aged 14–18. Players self-reported past-year shoulder, knee and ankle injuries at baseline, and weekly information on any handball-related injuries (irrespective of time loss and medical attention), illnesses, exposure hours and injury management over 31 weeks.ResultsAt baseline, 46% (95% CI 42% to 49%) of the players reported a past-year shoulder, knee or ankle injury. The weekly average injury and illness prevalence was 21% (95% CI 19% to 23%) and 2% (95% CI 1.7% to 2.3%), respectively, and the ir was 9.4 (95% CI 8.7 to 10.2)/1000 hours. Females experienced the highest injury burden from knee injuries (ir: 1.7 (95% CI 1.3 to 2.2) × 6.7 (95% CI 4.7 to 8.7) weeks with injury/1000 hours), while males experienced the highest injury burden from shoulder injuries (ir: 1.3 (95% CI 1.0 to 1.7) × 5.7 (95% CI 3.6 to 7.8) weeks with injury/1000 hours). Health professionals were consulted in 58% (95% CI 54% to 62%) of injuries, players independently made the return to sport decision in 44% (95% CI 37% to 51%) of injury recurrences, and used analgesics, mainly (91% (95% CI 85% to 95%)) sourced from home, in 24% (95% CI 21% to 28%) of injuries.ConclusionAlmost half of highest-division adolescent Danish handball players reported a previous past-year shoulder, knee or ankle injury. Any time during the season, 21% reported an injury and 2% an illness. The highest injury burdens were from knee injuries in females and shoulder injuries in males. Health professionals often managed injuries, but players frequently made return to sport decisions independently and commonly used analgesics sourced from home.

Comparative imaging modalities for diagnosing rotator cuff injuries

Rotator cuff injuries are a significant cause of shoulder pain and dysfunction, with their prevalence increasing with age. Diagnosing these injuries accurately is crucial for determining appropriate treatment strategies. Various imaging modalities, such as high-resolution ultrasonography (HRUS), magnetic resonance imaging (MRI), and magnetic resonance arthrography (MRA), play a pivotal role in identifying rotator cuff injuries. MRI, considered the gold standard, offers detailed insights into tendon degeneration, partial tears, and full-thickness tears. Meanwhile, HRUS is favored for its cost-effectiveness, non-invasive nature, and real-time dynamic assessments. This review compares these imaging techniques, highlighting their diagnostic accuracy, strengths, and limitations in the context of rotator cuff injuries. Although MRI provides comprehensive information on tendon pathology and associated conditions like muscle atrophy, HRUS remains a valuable tool due to its accessibility and accuracy in diagnosing both partial and full-thickness tears. Understanding the comparative efficacy of these imaging modalities is essential for clinicians to make informed decisions about patient management.