Int J Sports Med 2013; 34(07): 654-660
DOI: 10.1055/s-0032-1312587
Orthopedics & Biomechanics
© Georg Thieme Verlag KG Stuttgart · New York

Shoulder Strength Imbalances as Injury Risk in Handball

P. Edouard
1   Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University Hospital of Saint-Etienne, France
2   Department of Clinical and Exercise Physiology, Sports Medicine Unity, Faculty of Medicine, University Hospital of Saint-Etienne, France
3   Laboratory of Exercise Physiology, University of Lyon, Saint-Etienne, France
,
F. Degache
4   Institute of Sport Sciences, Department of Physiology. Faculty of Biology and Medicine, Bâtiment Vidy, CH-1015, University of Lausanne, Switzerland
,
R. Oullion
2   Department of Clinical and Exercise Physiology, Sports Medicine Unity, Faculty of Medicine, University Hospital of Saint-Etienne, France
3   Laboratory of Exercise Physiology, University of Lyon, Saint-Etienne, France
5   Handball French Federation, Paris, France
,
J.-Y. Plessis
5   Handball French Federation, Paris, France
,
S. Gleizes-Cervera
5   Handball French Federation, Paris, France
,
P. Calmels
1   Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University Hospital of Saint-Etienne, France
3   Laboratory of Exercise Physiology, University of Lyon, Saint-Etienne, France
› Author Affiliations
Further Information

Publication History



accepted after revision 30 March 2012

Publication Date:
26 February 2013 (online)

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Abstract

This study was conducted to analyze whether internal (IR) and external (ER) rotator shoulder muscles weakness and/or imbalance collected through a preseason assessment could be predictors of subsequent shoulder injury during a season in handball players. In preseason, 16 female elite handball players (HPG) and 14 healthy female nonathletes (CG) underwent isokinetic IR and ER strength test with use of a Con-Trex® dynamometer in a seated position with 45° shoulder abduction in scapular plane, at 60, 120 and 240°/s in concentric and at 60°/s in eccentric, for both sides. An imbalanced muscular strength profile was determined using ­statistically selected cut-offs from CG values. For HPG, all newly incurred shoulder injuries were reported during the season. There were significant differences between HPG and CG only for dominant eccentric IR strength, ER/IR ratio at 240°/s and for IRecc/ERcon ratio. In HPG, IR and ER strength was higher, and ER/IR ratios lower for dominant than for nondominant side. The relative risk was 2.57 (95%CI: 1.60–3.54; P<0.05) if handball players had an imbalanced muscular strength profile. In youth female handball players IR and ER muscle strength increases on the dominant side without ER/IR imbalances; and higher injury risk was associated with imbalanced muscular strength profile.