Shoulder 3D range of motion and humerus rotation in two volleyball spike techniques: injury prevention and performance

Prevalence and associated factors of nontraumatic shoulder pain during spike and serve movements in male high school volleyball players: a cross-sectional study

BACKGROUND/HYPOTHESIS

Nontraumatic shoulder pain is a prevalent issue among male high school volleyball players, yet prior research has often limited its assessment to isolated aspects of shoulder function. This study aimed to identify contributing factors to shoulder pain in this population. We hypothesized that limited shoulder internal rotation (IR) range of motion (ROM), imbalance in rotator cuff muscle strength, intrinsic sensory disturbance, and joint stability are associated with shoulder pain in male high school volleyball players. Additionally, we anticipated that a substantial proportion of players would experience shoulder pain but refrain from reporting it to coaches.

METHODS

Forty-nine male volleyball players aged 15-17 years were evaluated between February and June 2023. Questionnaires assessed the prevalence of shoulder pain during spiking and/or serving and the frequency of reporting this pain to coaches. Factors such as acromio-humeral distance, shoulder passive ROM, isometric strength, proprioception, joint stability (Upper Quarter Y-Balance Test), joint position sense, and upper extremity power (Seated Medicine Ball Throw Test) were quantified. Logistic regression analyses were conducted to explore associations between these variables and shoulder pain.

RESULTS

Shoulder pain was reported by 39% of participants, with only 5% communicating it to coaches. Jump serves (odds ratio 1.84, P = .02) and reduced shoulder IR ROM (odds ratio 0.94, P = .03) were associated with shoulder pain.

CONCLUSION

This study provides critical insights into the prevalence, severity, and factors associated with shoulder pain among male high school volleyball players. The findings underscore the importance of improving athlete-coach communication for early intervention and prevention. Significant associations between jump serves, reduced shoulder IR ROM, and shoulder pain highlight the role of specific volleyball techniques in injury prevention, offering valuable guidance for coaches and trainers in developing targeted interventions to mitigate shoulder pain and enhance player performance.

Rotation sequences for the calculation of shoulder kinematics of the volleyball attack

Calculating upper extremity kinematics during overhead movements presents with problems typically not seen for the lower extremity due to the large range of motion. Due to these unique issues, different rotation sequences have been suggested to circumvent challenges due to gimbal lock (GL) and angle coherence (AC). The purpose of this study is to determine the most appropriate rotation sequence for shoulder angle calculation during a volleyball attack.

METHODS

15 healthy experienced volleyball players (women = 8) performed 5 attacks off a stationary ball. A 12-camera 3D motion capture system was utilized to record trunk and arm kinematics to compare joint angles calculated using the YXY, ZXY, XZY, YXZ, ZYX, and XYZ rotation sequences. Instances of GL and AC inconsistences were marked for each trial. The last 3 trials were used for analysis.

RESULTS

The YXY and XYZ sequences presented with the least total number of errors (12 and 5, respectively). 5 instances of GL were present in the XYZ sequence while none were recorded for the YXY sequence. All other sequences returned incoherent angles that greatly exceeded known ranges of motion.

CONCLUSION

When performing kinematic analyses during a volleyball attack, researchers should adhere to ISB recommendations and employ the Eulerian YXY sequence for calculations. If greater anatomical understanding is desired, the XYZ sequence may be utilized for most subjects.

Functional and morphological changes in shoulder girdle muscles after repeated climbing exercise

This study aimed to investigate the acute effect of repeated climbing actions on functional and morphological measures of the shoulder girdle. Fifteen male indoor climbers participated in this study. All the climbers declared route level 6a+, as the best climbing grade (French climbing grade scale). Functional (range of motion - ROM and muscle strength), and morphological measurements (muscle/tendon stiffness and thickness) after a repeated climbing exercise protocol were analysed. The ROM and muscle strength showed significant decreases from baseline to Immediate-Post (IA) as well as significant increases from IA to 1 h-Post for all movements (p ≤ .001 for all). Muscle stiffness showed significant increases from baseline to IA after as well as significant decreases from IA to 1 h-Post for all muscles (p ≤ .001 for all). However, the thickness showed significant increases from baseline to IA for supraspinatus tendon and muscle thickness and occupation ratio (p ≤ .001 for all), while a significant decrease was observed in acromiohumeral distance (p ≤ .001). Significant decreases from IA to 1 h-Post were found for muscles/tendons and occupation ratio (p ≤ .001 for all), while a significant increase for AHD (p ≤ .001). Our data demonstrated acute alterations in tendon thickness due to acute signs of implement symptom in climbers.

Scapular Resting Posture and Scapulohumeral Rhythm Adaptations in Volleyball Players: Implications for Clinical Shoulder Assessment in Athletes

Volleyball players develop shoulder sports-related adaptations due to repetitive overhead motions. It is essential to differentiate between these sports-related adaptations and pathological patterns in clinical assessments, particularly on scapular resting posture and scapulohumeral rhythm. Using an electromagnetic tracking system, the 3D shoulder kinematics of 30 male elite asymptomatic volleyball players and a matching control group were recorded at rest and in eight humeral elevation positions, in 15-degree increments from 15 to 120 degrees. The results indicated that the dominant scapular resting posture of the volleyball group was more anteriorly tilted than the control group (Volleyball: mean = -12.02°, STD = 4.16°; Control: mean = -7.45°, STD = 5.42°; Mean difference = 4.57°; STD = 6.85°; CI95% = 2.1° to 7.1°). The scapulohumeral rhythm in the volleyball group showed greater scapular internal rotation (Volleyball: mean = 41.60°, STD = 9.14°; Control: mean = 35.60°, STD = 6.03°; mean difference = 6.02°, STD = 1.47°; CI95% = 4.80° to 7.25°) and anterior tilt (Volleyball: mean = -9.10°, STD = 5.87°; mean = -2.3°, STD = 9.18°; mean difference = 6.88°, STD = 0.66°; CI95% = 6.34° to 7.43°). These findings suggest that volleyball players have developed a sports-related scapular adaptive pattern. This information may be valuable for clinical assessment and rehabilitation planning in injured volleyball players and may aid in the decision-making process for determining a safe return-to-play after a shoulder injury.

Influence of jump height on the game efficiency in elite volleyball players

The aim of the study was to verify the impact of the jump height measured during the serve, attack and block on their effectiveness. The analysis of the literature and observations lead to the hypothesis that despite the similarities in men's and women's volleyball, the nature of the way of playing between women and men differs. The observation covered 39 male and 24 female elite volleyball players. We used a proprietary software tool, namely OpenCV to assess the jump height library. The analysis was performed on the jump serve height (SJH), attack jump height (AJH), and block jump height (BJH). The following analysis was performed to confirm the differences in the height of the jump and partially confirm the hypothesis. The main difference between men's and women's volleyball is how the serve, attack and block jump height affect winning or losing match sets. In male volleyball players, there is a decrease in the parameters of SJH, AJH and BJH in subsequent sets of matches, while in female volleyball players this relationship is reversed. For men, it seems reasonable to strive to increase the height of a jump to maximize effective offensive actions, as well as to maintain the developed performance throughout a match. In women's volleyball, it is worth using such training measures that allow players would achieve their maximum jumping abilities from the first set, and the main training goal should be focused on the technique and tactics of the whole team.

Prevalence of Glenohumeral Internal Rotation Deficit and Sex Differences in Range of Motion of Adolescent Volleyball Players: A Case-Control Study

Shoulder range of motion (ROM) adaptation is common observed among volleyball players, but studies on the shoulder joint function of adolescent athletes are lacking. This study aimed to clarify the prevalence of glenohumeral internal rotation deficit (GIRD) among adolescent players and differences in ROM based on sex. A questionnaire survey and ROM measurements of the shoulder joint and trunk using a plastic goniometer were conducted on 123 volleyball players (63 males and 60 females; mean age, 15.8 years). The prevalence of GIRD was investigated for internal rotation differences of >10° and total rotation motion of <5°. Questionnaire items and ROM were compared between GIRD and non-GIRD patients, and sex differences in ROM were also presented. Of the participants, 38.2% (n = 47/123) had GIRD. The GIRD group showed a decrease in external rotation on the dominant side (p = 0.003, 1 − beta = 0.84), but this was not associated with a history of shoulder injury. Sex differences in shoulder ROM showed hypomobility in males and hypermobility in females. However, there was no association between shoulder injury and GIRD among adolescent players. There are sex differences in ROM, which should be considered in future studies.

Spike Arm Swing Techniques of Olympics Male and Female Elite Volleyball Players (1984-2021)

In the last decades, indoor volleyball has experienced significant rule changes and a high player specialization in both sexes. Different spike attack arm swing techniques have developed which might affect performance and risk of injury. While a variety of arm swing techniques was already shown in world class beach volleyball players, it is unclear if this is also true for world class indoor volleyball. Therefore, the purpose of this study was to assess the spike attack arm swing techniques of Olympic volleyball winners and finalists (1984-2021) and to investigate possible differences between sex, playing position, scoring system, and compared to beach volleyball. Eighty-two male (M) and 85 female (F) players were assessed from video recordings from ten competitions. Five different arm swing techniques in the cocking phase (Straight, Bow-and-arrow high, Bow-and-arrow low, Snap, Circular) were classified by two experts. The most frequent technique for both sexes was the Circular (M = 40.2%; F = 38.8%), followed by Snap (M = 28.0%; F = 23.5%), Bow-and-arrow low (M = 20.7%; F = 21.2%), Bow-and-arrow high (M = 7.3% F = 11.8%), and Straight (M = 3.7%; F = 4.7%). Bow-and-arrow high and Straight techniques were significantly less used than other techniques in both sexes. There were no significant differences (p &gt; 0.05) in arm swing techniques between sexes, playing positions, and scoring system but significant differences (p &lt; 0.001) to beach volleyball. Although most volleyball textbooks only describe the Bow-and-arrow techniques, most of the world class indoor volleyball players used Circular and Snap arm swing techniques. Reasons for that could be the implicit knowledge of players (and coaches) regarding increased performance (ball speed) and injury prevention. Based on these results we suggest to critically revise arm swing technique training especially for young players and players with shoulder problems.

Volleyball Competition on Consecutive Days Modifies Jump Kinetics but Not Height

PURPOSE

In volleyball, jump execution is critical for the match outcome. Game-play-related neuromuscular impairments may manifest as decreased jump height (JH) or increased jump total duration, both of which are pivotal for performance. To investigate changes in JH and kinetics with game play, the authors conducted a prospective exploratory analysis using minimal-effect testing (MET) and equivalence testing with the 2 one-sided tests procedure, univariate, and bivariate functional principal component analysis, respectively.

METHODS

Twelve male varsity athletes completed 3-set matches on 2 consecutive days. Countermovement jumps were performed on a force platform immediately prematch and postmatch on days 1 and 2 and once on days 3 and 4.

RESULTS

Across sessions, JH was equivalent (P < .022, equivalence test), while total duration reported inconclusive changes (P > .227). After match 2, MET indicated that relative force at zero velocity (P = .036) decreased, while braking duration (P = .040) and time to peak force (P = .048) increased compared with baseline. With the first and second functional principal components, these alterations, together with decreased relative braking rate of force development (P = .092), were already evident after match 1. On day 4, MET indicated that relative peak force (P = .049), relative force at zero velocity (P = .023), and relative braking rate of force development (P = .021) decreased, whereas braking duration (P = .025) increased from baseline.

CONCLUSIONS

Impairments in jump kinetics were evident from variables related to the countermovement-jump braking phase, while JH was equivalent. In addition to these experimental findings, the present research provides information for the choice of sample size and smallest effect size of interest when using MET and 1- and 2-dimensional analyses for countermovement-jump height and kinetics.

Goal-Oriented Optimization of Dynamic Simulations to Find a Balance between Performance Enhancement and Injury Prevention during Volleyball Spiking

Performance enhancement and injury prevention are often perceived as opposite sides of a coin, where focusing on improvements of one leads to detriment of the other. In this study, we used physics-based simulations with novel optimization methods to find participant-specific, whole-body mechanics of volleyball spiking that enhances performance (the peak height of the hitting hand and its forward velocity) while minimizing injury risk. For the volleyball spiking motion, the shoulder is the most common injury site because of the high mechanical loads that are most pronounced during the follow-through phase of the movement. We analyzed 104 and 209 spiking trials across 13 participants for the power and follow-through phases, respectively. During the power phase, simulations increased (p < 0.025) the peak height of the hitting wrist by 1% and increased (p < 0.025) the forward wrist velocity by 25%, without increasing peak shoulder joint torques, by increasing the lower-limb forward swing (i.e., hip flexion, knee extension). During the follow-through phase, simulations decreased (p < 0.025) peak shoulder joint torques by 75% elicited by synergistic rotation of the trunk along the pathway of the hitting arm. Our results show that performance enhancement and injury prevention are not mutually exclusive and may both be improved simultaneously, potentially leading to better-performing and injury-free athletes.

Spike jump biomechanics in male versus female elite volleyball players

There are well-known biological differences between women and men, especially in technical-coordinative variations that contribute to sex differences in performance of complex movements like the most important offensive action in volleyball, the spike jump. The aim of this study was to investigate sex-dependent performance and biomechanical characteristics in the volleyball spike jump. Thirty female and male sub-elite volleyball players were analysed while striking a stationary ball with maximal spike jump height. Twelve MX13 Vicon cameras with a cluster marker set, two AMTI force plates, surface EMG, and a Full-Body 3D model in Visual3D were used. Main findings include sex differences (P< .05) in jump height (pη² = .73), approach [speed (pη² = .61), step length], transition strategy [plant angle, neuromuscular activation (pη² = .91), horizontal force maxima and impulses], acceleration distances [centre of mass displacement (pη² = .21), minimal knee and hip angles], use of torso and arms [incline, angular velocity (pη² = .23)]. Correlations support that the results cannot be explained fully by strength and power differences between sexes but represent the product of technical-coordinative variations. Their relevance is acknowledged for both sexes and numerous performance determinants displayed sex differences. The integration of such attributes into sex-specific training seems promising but its effect requires further investigation.

Influence of humeral abduction angle on axial rotation and contact area at the glenohumeral joint

BACKGROUND

Although the elevation angle of the arm affects the range of rotation, it has not been evaluated up to the maximal abduction angle. In this study we conducted an evaluation up to maximal abduction and determined the contact patterns at the glenohumeral (GH) joint.

METHODS

Fourteen healthy volunteers (12 men and 2 women; mean age, 26.9 years) with normal shoulders (14 right and 8 left) were instructed to rotate their shoulders at 0°, 90°, 135°, and maximal abduction for each shoulder at a time. Using 2-dimensional and 3-dimensional single-plane image registration, the internal rotation (IR), external rotation (ER), and range of motion (ROM; ie, axial rotations) at the thoracohumeral (TH) and GH joints, and the contribution ratio (%ROM = GH-ROM/TH-ROM) were calculated for each abduction. The glenoid position with respect to the humeral head was also analyzed.

RESULTS

The TH-IR and TH-ER shifted toward an ER with increasing abduction angle, whereas the TH-ROM significantly decreased except at abduction between 0° and 90° (P < .001). The GH-IR and GH-ROM significantly decreased except at abduction between 0° and 90° (P < .001), but the GH-ER remained constant regardless of the abduction. The contribution ratio exceeded 80% for every abduction angle. The glenoid moved on the central and posterior areas of the humeral head at 0° and 90° abduction, respectively, and on the posterosuperior and anterosuperior areas at 135° and maximal abduction, respectively.

CONCLUSION

Our results provide new knowledge about wide axial rotation up to maximal abduction and constant GH-ER at any abduction.

A Review of the Evolution of Vision-Based Motion Analysis and the Integration of Advanced Computer Vision Methods Towards Developing a Markerless System

BACKGROUND

The study of human movement within sports biomechanics and rehabilitation settings has made considerable progress over recent decades. However, developing a motion analysis system that collects accurate kinematic data in a timely, unobtrusive and externally valid manner remains an open challenge.

MAIN BODY

This narrative review considers the evolution of methods for extracting kinematic information from images, observing how technology has progressed from laborious manual approaches to optoelectronic marker-based systems. The motion analysis systems which are currently most widely used in sports biomechanics and rehabilitation do not allow kinematic data to be collected automatically without the attachment of markers, controlled conditions and/or extensive processing times. These limitations can obstruct the routine use of motion capture in normal training or rehabilitation environments, and there is a clear desire for the development of automatic markerless systems. Such technology is emerging, often driven by the needs of the entertainment industry, and utilising many of the latest trends in computer vision and machine learning. However, the accuracy and practicality of these systems has yet to be fully scrutinised, meaning such markerless systems are not currently in widespread use within biomechanics.

CONCLUSIONS

This review aims to introduce the key state-of-the-art in markerless motion capture research from computer vision that is likely to have a future impact in biomechanics, while considering the challenges with accuracy and robustness that are yet to be addressed.

Vascular Endothelial Growth Factor Receptor-2 Polymorphisms Have Protective Effect against the Development of Tendinopathy in Volleyball Athletes

The aim of the study was to investigate whether genetic variants in VEGF and KDR genes can be correlated with susceptibility of tendinopathy in volleyball athletes. This study was conducted at the Brazilian Volleyball Federation, and comprised 179 volleyball athletes: 88 had a confirmed diagnosis of tendinopathy (cases), whereas 91 had no evidence of the disease (controls). The VEGF (-2578C>A, -460T>C and +936C>T) and KDR (-604C>T, 1192G>A and 1719T>A) polymorphisms were determined by TaqMan real-time polymerase chain reaction. The odds ratio (OR) with their 95% confidence intervals (CI) were calculated using an unconditional logistic regression model. The evaluation of demographic and clinical characteristics revealed the athlete age (P < 0.001), years of practice in volleyball (P < 0.001) and presence of pain (P = 0.001) were risk factors for tendinopathy. KDR 1192 GA and GA + AA genotypes were associated with lower risk of tendinopathy (OR: 0.41, 95% CI: 0.19–0.88 and OR: 0.47, 95% CI: 0.23–0.98, respectively). The KDR (-604C>T, 1192G>A and 1719T>A) haplotypes CGA and CAT were associated with decreased tendinopathy risk (OR: 0.46, 95% CI: 0.21–0.99 and OR: 0.23, 95% CI: 0.07–0.76, respectively). With regards to pain, traumatic lesion and away from training due to injury, VEGF and KDR polymorphisms were not associated with clinical symptoms complaints. The present results provide evidence that the KDR polymorphisms were associated with development of tendinopathy, and can contribute to identify new therapeutic targets or personalized training programs to avoid tendinopathy development in athletes.

The volleyball athlete's shoulder: biomechanical adaptations and injury associations

In volleyball, the dominant shoulder of the athlete undergoes biomechanical and morphological adaptations; however, definitive conclusions about their exact nature, aetiology, purpose and associations with shoulder injury have not been reached. We present a systematic review of the existing literature describing biomechanical adaptations in the dominant shoulders of volleyball players and factors that may predispose to shoulder pain/injury. A thorough literature search via Medline, EMBASE and SCOPUS was conducted for original studies of volleyball players and 15 eligible articles were identified. Assessment of study quality was performed using the STROBE statement. The reviewed literature supports the existence of a glenohumeral internal rotation deficit (GIRD) and a possible (and less pronounced) external rotation gain in the dominant vs. the non-dominant shoulder of volleyball athletes. Unlike other overhead sports, the GIRD in volleyball athletes appears to be anatomical as a response to the repetitive overhead movements and not to be associated with shoulder pain/injury. Additionally, the dominant shoulder exhibits muscular imbalance, which appears to be a significant risk factor for shoulder pain. Strengthening of the external rotators should be used alongside shoulder stretching and joint mobilisations, core strengthening and optimisation of spike technique as part of injury management and prevention programmes.

Action Sport Cameras as an Instrument to Perform a 3D Underwater Motion Analysis

Action sport cameras (ASC) are currently adopted mainly for entertainment purposes but their uninterrupted technical improvements, in correspondence of cost decreases, are going to disclose them for three-dimensional (3D) motion analysis in sport gesture study and athletic performance evaluation quantitatively. Extending this technology to sport analysis however still requires a methodologic step-forward to making ASC a metric system, encompassing ad-hoc camera setup, image processing, feature tracking, calibration and 3D reconstruction. Despite traditional laboratory analysis, such requirements become an issue when coping with both indoor and outdoor motion acquisitions of athletes. In swimming analysis for example, the camera setup and the calibration protocol are particularly demanding since land and underwater cameras are mandatory. In particular, the underwater camera calibration can be an issue affecting the reconstruction accuracy. In this paper, the aim is to evaluate the feasibility of ASC for 3D underwater analysis by focusing on camera setup and data acquisition protocols. Two GoPro Hero3+ Black (frequency: 60Hz; image resolutions: 1280×720/1920×1080 pixels) were located underwater into a swimming pool, surveying a working volume of about 6m³. A two-step custom calibration procedure, consisting in the acquisition of one static triad and one moving wand, carrying nine and one spherical passive markers, respectively, was implemented. After assessing camera parameters, a rigid bar, carrying two markers at known distance, was acquired in several positions within the working volume. The average error upon the reconstructed inter-marker distances was less than 2.5mm (1280×720) and 1.5mm (1920×1080). The results of this study demonstrate that the calibration of underwater ASC is feasible enabling quantitative kinematic measurements with accuracy comparable to traditional motion capture systems.