Functional shoulder ratios with high velocities of shoulder internal rotation are most sensitive to determine shoulder rotation torque imbalance: a cross-sectional study with elite handball players and controls

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

OBJECTIVES

To assess the impact of preseason shoulder testing on the risk of significant shoulder injury (SSI) in elite badminton players.

DESIGN

Prospective cohort study.

SETTING

Secondary care, academic medical center.

PARTICIPANTS

Nineteen elite badminton players (19.37 ± 4.79 years, n = 13 males).

MAIN OUTCOME MEASURES

At preseason, they had shoulder examination tests including the table-to-acromion distance and the glenohumeral rotation range of motion. The glenohumeral internal rotation deficit (GIRD) was calculated. Isokinetic internal and external rotator shoulder muscle strength was tested at 60°/s (concentric and eccentric modes) and 240°/s (concentric mode). Bilateral strength ratio (non-dominant:dominant) and unilateral agonist:antagonist conventional and functional ratios (FR: eccentric-to-concentric) were calculated.

RESULTS

During the follow-up time of 38 weeks, SSIs were assessed by an experienced sport physician and 42% of the participants sustained at least one SSI at their dominant side. The preseason GIRD and FR at 240°/s (FR₂₄₀) were independently associated with SSIs (G² = 6.28, p = .012 and G² = 6.23, p = .013, respectively). FR₂₄₀ < 0.69 (odds ratio = 28.0) and GIRD> 14° (odds ratio = 36.14) were predictors for SSIs.

CONCLUSIONS

Lower functional deceleration ratio and greater GIRD are associated with a higher risk of SSI at the dominant side in elite badminton players.

Can the history of injury influence shoulder isokinetic torque parameters in volleyball players?

The aim of the present study was to compare shoulder internal rotator and external rotator isokinetic parameters in concentric and eccentric contractions between volleyball players with and without a history of shoulder injury. Thirty male volleyball players participated of this study, divided into two groups: with a history of injury (WHI) in the dominant shoulder (11 athletes; age: 19.4 ± 3.6 years) and no history of injury (NHI) (19 athletes; age: 18.3 ± 2.9 years). The peak torque (PT) and concentric (Con) and eccentric (Ecc) PT angles in internal (IR) and external rotation (ER) at velocities of 60 and 180°/s were measured. The conventional (Con_ER:Con_IR), functional spiking (Ecc_ER:Con_IR), and cocking ratios (Ecc_IR:Con_ER) were calculated. No significant differences were found between groups for PT and PT angle, or for conventional, functional spiking, and cocking ratios. However, the spiking ratio was considered low (0.87) in the WHI group. Moreover, for the spiking ratio in the WHI group, PT at 60°/s occurred at different angles. We conclude that previous injury in shoulder did not affect the peak torque, as well as conventional, spiking or cocking ratio. However, the PT angles at 60°/s used to calculate the spiking ratio shifted due the prior injury.

Upper limb muscle strength and knee frontal plane projection angle asymmetries in female water-polo players

Water-polo players frequently perform overhead throws that could result in shoulder imbalances. For overhead throws, execution of the 'eggbeater kick' (cyclical movement of the legs) is required to lift the body out of the water. Although a symmetrical action, inter-limb differences in task execution could lead to knee frontal plane projection (FPPA) differences. The present study examined imbalances shoulder and knee FPPA in female players. Eighteen competitive female field players (24.1 ± 5.5 years, 1.68 ± 0.06 m, 72.9 ± 13.3 kg) had their shoulder strength assessed in a shot-mimicking position with a portable dynamometer, standing and seated (isolating the shoulder contribution). Anterior: posterior and shooting: non-shooting shoulder comparison were made. Additionally, players performed a drop jump. Knee FPPA was recorded from digitising and comparing the frames just before landing and at stance phase. During standing, players exhibited higher shooting: non-shooting asymmetry (p = 0.032) in the anterior contraction direction, while during seated the shooting shoulder anterior: posterior asymmetry was higher (p = 0.032). Interlimb knee FPPA asymmetry was higher in the stance phase (p = 0.02). Despite the overhead throwing and egg-beater demands impacting differently on each limb, considerable asymmetries do not develop, suggesting the overall training requirements (e.g. swimming, resistance training) were sufficient to maintain the asymmetry within desirable limits.

Reliability of a standing isokinetic shoulder rotators strength test using a functional electromechanical dynamometer: effects of velocity

Background

The evaluation of the force in internal rotation (IR) and external rotation (ER) of the shoulder is commonly used to diagnose possible pathologies or disorders in the glenohumeral joint and to assess patient’s status and progression over time. Currently, there is new technology of multiple joint isokinetic dynamometry that allows to evaluate the strength in the human being. The main purpose of this study was to determine the absolute and relative reliability of concentric and eccentric internal and external shoulder rotators with a functional electromechanical dynamometer (FEMD).

Methods

Thirty-two male individuals (21.46 ±  2.1 years) were examined of concentric and eccentric strength of shoulder internal and external rotation with a FEMD at velocities of 0.3 m s⁻¹ and 0.6 m s⁻¹. Relative reliability was determined by intraclass correlation coefficients (ICC). Absolute reliability was quantified by standard error of measurement (SEM) and coefficient of variation (CV). Systematic differences across velocities testing circumstances, were analyzed with dependent t tests or repeated-measures analysis of variance in case of 2 or more than 2 conditions, respectively.

Results

Reliability was high to excellent for IR and ER on concentric and eccentric strength measurements, regardless of velocity used (ICC: 0.81–0.98, CV: 5.12–8.27% SEM: 4.06–15.04N). Concentric outcomes were more reliable than eccentric due to the possible familiarization of the population with the different stimuli.

Conclusion

All procedures examined showed high to excellent reliability for clinical use. However, a velocity of 0.60 m s⁻¹ should be recommended for asymptomatic male patients because it demands less time for evaluation and patients find it more comfortable.